THERAPY FOR

BURNOUT AND

PERFECTIONISM.

Burnout has an official definition.

In 2019 the World Health Organization described burnout in its International Classification of Diseases as a syndrome caused by chronic workplace stress that hasn't been successfully managed. It has 3 parts:

• Exhaustion, or feeling drained of energy
• Mental distance from your job, often as cynicism or negativity
• Reduced effectiveness at work

The WHO classifies it as an occupational phenomenon, separate from a medical condition, though it often travels with anxiety and depression.

Exhaustion is only one piece.

Christina Maslach, the psychologist whose research shaped how burnout is measured, draws a useful line. In a 2023 interview, she describes people who are exhausted but still like their work and feel good about its quality as overextended. Burnout adds two more things: growing cynicism about the work, and a turn against yourself, the quiet question of what’s wrong with you that you can’t keep up.

Maslach and Michael Leiter’s research points to six areas where a job and the person doing it can fall out of sync:

• Workload: too much to do, with too little to do it with
• Control: little say in how, when, or what
• Reward: effort that goes unrecognized or underpaid
• Community: missing trust, support, or someone safe to talk to
• Fairness: favoritism, bias, or rules that bend for some people
• Values: being asked to work in ways that cut against what you believe

Journalist Jennifer Moss builds on the same six drivers in The Burnout Epidemic. Her core argument will land for anyone who has been handed a meditation app as the answer: burnout grows out of the conditions of the work, so the fixes have to reach the conditions too.

Confident in public, uncertain in private.

Leadership asks for steady confidence on decisions that are genuinely uncertain. The people you'd normally think out loud with often report to you, invest in you, or depend on the outcome. So the doubt, the second-guessing, and the weight of other people's livelihoods tend to get processed alone, if at all.

Those figures come from a survey reported in Harvard Business Review. Founders face their own version: in a 2019 study of 242 entrepreneurs, 72% were affected by mental health conditions, either personally or through close family history.

The finish line keeps moving.

Research splits perfectionism into two parts. Perfectionistic strivings are the high standards. Perfectionistic concerns are the fear of mistakes, harsh self-judgment, and worry about how others will evaluate you. A 2016 meta-analysis of 43 studies found that concerns had medium-to-large links with burnout, while strivings on their own did not.

That figure comes from a study of more than 41,000 college students across the U.S., Canada, and the U.K. The pressure is cultural as much as personal, which is part of why it's so hard to turn down on your own.

Some of the signs.

• Sunday dread that starts on Saturday
• Rest that comes with guilt attached
• Rewriting, rechecking, and redoing work that was already done
• Cynicism about work you used to care about
• Snapping at home after holding it together all day
• Big decisions made alone at 11 p.m.
• Hitting a goal and feeling relief for about a day

Start with the mismatch that stings most.

Rest and self-care help you recover from strain. They do less about its source. A more useful starting point is to go down the six areas and notice which one hurts most, because a workload problem calls for different moves than a values conflict or a lack of control.

Moss points to a few levers individuals can pull: declining work that isn’t essential, spending more time on the parts of the job you’re good at, and keeping people close, at work and outside it, who you can lean on. For founders and leaders, many of the structural levers sit with you.

The body needs its own reset, too. In Burnout, Emily and Amelia Nagoski describe stress as a physical cycle that needs to finish, through movement, rest, and connection, separate from solving whatever caused it.

Separating the standard from the fear.

Cognitive behavioral therapy targets the thinking that fuels perfectionistic concerns: all-or-nothing judgments, treating mistakes as catastrophes, and tying self-worth to output. Acceptance and commitment therapy helps clarify what you actually value, so effort points somewhere you've chosen.

For leaders, a big part of the work is simply having a confidential place to think out loud, test decisions, and say the things that can't be said to a team or a board.

Related: Moral injury & the helping professions  ·  Therapy for men  ·  Anxiety