Feeling distressed at work? It may be more than just burnout
Many workers feel very miserable and quit their jobs in droves. The root cause could be something else: moral harm.
Workers — doctors and fast food restaurant workers, teachers and hotel workers — are quitting in unprecedented numbers, often in distress. Managers don't know how to respond. Addressing employee dissatisfaction and burnout with bonuses, mindfulness and extra time off did not seem to be working well; employees continued to quit, sometimes in anger and drama, expressing a range of grievances on social media.
But what if the problem we commonly call "burnout" isn't just burnout? What if it weren't for the other "usual suspects" - depression or anxiety? What if it looks similar but has a different cause that makes the individual feel worse and worse if not handled properly?
Properly dealing with the prevalence of employee distress and resignation requires proper identification of its cause and accurate terminology to describe it. While burnout is by far the most popular explanation for employee misery, in many cases the problem may be lesser-known but more insidious: moral harm. Preliminary data from my ongoing research suggests that, conservatively, at least 25% of people reporting experiences of feeling exhausted may be better explained as moral harm.
Consider the story of a man we call Henry. Henry joined a prominent non-profit organization to use his accounting talents for social causes he strongly supports. But he found shocking mishandling of donations - and was told to cover it up. Finding out about embezzlement was bad enough, but now Henry faces a dilemma: expose the individuals involved and risk a massive backlash against the entire cause he believes in, or keep silent and save face for the cause, but become a problem. Henry finds it difficult to sleep at night and control his emotions during the day, including anger at the organization's management for tarnishing his career and shame at his own lose-lose situation. In addition, his controlled health problems have returned.
In another example, "Kim" became an HR professional because she cared about people. At first, working for a budding marketing agency was a dream come true. Over time, though, she noticed a high rate of employee turnover, with many in the exit survey complaining of being "pushed out" or "bullied" as soon as they reached their mid-30s. A recruiter bringing in replacement talent confirmed her suspicions - there is an unwritten rule to only consider resumes from people in their twenties. Kim's boss made it clear that she would support the "energy" of the company if she wanted to keep her job. Growing up to respect her elders, Kim felt ashamed. When family members ask, "How is work?" What does she tell them? next party? Can she even face her family while working for an ageist company?
Definition of Moral Harm
The original understanding of mental harm, similar to PTSD, came from studies of the military. Understanding this origin also helps to understand the difference between these syndromes. While PTSD can be caused by threats to a person's death, moral harm is caused by threats to a person's morals, such as harming a child, destroying a school or place of worship. Jonathan Shea, who coined the term while working with veterans, also highlighted the role of leadership betrayal in the development of moral harm in high-stakes situations.
Based on previous research and extending the concept of moral harm to a range of occupations, I propose that it be part of a broader classification of workplace stress responses. In short, PTSD primarily affects feelings of safety, mental injury primarily affects feelings of trust and/or self-esteem, and burnout affects a person's sense of engagement and effectiveness. While these may occur simultaneously and overlap, the causes and effects are quite different and require different interventions.
The focus of nonmilitary research on moral harm has been on healthcare workers. Nurses and doctors are suffering greatly from being unable to provide the care they are sworn to provide due to a global pandemic, severe understaffing, bureaucratic red tape and a potential "profit before patient" organizational culture. About one in five healthcare workers have left their jobs since the pandemic began. However, prior to March 2020, the high incidence of ethical harm in healthcare was well documented and attributed to systemic issues that emphasized efficiency and financial metrics at the expense of physician/patient communication, trust and Holistic patient care.
Likewise, educators are currently experiencing the deadly effects of the pandemic and are struggling to get enough resources to meet the needs of their students. Yet even before the pandemic, K-12 professionals reported similar levels of moral harm as veterans, and teachers were distressed when they were forced to implement underresearched and potentially harmful curriculum and disciplinary practices.
Journalists and ordinary civilians covering the refugee crisis in Europe are also morally harmed.
In its most generic form, applicable to all occupations, workplace moral harm is a traumatic response to witnessing or engaging in workplace behaviors in high-risk situations that contradict one's own moral beliefs, which may cause physical, psychological damage to others , social or economic harm. A focus on high-risk situations and major injuries can keep the concept important.
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