Naked in the eyes of the public: A phenomenological study of the lived experience of suffering from burnout while waiting for recognition to be ill

Abstract

Although there has been a focus on problematic issues related to health care services and complaints made by patients, individuals who suffer from medically unexplained syndromes continue to report being epistemically marginalized or excluded by health professionals. The aim of this article is to uncover a deeper understanding of the what‐ness of experiencing being naked in the eyes of the public while waiting to be recognized as ill. Therefore, a phenomenological approach was chosen to inductively and holistically understand the human experience in this context‐specific setting. Semi‐structured interviews were conducted with two men and six women between 25 and 65 years of age, who had been on sick leave for more than 52 weeks. Their symptoms were consistent with Exhaustion Disorder (ICD‐10, F43.8A). The meaning of the interviewees' lived experience was explored using a life‐world approach to phenomenological reflection and writing. The participants described their experience of encountering the general practitioner as taking part in a battle. Feeling distrusted by others seemed to result in disconnection from their habitual lifeworld, which in turn triggered a shame reaction. Additionally, the study showed a possible distrust related to several communication levels within the health care system, which influenced the recovery process negatively. Lack of experienced support can lead to exacerbated feelings of distress. Accordingly, the psychosocial experience of being ill might be as important as its unknown aetiology. Therefore, in the context of these interpersonal relations, both norms, values, and attitudes, and issues of power need to be considered and addressed properly.

Facing a blind alley - Experiences of stress-related exhaustion: a qualitative study

“…The participants struggled not only with the challenge of understanding their condition but also with their need to understand themselves and their identities. This is in line with findings from previous studies, which have described the condition as a struggle with a threatening nothingness, 39 being disconnected from oneself 17 and a disconnection from the body and world. 37 …”

“…This results in disconnection from their lifeworld which in turn triggers shame reactions. 17 In our study, this experience was interpreted as deprivation of dignity due both to the guilt and shame caused by their views of their condition and feeling unheard in their encounters with healthcare professionals. Shame has been described as an emotion of self-assessment that causes the person to feel anxiety at the thought of how he or she is seen and judged by others.…”

Approaching complexity—Start with awareness

“…Engebretsen and Bjorbækmo in their contribution—published outside this section—about the lived experiences of suffering clearly articulate the reasons of discomfort with the prevailing reductionist research approaches that fail to see and understand the issue‐as‐a‐whole .

The majority of the empirical work consists of cross‐sectional designs and randomized controlled trials. These studies tend to miss much of the complexity, ambiguity, and ambivalence of the burned‐out individuals' lived experience and to a minor degree appreciate that these individuals are coping with more existential changes in their lives.

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Interactions between persons—Knowledge, decision making, and the co‐production of practice

“…Karin Engebretsen discusses the continuing problems of people suffering from medically unexplained systems, who report “being epistemically marginalized or excluded by health professionals.” Engebretson adopts a phenomenological approach to understand “the human experience in this context‐specific setting,” using extensive evidence from interviews with participants who found the experience of encountering general practitioners to be akin to “taking part in a battle” and who reported feeling distrusted by others. This, the author notes, resulted in a “disconnection from their habitual lifeworld, which in turn triggered a shame reaction.” This process had negative implications for recovery, and the paper concludes by noting the need to develop solutions to these problems, which address the “norms, values and attitudes” involved “as well as issues of power.”…”

“…It includes papers on the nature of reasoning and evidence, the on‐going problems of how to “integrate” different forms of scientific knowledge with each other, and with broader, humanistic understandings of reasoning and judgement, patient and community perspectives . Discussions of the epistemological contribution of patient perspectives to the nature of care, and the crucial and still under‐developed role of phenomenology in medical epistemology, are followed by a broad range of papers focussing on SDM, analysing its proper meaning, its role in policy, methods for realizing it and its limitations in real‐world contexts …”