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Emetophobia - when a fear of vomiting holds you back in life

Emetophobia, or a fear of vomiting, can have a significant impact on everyday life. Here’s a guide to signs of a phobia of vomiting and to treatments that work.

Emetophobia: when a fear of vomiting holds you back in life

By Giulia Villa

 

Many things that can be unpleasant or scary can be an unfortunate part of life: Spiders, heights, needles, flying. In this article, we’ll be talking about another addition to this category. That’s right - vomit. Among specific phobias, emetophobia, or an extreme fear of vomiting, is one not often spoken about. Keep reading to learn more about:

  • Why emetophobia is so debilitating

  • About emetophobia: What is emetophobia, and what makes it unique

  • Spotting the signs of emetophobia

  • Emetophobia, eating disorders, and OCD

  • Treatment options for emetophobia

And if you’re unsure about the difference between a phobia and the experience of fear or anxiety – take a look at this page where we clarify the distinction between these concepts in more detail.


How debilitating can a fear of vomiting be?

To those who don’t experience it, a fear of vomiting may not seem that problematic – after all it could be a low frequency event as some people do not vomit for years. However, emetophobia is so much more than that. Unlike, say, a fear of heights and flying which can usually be avoided, a fear of vomiting means chronic hypervigilance and manoeuvring for a wide range of everyday situations in which vomiting may be possible. Some examples include:

  • Your study group wants to go to a local cafe for lunch whilst you’re all working hard on a group assignment. Unfortunately you can’t take your own food in! You don’t know your study group that well, so you feel the pressure to go along with the groupthink. Whilst you’re there, there are all sorts of smells that make you want to gag… cheeseburgers, fish sauce, parmesan… it’s a minefield.

  • Your out-of-town relatives are visiting for the first time ever and really want to take a boat to an island to see quokkas which they won’t find anywhere else in the world. The mere thought of being stuck on a boat and experiencing motion sickness strikes fear into your heart.

  • There’s a morning tea at work to celebrate finishing a big project that you’ve played an important part in. However, you avoid going as you don’t want to eat or drink, and don’t want to spend that time explaining yourself.

  • You’ve been invited to a close friend’s wedding reception at a winery. Unfortunately there’s food you would not usually eat that’s been prepared by someone else, and the other guests will be people drinking alcohol. To top it all off…the winery is a 40-minute drive away along winding roads and your friend has organised a bus to and from the reception so that everyone can “feel more comfortable”.

From the above examples, it’s clear that a fear of vomiting can really affect daily life. Given its wide-ranging impact, let’s take a closer look at what emetophobia is.


What is emetophobia?

Emetophobia is an anxiety disorder which falls under the classification of a specific phobia. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) [1] defines a specific phobia as:

  • An intense fear or anxiety about a specific object or situation that lasts at least 6 months

  • The phobic object/situation always provokes immediate fear or anxiety

  • The phobic object/situation is actively avoided or endured with intense fear or anxiety

  • The fear or anxiety is disproportionate to the actual threat posed by the phobic object or anxiety

  • The fear, anxiety or avoidance causes significant impairment to daily functioning e.g. not being able to eat food cooked by others, not seeing friends and family, not going to work etc.

  • The fear, anxiety or avoidance isn’t better explained by another medical disorder

Emetophobia is thought to affect between 0.1% and 0.2% of the population [2], though this is thought to be a conservative estimate [2], and usually starts in childhood or early adolescence. This condition is more common in women than in men.


what makes emetophobia unique

At its core, emetophobia shares many similarities with other specific phobias - intense fear, anxious thoughts, and avoidance. However, there are certain characteristics that are unique to the fear of vomiting which are important to consider:

 

Control in emetophobia

A distinct belief held by many people with emetophobia is that, if necessary, they can exercise enough physical control over themselves and their environment to prevent vomiting. Most people with emetophobia have not thrown up in a considerable length of time, and they credit their strategies (or safety behaviours, which we will look at in more detail) for this. In the context of treatment, this belief can make it very difficult for individuals to let go of such safety behaviours and coping mechanisms as they believe these are vital.

 

Gastrointestinal anxiety symptoms in emetophobia

A common feature of anxiety is stomach and intestinal discomfort. This is because of the strong connection between the brain and the body’s gastrointestinal system. When stress or anxiety becomes significant enough to trigger a fight-or-flight response, our body suppresses digestive functions in order to redirect resources to other areas and can lead to a reduced appetite, nausea, stomach pain/cramps, acid reflux, butterflies, and irregular bowel movements. With emetophobia this gets tricky, as intestinal discomfort can be anxiety-provoking in itself, catapulting individuals into worrying about whether they’re about to be sick.

This creates a vicious cycle, where the intense fear and anxiety around vomiting leads to physical sensations, which intensify the anxiety felt by the emetophobic individual. Over time, someone with emetophobia may become hypervigilant of their bodily sensations, constantly directing their attention towards sensations that could suggest the possibility of vomiting. For a person with emetophobia, a tummy gurgle or a brief wave of nausea has the power to trigger a spiral of anxious thoughts. Avoidance of vomiting then reinforces this cycle.


Spotting the signs of emetophobia

How do you know if you have emetophobia rather than just a dislike of vomiting? In addition to the chronic intense and disproportionate fear and anxiety in relation to vomiting, consider the role of avoidance and how it interferes with your daily life. Below are some common signs of avoidance that we commonly see in emetophobia - monitoring your environment on an ongoing basis to avoid these threats can be extremely debilitating indeed.


What’s the difference between Emetophobia, Eating disorders, and Obsessive Compulsive Disorder?

The lack of current research and training around emetophobia mean that this condition is unfortunately often misdiagnosed. Most commonly, emetophobia may at times be misdiagnosed as Anorexia Nervosa (AN) or Obsessive Compulsive Disorder (OCD) due to similarities between the conditions. Below we outline common and distinct features of these conditions in comparison to emetophobia.

 

Emetophobia and Anorexia Nervosa (AN)

People with emetophobia may restrict the types and quantity of food that they eat, in order to reduce or eliminate the risk of being sick, which might result in significant weight loss. Restriction of food is also a key feature of AN, but in the case of AN the restriction serves the purpose of weight control rather than avoidance of vomiting. Another key difference in these diagnoses is that AN is characterised by an intense fear of gaining weight and a sense of self-worth that is heavily influenced by one’s weight or shape (DSM-5). These features are not present in emetophobia, where the fear itself is of the act of vomiting.

 

emetophobia and Obsessive Compulsive Disorder (OCD)

Individuals with emetophobia may also take measures like excessive hand-washing and wearing a face mask to reduce the risk of contracting an illness that may lead to vomiting. Obsessive, persistent, and distressing thoughts that revolve around fear of exposure to germs are a symptom that might also both present in emetophobia and OCD.

An important distinction between a diagnosis of OCD and emetophobia is the presence or absence of magical thinking and ritualistic safety behaviours. While both conditions can involve seemingly irrational thoughts and excessive behaviours, the context and motivation behind these actions can help differentiate between the two conditions.

Magical thinking is a feature of OCD which refers to the belief that a person’s thoughts or actions have a very real potential to influence events, even in the absence of a logical cause-and-effect connection between the two. For example, someone with contamination OCD might think "If I don't wash my hands exactly seven times after touching a doorknob, I'll get sick and start vomiting." In emetophobia whilst the act of hand washing is seen to reduce the likelihood of contamination, there is not stipulation around the number of times this is to be performed.

Ritualistic behaviours are also a feature of contamination OCD that can distinguish it from emetophobia. Rituals and other neutralizing behaviours are a hallmark of OCD. These compulsions, (e.g. repetitive hand washing, excessive cleaning, checking, counting, arranging objects in a specific way) are carried out in an attempt to prevent feared outcomes (i.e., vomiting) or reduce the anxiety caused by obsessive, irrational thoughts. Thus, someone may wash their hands exactly seven times, and in a prescribed order (and, if interrupted when performing this ritual, will feel compelled to restart the ritual again).

Individuals with emetophobia may also engage in similar excessive behaviours like frequent hand-washing or avoiding certain foods, however these actions do not have a ritualistic flavour to them but instead these behaviours (frequency, number) have a straightforward link to preventing vomiting. For example, someone with emetophobia who fears contracting a stomach virus may thoroughly wash their hands once. However, they are unlikely to believe in washing their hands a specific number of times or in a particular way in order to guarantee that they won't become ill.


Treatment options – what works for emetophobia

The recommended treatment for all specific phobias is Exposure Therapy as part of Cognitive Behaviour Therapy (CBT). Essentially, this involves facing vomit-related fears, and thus the thought of exposure therapy can be incredibly intimidating as it involves confronting the very subject of fears.

Facing something that we are scared of is daunting, which is why it’s important to work with a trained professional who can guide you at a pace that stretches you but does not create excessive fear. The goal of exposure therapy is to shift your fear of vomiting, help your body to adjust to the increase in anxiety in that situation, and then to help you recognise your ability to cope.

Treatment for emetophobia needs to be highly tailored to the individual, because different people experience the phobia in different ways and intensities. Working with a psychologist helps with considering where the individual is at, what typical triggers there are, and what avoidance strategies are in place. Consider:

  • Ty may have a fear of vomiting and overestimates the likelihood of himself vomiting. He works as a librarian in administration and is not often exposed to people vomiting, nor is he concerned by others vomiting. Ty’s main concern when it comes to vomiting is in his personal life – his friends are all hitting the age of weddings and he anticipates having to eat many foods that he considers ‘unsafe’.

  • Priya is a doctor who will be rostered to work in the gastroenterology department in a few months’ time. She cannot stand seeing others vomit and is very worried about catching illnesses from people who are unwell. Needless to say, her emetophobia makes work extremely challenging. Priya also wants to start a family in the near future, but experiences extreme fear due to the prospect of feeling nauseous due to morning sickness.

Thus, whilst both Ty and Priya have emetophobia, treatment will look different for them due to the differences in triggers, situations where they have to face vomiting, and the impact on their lives.

 

What does treatment of vomit phobia look like?

After a thorough and individualised assessment, a therapist will guide you through systematically increasing your tolerance to these three key areas:

  1. The physical sensations associated with vomiting (e.g. nausea, stomach pain).

  2. Vomit-related triggers like words, pictures, sounds, and videos

  3. Environmental triggers, such as food, smells, and public places

Treatment for emetophobia also involves a cognitive component which aims to challenge and restructure unhelpful thoughts and beliefs that are contributing to the fear. Working one-on-one with an experienced clinician means that you will be receiving a tailored approach that will provide you with adaptive skills to take into your life outside of therapy.

Here at The Skill Collective we work with emetophobia – and the following psychologists in our team have a passion for exposure therapy, so why not book in and get started on shifting this debilitating fear?

 



REFERENCES

[1] American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington: American Psychiatric Publishing.

[2] Becker E, Rinck M, Türke V, Kause P, Goodwin R, Neumer S, Margraf J. (2007). Epidemiology of specific phobia subtypes: Findings from the Dresden Mental Health Study. European Psychiatry,22,69–74. doi: 10.1016/j.eurpsy.2006.09.006. 

 [3] Sykes, M., Boschen, M. J., and Conlon, E. G. (2016) Comorbidity in Emetophobia (Specific Phobia of Vomiting). Clinical Psychology & Psychotherapy., 23: 363–367. doi: 10.1002/cpp.1964.



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Public speaking anxiety at work: Tips to manage a common challenge

Public speaking anxiety holding you back at work? Step up to the next level with these tips to help you manage your anxiety.

STEPPING UP AT WORK: TIPS FOR OVERCOMING PUBLIC SPEAKING ANXIETY TO HELP YOUR CAREER

By Giulia Villa

 

What holds you back at work? Over your working life, there will inevitably be barriers and missed opportunities. At times, these barriers will be external – the work environment may not be suitable, or the workload unrealistic. At times, however, these barriers are internal – your mindset, skills, and habits get in the way of stepping up to the next level at work. Some examples of these include difficulties with being assertive at work and setting boundaries, managing procrastination, managing a team, or managing burnout. Another common internal barrier we often see – that touches so many areas of working life – is that of public speaking. In fact, public speaking is seen as an important skill in the workplace. However, a fear of public speaking – or glossophobia – is widespread, with estimates ranging from upwards of 20% to a whopping 75% of populations. How far-reaching is the impact of public speaking anxiety at work? Let’s look at some examples:

 

Ella, a high-achieving teacher, has been asked by the Department of Education to train a cohort of early-career teachers. In spite of her passion for educating the next generation of teachers, Ella is considering turning down the role because it involves public speaking – training large groups of teachers, giving regular progress updates to senior staff, and speaking at Department of Education conferences. At present, Ella copes with public speaking anxiety by preparing for hours to reduce the likelihood of making mistakes and ease her anxiety. She knows given the sheer number of sessions she will be delivering, it will not be possible to overprepare for each session whilst maintaining her usual teaching duties without experiencing burnout. Ella could turn down the position and keep her workload and anxiety more manageable, however she knows she will feel trapped remaining at her current level, without opportunity to progress.

Oliver was recently promoted to management level due to his excellent technical skills as an engineer. However, while he excelled at research, problem solving, and producing written deliverables, the director of his team has recently expressed concern at Oliver’s performance in his new role. Notably, Oliver has cancelled several meetings, preferring instead to communicate via email to avoid being put on the spot and to have time to plan what to say. Rather than delegate project work to the team and Oliver being the ‘face’ of the project, Oliver carries out the technical work himself and assigns more junior staff to present project updates and lead team calls. After a conversation with his director, understands he will struggle to progress in this workplace without tackling his avoidance of public speaking.  

 

The situations faced by Ella and Oliver are just a few examples of how typically high-performing individuals may be held back by their fear or avoidance of public speaking in their workplace. Let’s break down public speaking anxiety a little further. In the DSM-5-TR (2022) public speaking anxiety is a specific subset of social anxiety. Key features of this type of anxiety include:  

  • A fear of acting in a way or showing anxiety symptoms (e.g., blushing, trembling hands, excessive sweating) that will be embarrassing or lead others to negatively judge the speaker or the content of the presentation.  

  • An avoidance of public speaking situations, or enduring these situations with fear and anxiety. Avoidance might crop up as frequent sick days, low involvement in work meetings, joining calls at the latest possible moment, or agreeing with everyone to avoid conflict.  

  • The fear provoked by public speaking situations and the possibility of being judged negatively by others is intense and significantly impacts one’s functioning in their work and/or social life.  

 


HOW PUBLIC SPEAKING anxiety HOLDS YOU BACK AT WORK

As we’ve seen in Ella and Oliver’s examples, there are many situations at work in which public speaking may have a negative impact and hold you back from succeeding in your career. Let’s take a closer look at some of these scenarios.

 NETWORKING: A MINEFIELD FOR SOCIAL ANXIETY

Networking is often a highly dreaded activity for those with public speaking anxiety – in effect it’s being ‘on show’, making small talk in a work context, often in small groups. However, networking has become an essential component of success in our hyper-connected society – did you know over half of jobs are never publicly advertised? In 2016, LinkedIn reported that 70% of professionals starting a new role already had an existing connection at their company. The takeaway? You’ve got to meet groups of people and make connections so as to be at the forefront of people’s minds when upcoming jobs arise. Unfortunately, nerves about being on show in public can make the ever-important act of networking a nightmare and may lead you to connect online, to avoid unfamiliar people, or even to undersell yourself during in-person networking events. In any case, anxiety stops you from making the most of an important networking opportunity. 

 

WORK MEETINGS

Speaking up in front of others – whether it’s the weekly check in around the meeting table, or your turn to give an update on a project – can feel extremely daunting to someone who dislikes public speaking. You may focus on all eyes being on you, and have spent the night before thinking about how exactly to present what you need to but minimise your time ‘on display’.

Post-pandemic flexible work arrangements may mean that many meetings now take place over video calls. For some, these online meetings may be even more anxiety-inducing than face-to-face meetings. You may feel more aware of being watched and of being negatively judged by others, and thus experience more pressure to perform well. Social anxiety can also lead to a greater focus on scrutinising one’s own onscreen image, thus amplifying self-consciousness. Additionally, brief moments of silence that feel natural in person may become accentuated and feel awkward in a video call.   

 

DELIVERING PRESENTATIONS AND SALES PITCHES

If the idea of delivering a presentation to a client or even your own colleagues is enough to make your heartrate quicken, you may have developed ways to deal with this seemingly inevitable anxiety. For example, you may spend hours overpreparing like Ella. Or you may be so focused on getting the presentation over and done with, you don’t have much energy to put into designing the presentation itself. Then, of course, there is question time – a period where you don’t know what questions will be thrown at you.

A good presentation in a work setting boils down to how you design your presentation and the speaking techniques that you employ to deliver your message. Unfortunately, it can be incredibly challenging for someone with anxiety to simultaneously manage uncomfortable physical symptoms, quiet down unhelpful self-talk, remember the content, and remember how to deliver it, and have the presence of mind to adapt the presentation to the audience.  

Public speaking anxiety might also affect your presentation by impacting:  

  • Speech rate  

  • Tone of voice  

  • Posture and body language  

  • Use of filler words  

  • Use of visual materials  

  • Engagement with the audience  

Public speaking anxiety may hold you back from being able to recognise what style is most appropriate for your audience and situation, and also on helping you to handle unknown questions (as part of question time). This is where we can help – keep reading to find out how our team of counsellors and psychologists can help you manage anxiety and become a more confident public speaker in your workplace. We’ve helped students manage anxiety for their university presentations, helped doctors to present confidently in their clinical exams, helped teachers to present to peers and parents, and helped professionals develop networking and sales pitch skills. We enjoy helping people grow their skill set and their confidence.


tips for managing PUBLIC SPEAKING ANXIETY

Try the following tips for managing social anxiety at work:

TIP 1: LEARN TRIGGERS AND HABITS THAT MAINTAIN PUBLIC SPEAKING ANXIETY

What exactly is it about public speaking that causes you anxiety? Perhaps it’s the idea of drawing attention to yourself, or perhaps you’re worried about visibly freezing or sweating. Having a clear grasp on what causes and maintains your anxiety goes long way in developing a targeted action plan to reduce your fears. 

 

TIP 2: DISMANTLE UNHELPFUL SELF-TALK THAT FUELS YOUR FEAR OF PUBLIC SPEAKING

Negative self-talk is a common thread underpinning public speaking anxiety. The ‘stories’ you tell yourself can increase your anxiety. For example, Ella might notice a senior staff member check their phone during one of her presentations. Self-talk along the lines of “I’m not doing enough to hold their attention, they can tell I’m inexperienced and underprepared” is likely to make Ella more nervous, possibly increasing her likelihood of making mistakes.

On the flipside, self-talk can also be a helpful tool to reduce anxiety and help you to feel more comfortable during your presentation.  A more helpful thought for Ella in the above situation could therefore be, “They may be checking their phone as they could be expecting a call”. In this case, Ella would feel less nervous and better able to continue with her presentation as planned.   

TIP 3: FINE-TUNE YOUR PRESENTATION STYLE

We all have a different idea of what it means to be a good public speaker. Presenter ‘personas’ can vary widely across people, furthermore different types of speeches require different styles and components – presenting a sales pitch marketing muesli requires a different approach to delivering a lecture on research developments in biotech. By clarifying your goal – for example, who is your target audience (Formal? Informal?), what are you trying to achieve (Sell a product? Disseminate information?) – you have a clearer idea of how to shape your message and design an effective presentation. By having confidence in your materials and your messaging, you will also feel more comfortable in delivering!  

TIP 4: GET EXPERIMENTING

Running ‘experiments’ on yourself is a great way to challenge pesky thoughts and fears that are standing in the way of your career success. Thoughts aren’t exactly the most reliable source of information when it comes to public speaking – fears that ‘everyone will laugh at me’ or ‘if I stumble over my words I’ll get fired’ can disproportionately dial up your anxiety to the point of interfering with your presentation. 

In order to move past your fears try setting up small behavioural experiments to test how true these predictions are. The next time you are asked to speak in front of others, perhaps intentionally slip in a small mistake. Carefully notice the reaction of your audience – does it fit with your predictions? This testing can help you to determine whether the evidence fits with what you’ve been telling yourself.   

If you’re interested in a tailored approach to dismantling your public speaking anxiety at work, check out our Speaking Volumes course. Over six weeks (allowing for time to practice your new skills in between sessions), you will work individually with one of our clinicians through an evidence-based, practical approach, to reduce public speaking anxiety and provide you with the skills and tools you need to succeed in the workplace.   


Speaking Volumes, our 6-week course to help with public speaking anxiety covering how to improve your presentations skills as well as anxiety management skills (cognitive restructuring, exposure therapy). This course is based on CBT and social skills training.





REFERENCES

Aderka, I.M., Hofmann, S.G., Nickerson, A., Hermesh, H., Gilboa-Schechtman, E., & Marom, S. (2012). Functional impairment in social anxiety disorder. Jounral of Anxiety Disorders, 26, 393-400. Doi: 10.1016/j.janxdis.2012.01.003

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text revision). American Psychiatric Association Publishing.

Blöte, A. W., Kint, M. J. W., Miers, A. C., & Westenberg, P. M. (2009). The relation between public speaking anxiety and social anxiety: A review. Journal of Anxiety Disorders, 23(3), 305–313. https://doi.org/10.1016/j.janxdis.2008.11.007

Ebrahimi, O. V., Pallesen, S., Kenter, R. M. F., & Nordgreen, T. (2019). Psychological Interventions for the Fear of Public Speaking: A Meta-Analysis. Frontiers in psychology, 10, 488. https://doi.org/10.3389/fpsyg.2019.00488

Martin-Lynch, P., Correia, H., & Cunningham, C. (2016). Public speaking anxiety: The S.A.D. implications for students, transition, achievement, success and retention. In: Students Transitions Achievement Retention & Success (STARS) Conference 2016, 29 June - 2 July 2016, Perth, Western Australia. https://researchrepository.murdoch.edu.au/id/eprint/39766/1/SAD.pdf

Vriends, N., Meral, Y., Bargas-Avila, J.A., Stadler, C., & Bogels, S.M. (2017). How do I look? Self-focused attention during a video chat of women with social anxiety (disorder). Behaviour Research and Therapy, 92, 77-86. https://doi.org/10.1016/j.brat.2017.02.008. 

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Early career burnout - Part 2: Workplace factors

Burnout is on the rise, and it’s disproportionately affecting millennials, Gen Zs, and those in the early stages of their career. Read on to learn what workplaces can do to help.

Early Career Burnout and mental health in the workplace reflecting organisational culture and workload challenges as well as individual factors such as perfectionism and imposter syndrome. By Perquiro and The Skill Collective Clinical Psychologists …

EARLY-CAREER Burnout (Pt 2: workplace factors)

by Giulia Villa, Fel Donatelli + Joyce Chong

 

EARLY CAREER BURNOUT – A REFRESHER

In case you missed it, our last article was a primer on early career burnout and those individual factors that increase the risk of suffering from this affliction. To refresh:

  • Early career burnout refers to the work-related state of mind comprising exhaustion, distancing from one’s work, and decreased personal achievement [1] affecting new graduates.

Looking at individual factors in burnout sheds light on only one piece of the puzzle. Critically, workplaces shape conditions that lead new graduates down the path of burnout. In this second part of our series on early career burnout, we look at those organisational factors and see what actions workplaces can take.


Organisational factors in early career burnout

Various organisational factors contribute to early career burnout, and it’s helpful for workplaces to consider how they can promote better wellbeing to buffer against it.

  

Job characteristics and design

The overall environment of a workplace is a major contributor to the wellbeing of every employee. Burnout has been linked to excessive workload, inadequate compensation, lack of community and absence of administrative support [2] . More specifically, the following job characteristics are believed to contribute to burnout:

  • Low autonomy and job control where an employee does not have much independence or influence in their role.

  • Low role clarity where an employee has low understanding of their role and responsibilities.

  • Subjective overload where the expectations of the workplace exceed the employee’s capabilities.

Optimising job design means crafting a balance between keeping the employee engaged and benefitting the organisation. The presence of low autonomy/job control, low role clarity, or subjective overload, all pose a risk to employee motivation and satisfaction. Indeed, job characteristics are more likely to predict burnout than individual factors, suggesting that job re-design is the most effective way to prevent burnout.

 

 

Onboarding processes: Lack of adequate support, training, and socialisation in the role

Commencing a new role is fraught with confusion and uncertainty. Questions fill the heads of new graduates - what will my colleagues be like? What does my future have in store? What’s expected of me? Indeed, a lack of role clarity is most frequently observed as ambiguity in relation to:[3]

  • How their job performance will be evaluated.

  • Whether there are paths for career progression.

  • What is the scope of the responsibilities.

  • The expectations of others.

This confusion about their role is just another thing for new starters to worry about and in fact has been linked to higher stress levels and emotional exhaustion.[4] A good understanding of the job description and the relevant duties and responsibilities is crucial to ease the anxiety and inadequacy often experienced by new graduates. It is important to inform new starters of all things relating to their role as part of their onboarding process.

Sometimes, new graduates face a culture of ‘learning by osmosis’. However, a lack of adequate support, training, and socialisation as part of an onboarding process, can contribute to individuals feeling overwhelmed early on in their career. This can lead to feeling underprepared for the role, and inadequacy and frustration can set in thereafter. A lack of socialisation with peers into the role may mean new graduates struggle to assimilate into the role.

 

Flexible work practices and ever-evolving technology breeds the ‘always on’ culture

Even before COVID-19’s arrival we were witnessing an increasingly blurred boundary between work and play due to technology and flexible work practices (in fact, take a look at this article on constant connection contributing to burnout amongst millennials ). Smartphones and laptops have revolutionised the way that we work; their portable nature means we can essentially always be ‘always on’. Notifications and alerts can lead to overwhelming ‘telepressure’: the feeling that you have to respond to any email as soon as it arrives[5] .

If the separation between work and play wasn’t already challenging enough, the global pandemic transformed traditional ideas of what can constitute a workplace. Many companies opted out of physical office spaces indefinitely in favour of working from home, whilst others were in prolonged lockdown and forced into a more permanent state of blurring the boundaries between work and home lives.

Unfortunately for those commencing their careers just before, or during the pandemic, working from home early in the piece meant missing out on structured formal onboarding processes as well as the informal, ad hoc collegiate support that emerges from being co-located. Put simply, it meant that some new graduates were left to navigate the overwhelming world of their new career from the solitude of their home.

 

 

Organisational culture

Workplaces play a pivotal role through their culture, so is your organisational culture building graduates up or burning them out? Organisational cultures that expect high performance and value output above all else, reinforce maladaptive perfectionistic behaviours, emphasise constant connection with the expectation of immediate replies to emails sent all hours of the day, and disparage errors made upon first attempt, are environments that may contribute to burnout.

Certainly, organisations hiring graduates are aware that they are in the early stages of their career, thus careful consideration should be given as to how to support them through this process through a combination of setting expectations in relation to a learning and feedback culture, as well as communicating realistic work practices and performance expectations.


Tips for organisations

 Given the importance of the workplace in fostering burnout or sustainable work practices amongst new graduates, how can organisations better support those in the early stages of their careers?



1.   NURTURE A SUPPORTIVE ORGANISATIONAL CULTURE

Getting an organisation’s culture right is critical as it serves to support new graduates early on in their career. Ways to promote a positive organisational culture include:

  • Hiring the right leaders who practice intentional leadership styles who will promote a culture of support and sustainability across the employee lifecycle and emphasise realistic work practices as well as valuing the idea of failing forward. The standards and behaviours imposed by leaders trickle down to affect all employees, greatly influencing organisational culture. Transformational leaders, who engage and motivate employees to enact the change they want to see, have been shown to decrease burnout by improving job satisfaction, performance and personal accomplishment.[6][7]

  • Actively discourage leaveism, or the practice of working when one is not supposed to be working, including using annual leave, sick days, or weekends to catch up.[8] This may include limiting access to technology and encouraging ‘proper’ time off. Discourage long working hours and constant connection as badges of honour, and instead stress the responsibility of employees to look after themselves to enable optimal performance when they are at work.  

  • Model realistic work practices and work/life balance, particularly in high performance cultures. It’s important for early career individuals to get an idea of how to step into this next phase of their lives, and how to set boundaries around work so that they have time to recuperate and focus clearly the next day.

  • Have a culture of learning and foster a feedback culture insofar that a new graduate is expected to not know the answers, to make errors, and to fail and these are all viewed as a necessary part of career development. Emphasise the value that new graduates can bring to the organisation. A rigid feedback culture can foster feelings of frustration and hopelessness in new hires. The ability to give feedback is an important component of any employee’s job control and engagement, which we know can be a predisposing factor for burnout.



2. HIRE NEW GRADUATES FOR ‘BEST FIT’ AND CHECK IN REGULARLY

Organisations that hire on the basis of school grades fail to consider if a graduate will be a good fit for that particular role. Developing capability frameworks and success profiles means that organisations are aware of what it takes to succeed in the roles they are hiring for. This cascades down to the hiring process, and incorporating psychometric assessment to match job characteristics to new graduates can not only reveal who may be the ‘best fit’ for the role, it may also reveal areas for an employee’s development and potentially reduce turnover.

Once hired, it’s important to check in on a regular basis with graduates particularly on those aspects known to contribute to burnout (autonomy, job control, role clarity, workload) and make adjustments to their role where indicated.

 

3. INVEST IN YOUR LEADERS (and, in turn, your culture)

Leadership plays a vital part in your organisational culture.[9] Leaders set the tone for their team in terms of expectations for performance, they can motivate them towards high performance and cohesion, and in doing so weather challenging times.

There are factors that contribute to good leadership, and by investing in the development of their leaders organisations are investing in better organisational culture. Perquiro outlines these factors in their A BRAVE Leader model, identifying these qualities as critical to good leadership:

Organisational leadership development and workplace culture by Perquiro Organisational development and consulting in Subiaco Perth
  • Authentic leaders have a strong understanding of their own values and act with integrity.

  • Balanced leaders remain calm in challenging situations and are open to feedback.

  • Rational leaders use logic to guide decision making, are consultative, and check their own assumptions.

  • Action-oriented leaders act promptly and demonstrate accountability.

  • Visionary leaders communicate the organisation’s vision and invests in building collective goals.

  • Empathetic leaders show genuine care and concern for others.

 

4. SEEK ASSISTANCE

In much the same way that we would encourage individuals to reach out and seek help if they’re experiencing burnout, organisations would be well-placed to call in consultants to look at their overall culture, as well as their hiring and onboarding processes, and how these facilitate or buffer against burnout in their team and, particularly, their new graduates.

A blend of organisational design and workplace consultants (such as our organisational psychology arm Perquiro) and clinical and registered psychologists that focus on workplace mental health (that’s us!) can help set your organisation on the right path through helpful work design, appropriate recruitment practices, and equipping employees with the right tools to help them manage their own wellbeing.

 


Early-career burnout getting you down? Grab our tip sheet below to learn more about how to help yourself.

 

Grab our tip sheet and you'll also get access to our Resource Library filled with even more tips on wellbeing, mental health, and performance. You'll also receive news and updates at The Skill Collective. You can unsubscribe at any time by clicking the unsubscribe link in the footer of any newsletter email you receive from us, or by contacting us. For more information please read our Privacy Policy and Terms + Conditions.

 


REFERENCES

[1] Maslach, C., Schaufeli, W.B., & Leither, M.P. (2001). Job burnout. Annual Review in Psychology, 52, 397-422.

[2] Maslach, C., & Leiter, M. P. (2008). The truth about burnout: How organizations cause personal stress and what to do about it. John Wiley & Sons.

[3] Handy, C.B. (1976). Understanding Organisations. Penguin, Harmondsworth.

[4] Jackson, S. E., Schwab, R. C., & Schuler, R. S. (1986). Towards an understanding of the burnout phenomenon. Journal of Applied Psychology 71, 630-640.

[5] Peake, M. (2015, July 10). Do you have early career burnout? Friday Magazine. https://fridaymagazine.ae/life-culture/people-profiles/do-you-have-early-career-burnou-1.1547679

[6] Lowe, K. B., Kroeck, K. G., & Sivasubramaniam, N. (1996). Effectiveness correlates of transformational and transactional leadership: A meta-analytic review of the MLQ literature. The leadership quarterly7(3), 385-425.

[7] Zopiatis, A., & Constanti, P. (2010). Leadership styles and burnout: is there an association?. International Journal of Contemporary Hospitality Management.

[8] Hesketh, I., & Cooper, C.L. (2014). Leavism at work. Occupational medicine, 4, 146-147.

[9] Mohelska, H., & Sokolova, M. (2015). Organisational culture and leadership – joint vessels? Procedia – Social and Behavioural Sciences, 171, 1011-1016.

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Achieve, Bounce Back Joyce Chong Achieve, Bounce Back Joyce Chong

Early career burnout - Part 1: Individual factors

Burnout is on the rise, and it’s disproportionately affecting millennials, Gen Zs, and those in the early stages of their career. Read on to learn what you can do to manage your burnout.

Early Career Burnout and mental health in the workplace reflecting organisational culture and workload challenges as well as individual factors such as perfectionism and imposter syndrome. By The Skill Collective Clinical Psychologists and counsello…

EARLY-CAREER Burnout (Part 1: Individual factors)

by Giulia Villa + Joyce Chong

 

What is EARLY CAREER BURNOUT ?

Commencing a career is an important transition point in a young person’s life, and the first ‘real’ job should be an exciting new adventure. Yet the challenge of adapting to a new role and a new lifestyle can come with a great deal of stress. For many who are in the early stages of their career, and starting to feel stressed and anxious about work, it’s important to consider if poor wellbeing is tipping into early career burnout. Burnout is a work-related state of mind comprising exhaustion, distancing from one’s work, and decreased personal achievement [1].

Why are new graduates at the beginning of their career at a higher risk of burnout? There may be a combination of factors, including experiencing challenges they feel underprepared to cope with, or unable to fit into a new culture and way of life. Overwhelmed and unable to adjust to their new circumstances (both professionally and personally), these individuals then start to experience burnout.

Burnout is a phenomenon recognised in many professions - something routinely identified amongst junior doctors and nursesteachers and academics (amongst many others) - yet we all have the potential to experience burnout, no matter our profession or our stage of career, and it has a very real effect.

Consider the impact of health professionals caring for the lives of others, workers operating heavy machinery, and teachers tasked with educating the next generation, turning up to work feeling frazzled and overwhelmed.


Indeed, burnout is regarded as such a significant issue that the 11th Revision of the World Health Organisation’s International Classification of Diseases (ICD-11) has classified it as an occupational phenomenon resulting from chronic workplace stress that has not been successfully managed.[2]

Organisations should sit up and notice the very real implications that burnout has for employee wellbeing and mental health, lost productivity, and turnover, and it is something that is disproportionately affecting early career employees. In fact:

In this two-part series on early career burnout we look at reasons why new graduates at the beginning of their career trajectory are at risk of burnout, and what can be done to make the transition easier at the organisational and individual levels. Here, we shine a light on those personal factors that contribute to early career burnout.


Individual factors in early career burnout

For many, ‘early career’ follows many years at university or in an apprenticeship. Stepping into a job can look very different from sitting in a classroom, or working under significant direction, as you transition into working independently in an organisation. Below are some individual factors that contribute to early-career burnout.

Mindset, Imposter syndrome, Perfectionism, and early career burnout

Mindset plays a powerful role in early career burnout. Consider the expectations you had of your first ‘real job’, and your desire to make a good impression in the workplace. Stepping into the real world may even trigger Imposter Syndrome, in which you feel like an intellectual fraud and fear being exposed. These fears can then lead to perfectionistic coping behaviours so as to avoid negative evaluation, which in turn can inflate workload and contribute to burnout. [3][4]

 

Openness to feedback and normalisation of ‘failing’

When there is a fear of failure, feedback and asking for help can seem taboo - as if bringing into sharp attention one’s inability to understand what’s expected of them. This mindset [5] can be self-sabotaging, particularly where goals are not communicated clearly to you - rather than asking for clarification, a fear of failure can lead you to spend too much time trying to guess what you’re supposed to be doing.

Ability to manage yourself - what your study habits reveal

Congrats! Your uni days are finally behind you. Or are they? You may have heard every tertiary student’s favourite saying: “Ps get degrees”, mainly that passing your course and getting a degree helps with finding a job. While this is hard to argue against, there are certain student characteristics that set you up for a helpful adjustment to your new role or early career burnout. An 18-year exploratory longitudinal study tracking students through their university studies and subsequently into the workforce found that individuals who showed high initial social optimism, and whose social optimism increased, were less likely to withdraw and ‘self-handicap’ through task avoidance.[6],[7]. Put simply, being able to manage yourself and avoid procrastination bodes well for an easier transition into the workforce.

Constant connection and social comparisons

Yes, smartphones and laptops, as well as the blurring of work and personal spaces thanks to COVID-19, means that many early career individuals can essentially be constantly connected. However, is it in your best interest to be tethered to your work at all hours of the day, dreading each time you receive an email notification?

Constant connection can also breed upward social comparisons with other early-career colleagues, or even those whom you studied with. This can lead to lowered self-esteem as you believe that everyone else has achieved more than you, and create pressure to perform at - or even exceed - what you think others are doing [8].

 


Tips TO MANAGE early career burnout

1.Manage your expectations

The start of your career is an exciting time indeed, but it’s important to manage your expectations (about the job, about your work pace, about what is expected) appropriately to avoid burning out. Learn all you can about your role, look to others who perform similar roles for guidance, but above all recognise that you are at the very start. Avoid comparing yourself to someone who has done this for 5 or 10 years.

2. Practice self-care (no, really!)

Nurturing your mind, physical health and social life is just as important as nurturing your career. Some ideas for finding balance are:

  • Make the most of your lunch breaks. Take a mindful break by going for a walk, enjoying a meal away from your desk or calling a friend. This will give your brain a much-needed rest and boost your energy levels for the rest of the day.

  • Schedule ‘me time’ as you would schedule meetings. Whether it’s an exercise class, your meal-prep time or a social outing, blocking this time out in your calendar will help you stick to your plans.

  • Listen to your body’s cues. Everyone is different. You may find yourself losing sleep, getting sick more often, or simply being in a worse overall mood. Ignoring these signs is likely to lead to a breaking point later down the track, so be vigilant that your body may be trying to tell you something.

3. Set boundaries with others and with yourself

This may seem daunting to a new starter, but protecting your own wellbeing will make you a better employee in the long run. If you are able to, consider removing unessential work-related content from your mobile phone. Reducing the notifications you’re receiving after work hours will help you switch off, so that you can be more refreshed and productive the next day. New employees often overestimate what their boss actually expects of them. To avoid miscommunications, setting boundaries may involve having a conversation with your employer about your availability outside of work hours and the importance of this time for your rest and wellbeing. Our article on leavism can help you understand what leads us to work outside of work hours or on holidays and what we can do about this.[7]

 

4. Seek help

Our tip sheet below looks at some ways in which you can manage burnout, but if your burnout symptoms have reached a level that you feel you no longer can control, it may be time to speak to a professional. Most workplaces provide confidential psychological support services via Employee Assistance Programs, or you can reach out to an external professional to assist you in this time such as a psychologist who works with workplace mental health (like us!) to help you understand the cause and drive of your burnout as well as help you manage them so you can go back to feeling like yourself.


Early-career burnout getting you down? Grab our tip sheet below to learn more about how to help yourself.

 

Grab our tip sheet and you'll also get access to our Resource Library filled with even more tips on wellbeing, mental health, and performance. You'll also receive news and updates at The Skill Collective. You can unsubscribe at any time by clicking the unsubscribe link in the footer of any newsletter email you receive from us, or by contacting us. For more information please read our Privacy Policy and Terms + Conditions.

 


REFERENCES

[1] Maslach, C., Schaufeli, W.B., & Leither, M.P. (2001). Job burnout. Annual Review in Psychology, 52, 397-422.

[2] https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases

[3] Sakulku, J., & Alexander, J. (2011). The imposter phenomenon. International Journal of Behavioral Science, 6, 75-97.

[4] Dudau, D.P. (2014). The relation between perfectionism and imposter phenomenon. Procedia – Social and Behavioral Sciences, 127, 129-133. Doi:10.1016/j.sbspro.2014.03.226.

[5] Dweck, C. S. (2006). Mindset: The new psychology of success. New York: Random House.

[6] Salmela-Aro, K., Tolvanen, A., & Nurmi, J. E. (2009). Achievement strategies during university studies predict early career burnout and engagement. Journal of Vocational Behavior75, 162-172.

[7] Salmela-Aro, K., Tolvanen, A., & Nurmi, J.A. (2011). Social strategies during university studies predict early career work burnout and engagement: 18-year longitudinal study. Journal of Vocational behavior, 79, 145-157.

[8] Patrick, H., Neighbors, C., & Knee, C.R. (2004). Appearance-related social comparisons: The role of contingent self-esteem and self-perceptions of attractiveness. Personality and Social Psychology Bulletin, 30, 501-514.

[9] Hesketh, I., & Cooper, C.L. (2014). Leavism at work. Occupational medicine, 4, 146-147

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