Summary of the article: Burnout: 35 years of research and practice - Schaufeli - 2009.

The purpose of this article is to focus on the concept burnout itself, instead of reviewing research findings on burnout. Burnout is an important concept in work related environments and it has inspired a lot of researchers to better understand and study the concept. In Sweden and the Netherlands burnout is even a medical diagnosis. 

What is the nature of a burnout?

Researchers often use a metaphor for referring to a burnout, they say its like the smothering of a fire that can't be bright again due to insufficient resources. Maslach was the first to be interested in how people cope with emotional arousal at work and she learned that workers often felt very emotionally exhausted, and they referred to this as a burnout. Maslach also came with a definition of burnout: "burnout is a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment that can occur among individuals who work with people in some capacity". The term burnout came up around 1970s and was linked to work in the human services. Charnezz and Kranz (1983) saw that burnout wasn't a thing in Montessori schools and religious care centers. They said that it were ideological communities that provided a collective identity that prevents burnout from happening.

A development that was at the beginning of burnout is the transformation from an industrial society into a service economy. This transformation also gave more psychological pressure. First, people thought burnout only happened to the young idealist type of people. The idea was that people have few illusions about the working world and the boomers who have been working for a long time are less vulnerable to burnout. 

There was also a bigger potential for value conflicts within a company because employees were able to speak their own visions and hold personal values, and young people also distrusted the older generation. 

Burnout has thus been a big influence in research ideas and despite methodological problems, biases and quantitative studies (not always reliable and valid), studies do suggest that burnout is not exclusively a North American or Western phenomenon. But the thing that burnout is a global fact does not mean that the definition is the same in all the countries and languages. 

Is burnout a social problem or a medical diagnosis?

The 'medicalization' of burnout is intertwined with the debate about whether burnout should be considered as more than just exhaustion. Most researchers use the Maslach Burnout Inventory that uses a three-dimensional description: exhaustion, cynicism, and inefficacy. There are some alternative burnout instruments (Copenhagen Burnout Inventory for instance), but the MBI remains the golden standard. 

There is no scientific reason to use the term, burnout, when referring to exhaustion only. You can say burnout is the metaphor used to reflect an 'experience' rather than a feeling. You can also argue that burnout is a generic experience. That is why researchers made a burnout inventory in which they try to make a dichotomy that discriminates between burnout 'cases' and 'non-cases'. 

Schaufeli (2001) states that in order to be able to be diagnosed with a 'burnout', the symptoms should additionally be work-related, and the individual should receive professional treatment. The dichotomization also ensured that burnout gradually became a medical diagnosis instead just a 'psychological phenomenon'. The criteria are:

• Physiological or mental symptoms of exhaustion for at least two weeks
• An essential lack of psychological energy
• Difficulty to concentrate 
• Decreased ability to cope with stress
• Irritability or emotional instability
• Sleep disturbances
• Muscle pain
• Dizziness
• Palpitations

Al these symptoms have to be around every day for two-weeks and must also cause significant suffering and impair someone's work capacity. In the Netherlands researchers made a classification between three levels of stress-related disorders:

1. Distress is having mild symptoms that lead to only partly impaired occupational functioning
2. Nervous breakdown is having serious distress symptoms and temporal loss of occupational role
3. Burnout is having work-related neurasthenia and long-term loss of the occupational role. 

The definitions of burnout differ in countries and languages and it has also to do with the context and intentions the researchers have with the meaning of burnout. 

Burnout was always defined as having a negative state of mind, but Maslach and Leiter came with a more positive perspective on burnout. They rephrased burnout as 'an erosion of a positive state of mind', which they labeled engagement. The idea is that a burnout starts when engagement starts to wear out, and this was the beginning of the positive psychology. It can be said that developments in science and organizations strengthen the positive turn in burnout research that is rephrasing burnout as an erosion of engagement.