Professionals in Direct Care in Conflict-Affected Areas: Prevention and Management of Burnout, a Logotherapeutic and Holistic Approach
Vedrana Grgić — logotherapist, architect, and storyteller, accredited member of the Viktor Frankl Institute in Vienna. She teaches, mentors, and supervises at Ukrainian institutes of Logotherapy, with a special focus on personal development, the use of narrative methods in therapy, and family Logotherapy, particularly working with families of children with developmental disabilities.
Keywords: Professionals in direct care, Conflict-affected areas, Burnout prevention, Logotherapy, Holistic approach
Professionals providing direct care in educational, psychosocial, and healthcare institutions (hereafter referred to as professionals) operating in war-affected areas face extremely demanding circumstances. They must maintain continuity in daily and professional life despite frequent alerts, constant news from the frontlines, and personal and professional losses. Organizational challenges include limited resources and the adaptation of classes, therapies, and social interventions, which are often interrupted by evacuations and sirens. Physical working conditions further complicate their work, as professionals often operate in inadequate spaces and are exposed to prolonged latent danger. Psychosocial challenges involve working with traumatized clients, managing conflicts and crisis situations, and building positive relationships with patients and their families. Personal challenges include coping with trauma, loss, fear, and the psychological consequences of war events, alongside the need to preserve professional identity and inner resilience. The combination of external and internal stressors significantly increases the risk of stress and professional burnout.
According to Elisabeth Lukas (2012), in 1972 Viktor Frankl was the first to describe the phenomenon called "managerial disease," today known as burnout. Two years later, Herbert Freudenberger (1974) formally defined burnout as a state of physical and mental exhaustion resulting from prolonged exposure to professional stress and continuous emotional engagement in demanding work situations. Stress is defined as the physiological and psychological reaction of the organism to external demands perceived as threats or challenges, activating adaptive mechanisms through three phases: alarm, resistance, and exhaustion, while a lack of adaptation can lead to “adaptation disease” (Selye, 1978). The alarm phase prepares the body to face the threat, the resistance phase maintains heightened alertness while gradually depleting resources, and the exhaustion phase is characterized by reduced adaptive capacity and increased risk of physiological and psychological disorders (Selye, 1978). Chronic stress leads to psychological symptoms, physiological disturbances, and long-term chronic diseases, highlighting the close connection between the psychological and somatic consequences of burnout (Agyapong et al., 2022).
According to Frankl (2014), burnout cannot be viewed merely as psychosomatic exhaustion but also as an existential crisis of meaning, that is, a loss of a sense of purpose, values, and inner motivation. Human beings should be understood as a unity of physical, mental, and spiritual dimensions, with the search for meaning representing a primary force rather than a secondary psychological mechanism. Unlike the physical and mental aspects of existence, which are subject to causal laws, spirituality is characterized by freedom and the capacity for conscious decision-making, shaping life and circumstances (Purjo, 2020). Purjo draws on Rauhala’s holistic concept of the human being, emphasizing three dimensions of existence – corporeality, consciousness, and situatedness – whereby situatedness denotes a deeper mode of being in the world that transcends the physical environment and places existence in the context of the uniqueness of the person, moment, and space. Frankl (1967) emphasizes that a person is responsible not only for their actions but also for what they are and become, and that despite inevitable suffering, they have the freedom to choose their attitude toward it.
The phenomenon of burnout in the contemporary context is often not only a consequence of overload but also of an inner emptiness, that is, a loss of life direction and a sense of purpose, which Elisabeth Lukas (2012) describes as the “burnout” of the idle person. Excessive self-reflection, anxiety, doubts, lack of sleep, fear, and unnecessary stress further deplete psychophysical energy and reduce basic trust, tolerance for frustration, and gratitude, which support inner stability and spiritual resilience. From a logotherapeutic perspective, such a state corresponds to Frankl’s concept of the existential vacuum (1946/2004) – a sense of emptiness when a person loses connection with meaning and does not know what they live for.
In wartime conditions, professionals usually do not suffer from idleness, but while trying to maintain the appearance of normalcy while working, raising children, or helping others, they experience a double burden. During work, they function and maintain strength focused on others, reflecting the principle of self-transcendence, while in moments of respite they may face anxiety, insomnia, feelings of helplessness, and survivor guilt. These patterns of emotional exhaustion demonstrate that burnout is not merely a psychological or social condition, but a deeply existential issue. The logotherapeutic approach does not seek to avoid suffering, but enables the rediscovery of meaning that transcends the individual and allows one to say “yes” to life despite everything. It is important to consider all three dimensions of human existence, the context of situatedness, and to make full use of a person’s spiritual endowments to prevent burnout. Frankl’s experience in concentration camps shows that even under extreme conditions, the will to meaning remains a decisive factor for survival, and that an individual, even in suffering, retains the ability to choose their own attitude and respond with love, responsibility, and solidarity.
The phenomenon of professional burnout in war-affected areas represents a multidimensional problem encompassing physiological, psychological, and spiritual aspects. While classical models emphasize stressors and resource depletion, the logotherapeutic approach views burnout as an existential response to a loss of meaning. In conditions of war-related threat, ongoing uncertainty, and personal losses, professionals in direct care face questions of their own purpose, doubts about the effectiveness of their actions, and an identity crisis that extends beyond the work context. Purjo (2020) emphasizes the importance of self-distancing and self-transcendence as key spiritual capacities of a person. Self-distancing allows one to step back from one’s own thoughts, emotions, and circumstances and to choose one’s attitude, corresponding to Frankl’s concept of freedom in relation to life situations. Self-transcendence directs a person toward values and others, surpassing the self, and represents the path to meaning through action and contribution. Meaning is thus realized as the result of a spiritual act and an active engagement with life.
Overcoming professional burnout is possible through a series of interconnected strategies based on logotherapeutic principles and a holistic approach to the human being. The foundation of everything is self-awareness, that is, the conscious recognition of one’s own thoughts, emotions, values, and reactions. Developing self-awareness allows for the identification of internal states, vulnerabilities, and sources of stress, and serves as the starting point for activating self-distancing and self-transcendence (Purjo, 2020). Self-distancing enables professionals to gain an objective perspective on their own reactions and circumstances, reducing psychological determinism and creating space for the freedom to choose one’s attitude, while self-transcendence directs energy toward values, goals, and others, fostering purposeful actions and meaningful contribution.
Developing emotional resilience is a crucial component of burnout prevention. Through self-distancing, professionals gain the ability to objectively observe their own emotional reactions. Awareness of being part of a larger whole helps to overcome personal problems, restores inner energy, and reinforces a sense of purpose. Managing goals and priorities in accordance with one’s personal value system directs energy and attention toward tasks that are truly meaningful. The use of tools such as the Eisenhower priority matrix (Covey, 1989) reduces overload, enables more effective planning and resource allocation, and encourages active participation in shaping one’s life. Frankl’s emphasis on freedom of choice and responsibility helps to view situations more objectively and reduce emotional clouding.
Planning the use of time and energy requires setting boundaries, delegating tasks, and consciously deciding when to say “no.” Developing and maintaining healthy habits, when circumstances allow, strengthens resilience and the capacity to act. Regular physical activity, quality sleep, balanced nutrition, and recovery rituals during the workday increase physical and mental strength. Regular monitoring of progress and evaluation of personal changes further enhance the sense of control and autonomy.
All of these strategies together constitute a holistic approach to burnout, encompassing the physical, mental, and spiritual dimensions of a person. The focus is not merely on alleviating symptoms, but on finding meaning, shaping one’s own attitude, and actively navigating and responding to real-life circumstances. This approach connects professional work with purpose, which is the core of the logotherapeutic concept.
References
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