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Stress, Burnout Helper and Presuicidal Syndrome

Stressz kiégés Helper és megküzdési módok

Janos Kollar

on 19 February 2017

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Transcript of Stress, Burnout Helper and Presuicidal Syndrome

Psychological crisis, presuicidal syndrome
and burn-out prevention.
Dr. János Kollár
assistant professor
What is burnout?
General Signals of Burnout
Lack of Empathy
Tiredness disinterest, insensitivity
Losing motivation
Helplessness, hopelessness
Weak immune system
Sexual problems
Physical symptoms:
nausea, tachycardia, tic etc.
Excessive use of alcohol, coffein, drugs
psychosomatic problems
Process of Burnout
1. From goodwill to burden of proof
2. Excessive efforts
3. Neglecting personal needs
4. Suppressing personal needs
5. Change in values
6. Denying existing problems
7. Withdrawal
8. Change in behavior
9. Depersonalization
10. Emptiness
11. Depression
12. Total burnout
Self Diagnosis
What is my motivation for my profession?
What is the opinion of other people about me?
Where am I on the process of burnout?
Therapy of Burnout Syndrome
1) Prevention
2) Intervention
3) Crisis Intervention
a. General motivation (for eg. support system on the workplace)
b. Personal motivation
(why did you want
to become a doctor?)
a. Learn to handle stressful situations!
b. Develop support system aiming at
sharing responsibility
and reducing stress!
Levels of Prevention
I. General strategies
2. Workplace tips
3. Home tips
a.) Be fully aware of your own power and expectations!
b.) Appreciate even the "smallest"
c.) Live in present!
d.) The "Stones of Gratitude"
a. Appreciate your own
and your friends' and
colleagues' successes!
b. Don't complain too often!
c. Search for opportunities of development!
a. Healthy nutrition
b. Don't forget about the daily exercises!
c. Learn to relax!
Kristin Duare McKinnon: Coping with caring --- the dangers of chronic stress and burnout (July 6, 1998) (http://www.charityvillage.com/cv/research/rpersdv1.html)

Sylvia Wetzel: Relaxation, Meditation and Buddhism
(http://www.sylvia-wetzel.de/english/ WomenAskQuestions.htm#_edn1)
Ónody Sarolta: Kiégési tünetek (burnout szindróma) keletkezése és megoldási lehetőségei.
(Új Pedagógiai Szemle, 2001. május p. 80.-85.)
Burnout is a psychological term for the experience of long-term exhaustion and diminished interest usually in the work context.

(H. J. Freuderberg)
What is stress?
Every change requiring adaptation
Selye János (1907 - 1982)
A stressz nem feltétlenül káros.
Hiánya enerváltságot okoz.
Holmes and Rahe Stress Scale (1967)
Score of 300+: At risk of illness.

Score of 150-299: Risk of illness is moderate (reduced by 30% from the above risk).

Score <150: Only have a slight risk of illness.
The Helper syndrome
The profession turns into a kind of "drug"
Negative self image
Hidden narcissistic needs
Suppressed aggression
Uncertain self image
Misinterpreted empathy
(Extreme identification with the client)
Incapability for
balanced relationships
Unconscious parental rejection can be in the background
Presuicidal Syndrome
Erwin Ringel: Cry For Help signals
1. Narrowing (stenoestesia)
2. Inhibited agression against
one’s own personality
3. Suicidal fantasies
Life event Life change units
Death of a spouse 100
Divorce 73
Marital separation 65
Imprisonment 63
Death of a close family member 63
Personal injury or illness 53
Marriage 50
Dismissal from work 47
Marital reconciliation 45
Retirement 45
Change in health of family member 44
Pregnancy 40
Sexual difficulties 39
Gain a new family member 39
Business readjustment 39
Change in financial state 38
Death of a close friend 37
Change to different line of work 36
Change in frequency of arguments 35
Major mortgage 32
Foreclosure of mortgage or loan 30
Change in responsibilities at work 29
Child leaving home 29
Trouble with in-laws 29
Outstanding personal achievement 28
Spouse starts or stops work 26
Begin or end school 26
Change in living conditions 25
Revision of personal habits 24
Trouble with boss 23
Change in working hours or conditions 20
Change in residence 20
Change in schools 20
Change in recreation 19
Change in church activities 19
Change in social activities 18
Minor mortgage or loan 17
Change in sleeping habits 16
Change in number of family reunions 15
Change in eating habits 15
Vacation 13
Christmas 12
Minor violation of law 11
The most difficult patient is the patient in crisis
The greatest risk of crisis is suicide
The doctor’s task:
Recognize, explore and treat
Help the person to be motivated to accept external help
Offer alternative behaviour forms
Bálint groups
J.D. Schramm:
Break The Silence
Prejudices against suicide
„He who speaks about it does not commit it”
(Truth: 80 % of people with attempted or committed suicide give „cry for help” signals before the attempt.)
„Those who survived it did not mean to die.”
(Truth: 25-50 % of those who die by suicide had previous attempt.)
„If you have tried it once you will always live in the shadow of suicide risk.”
(Truth: 95 % of those who have attempted suicide are happy with their lives have been saved.)
Consequences of attempted suicide:
A crisis situation is accompanied by regression
(Difficult to treat adults’ childish behaviour)

The suicidal episode is frequently founded on a complex, often life-threatening disease (for eg. alcoholism or narcissistic personality disorder)

Dependency (has to be solved by the doctor)
Full transcript