Burnout as a Failure of Holding by Dr Richard Duggins

I invite us to explore burnout through a psychoanalytic lens as a failure of holding within organisational life.

The term “burnout” has psychoanalytic roots. It was coined by Dr Herbert Freudenberger, himself a psychoanalyst who personally endured the phenomenon he sought to describe. The psychologist, Professor Christina Maslach, formalised the definition as a sustained experience of three core features: overwhelming exhaustion, emotional detachment, and a loss of joy in work.

Harold Bridger, one of the founding figures of the Tavistock Institute, extended Donald Winnicott’s concept of holding into the realm of institutions. He saw organisational life as requiring environments that could offer containment and psychological support, particularly during times of transition and change. Bridger recognised that when this form of institutional holding breaks down, the individual's adaptive capacities falter.

More recently, William A. Kahn has developed this concept in contemporary contexts. In Holding Fast: The Struggle to Create Resilient Caregiving Organizations, Kahn examines how modern organisational structures, especially in health and care professions, have become more complex, ambiguous, and permeable. These very conditions undermine holding when it is most critically needed, contributing to what we increasingly recognise as burnout.

From a Winnicottian perspective, burnout reflects a collapse of the ‘continuity of being.’ Professionals subjected to chronic organisational impingement become fragmented; their true self retreats, and a false self takes over as a survival mechanism. Over time, when the system fails to contain psychic pain or provide reparative experiences, the individual’s capacity to metabolise sustained stress erodes. This culminates in what I call the Burnout Cliff: a sudden psychic collapse often experienced as both shocking and inexplicable.

Rather than misdiagnosing burnout as a failure of personal resilience, we should frame it as a relational and systemic failure of containment. Recovery, therefore, cannot be left to individuals alone. Therapeutic work, rest, and personal boundaries are necessary but insufficient. Recovery must be embedded within contexts of restored organisational holding, spaces marked by psychological safety, peer connection, compassionate leadership, and cultural permission to mourn.

Ultimately, helping the burnt-out professional involves not just bolstering their defences, but restoring their capacity to be held. At its core, recovery is not just about endurance, it is about re-finding the conditions in which it is safe to be vulnerable, real, and whole.

About the speaker

Dr Richard Duggins is an NHS Consultant Psychiatrist in Medical Psychotherapy and a Psychoanalytic Psychotherapist with BPF North. He is internationally recognised for his work on workplace mental health, and his new book, Burnout-Free Working: Your Expert Guide to Thriving in a Stressful Workplace (Jessica Kingsley Publishers, 2025), offers an evidence-informed roadmap to recovery.

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