Burnout and Breakdown and the Neurobiology of Resilience - British Association for Holistic Medicine & Health Care
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Burnout: a Symptom of Paradigm Collapse?

Prof David Peters in conversation with David Lorimer

Persistent stress responses – and obviously not only in the field of medicine – distort our view of ourselves and world. If demands continue to rise but cannot be met, the over-activated autonomic nervous system may switch from flight-fight into freeze and fold mode: the spiralling slide into dissociation and cynicism that characterise end-stage ‘burnout’.

According to research, empathic doctors are safer, more effective and happier in their work, but recent studies suggest burnout doubles the rate of clinical errors.   It seems then, that long before unrelenting stress has made us ill it can make us dull and unfriendly – cognitively slower, less empathic and uncommunicative.

Personal resilience – the capacity to adapt creatively to adversity without too great a cost – though it varies over time, depends greatly on the balance of positive and negative influences. These needs are both culture-bound and determined by our evolutionary heritage, so a better grasp of the interpersonal neurobiology of stress, emotion, social engagement and empathy could help us – as a profession certainly but perhaps as species – make better sense of our overlapping personal, professional and planetary predicaments, and how to embark on the necessary journeys of personal, organisational and cultural change whereby we might come to re-imagine ourselves.

Neuroscience and evolutionary biology – so it’s widely claimed – make possible a better understanding of human nature. And arguably, 21st century industrial-consumer society is going against the grain.   Whatever the truth of these narratives, they help explain western medicine’s predicament and why the practice of medicine has become so stressful.

With clinical work being ever more demanding, when half the doctors surveyed internationally say they are burned out, and so many junior doctors are leaving the NHS we need to ask what’s going on. Is ‘resilience’ just a personal matter, or pre-eminently organisational and cultural? As the medical and planetary emergencies march in lockstep, are we witnessing signs of a paradigm collapse?

Can this collapse and downward spiral be reversed? Join resilience expert Professor David Peters for an in-depth conversation on what can help us to weather stress-making factors and find ways to embark on personal, organisational and cultural change.

In challenging and stressful circumstances, if we can cultivate self-care and self-awareness, core values, and especially the ability to self-soothe, we may give ourselves a better chance to flourish both individually and in our communities.


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