BURNOUT & SPIRITUAL INCONGRUENCE
CSAC Conference
April 10, 2013
Lynette M. Monteiro, Ph.D., C. Psych.
THE PATH WE WILL WALK
Burnout
Spirituality
Contemplative
Practices
COMPASSIONATE CARE
BURNOUT:
THEORY AND IMPLICATIONS
PRACTICE 1 – WHAT MATTERS
Three-minute Breathing Exercise (Goblet)
Bring awareness to all sensations
 Open to what is arising
 Invite an experience that brought you joy,
energy, faith in the process, personal
satisfaction.

 ground,
step back, observe
What would happen if that was your task:
not to save the world but to love it?
Joanna Macy
WHAT WE KNOW ABOUT BURNOUT



Burnout is defined as
experience of multi-level
exhaustion, cynicism, and a
sense of diminished personal
effectiveness (Leiter et al. 2010)
Demands
EX
Value incongruence
CY &
PE, less with EX
DEMANDS
available resources &
control of work flow

EXHAUSTION
CYNICISM
PERSONAL
EFFECTIVENESS
VALUES
e.g.,organizational
climate, fairness, trust
WHAT WE KNOW ABOUT BURNOUT - 2
Values
Incongruence between personal values and
organizational values contributes to probability
of burnout
 Helping
may be perceived differently at the different
levels of organizational structure
 Compensating for divergent ways of manifesting common
values (e.g. – funding vs client care) lead to EXhaustion
 Perceived lack of fairness and compensation lead to
CYnicism
 Inability to effect change leads to doubt about Personal
Effectiveness, role insufficiency & role boundaries
WHAT WE KNOW ABOUT BURNOUT - 3
Balancing personal and work life



Multiple demands with overlapping timelines
Uncertainty
Perception of who we are in the context of community we
serve – split between roles
An allegory

Sen-jo and her soul – Chinese legend and Zen koan
Sen-jo and her soul are separated.
Which is the real soul?
PRACTICE 2 – CONNECTING WITH WHAT IS



Let’s take a moment to get a personal sense of how we
experience Emotional Exhaustion, Cynicism and Lack of
Confidence in our own lives.
Settling into an ordinary pattern of breathing
 Starting with the phrase Emotional Exhaustion, bringing it
into our awareness
 Noticing what sensations, emotions or thoughts may (or may
not) arise
 Allowing time to notice what may or may not resonate with
this phrase
And then, when ready bringing the next phrase into awareness
(Popcorn responses)
SPIRITUAL WELL BEING:
CONGRUENCE AND IMPLICATIONS
SPIRITUALITY & WELL BEING - 1
Spirituality – a distinctive, potentially creative and universal
dimension arising within inner subjective awareness and
within communities concerned with matters of meaning
and purpose in life, truth and values. (A. Sims & C. Cook, 2009)
A lived experience that is
 an emergent quality of relationships
 a stance to the sacred in social & health contexts
 independent of appraisal of well being (“I feel at peace in
the presence of the Divine” vs “I feel the presence of the
Divine” – prevents confounds with measures of health)
SPIRITUALITY & WELL BEING - 2
Spiritual Incongruence – a measure of discrepancy
between an assessment of what matters in a spiritual
life and the lived experience of that spirituality. (Fisher &
colleagues, 1998, 2003)
Fisher’s Spiritual Well Being Questionnaire
Personal
Communal
Environmental
Transcendental
PRACTICE 4 - FISHER’S SWBQ
Take a moment to complete the questionnaire
and score.
What did you notice?
Hypotheses and Results
RESEARCH STUDY
WHAT WE WANTED TO KNOW
Is there a relationship between burnout and a specific
form of values incongruence – spiritual incongruence
(Fisher 2010)?
Does that relationship reflect a personal or
transcendental stance to burnout?
(How can Buddhist teachings be a door out of that
suffering?)
THE WHO & HOW OF OUR STUDY
48 participants beginning an 8-week MBI
program (pre-course)
 Maslach Burnout Inventory: exhaustion,
cynicism, effectiveness
 Fisher’s Spiritual Well Being Questionnaire –
incongruence as difference between ideal and
actual scores on spiritual well being on four
dimensions: personal, communal,
environmental & transcendental

RESEARCH STUDY – HYPOTHESIS 1
The dimensions of burnout would be associated
with incongruence in the four domains of
spiritual well being
(i.e., is burnout related to spiritual values?)
MEANS, STANDARD DEVIATIONS, INTERCORRELATIONS
Variable
Exhaustion
EX
CY
PE
iP
iC
iE
iT
0.74†
Cynicism
-0.30*
-0.55†
0.33*
0.33*
-0.45**
iCommunal
0.05
0.15
-0.38*
0.62†
iEnvironmental
0.17
0.11
-0.44**
0.76†
0.49†
iTranscendental
0.06
-0.07
-0.04
0.40**
0.28
0.53†
3.61
2.83
4.44
1.54
1.03
0.92
0.80
1.79
1.28
0.80
0.61
0.88
0.82
Effectiveness
iPersonal
M
1.69
SD
†p < .001 , **p < .01, *p < .05
WHAT THIS MEANS
Incongruence in personal spiritual well being
was related to all three burnout factors
 Feeling disconnected in identity, joy, meaning,
and self-awareness were associated with
feeling unable to manage the challenges of the
workplace (item analysis)
 Personal Effectiveness was related to personal,
communal, & environmental incongruence

RESEARCH STUDY – HYPOTHESIS 2
The ideal and actual experience scores of each
factor (Personal, Communal, Environmental, &
Transcendental) would be significantly
different, with ideal being higher than actual
scores.
(i.e., do the participants have high ideals?)
Spiritual Well Being Scores
SPIRITUAL WELL BEING SCORES
Ideal
Mean SD
Actual
Mean
SD
Difference
Scale
Personal 4.70
0.46
3.16
0.82
t(47)
13.40†
Communal 4.69
0.44
3.66
0.65
11.66†
Environmental 4.33
0.63
3.41
0.91
7.25†
Transcendental 3.38
1.38
2.58
1.27
6.81†
One-tailed t-tests. † p < .0001
WHAT THIS MEANS
Ideal scores were higher than actual (lived)
scores
 Participants believed they were moderately
meeting their aspirations in all four spiritual
domains

RESEARCH STUDY – HYPOTHESIS 3
The spiritual incongruence of each factor
(iPersonal, iCommunal, iEnvironmental, &
iTranscendental) would differ from each other.
(i.e., can we localize the incongruence?)
SPIRITUAL WELL BEING INCONGRUENCE
t (47)
Scale
Mean
SD
iPersonal
1.54
0.80
iCommunal
1.03
0.61
5.58†
iEnvironmental
0.92
0.88
7.34† 0.95
iTranscendental
0.80
0.82
5.78† 1.80 1.00
Two-tailed t-tests. † p < .001
iP
iC
iE
iT
WHAT THIS MEANS 1
Summary
 Burnout
 exhaustion
& cynicism related only to personal values
incongruence
 personal effectiveness was related to personal,
communal, & environmental incongruence
 High
personal spiritual ideals and moderate
fulfillment
 Personal incongruence was largest of the four
WHAT THIS MEANS 2
The personal domain played a significant role in
SWB as it did on the burnout measure
Self:
personal stewardship of care
Organizational: shift our stance to demands
Counselling burnout
THREE STORIES – ONE ENDING
MODEL OF COUNSELLING FOR BURNOUT

The current paradox of work and life



work and personal lives are viewed as separate and much
energy is expended holding the boundaries between them
the emotional turmoil from one domain is kept from
interfering with the other
Resolve the paradox


seeing separation of self as artificial, socially constructed
engaging through personal values and wisdom
Waking up to what is
 Aligning to our passion
 Acting in a way that brings us alive

FIRST STORY: WAKING UP

Siddhartha (historical Buddha) found alignment
between the evidence around him of suffering and
responded only to what it asked of him
 resolution
was not transcendental but boundless
 dissolved boundaries between work and personal lives
 refused to be defined by the organization or by a narrow
vision of who he was
 could not be held in the thrall of values and expectations
that were not always congruent with who he was or
wanted to be (Musten & Monteiro 2010)
SECOND STORY: ALIGNING TO PASSION

Sen-jo
 surrendered
her self-stewardship
 not animated by her passion and dedication
 not aligned with her aspirations, not in conversation with
herself

Paradox is artificial and designed to create discomfort
 dualistic
choices ignore the boundless and seamless
nature of how we are in relationship

Single breath (pneuma, soul) sews together internal &
external, becomes one, gives vitality (nb vital exhaustion =
burnout)
THIRD STORY: OUR COMING ALIVE IN CHAPLAINCY

Our role is to hold



the middle ground in apparent paradoxical states
a dynamic tension between the individual’s ideal and lived
experience and is expected to take the “subjective pulse” of
the person
Our practice is to embody the ministry


remain connected with our soul
engage fully beyond the boundaries of work-and-life by being
aligned through
 Ethics
 Mindfulness
 Wisdom
PRACTICE 3
How do we remember what is important?
Seventh Generation Exercise*
Was
it true that the world was in crisis?
What did you do in the face of the despair?
What kept you going?
*From Coming Back to Life by Joanna Macy
ETHICS
Trust in our values, our ethics
align with our aspirations
detach from specific outcomes to define our
worth or fire our passion
Hold a disciplined conversation (Whyte, 2001) with
ourselves about our intentions and our
alignment with our values
MINDFULNESS
Cultivate Mindfulness or awareness in the system we are
embedded
become the captain of our own ship, cultivate
captaincy that is not hinged on any specific
person or circumstance for safety and fulfillment
(Whyte 2001)
become
wise to the systemic nature of our lives
and avoid becoming absorbed into the system
itself
WISDOM
Nurture our wisdom by opening to our experience,
setting out on seamless adventures
wholeheartedly
 personal
life is no longer defended from work but part of
the entire seascape we navigate
 work is not about producing objects or outcomes
 life is alignment with who we are independent of label or
space we hold
 work-and-life gives way to engaging fully in life’s work
You, sent out beyond your recall,
Go to the limits of your longing.
Embody me.
Flare up like a flame
And make big shadows I can move in.
Let everything happen to you: beauty and terror.
Just keep going. No feeling is final.
Don’t let yourself lose me.
Nearby is the country they call life.
You will know it by its seriousness.
Give me your hand.
Rilke
REFERENCES
Fisher, J. W. (1998). Spiritual health: Its nature and place in the school curriculum. PhD,
University of Melbourne, Melbourne AU.
Gomez, R., & Fisher, J. W. (2003). Domains of spiritual well-being and development and
validation of the Spiritual Well-Being Questionnaire. Personality and Individual
Differences, 35(8), 1975-1991. doi: 10.1016/s0191-8869(03)00045-x
Fisher, J. W. (2010). Development and application of a Spiritual Well-Being
Questionnaire called SHALOM. Religions, 1, 105-112.
Leiter, M. P., Gascon, S., & Martinez-Jarreta, B. (2010). Making sense of work life: A
structural model of burnout. Journal of Applied Social Psychology, 40(1), 57–75.
Macy, Joanna (2009). Coming back to life. New Society Publishers, Gabriola BC Canada
Musten, R. F., & Monteiro, L. M. (2010). Minding the life you have. Ottawa Mindfulness
Clinic. Ottawa, ON.
Sims, A., & Cook, C. (2009). Spirituality in psychiatry. In C. Cook, A. Powell & A. Sims
(Eds.), Spirituality and psychiatry (pp. 1-15). London, UK: The Royal College of
Psychiatry.
Whyte, D. (2001). Crossing the unknown sea: Work as a pilgrimage of identity. New York,
NY: Riverhead Books.
CONTACT
Lynette Monteiro, PhD, C.Psych.
595 Montreal Road Suite 301
Ottawa ON
K1K 4L2
t. 613.745.5366 x3
e. lynette.monteiro@gmail.com
www.ottawamindfulnessclinic.com