Correspondence (letter to the editor): Consider Etiopathogenesis

From my perspective as a psychoanalytically oriented medical psychotherapist I wish to add further to what the authors said in their informative article.

My personal mission is to research the etiopathogenesis of burnout. The causes may lie within an individual's “intrapsychological conflict.” In my practice I have often encountered persons who unconsciously repeated experiences from their early life (for example, a perceived lack of appreciation by close contacts) in the workplace. In the present this can trigger exhaustion owing to overcommitment and over-willingness—in the hope to finally gain the desired praise and recognition, so to speak.

This sort of “psychodynamic” is one possible factor among many others that may contribute to burnout.

Why not look for such causes of this self-harming behavior—for example, by means of psychoanalytically based psychotherapy?

By taking a thorough history and paying attention in the therapeutic sessions to the patient's feelings and behaviors vis-à-vis the therapist (“transference”), possible causes can be elucidated. The aim is to establish, jointly with the patient, keys to gaining insight into themselves. By so doing one provides an opportunity to let go of old behavioral patterns, and the symptoms of burnout will subsequently vanish.