System or individual: who is responsible for burnout

“Maybe I’m just not resilient enough.”

She said it quietly, almost apologetically, after listing what had happened in her department over the past year. Two colleagues had left and nobody had been hired to replace them. The project deadline had been moved three times — always forwards, never back. Her manager replied to messages at eleven at night and expected the same. And when HR noticed that sick leave in the department was piling up, they sent everyone an invitation to an online workshop on resilience and mindfulness. At six in the evening, after work.

None of this was wrong in itself. Resilience is valuable, and mindfulness helps. But there is something in this scene that bothers me every time: the question of why people in a particular setting burn out has quietly turned into the question of what is wrong with them. That is what this article is about — the causes of burnout, where science looks for them, and what is in your hands and what is not.

What the World Health Organization says

In 2019 the World Health Organization (WHO) included burnout in the eleventh revision of the International Classification of Diseases (ICD-11), which came into effect at the start of 2022. The news went round the world under headlines saying burnout was “now officially a disease”. It isn’t. And that is precisely the point.

The WHO describes burnout as an occupational phenomenon, not a medical condition. It sits in the chapter on factors influencing health status or contact with health services — among the reasons people seek help, not among illnesses. The definition says it is a syndrome resulting from chronic workplace stress that has not been successfully managed. It has three dimensions:

• feelings of energy depletion or exhaustion,
• increased mental distance from one’s job, or feelings of negativism or cynicism related to it,
• reduced professional efficacy.

And there is one more sentence in the definition that people often overlook: the term refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.

Why does this matter? Because the definition itself says where the source lies: in the relationship between a person and their work. Not in character, not in a lack of willpower, not in someone “not knowing how to rest”. If you want to recognise in more detail how burnout shows up in the body and in mood, I wrote about it in Burnout is not laziness: signs your nervous system is asking for a break. You will also find a short explanation in the knowledge base under burnout.

Christina Maslach: burnout lives in a relationship

The term burnout entered the professional literature in the 1970s through the psychiatrist Herbert Freudenberger, who used it to describe the exhaustion of volunteers at a free clinic in New York. At almost the same time, the social psychologist Christina Maslach at the University of California, Berkeley, began studying what happens to people in the helping professions — nurses, social workers, teachers. The questionnaire she developed with Susan Jackson is still the most widely used measure of burnout in the world.

But something else mattered more than the questionnaire. Over decades of research, Maslach and her long-time collaborator Michael Leiter reached a conclusion they put very directly in their book The Truth About Burnout: burnout is not primarily a problem of people but of the social environment in which people work. When the workplace does not recognise the human side of work, the risk of burnout rises — however capable and committed the individual is.

Instead of asking “who is vulnerable”, they began asking “where do the work and the person fail to fit”. Out of this came the model of the six areas of worklife.

Six areas where work and the person part ways

Maslach and Leiter understand burnout as the result of a mismatch — a gap between what work demands and offers and what a person needs and can manage. A mismatch can arise in six areas:

1. Workload. Too much work in too little time, with too few resources — and above all with no chance to recover in between. Short bursts of overload are part of every job; the problem is when they become the norm.
2. Control. How much say you have over how, when and with what you work. People who carry responsibility without authority are especially vulnerable.
3. Reward. Not only pay, but recognition, thanks, the sense that your effort is noticed. Invisible work is exhausting work.
4. Community. The quality of relationships with colleagues and managers: support, trust, the ability to resolve conflict. Loneliness at work is one of the strongest predictors of exhaustion.
5. Fairness. Whether the rules apply equally to everyone, whether decisions are transparent, whether work is shared out honestly.
6. Values. Whether what you do fits with what matters to you. A nurse whose targets leave no time to attend to a patient experiences exactly this mismatch.

The model is useful because it does not treat burnout as a single thing. Two people who are equally exhausted can be exhausted for entirely different reasons. One simply has too much work. The other has just the right amount, but has spent two years watching those closer to management get promoted. A plan to ease the workload will help the first. It will do nothing for the second until the sense of unfairness changes.

Fairness and values: the quiet areas

When people talk about burnout, they almost always talk about workload. Number of hours, number of tasks, number of messages. That is understandable, because workload is visible and measurable. But research shows the quiet areas are no less important.

In one of their longitudinal studies, Maslach and Leiter followed employees over the course of a year. They were particularly interested in people who at the start were neither burnt out nor especially engaged — somewhere in between. Which of them moved towards burnout over the year, and which towards engagement? The strongest predictor, which emerged as a kind of tipping point, was fairness. People who experienced their workplace as unfair drifted towards burnout; those who experienced it as fair drifted towards engagement.

The story with values is similar. The people who burn out are often not those who don’t care about their work, but those who care a great deal — and who, day after day, work in conditions that don’t let them do the job the way they believe it should be done. The teacher who knows what a pupil needs but has no time for it. The social worker writing reports instead of being with a person. The cynicism that develops is not a sign that they no longer care. It is protection against the pain of still caring.

That is why, when we talk about burnout, I think it matters that I don’t only ask “how much do you work”, but also “does it feel fair” and “are you doing what made you choose this profession”.

Why we are so quick to blame the individual

If the science is so clear, why is a resilience workshop still the first response of so many organisations? I think for several reasons that reinforce one another.

The first is practical. An online workshop costs little and can be organised in an afternoon. Redistributing work, hiring another person or changing how people are managed costs a lot — and requires someone to admit that something was wrong.

The second is cultural. In settings where productivity is a value, exhaustion is often almost a badge of honour — until it becomes too visible. Then it turns into personal weakness. The person who burns out becomes “the one who couldn’t cope”, rather than a sign that the system has exceeded the limits of the people working in it.

The third reason lies within us. People who burn out are often precisely those who learned that responsibility for everything should first be sought in themselves. When they come to therapy, they don’t ask “what is happening in my workplace”, but “what is wrong with me”. Such patterns often have roots in a family where the child was the one who made sure everyone else was all right — I write about this in more detail in Why the most responsible and reliable people are the ones who burn out.

Guilt plays an interesting role here. If burnout is my fault, at least I have a sense of control: I can try harder, organise myself better, meditate more. Admitting that the source lies in an environment I have little influence over is, in a way, more frightening. So people sometimes cling to self-blame — not because they believe it is fair, but because it is more bearable than helplessness.

What you can do

None of the above means the individual is powerless. It only means that it is not their job to single-handedly fix what is wrong with the system. Their job is to protect themselves, to say clearly what they see, and not to take on blame that isn’t theirs.

What this means in practice:

• Name the area, not just the feeling. “I’m exhausted” is true, but it is hard to change anything with it. “For the past six months I’ve been doing two people’s jobs because the post was never filled” is a conversation that can be had.
• Protect recovery, not just free time. Research on recovery from work stresses that what matters is psychological detachment — not just being at home, but being at home in your head too. That means boundaries around your availability, which are often the hardest to set — I wrote about this in Setting boundaries: why it feels selfish even though healthy relationships depend on it.
• Look for allies. If you feel the exhaustion, someone else almost certainly does too. Shared observations, calmly expressed, carry more weight than a single complaint and are less personally risky.
• Notice your own part. Not to blame yourself, but because it can be changed. Do you take on tasks before anyone assigns them? Do you answer messages that could wait? Do you invest your sense of worth in your work?
• Don’t wait too long for help. Your GP is the first port of call when exhaustion lasts for weeks, when physical symptoms appear or when you can no longer sleep. Burnout often overlaps with depression and with physical illnesses that need to be ruled out.

Here is how a conversation might sound in which someone puts into words for the first time what is happening to them (a composite, not a real person):

“When I was preparing a list for the talk with my manager, I first wrote: I work too much, I can’t cope any more. Then I looked at your areas and saw that it isn’t the number of hours that’s killing me.”
“What is it, then?”
“That the project I slaved over for two years is being presented by someone else. And that nobody sees that as a problem.”
“How is it for you, saying that out loud now?”
“I’m angry. And somehow it’s easier. Because it isn’t something I’m supposed to fix by sleeping more.”

That very shift — from “I can’t cope” to “something doesn’t fit here” — is often the first step. Not because it solves the problem, but because it gives the person back their dignity. And because it points the conversation to where it can actually be had.

What the employer has to do

When we look at research on what works for burnout, a similar pattern keeps appearing. In 2017 Panagioti and colleagues gathered 19 studies involving more than 1,500 doctors in a meta-analysis and compared two kinds of intervention: those aimed at the individual doctor (mindfulness training, stress management, communication workshops) and those that changed how work was organised (schedules, workload, teamwork). Both helped, but organisation-level interventions had a larger effect.

This doesn’t mean resilience workshops are useless. It means they cannot replace changes in the environment. Resilience taught to a person who is then sent back into the same conditions is like an umbrella given to someone standing under a waterfall.

So what belongs on the employer’s side? Following the six areas:

• Workload: realistic staffing, filling vacant posts, deadlines that take into account that people need time to recover.
• Control: more autonomy over how tasks are carried out; involving people in decisions that affect their work.
• Reward: regular, specific recognition — not only at the annual review — and pay that matches the responsibility.
• Community: managers who know how to resolve conflict, and time in which people can meet as people, not just as task-doers.
• Fairness: transparent criteria for promotion, allocation of work and rewards.
• Values: an honest conversation about whether the organisation’s goals and its everyday demands actually go together.

In Slovenia, the Health and Safety at Work Act (ZVZD-1) requires employers to include psychosocial risks, among them workplace stress, in their risk assessment and to plan health promotion at work. Looking after this is therefore not just goodwill but a legal obligation. Whether in practice it is carried out as a serious analysis or as a form someone fills in once every few years is, of course, another question.

Exercise: your map of the six areas

This exercise takes about fifteen minutes. You need a sheet of paper and a little peace — ideally not at work.

1. Write the six areas in a column: workload, control, reward, community, fairness, values.
2. Rate each from 1 to 5, where 1 means “here my work and I don’t fit at all” and 5 means “here it’s fine”. Don’t think too long; the first rating is often the most honest.
3. For the two lowest ratings, write down one concrete example from the past month. Not “there’s always too much”, but “on Tuesday I was given three urgent tasks at once”.
4. For each example, separate two things: what is within your influence (how you respond, what you don’t take on) and what isn’t (staffing levels, management decisions).
5. Choose one small step for what is within your influence, and one observation you can share with someone who has influence over the rest.

If you want to check how exhausted you are, you can use the burnout self-check in the knowledge base. It isn’t a diagnosis, but it is a good starting point for a conversation with a doctor or therapist.

Something interesting often happens during this exercise: people discover that the area wearing them down most is not the one they talk about all the time. They complain about the amount of work, but what really hurts is that nobody trusts them with decisions. Or that the manager is kind to some and not to others.

An insight like that changes nothing in the office by itself. But it changes where you look for a solution — and often how much guilt you carry home.

Where this view falls short

It would be dishonest of me to claim that burnout is always and only a problem of the system. This view has its limits, and I want to name them.

People differ in the same conditions. In the same department, with the same manager and the same workload, one person burns out and another doesn’t. Traits such as perfectionism, difficulty saying no, equating your own worth with success at work — all of this increases vulnerability. The six-areas model doesn’t deny this; it simply says that individual vulnerability always exists in relation to the environment. If you recognise yourself here, you may also find Perfectionism and overthinking: two sides of the same fear useful.

Exhaustion isn’t always burnout. Depression, anxiety disorders, thyroid problems, anaemia, chronic illness — all of these can look very similar. Because the WHO doesn’t treat burnout as an illness, it is all the more important for a doctor to rule out other causes. If you are having thoughts that you don’t want to live any more, don’t wait: in Slovenia, call the crisis line Klic v duševni stiski on 01 520 99 00 (every day from 7 pm to 7 am), the Samaritans helpline (Zaupni telefon Samarijan) on 116 123 (24 hours), or in an emergency 112.

Exhaustion isn’t only about work. The WHO definition is deliberately narrow, but people also burn out as parents or as carers for loved ones. These experiences are real even though the definition doesn’t cover them; in the knowledge base, for example, they are described under parental burnout. For many people, pressure at work and at home add up — and neither alone would have been too much.

“The system is to blame” can turn into helplessness. A view that places all responsibility on the environment can be just as paralysing as one that loads it all onto the individual. If I am only a victim of circumstances, there is nothing I can do. The truth is almost always somewhere in between: the environment sets the frame, within which I still have some choice.

The self-employed and business owners are often both the worker and the system. For them, the question “what does the employer have to do” becomes the question of what you can change in conditions you set yourself — which is both liberating and demanding.

From exhaustion back to work

Once burnout is already here, the answer to “system or individual” becomes very concrete. A person who returns after sick leave to the same environment, under the same conditions, has a good chance of burning out again. So returning is not only a question of whether you have recovered, but also of whether anything around you has changed. I write about how to prepare for the return and what has to change in the environment in Returning to work after burnout: how to keep it from happening again.

Relationships at work also play an important role. How we experience our manager, whether we expect support or rejection from colleagues, whether we dare ask for help — all of this is often coloured by patterns we bring from our early relationships. In relational family therapy, in which I am training, we see this as part of a whole: what happens at work is not separate from what a person learned at home. More on this in Attachment at work: how the pattern shows with your manager and colleagues.

The aim here is not to push responsibility back onto the individual. The aim is for a person to understand why a particular mismatch hurts them so much — and so to be able to say, with more calm, what they need.

What to remember

• In ICD-11 the WHO defines burnout as an occupational phenomenon, not an illness: the result of chronic workplace stress that has not been successfully managed.
• According to Maslach and Leiter, burnout arises from a mismatch between person and work in six areas: workload, control, reward, community, fairness and values.
• The quiet areas, such as fairness and values, can matter as much as the amount of work.
• Organisation-level interventions work better than those aimed only at the individual — a resilience workshop doesn’t replace a change in conditions.
• Your job is not to fix the system on your own, but to protect yourself, say clearly what you see, and not take on blame that isn’t yours.