Last Updated: 2nd October 2002.
參自《永不疲倦》+ 經驗 + 網上資料
- a. 傳染病
- b. 代謝失調: 甲狀腺、避孕丸，月經來潮、懷孕和更年期
- c. 營養和內泌素失調: 食譜、減肥食譜、營養過度
- d. 貧血(anemia):
- e. 少見的病症: 重症肌無力症(myasthenia gravis)
- f. 罕見的病症: 週期性肌肉癱瘓症(Familiar Periodic paralysis)
- g. 正常: 不斷工作
- a. 個人天賦差異
- a. 工作過度: 以利亞
- b. A型人: 可能是'adrenalin addiction' 甲狀腺上癮症.
- c. 其他: 個人問題
11. 耗盡(Burnout) ，
12. 長期失眠(Chronic insomnia: 引起的原因不少; 大家可以在google下找這個英文學名)，
14. 神經衰弱(但近代一些醫生放棄這個分類, 認為太過空泛)，
3. 「靈命中年」危機 ，
 以上的要點主要參考懷特卡森醫生著<<永不疲倦>>, (台北: 中華基督翻譯中心, 1979)。
 Churchlink - STRESS AND BURNOUT IN MINISTRY
STRESS AND BURNOUT IN MINISTRY
by Rowland Croucher
It was a grey Canadian morning in April 1982. The children had gone to school, my wife to work, and I did something I'd never done before. I turned the phone down, put a note on the front door, and went back to bed. I was burned out - and within two months resigned my ministry there.
Meanwhile, back in Australia, four books about ministry had come off the presses. Note the titles: The Plight of the Australian Clergy, High Calling High Stress, Battle Guide for Christian Leaders - an Endangered Species, and Conflict and Decline.
FIRST, THE BAD NEWS
(1) 'Stress now contributes to 90% of all diseases. Half of all visits to doctors are stress-related'. 'Anxiety reduction' may now be the largest single business in the Western world.
(2) 'Doctors, lawyers and clergy have the most problems with drug abuse, alcoholism and suicide.'
(3) 'Research 25 years ago showed clergy dealing with stress better than most professionals. Since 1980, studies in the U.S. describe an alarming spread of burnout in the profession. For example, Jerdon found three out of four parish ministers (sample: 11,500) reported severe stress causing 'anguish, worry, bewilderment, anger, depression, fear, and alienation'.
Why is pastoral ministry so stressful? The reasons may be as numerous and unique as there are pastors. However, recent research is unanimous in citing the following problem areas: the disparity between (somewhat idealistic) expectations and hard reality; lack of clearly defined boundaries - tasks are never done; workaholism ('bed-at-the-church' syndrome); the Peter Principle - feeling of incompetence in leading an army of volunteers; conflict in being a leader and servant at the same time ('line-support contamination'); intangibility - how do I know I'm getting somewhere?; confusion of role identity with self image - pastors derive too much self-esteem from what they do; time management problems (yet pastors have more 'discretionary time' than any other professional group); paucity of 'perks'; multiplicity of roles; inability to produce 'win-win' conflict resolutions; difficulty in managing interruptions; the 'little adult' syndrome (Dittes) - clergy are too serious, they have difficulty being spontaneous; preoccupation with 'playing it safe' to avoid enraging powerful parishioners; 'administration overload' - too much energy expended in areas of low reward; loneliness - the pastor is less likely to have a close friend than any other person in the community.
Stress and burnout are not the same (see box). Hans Selye defines stress in terms of the response your body makes to any demand on it. There is 'good stress' (eustress) - associated with feelings of joy, fulfilment, achievement - and 'bad stress' (distress), which is prolonged or too-frequent stress.
It is not possible (without a frontal lobotomy) to live without stress. Originally the term came from physics: the application of sufficient force to an object to distort it. So stress comes from 'outside' the organism, causing your body to respond in either 'fight' (when angry) or 'flight' (fear). Actually, stress is the transaction that takes place between you and your environment. The outside event impinges on your belief system, your brain interprets what's happening, and tells your body how to respond. Adrenalin is pumped into your bloodstream; blood is diverted from various organs to brain and muscles; pupils
dilate (making vision more acute); hands and feet perspire; breathing and heart-rate increase, etc. The body is on 'red alert', the alarm response.
Most of us are not subject to physical danger very often, but whenever you are 'driven' by a very tight program, or threatened by a demand or expectation you don't think you can meet, your body reacts in the same way. In fact, medical experts are now saying that 'Type A' people in particular may be suffering a kind of 'adrenalin addiction'. Dr. David McClelland, professor of psychology at Harvard, says stress addiction is similar to the state of physiological arousal some people derive from a dependency on alcohol, caffeine and nicotine. A recent book Management and the Brain (Soujanen and Bessinger) suggests that some professionals are actually 'hooked' on stress. They get a 'high' out of controlling people and making complex decisions. Dr. Paul Rosch, president of the American Institute of Stress, says the Type A male (50% of all pastors are Type A, according to Dr. Arch Hart) who is 'living in the fast lane... has become addicted to his own adrenalin and unconsciously seeks ways to get those little surges'.
These days more of us will die from a stress-related illness than from infection or old age. The only advantage of living stressfully : you'll get to meet your Lord earlier!
DISTRESS: SYMPTOMS AND CAUSES
Your body is designed to give warning signals of stress overload, which may include insomnia or disturbed sleep, digestive problems, headaches, low energy, chronic tiredness, psychosomatic illnesses, muscle tension, teeth grinding, high blood pressure, etc. Arch Hart again: 'Stress is 'hurry sickness'. The symptoms are often seen by the victim as obstacles to performance and success that he or she merely wants to get rid of. Seldom does the disease of over-stress slow the victim down - not until the final blow is struck and the ulcer, stroke or heart attack occurs.'
Stressors come to Christian leaders in four categories.
(1) Bio-ecological factors related to poor diet (too much caffeine, refined white sugar, processed flour, salt etc.) and poor exercise habits. They also include noise and air pollution.
(2) Vocational factors include career uncertainty; role ambiguity (a lack of clearly defined and mutually-agreed ministry functions); role conflict (between church expectations and personal or family needs); role overload (too many real or imagined expectations); lack of opportunities to 'derole' and be yourself, for a change; loneliness (95% of Australian pastors do not have a spiritual director); time management frustrations - and many more.
(3) Psychological factors relate principally to the great life-change stressors - from the most stressful (such as the loss of a spouse), through divorce, death of a close family member, personal injury or illness, all the way to getting ready for Christmas or being handed a speeding fine!
(4) Spiritual causes of stress may include temptations of all kinds (sexual, despair if your church isn't growing, jealousy of the success of others, anxiety over financial problems, anger - 'close to a professional vice in the contemporary ministry' says Henri Nouwen - and any other way the devil can get at us). Even prayer can be stressful according to one study!
Burnout is emotional exhaustion, 'compassion fatigue' (Hart). So even less-competitive Type B Christians can suffer burnout. And the most conscientious people-helpers are most vulnerable. Researchers like Maslach, Freudenberger and others from 1977 onwards gave the name 'burn-out' to the special stressors associated with social and interpersonal pressures. Dr. Arch Hart says burnout symptoms may include
1) demoralization (belief you are not longer effective as a pastor);2) depersonalization (treating yourself and others in an impersonal way);3) detachment (withdrawing from responsibilities);4) distancing (avoidance of social and interpersonal contacts); and5) defeatism (a feeling of being 'beaten').
Christina Maslach, who described burnout as 'a state of physical, emotional and mental exhaustion marked by
1) physical depletion and2) chronic fatigue,3) feelings of helplessness and hopelessness, and4) by development of a negative self-concept and negative attitudes towards work, life and other people', offers the following signs:(1) Decreased energy -'keeping up the speed' becomes increasingly difficult;(2) feeling of failure in vocation;(3) reduced sense of reward in return for pouring so much of self into the jobor project;(4) a sense of helplessness and inability to see a way out of problems; and(5) cynicism and negativism about self, others, work and the world generally.
Personality and attitudinal factors may increase the propensity to burnout eg.:
1) the pressure to succeed;2) an authoritarian personality which may come across insensitively (or a too-sensitive person who can feel with others' hurts but who is vulnerable to criticism);3) inner-directed rage;4) underassertiveness - feeling victimized; carrying too much guilt about our humanness (an occupational hazard for clergy, so we develop facades for various occasions);5) inflexibility; and many more.
The essence of the problem, however, is the clash between expectations and reality. Clergy are often put on a pedestal - by others, and by themselves. Many of these expectations just can't be met. We try to please, but may either become too goal-oriented for our people, or else too accommodating to their spiritual 'slackness'. 'Strongly goal-oriented ministers will almost inevitably experience more frustration than process-oriented ones' (Hart). We are working with volunteers, many of whom aren't there when the work is unrewarding. And we're stuck with each other - pastors have not hired most of the lay people they work with.
And so if we're not careful, depending on our personality-type, we may become perfectionistic, over-conscientious, develop one side of our ministry disproportionately, or maybe identify so closely with our calling that if it falls apart, we do too.
People-helpers have another hazard: in our counselling we're exposed almost exclusively to the negative sides of people's lives. So the pastoral leader ought to spend as much time with the strong as with the weak - for his own sake (they give him strength and support), for the leaders' sakes (they can be trained for ministry), and for the spiritual and emotional health of the whole church (there are more ministering persons available to help). Wasn't it A.B. Bruce who suggested Jesus spent more time with the disciples than with the crowds?
PREVENTION AND CURE
Again, the people studying this phenomenon are becoming unanimous in their suggestions to Christian people-helpers:
1. Find fresh spiritual disciplines. A conference in California has the theme 'One Hundred Ways to Pray'. Well, find about three or four, and 'shut the door' as Jesus said (i.e. put in a telephone answering-machine), and learn the art of relaxing, contemplative prayer.Then, as the New Testament suggests, don't be surprised when trials come your way. Jesus promised us trouble! So, as psychotherapist M. Scott Peck points out in his brilliant book The Road Less Traveled, when you expect life to be difficult, it is much less difficult.
2. Take regular time off. You aren't called to work harder than your Creator. Develop a way of being 'through for the day' (at least most days). Take your full four weeks' annual leave in one stretch (and make alternative arrangements for weddings, etc.). Encourage your denomination to include two weeks' extra, all-expenses-paid study leave each year. On your day/s off, do something very different from what you do the other days. (Wednesday or Thursday is best for preachers - away from the adrenalin-arousing Sundays). Listen to Spurgeon:
'Repose is as needful to the mind as sleep to the body... If we do not rest, we shall break down. Even the earth must lie fallow and have her Sabbaths, and so must we'. Jesus said, 'Come apart and rest awhile'. (If you don't rest awhile, you'll soon come apart!).
3. Get proper exercise and sleep. Exercise fairly vigorously 3-4 times a week. Walk, swim, play tennis; perspire and regularly breathe deeply. Allow adequate time for sleep. Dr. Hart again: 'Adrenal arousal reduces our need for sleep - but this is a trap; we ultimately pay the penalty. Most adults probably need 8-9 hours' a night!'
4. Relax. The relaxation response is the opposite of the fight/flight response. Just 20 minutes a day when we're free from the tyranny of 'things present' is enough to counteract the harmful effects of stress. Two ways to relax: tighten each set of muscles from your feet to your face, counting to five before relaxing them; or begin meditation by repeating a one-word or one-phrase prayer ('Maranatha', 'Lord have mercy'), repeat it slowly over and over and enjoy the 'other side of silence'.
5. Join a small support/prayer group. Ministry peers will better understand your needs; a cross-denominational group will enhance trust and provide other spiritualities. Then there's the classical discipline of 'spiritual direction' (or spiritual friendships). Who is Paul to your Timothy? Who teaches you to pray aright, as John the Baptist and Jesus taught their disciples? To whom do you confess your sins (James 5:16)? Luther said every priest ought to have such a 'father in God'. Congregations can help their pastor by praying more than they criticize him or her; having open communications re goals and expectations; recognizing that the pastor is human and will make mistakes like all of us; being as generous as possible financially (e.g. encouraging study leave); and protecting the privacy of the pastor's family life.
6. Cognitive restructuring (i.e. changing one's thinking). Take a personal audit. Reassess your goals; like your clothes, change them sometimes. Improve your self-attitudes. Learn a healthy assertiveness (e.g. by using the middle two letters of the alphabet - NO - sometimes, without apology). Know your gifts, and your limits. Face your fears; don't avoid them by pretence, or bury them in an addiction. Above all, avoid states of helplessness: take time to develop coping strategies for difficult situations. Learn not to make catastrophes out of ordinary events (increasing paranoia - 'they're out to get me' - is a sign of burnout). Be a growing person: if God has yet more light and truth to break forth from his Word, what new understandings have you experienced recently?
Freudenberger suggests: 'Discard outmoded notions. Don't wear points of view just because you used to! Like old-fashioned clothes, they may become ill-fitting and ridiculous as time goes on'.
7. Have fun! To belong to the kingdom you have to be like little children. They aren't bothered about piles of correspondence or running the world. They get absorbed in things, even forgetting to run their own lives! So develop a few 'interesting interests': buy a bird-book and identify 100 native birds; collect stamps; play indoor cricket; take your spouse to an ethnic restaurant; give each of your kids an hour a week, where you do together what they suggest; build something ; audit a course. But do something! And laugh sometimes! Did you know your body will not let you laugh and develop an ulcer at the same time?
Remember, with humourist Kin Hubbard: 'Do not take life too seriously; you will never get out of it alive!'
1. Dr. Kenneth Greenspan, director of the Centre of Stress Related Disorders at New York's Presbyterian Hospital.
2. From the Report of Adult Dependence Treatment Unit, St. Mary's Hospital, Minneapolis, 1980.
3. Quoted in S. Daniel and M. Rogers' 'Burn-out and the Pastorate...', Journal of Psychology and Theology, Fall 1981, 9 (3) 232-249.
Some Helpful Books
Ross Kingham & Robin Pryor, Out of Darkness - Out of Fire: A Work-book for Christian Leaders under Pressure (JBCE 1988);
Ed. Bratcher, The Walk-on-Water Syndrome: Dealing with Professional Hazards in the Ministry (Word, 1984);
Kent and Barbara Hughes, Liberating Ministry from the Success Syndrome (Tyndale, 1988),
Robin Pryor, High Calling High Stress, & At Cross Purposes: Stress and Support in the ministry of the wounded healer (Uniting Church, Victoria, 1982, 1986);
John Sanford, Ministry Burnout (Paulist, 1982);
Archibald Hart, Coping with Depression in the Ministry and Other Helping Professions (Word, 1984), and The Success Factor (Revell, 1984);
David Augsburger and John Faul, Beyond Assertiveness (Word, 1980);
Brooks R. Faulkner, Burnout in Ministry (Broadman);
Keith W. Sehnert, Stress/Unstress (Augsburg);
Charles Rassieur, Stress Management for Ministers (Westminster, 1982);
Leadership (Christianity Today, Summer 1984. Theme: Roles and Expectations);
Robert Banks, The Tyranny of Time (Lancer, 1983)
Herbert Freudenberger, Burnout: How to Beat the High Cost of Success (Bantam, 1980);
Christina Maslach, Burnout - The Cost of Caring (Prentice-Hall, 1982);
Robert Alberti and Michael Emmons, Your Perfect Right (Impact, Calif., 1978);
Karl Albrecht and Hans Selye, Stress and the Manager (Prentice-Hall, 1979).
On contemplative prayer: Anthony de Mello, Sadhana (St. Louis, 1978);
Mark Link, You, and Breakaway (Argus);
Morton Kelsey, The Other Side of Silence - A Guide to Christian Meditation (Paulist, 1976);
Simon Tugwell, Prayer (Vols 1 & 2) (Veritas, Dublin, 1984).
DIFFERENCES BETWEEN BURNOUT AND STRESS
Dr. Arch Hart
Director, JOHN MARK MINISTRIES --- resources for pastors/leaders & spouses
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