Burnout and Spasmodic Torticollis.

Some day in the spring of 1999 I woke up with my head pressing against my pillow. Obviously something was wrong. Immediately I made an appointment with my doctor who advised me to stop working for a while: there´s more to life than just working she added. The next step was to contact my doctor at work who advised me to do the same. This was the start of period in which I was very much restricted in my possibility´s, in my work as well in my private life. After only about a year I could give it a name: Spasmodic Torticollis. For some time this caused a crisis in my life which was a big burden for me and the people who surround me. Looking back I consider the events form this period as a signal from my body and mind telling me I really could not go on this way: all the signals said stop!! In the mean while I saw a link between Spasmodic Torticollis and burnout: I noticed a very prolonged situation of hypertension which had started to live of his his own. Of course a physical predisposition for my disorder is also involved.

In my case my body showed his limitation in a very specific way. However, burnout can show itself in many ways. For example, I know someone who suddenly collapsed completely, had a period of depression and anxiety but after a while somehow recovered and restarted (another kind! of) work. Another person told me how he came to sit on his couch as if knocked out unable to handle anything; however after some time he was able to build up his working process again step by step.

There are numerous story´s like this which have one thing in common: you are confronted very hard with your limitations and you experience it as a crisis. A crisis is something which takes you by surprise and completely takes over the control over your life. The reality of that moment forces you physically and mentally into corners where you lose the power over your life and you just have to follow. To quote a Dutch professor named Zwart: it is a "zeropoint" experience which only leaves you one option: to go through it. In his vision a crisis has the meaning of a signal to change something radically because old ways don´t work anymore. So, if you´re able to find this new way it often is an improvement; if on the other hand you try to stick to the old situation you just hang on or even get worse. True or not, his analysis gives an indication what burnout may mean on the mental and spiritual level.

The causes of burnout.

Is the cause of burnout physical or psychological?.  I, for myself don´t think it´s the one or the other; what matters is the fact that one is forced to a stand still in which case the question arises what it means for a person and how to get moving again in the right way. Educated as a psychologist I was learned to explain a lot of things in the psychological way. However, trying to understand the dynamics of S.T. as well that of crises, caused a shift in my thinking about these things. In my opinion it is always an interaction between body and mind but it is my belief now that in the first phase of (possible) recovery of burnout -and torticollis!- the starting point should be a physical one.

The many burnout-specialists often disagree about the causes of burnout. On the other hand, in regard to some aspects of it there evolves a kind of consensus:

Besides these similarities there are, as said before, differences. In my view some people are more susceptible for the consequenses of longterm stress because of their predisposition. On the one hand I see a category of people (in which I actually put myself) with an inherited high sensitivity. More than average people they are tended to be overwhelmed by certain situations. If such persons are not keen enough to perceive that (for example by good self management) this will lead to an unceasing flow of stresshormones in the body and possibly to exhaustion and overcropping. On the other hand I see another category of people who are more than average susceptible: the very hard workers with high ambition (the so called "a type"). They often tend to go on and on until they reach their limits and finally collapse anyway.

Burnout and the regime of stresshormones: the vision of Sonja van Zweden.

A person who inspired me with new insights, is a Dutch woman Sonja van Zweden. In The Netherlands she is known as one of the outstanding specialist regarding burnout. Van Zweden was educated as a psychotherapist and did neurophysical and -psychological research as well. When she was about 45 years of age she was herself struck by burnout so it´s clear she can speak from personal experience. She got out of the working process but after a few years, when she had gathered enough energy again to tackle things again and analyse her situation, she came to the conclusion that burnout is something "physical". She started to read about it and laid contacts withs the medical world, i.e. neurologists and physiologists. This way she developped her own what I would call systemapproach about burnout and made her job out of it. Systemapproach means in my vision: a relatively fundamental insight into the way burnout develops as a condition of interrelated phenomena and eventually gets a form. This on his turn makes it possible to develop an effective kind of therapy. These are the headlines of her vision:

In situations of stress, especially in so called fight/fight conditions, the body releases stresshormones like cortisol and adrenalin. Normally, if these situations which evoke stress go away, the production of stresshormones also ends and physical and mental relaxation occurs. However, when physical and mental stress in endures and becomes longterm (and out of which physical stress can evoke psychological stress and vice versa), the neurophysical system producing stresshormones doesn´t come to a rest. This undermines the resources of the body to recover leading to a negative loop of being stressed up all the time without having the possibility to rest and/or relax. Recovery isn´t possible anymore and a period of cumulative exhaustion starts which may result in burnout. There´s second consequense of this process. Actually the  body gets "used" to this abnormal situation of overproduction of stresshormones and is adjusting itself to it. The neurophysical system starts to consider the abnormal, dysfunctional situation as the normal one.

To illustrate this mechanism two metaphors. Number one: if you put the thermostate which regulates the heating of your house in a normal Dutch winter (which normally  is quite mild with not much frost) on 70 degrees Farenheit (21 Celsius), it will sometimes warm up and then turn off but if this thermostate reacts as if it´s always minus F 30 (-35 C) outside it will keep on burning and roaring even if you feel warm enough. Number two: natural ecosystems which suffer from longterm stress (for example because of pullution) impoverish because vulnarable species disappear which weakens the ecosystem more and more. Prolonged and strong disturbance eventually leads to so called contingency. This means that the ecosystem retreats itself into an impoverished state of being to some basic forms unable to recover spontaneously out of its own. Only interventions outside of the system will enable (possible) recover.

In summary I learned the following lessons from Sonja van Zweden:

Last conclusion:

I think in a lot of cases (although definitely not all) the origins of Spasmodic Torticollis are related to overexhaustion/burnout coming from burdens accumalating in one´s life. If so, logically, in my vision the input for therapy should be a physical one. In my view this more or less explains the therapeutical succes of people like Abigal Brown Collins.

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Hope to hear from you!

Rob Oele

December 2002