Emotional Regulation and Burnout in the Workplace

Burnout is a state experienced by numerous people, notably in the health care system. While it is expected that being in healthcare is tough, the issue with burnout is that it affects the wellbeing of the healthcare practitioner and the quality of care given.

Currently, few methods address the burnout pandemic. The issue is further exacerbated by short-staffed hospitals and clinics that need extensive manpower. As such, healthcare practitioners are forced to look within themselves to cope with the stress, and emotional pressure.

Burnout and Quality of Care

Burnout is a serious problem among healthcare providers and is the number one cause of sick leave, turnover, and psychopathology and physical complications^2,7. These negative outcomes further stress and strain the healthcare system which creates a vicious cycle between the health of providers and the care received by patients⁹.

The onset and severity of burnout is linked to several factors, such as gender, age, marital status, culture, workload, physical activity, and coping strategies. Due to the complexity of burnout, few workplace interventions have successfully been employed; however, the few that have seem to be promising and cost-effective⁸.

Emotion Regulation^1,3,4,6

Emotional regulation is one of the interventions that has been shown to reduce stress in the workplace, notably the health care system. Emotional regulation refers to the process in which an individual can influence which emotions they have, when they have them, and how they experience and express these emotions. In other words, it is the process of controlling your emotions. The two proposed methods to control our emotions are: emotional suppression and cognitive re-evaluation.

1. Emotional Suppression^1,5

Right off the bat, you might assume emotional suppression is the act of “swallowing” your true feelings, and, to an extent, you are correct! However, that is only half of it. Emotional suppression refers to the suppression of undesired emotions to favour desired emotions.

There are two types of emotional suppression: Surface emotional suppression and deep emotional suppression.

An example of surface emotional suppression is suppressing your annoyance towards someone and acting happy to see them. This example is “surface” or superficial and is actually related to negative outcomes for the person faking.

Successful interventions looked at deep emotional suppression, where the internal, “true” feelings are modified. When these feelings are modified, there is no discrepancy between what is seen and what is felt. For instance, you not only seem happy to see that annoying person, but you feel happy to see that annoying person. A medical resident may, for example, not feel confident in their first days at the hospital. Deep emotional suppression would imply replacing that lack of confidence by strategies to make them feel and seem confident, until they are confident. Strategies may imply using technical words in a patient’s presence as this would demonstrate both ability and knowledge.

2. Cognitive Re-evaluation³

Cognitive re-evaluation refers to the act of re-evaluating a situation so that it leads to the desired or required emotion, and it comes more naturally to some. Again, it can be superficial or deep. Once again, deep cognitive re-evaluation has the positive outcomes.

One way a medical resident, for example, can use cognitive re-evaluation is by reminding themselves that they are still in training and are expected to lack specific knowledge and abilities. Their time in the hospital is to challenge them, and ultimately, to improve. In doing so, they alleviate psychological pressure and are less critical of their performance.

Cognitive re-evaluation is more effective than emotional suppression and decreases the prevalence of most negative outcomes associated with burnout. This result is likely because cognitive re-evaluation is more easily executed at a deeper level. Whereas, emotional suppression is more commonly done superficially, which poses a psychological toll and worsens burnout.

Conclusion

All in all, both tactics are effective as well as easy to learn, adopt, and employ. Both have the potential to increase the quality of patient care and the work-related quality of life of healthcare practitioners (or anyone suffering from work overload)! It never hurts to try either; just choose which works best for you! Maybe even try both!

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Reference

1. Colombo, D., Fernández-Álvarez, J., Suso-Ribera, C., Cipresso, P., Valev, H., Leufkens, T., Sas, C., Garcia-Palacios, A., Riva, G., & Botella, C. (2020). The need for change: Understanding emotion regulation antecedents and consequences using ecological momentary assessment. Emotion (Washington, D.C.), 20(1), 30-36. https://doi.org/10.1037/emo0000671
2. Chien, W., & Yick, S. (2016). An investigation of nurses’ job satisfaction in a private hospital and its correlates. The Open Nursing Journal, 10(1), 99-112. https://doi.org/10.2174/1874434601610010099
3. Gross, J. J. (2015). Emotion regulation: Current status and future prospects. Psychological Inquiry, 26(1), 1-26. https://doi.org/10.1080/1047840X.2014.940781
4. Grandey, A. A. (2000). Emotion regulation in the workplace: A new way to conceptualize emotional labor. Journal of Occupational Health Psychology, 5(1), 95-110. https://doi.org/10.1037/1076-8998.5.1.95
5. Hülsheger, U. R., & Schewe, A. F. (2011). On the costs and benefits of emotional labor: A meta-analysis of three decades of research. Journal of Occupational Health Psychology, 16(3), 361-389. https://doi.org/10.1037/a0022876
6. Martín-Brufau, R., Martin-Gorgojo, A., Suso-Ribera, C., Estrada, E., Capriles-Ovalles, M. E., & Romero-Brufau, S. (2020). Emotion Regulation Strategies, Workload Conditions, and Burnout in Healthcare Residents. International journal of environmental research and public health, 17(21), 7816. https://doi.org/10.3390/ijerph17217816
7. Paris Jr, M., & Hoge, M. A. (2010). Burnout in the mental health workforce: A review. The Journal of Behavioral Health Services & Research, 37(4), 519-528. https://doi.org/10.1007/s11414-009-9202-2
8. Schaufeli, W. B., Bakker, A. B., van der Heijden, Frank M.M.A, & Prins, J. T. (2009). Workaholism, burnout and well-being among junior doctors: The mediating role of role conflict. Work and Stress, 23(2), 155-172. https://doi.org/10.1080/02678370902834021
9. Williams, E. S., Savage, G. T., & Linzer, M. (2006). A proposed physician-patient cycle model. Stress and Health, 22;16;(2;6;), 131-137. https://doi.org/10.1002/smi.1088