Podcast #476: Are Modern People the Most Exhausted in History?

People often complain about being tired and burnt out these days from work and family responsibilities. We think itâ€™s because of the way technology has sped up the pace of life, and the way weâ€™re always â€œon,â€ and figure weâ€™re living in the most exhausting age in history. But are we really?

My guest today argues that, no, people have been complaining about being tired since at least antiquity. Her name is Anna Schaffner and sheâ€™s written a book called Exhaustion: A History, which traces the fascinating evolution of physical, psychological, and existential fatigue from the ancient Greeks to the modern day. Today she takes us on this tour, and as we move from age to age, we dig into how exhaustion has changed as to how its described, whether we blame external or internal factors as its source, and how much we believe personal agency can control it.

Show Highlights

How exhaustion has been complained about since antiquity
How did ancient Greeks view exhaustion?
The way Christianity reframed exhaustion as sinful
Exhaustion in Dante’s Divine Comedy
Changing perceptions of exhaustion in the Renaissance
Why neurasthenia became a desirable “disease”
Various efforts at cures for exhaustion â€” from electrotherapy to potions
The gender politics of exhaustion and neurasthenia, and how it’s changed over time
Freud’s approach to exhaustion and depleted energy stores
What is Chronic Fatigue Syndrome? What causes it?
Balancing the physiological vs psychological nature of exhaustion
Burnout â€” the latest exhaustion “syndrome”
The 3 components of burnout
Exhaustion as a status symbol today
Modern treatments for exhaustion (and how unchanged they are from ancient times)
What’s the big takeaway from this history of exhaustion?

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Read the Transcript

Brett McKay: Welcome to another addition of The Art of Manliness Podcast. People often complain about being tired and burnout these days from work and family responsibilities. We think it’s because of the way technology has sped up the pace of life and the way we’re always on, and figuring we’re living in the most exhausting age in history. But, are we really? My guest today argues that no, people have been complaining about being at tired since at least antiquity. Her name is Anna Schaffner, and she’s written a book called, Exhaustion in History, which traces the fascinating evolution of physical, psychological, and chronic fatigue from the ancient Greeks to the modern day.

Today, she takes us on this tour, and as we move from age to age we dig into how exhaustion has changed as to how it’s described, whether we blame external or internal factors as its source, and how much we believe personal agency can control it. After the show is over check out the show notes at AOM.IS/exhaustion.

Anna joins me now via Skype.

All right, Anna Catherina Schaffner, welcome to the show.

Anna Schaffner: Well, hi! Welcome. Thank you for having me on your program.

Brett McKay: So, you wrote a book called Exhaustion of History. I’m curious, this is an interesting topic to delve into the history of, exhaustion. So, what got you looking into that? Were you just really tired one day and you were thinking, did the ancient Greeks complain about being tired of being tired too, and I’m going to explore that, so what happened there?

Anna Schaffner: Yeah. It wasn’t quite like that but it was similar. I did often, you know feel very exhausted and tired, and weary and overburdened, you know as academics tend to at numerous times in their lives. I also noticed a really interesting increase in newspaper reports, and television programs, and scholarly studies on stress and burnout, especially in Germany. The Germans, we were really, really obsessed with that topic a couple of years ago. Everybody basically said that we’ve never, ever been that exhausted collectively. That we’re living the most exhausting age ever. And, that basically you know, everything about our time was sucking out our energies and that we’re confronted with this really demanding environment in which we constantly have to be completely switched on. And, new technologies basically mean that we can never properly switch off, and also you know, new level of working arrangements were cycle socially really stressful.

So, everybody was making these big grand claims about our utterly exhausted and exhausting age. Then, I did think, yeah. I mean, I agree with that, but I do wonder really whether exhaustion as a mental and physical state is unique to our age. Then, I thought I’d look into it. I was really interested. Then, I really did find that exhaustion is really a topic that has concerned people throughout the centuries. It is not as we might think related to new technologies. It is not related to those sort of hyper competitive new liberal environment, but it’s really ubiquitous and timeless concern.

And, I think … you know, I don’t deny that we’re living in a stressful age, and that there are numerous new cycle social challenges that are very unique and specific to our times, but I did find that every age has sort of struggled with its own burden, and its own challenges. Every age has also perceived itself as exhausting and a lot of people before us have actually made similar claims as to you know, how suddenly everything was terrible and they look back nostalgically to the past, imagining the past as much more kind of peaceful, less stressful.

So, you had this sort of nostalgic glorification of the past as an age in which the stressors were fewer. That happens in lots of different periods. Not just in ours. Basically I was really fascinated with that because that’s not how most people perceive it. And, I did also find that quite soothing as an idea, you know, that we’re not the only age that has struggled with the problem of exhaustion.

Brett McKay: So, yeah. I thought that was soothing too. It’s like well, you know, people thousands of years ago also were tired. Just like I am. So, let’s talk about that. When was the first time we see in recorded human record of people complaining about being tired, or exhaustion?

Anna Schaffner: Yeah, I think … I mean, my investigation and research took me all the way to the age of classic antiquity. You really do find it in some of the epics, you find it also in Gailand’s writing. You know, this great doctor who basically established humoral medicine. He was looking at exhaustion in the context of melancholia because basically, exhaustion you never really encounter it purely on its own in the literature of the past, in the medical text, or in the theological text, or in the philosophical text.

What I did is I looked at different syndromes that entailed exhaustion as a core symptom. So, I looked at texts on melancholia. I looked at text on neurasthenia, on nervous weakness, on depression, on chronic fatigue syndrome, and on burnout. Exhaustion is always central to these syndromes, but it’s not the same of course because in those syndromes it is always combined with other symptoms. Sometimes these symptoms are thought to be the cause of … exhaustion is the cause of these other symptoms, and sometimes exhaustion is thought to be one of the consequence of them.

So, it’s always really interesting. And, one of the earliest writing coming back to your question about exhaustion is really in the sort of humoral medical text on melancholia. And, humoral medicine is really based on the idea that we have four humors that need to be in balance with one another, and all illnesses, all distress, all forms of discomfort can be explained with recourse to imbalance. So, Gailand saw that exhaustion mainly in the form of weariness and pessimism is one of the core symptoms of melancholia.

He had a lot to write about exhaustion in the sense that he thought it was caused by surplus of black bile. He had also this very lovely image of how we kind of … how black moods, and pessimistic world views. He basically saw that when the body is confronted with too much black bile it starts to burn the excess of black bile, and fumes of black bile, they’ll sort of rise up into our head, and literally cloud our vision. You know, they make us see everything through a dark … through a glass darkly.

So, Gailand was one of the very first to write about exhaustion, and he has this interesting idea that it was partly physical, you know, this idea that it was because of an imbalance of the humors and an excess of black bile. But, this physical imbalance obviously had effects on peoples’ mental life. So, it really manifested itself as a lack of energy but also, as a mood disorder so to say.

Brett McKay: Well yeah, that’s an interesting point because that’s something that I notice throughout the book is as you go through the different stages of civilization and how they approached exhaustion, there was this, I don’t know, a tension between whether exhaustion, or depression, or whatever you want to call it, is physiological, right? It’s in the body. Or, if it’s psychological, it’s just in the mind or spiritual.

So, it sounds like Gailand was saying it was a little bit of both at the time.

Anna Schaffner: Yeah. I mean, he thought it was originally physical, but then they had psychological impacts. What is really interesting is how that relationship between the physical, the mental and the social shifts in the different series of exhaustion. And, basically in my book I look at forms of exhaustion that constitute physical and mental states, and that are all also at the same time broader cultural phenomenon.

So, physically exhaustion really manifest itself as fatigue, lethargy, and weakness, and it can be a temporary state. Those aren’t particularly scary because they pass. Or, that kind of state of exhaustion can be a chronic condition. In my book, I really look at the pathological forms of exhaustion, and those that are not obviously the result of an underlying and clearly diagnosable medical condition. And, emotionally exhaustion can be described at weariness, disillusion, and apathy and hopelessness or a lack of motivation.

What I find really fascinating is that throughout the ages the different theories always theorize the relationship with the mind, the body and the social very, very differently. That was, for me, the attraction about that topic because you know, the ways in which we think about the interconnection between the mind, the body, and the social is really, really interesting and, it also tells us a lot about other assumptions about self, and how connected we are, and also the kind of whole idea … the idea of a split between the mind and the body, obviously a later phenomenon, and most of the earlier text and series are much more holistic. They assume that there is this sort intricate connection between the mind and the body. They try to sort of theorize that connection in very interesting ways.

Brett McKay: Also, so there’s this tension between mind and body, but there’s also … you see throughout the history, and we see it even with the ancient and classical antiquity, whether exhaustion is a sign of weakness, right? Like a moral failing, or if it’s just something that just happens to you, and you’re pretty much blameless for it. That changes, but before we see how it changes, what did, say, the ancient Greeks or the ancient Romans think of exhaustion? Was it seen as a moral failing, or moral weakness of some sort, or was it just something like, well yeah that just happens to you, and that’s okay?

Anna Schaffner: Yeah. I think it wasn’t seen as a moral failing, and it was also not considered as weakness as such. It was something that started out in the body, and I mean, they did believe that you cure exhaustion and melancholic states by paying attention to diet, by living a very moderate lifestyle, you know avoiding excesses of all sorts. So, there wasn’t sort of … there was an idea that our behavior contributes to our exhaustion if we’re not careful. If we eat the wrong kinds of food, if we indulge in activities that are not restful, if we don’t pay attention to our energy levels that we are partly responsible for suffering from exhaustion, and states of exhaustion.

But, the other interesting thing about melancholia because you know, melancholia was the big sort of exhaustion syndrome in that period, was that melancholia also had a vaguely positive connections back then already because Aristotle actually connected melancholia and the melancholic temperament with genius. So, being melancholic wasn’t just seen as something negative. There was also this you know, connection with scholarship and, with creativity and with intellectual powers. But, overall I would say exhaustion in the Greek or Roman period wasn’t vilified. It wasn’t considered a sinful, it wasn’t considered a weakness. It was rather about sort of temperament and physical responses that we can influence by watching our behavior.

But it didn’t have these sort of excessive moralistic connotations that came with later diagnosis.

Brett McKay: And, so yeah. Let’s talk about that change. That sort of changing in the middle ages with Christianity.

Anna Schaffner: Yeah. I think that’s … you know, that’s for me, probably the most interesting theory of exhaustion. The idea that exhaustion is sinful and medieval exhaustion was actually really present in a syndrome cluster that is called Acedia, and that was later renamed as sloth. So, Acedia really was born amongst Hermit Munks in the Egyptian Desert, and early theorist including Evagrious Ponticus, and Yohanus Cassian who lived in the Egyptian Desert, and blamed exhaustion on the noon day demon. Acedia is really a very interesting phenomenon. It’s a mixture of melancholia and, sloth. It was thought to be manifest in listlessness, apathy and lack of care.

It was originally diagnosed exclusively in monastic environments. But then, it became sort of more ubiquitous and became democratized, and everyone was able to suffer from Acedia. Acedia has also very poetically been described as weariness of the heart.

And, the 13 Century Italian theologian, Thomas Equinus, was the first to very, very explicitly define Acedia as a spiritual sin. I think that was a really interesting term in the history of exhaustion because he thought exhaustion was a failure of morality, and it was owing to a lack of proper faith. So, basically the exhausted, the lethargic, the lukewarm, the weary were guilty of refusing to accept divine grace. They were basically guilty of a bad mental attitude.

In fact, very few people know that Acedia or sloth was considered the most dangerous of the Seven Deadly Sins. It was the most dangerous because it basically breeds all the other bad behaviors, and the other sinful forms of acting because it can all be traced back to this lack of faith in God’s goodness. This sort of, you know, dismissive attitude about what is good and what is important, and what is divine.

The underlying idea was also across that by giving into exhaustion we are guilty because are we weak, our flesh is weak, our mental state is weak, and we let the evil forces from the outside take over because we’re not vigilant enough, and we don’t have enough faith tho fend off the noon day demon for example. And, of course, that has implications for responsibility and agency. I mean, one of the other interesting things about exhaustion is that it always bring a bigger philosophical questions about personal responsibility and agency.

And, in the middle ages, really, the slothal and the Acedic and the weary, and lethargic were thought of as sinners.

Brett McKay: So, what’s interesting is you talk about Italians in the medieval times was Donta and his divine comedy, like exhaustion was front and center of that. What did … what can the divine comedy teach us about how people within that period thought you could overcome the sin of Acedia.

Anna Schaffner: Yeah. When I reread the divine comedy I was really struck by how it can really be read as a book, but traces the gradual overcoming of weariness, of spiritual and physical weariness. There are lots and lots of reference to sleepiness, to lethargy, to tiredness, to heaviness, and Donte, you know he sheds all his sins on the way to paradise. So, he’s lost spiritually and, literally at the beginning of the divine comedy. Then, he meets his guide who basically guides him through the infernal, and to Purgatory, and in the end he’s reunited with his beautiful wife in paradise.

In the course of his journey he becomes more and more energetic and he shakes off this torpor, this lethargy. It becomes very clear that exhaustion, in the form of Acedia and slothfulness, has been his major sin. He encounters lots of other slothful characters in the course of his journey, all of whom get punished. You know, there’s this sort of law of Contrapasel at work in the divine comedy, this idea that all the sins are punished by tortures, that either resemble or contrast with the sin in question. So, some of the weary and slothful characters are forced into eternal activity.

And, the lukewarm, who never really wanted to commit to God’s goodness or to good causes, they’re forced endlessly to run after an empty banners, for example, which is a very beautiful image I think. Then, of course, Donta also encounters the wonderful figure of Belacra, who sits really tired and lethargic and weary at the bottom of Mount Purgatory. If he were able to climb up to the summit of Mount Purgatory he could really find salvation there, but ironically, he is just too tired to make that climb. He can’t be bothered, and he doesn’t really believe that he would succeed in being forgiven for his sins. So, he just sits there at the bottom of Mount Purgatory with his head bowed, and leaning against the bolder in the shade. This wonderful image of someone who has really given up on the idea of salvation.

But, not so Donta, you know, who is very controlled by Virgin, his guide, and who in the end succeeds in shaking off his torpor, his spiritual torpor and recommits to God in the end.

Brett McKay: I think it was interesting you mentioned that the sin of slothfulness originated in monastic scenarios or environments. When I was reading this, I was actually, at the time, I stayed in a monastery here in … close by to my house. It was like an hour away. One of the things I found was interesting, I got there. All I wanted to do was sleep. The day before I was fine, active, but it’s like I got there and I just got really sleepy. I just wanted … I wonder if it’s something about the monastic way of life that it is so regular, and it is so … I don’t know, it is kind of relaxing. It just makes you tired, it makes you want to sleep. I don’t know what was going on there.

Anna Schaffner: Yeah, I can imagine that. You know, if you have very kind of regular routines and, also you know, they had to meditate, the Monks in the past. You know, especially the hermits. They were by themselves all day long, every day, and they had to be really, really disciplined about their kind of spiritual commitments and the meditation aspect of it. Of course, that can be really, really hard and, can cause incredible problems with concentration. There’s some wonderful descriptions of weary monks in some of the text I studied. You know, monks who were basically engaged in all sorts of very modern sounding displacement activities. You know, they’d go out, they’d stare at the sun. They’d become really sleepy. Then, they’d go and see another monk, and idly chat for hours. Then, they’d feel really tired again.

You know, there are all these descriptions of monks who don’t quite manage to commitment to that very rigorous discipline that was required. Then, of course, I think what also becomes interesting is that in a monastic setting, you know, because the sort of hermit monks, they were obviously all living separately in their own little … I’m not entirely sure.

Brett McKay: Cell.

Anna Schaffner: Yeah, but then, when Christianity became more broadly organized around monasteries, the lazy monk became a big social problem. You know, because monasteries depend on everybody chipping in, everybody doing their job, everybody contributing to the community. The one lazy monk could cause a lot of resentment. And, that, you know is still the case nowadays.

Brett McKay: All right, so during the medieval time, middle ages, exhaustion was seen as a spiritual. It’s the weakness of the will. As we shift into the Renaissance though, again we see exhaustion changing. So, how did it change during the Renaissance?

Anna Schaffner: Yeah. I actually studied a really interesting text by a 15th Century humanist called Macilio Fechino. He wrote a text that’s called Three Books on Life. Fechino was a Neoplatist, and was very, very interested in occult theories. He was in to alchemy. And, he was into astronomy, astrology, all of these slightly more obscure sciences.

He profoundly believed in the sort of microcosm, macrocosm connection. His main cure for exhaustion was really the idea that we need to realign our patterns of behavior with the movements of the planets. So, he believed that exhaustion, and again in the form of melancholia, was caused by the planet Saturn. And you know, Saturn really, really held sway over the melancholic temperaments, and that basically people with a melancholic temperament needed to do quite a lot to counteract the influence of Saturn.

He came up with fantastically obscure recipes for what the melancholic should do. He also recommended, which is one of my favorite cures for exhaustion, Orphic dancing. Orphic dancing is all about realigning your energy with the energy of the planets. So, he recommended that we imitate the movement of the planets by moving our body in a certain way. So, reading Fechino is actually very entertaining nowadays.

Brett McKay: One of the things … so, it sounds like here instead of seeing as exhaustion is the source … the individual being the source of exhaustion, like the planets were. It was like an outside source that caused you to be really tired.

Anna Schaffner: Yeah. I think that’s another really interesting factor in the history of exhaustion where responsibility shifts from inner sources to outer sources. You know, sometimes they can be environmental like the planets, and very often they can be very specific socio political developments as we will see later on.

For example, in the 19th Century, when theorist began to talk about nerves, weak nerves, and nerve force, and a lack of nerve force. They started to think of exhaustion as basically being caused by a lack of nervous energy, a lack of nerve power, a lack of nerve force. They very, very explicitly blamed this lack of nerve force on the modern urban environment. That was the sort of first, very clear cut, and reassignment of responsibility to something that is outside of our control.

You know, basically the theories of … the theorist of nervous exhaustion were all saying that we are victims of socio political developments, and technological developments. Most famous amongst these was of course the American physician George N. Beard, who coined the neurasthenia diagnosis in 1880. So, he invented this new diagnostic cluster, neurasthenia, which included all sorts of things.

I mean, it’s absurdly long, and absurdly wide ranging. It’s no longer in use because it basically included far too many symptoms. So, it became very kind of baggy as a concept. But, what is interesting about neurasthenia was that it was very clearly saying that the main cause of nervous exhaustion is to be found in the modern urban environment. The idea was that the modern urban environment assaults the highly sensitive nervous system of modern man and women with an incessant stream of stimuli.

So, you know, Beard was worried about speed, he was worried about noise, he was worried about the telegraph. He was worried about all sort of technological developments and how they basically kind of over stimulate our cognitive systems. That Beard was also very clever because he associated neurasthenia with a whole range of very positive connotations as well, because he said only the very sensitive types actually suffer from neurasthenia. So, everybody of course wants to be sensitive and cultured and civilized. That was one of the reasons for why neurasthenia became a very, very fashionable disease.

It actually spread like a wildfire. Everybody wanted to be neurasthenic because being neurasthenic meant you were sensitive. You were in touch with your emotions. You weren’t crude. You were highly civilized. You were sophisticated, and he also said neurasthenia mainly effects captains of industry and brain workers.

Brett McKay: That’s interesting because you see that also, like going back to Aristotle, right? Being a melancholic tired guy was a sign of genius. The Renaissance had that same idea. The romantics as well. In the 19th Century if you had a depressive outlook on life, well it meant you were poetic right, and it became fashionable to do that. You see that also with neurasthenia.

What’s interesting too is not only how we think about exhaustion changes, but the metaphors we use to talk about exhaustion. So, in the 19th Century you mentioned that people started talking about nerve force, or nerve power. Like, electricity was invited in the 19th Century, or there abouts. You know, people starting having it in their homes.

So, they started using that as a way to explain exhaustion, right?

Anna Schaffner: Yeah, absolutely. I think you know, the metaphors of exhaustion are really, really crucial because metaphors really matter, especially in the field of medicine because they really shape the way we imagine what is happening inside us. So, if we imagine our nervous capital as comparable to a battery, for example. That has lots of implications. I mean, the battery, the empty battery, was a very, very popular image that Beard used, you know, a certain response to the thread of electricity and related technologies.

But, the empty battery was very, very popular back then as an image that sort of captured what happens if we don’t manage our nerve force carefully. Of course, the idea was that batteries are … I think they were non rechargeable back then. I’m not entirely sure, but you know, the idea was that nerve force is fine eyed. It can not be easily be renewed. It’s a precious resource, and if we squander it we will be left with nothing.

So, another very popular metaphor cluster that was used a lot in the 19th Century was revolving around economic imagery. So, the idea that we have an account and we have to manage it wisely. So, we have to manage our nervous energy just as wisely as we would manage our financial assets because if we squander it all at once it’s gone and we’re bankrupt. So, I think George Beard even uses the term nervous bankruptcy at some point.

He often makes these economic comparisons, which again, implies agency. That although he blames exhaustion mainly on the modern environment there’s always a dimension of agency involved because otherwise, if we had no agency we couldn’t defend ourselves against exhaustion. We can’t just be victims in this. There has to be something we can do about it. So, he is very much in favor of managing our nervous energy very cautiously, very wisely, very studly.

Other really interesting images that the medieval theorist used, one of my favorites is really the idea of the tepid bowl of milk on which flies settle. That is a sort of … I think it’s from the 11th Century if I remember correctly. This is the idea that you know, if we let our spiritual essence go sour we will attract demonic and disgusting outside forces.

And, I think it’s a very powerful image. The tepid bowl of milk on which flies settle. And of course, other really interesting and important metaphors are related to … I mean, modern day ones would be related to the mind as a computer. That has lots of implications as well. Imagining the mind as a computer is very reductive, and I think very worrying because you know, just entails that we can reprogram our cognitive structures, and we can get rid of unwanted data. We can delete and you know, reload. We can recharge and reprogram. And, we can basically get rid of everything we don’t like.

But, I think it really doesn’t capture the human animal as a very kind of irrational creature. We’re not just rational, and we can’t just be easily reprogrammed, you know? We’re not robots. But, I think the idea of the mind as a computer, and that’s very popular in the sort of modern burnout literature is a kind of dangerous one because it really dismisses everything that makes us human.

Brett McKay: Well no. Yeah, I think I’ve seen devices you can buy … I don’t know if they exist anymore. It was out there. I remember seeing a viral article about it. It’s this little device you kind of stick to your forehead, and then it sends electric pulses into your brain. You can somehow energize you, or make you calm. So, it’s that idea like, oh yeah, you can just reprogram your brain like it’s some sort of digital device with electrical currents.

Anna Schaffner: Yeah. Interestingly, George N Beard, the inventor of the neurasthenia diagnosis, he used electro therapy for the exhausted. That was one of his therapeutic suggestions. Like mild electric shocks.

Brett McKay: Yeah. So, besides the electro therapy, there was also hydro therapy.

Anna Schaffner: Yeah, hydro therapy was another popular cure for exhaustion. In fact, the cures that were proposed for exhaustion that was really interesting in themselves. So, taking the waters was very, very popular in 19th Century Britain for Darwin, for example, also suffered from exhaustion. He often took the water, so he indulged in water cures at numerous times in his life. He was also very cautious about managing his energy. So, he would always have very rigorous periods of activity and periods of rest, periods of activity, periods of rest.

So, reading his letters, it’s very fascinating because he was really extremist about the way he organized his letter time, and his work time for example. Yeah, then there are more obscure suggestions for curing exhaustion. You have lots of potions, lots of strange chemical mixtures, and of course in the middle ages I think that was probably the cruelest cure because the cure was just more work, more spiritual exercise. So, you know, those were exhausted by this, by spiritual duties, were just told to focus even harder on their spiritual duties, or to work even harder. So, that was of course a vicious circle.

Brett McKay: So, in the late 19th Century exhaustion was seen as neurasthenia. Exhaustion was one of the symptoms of neurasthenia. There was a whole bunch of other symptoms that associated with it. But then, as you noticed as you note in the book, in the 20th Century neurasthenia almost disappeared, like after World War I. What happened? Or, did just exhaustion change the way it was described or talked about?

Anna Schaffner: Yeah. I think what always happens is that certain diagnosis they run their course, and new ones emerge. I mean, we can even see that nowadays where DSM constantly comes up with new diagnosis and gets rid of older ones and so on and so on. So, there’s always an attempt to redesign, refashion or diagnostic tools in order to capture what is bothering us in more modern, more accurate, terms. I think that is true of exhaustion as well.

But, one of the reasons why neurasthenia disappeared from the scene was that … I mean, also the gender politics of exhaustion are very interesting. So, neurasthenia was associated with women, and the rest cure was often proposed for neurasthenic women, and … Perkins Gilman wrote a very famous story about that, The Yellow Wallpaper. Then, the kind of gender politics of exhaustion changed in that quite a lot of sensitive men to begin to self identify as neurasthenics. I love artist. I love writers. It’s very fashionable to be neurasthenic for a long time.

You know, most of the turn of the century writers would self identify as neurasthenic because it was just fashionable to do so. But then, there was a shift and neurasthenia was beginning to be … people felt it was too baggy, too loose a diagnosis. And, it was also associated with creativity. You know, obviously during the first World War and after there was much less tolerance for suffering of the soul because it all became very, very kind of physically orientated, outwards orientated, and of course Froyd had entered the scene by then. Froyd really shifted the discourse, and very dramatically.

He came up with some very revolutionary ideas about exhaustion. So, Froyd obviously, he came out with three core ideas. So, he did say that it’s very exhausting constantly having to repress our desires because we have to do that, because we live in a society that depends on individuals repressing their selfish desires. But, repressing those desires makes us neurotic because you know, they have to … somehow the forbidden wants out and it becomes manifest in neurosis for example. It also becomes manifest in sublimation of course. But, it doesn’t always work.

Then, we can end up suffering from exhaustion as a result. But, his more interesting theories about exhaustion concerned, of course, his sort of meta psychological idea of the desk drive. So, he famously argued that there’s a life drive that is responsible for us striving, for us wanting to procreate, for us wanting to be active and do things. He also said that this drive is countered by its opposite drive, the desk drive. The desk drive wants to return us to a state of passivity, a state of inertia, an anorganic state. It wants to return us to basically a state before individuation, before we became separate, before we became you know, individuals.

He argues that those drives are conservative, and they battle against one another, which is quite exhausting because you have these conflicting drives that are operative within us, and also sometimes the desk drive takes over. It takes us into a lethargic state where we want to avoid all activity, all novelty, all challenge, where we just want to basically return to a state where nothing disturbs our peace. You know, where we seek a sort of fake kind of nirvana by avoiding anything that might be upsetting or challenging or threatening.

And, you can still say about certain people now. They’re very desperate in the sense that they have become extremely passive, and adverse to challenges, and adverse to anything that is associated with life, a novelty. And of course, Froyd also came out with the idea of conflict inside us that can eat up all our energy, that can use up all of our power in internal battle. So, he famously sub theorized the ego and the super ego as psychological instances. He also argued that they can do battle with one another, you know, that the it and the ego, and the ego and the super ego can be in conflict. That takes up a lot of energy. Energy that is then wasted and can not be invested into any interactions with the outside world.

So, I think this idea of internal conflict eating up our energy is also quite interesting. Then, he also talked about melancholia and the idea that losing a love object can often result in us losing a stable sense of self. It’s a very complicated process of substitution but, it can happen that we become so eaten up by lust that this kind of obsession with lust has an effect on our sense of self. Then, we’ve lost our sense of self, we can basically no longer properly interact with the outside world because we have used up our energy in psychological conflict operations.

Brett McKay: All right, so yeah. Froyd changed the game big time. He added to the idea that exhaustion can come from within, based on all these conflicts. And, I can see that happening, right? Because Froyd changed the way we thought about ourselves, right, or talk about ourselves. I can see people being like, “yeah, I’m just … I got sort out this problem. This internal problem.” Before Froyd they wouldn’t ever thought of it but, now that Froyd says oh it’s there, and you’re like, okay maybe it is there. This is one more thing to think about and, that makes me tired. So, we’re just adding to it.

Anna Schaffner: Yeah. But, you can really see that at work I think in every day life. When people are really preoccupied with their own problems to such an extent that they really can not give to anybody else, or to outside activities. I still find it a very convincing narrative personally.

Brett McKay: So, let’s talk about recent developments in the history of fatigue and exhaustion because it’s been controversial. In the 80s we start seeing people talking about chronic fatigue syndrome. For those who aren’t familiar with this, what is chronic fatigue syndrome? What does it feel like to have chronic fatigue syndrome? Do we know what causes it? Et cetera.

Anna Schaffner: Yeah, I mean chronic fatigue syndrome is of the different exhaustion syndromes I discussed in my book, it’s by far the most controversial one, and it is … in terms of symptoms, it is similar to some of the other. Similar to neurasthenia, similar … and there’s overlap with some of the older ones as well.

But basically, ME, or chronic fatigue syndrome means that people who are afflicted by these syndromes suffer from mental and physical fatigue and also, post excursion malaise, and the stance of extreme effort that renders many every day activities impossible. It also entails difficulties with concentrating, cognitive tasks, and short term memory. It is a highly controversial diagnosis because there were quite a few people, especially in the 80s, who were very unsympathetic to people who suffered from CFS or ME as it is also known.

There are some differences between the two, but often people talk about ME/CFS, ME/chronic fatigue syndrome. I think what happened in the 80s was that there was a very, very unsympathetic reaction in the press. People talked about yuppy flu and, basically said it was a sham condition and, that it was all in the sufferers heads.

The problem is that nowadays the discussion about CFS and ME is very, very polarized. A lot of CFS and ME sufferers feel very strongly that theirs is a purely biological condition, a purely physical condition, and then there are some people who argue that there might be a psychological dimension to this illness.

Nobody is saying that this is just in sufferers heads, and I think that very crude and horrible attitude has become unacceptable. But, there are some people, some psychiatrist, and some medical researchers who say yes, there is some physiological cause to that illness, but then there may be a psycho sematic or a behavioral dimension to recovery from the physiological issue.

Now, the problem with CFS and ME is is that it has become a very acronymous debate in that sufferers feel terribly misunderstood and misrepresented by the press in particular but, also by certain medial researchers. They reacted very, very strongly to any suggestions that there may be a psycho sematic dimension to the recovery process, for example, or to the illness as such.

I haven’t taken a position on this in my book because I’m not a medical expert, and I really couldn’t make a judgment on what is the true narrative here. I have simply presented the two arguments. I have presented the view point of a sufferer and I’ve presented the view point of a psychiatrist who argues that there’s a behavioral and psychological dimension to the illness. Although, this psychiatrist also never, ever says that it’s all in sufferers heads. However, I’ve been attacked horribly for my chapter on CFS and ME by some sufferers who hated when you even mention the other viewpoint. As I said, I haven’t actually made a judgment call. How could I?

I think it is slightly that there might be a biological cause for Me and CFS but, hasn’t yet been found. I very much hope that it’s the case because that would mean that sufferers could be cured once that cause can be identified. At the same time, I think it’s not in any way shameful to say that there is some psychological dimension to some of our conditions. I mean, I would always readily admit that my health is affected by my psychological state of mind, you know? When I’m stressed and anxious my immune system is lower, and I’m more likely to get ill.

So, I don’t think it’s a horrible thing to say that some of our illnesses may have a psychological dimension. You know, not as an exclusive cause, but as a contributing factor. But, I think because ME and CFS patients have been treated so horribly by the press the debate has become very, very polarized.

Brett McKay: Yeah, I think what it also does too is it shows very acutely that tension between physiological and psychological. So, if it’s physiological we tend to think we don’t blame people as much. If it’s psychological we think, well just get it together. You’re responsible for that. But, maybe we shouldn’t have that approach even to psychological issues.

Anna Schaffner: Yeah, of course not. I think I find it surprising because you know, people who suffer from depression they would not be stigmatized … I mean, they still are in certain unfortunate scenarios. There’s still a stigma that comes with mental health, but there shouldn’t be, of course. And, depression also has some biological causes. I think it’s in most cases, and we have a both end scenario, not a neither nor, or either or scenario.

Brett McKay: So, chronic fatigue syndrome, the latest development, or one of the latest developments in how we experience exhaustion, describe it. But, let’s talk about the thing that got you thinking about this was all those articles that were going on in Germany about burnout, because if you live in America too, we see those articles as well. That burnout is on the rise. So, let’s first talk about, how do we … when we talk about burnout, what are we describing? How is it different from exhaustion in the past? Is it the same? Can you kind of walk us through that?

Anna Schaffner: Yeah. So, burnout is the latest exhaustion syndrome. Burnout is really very, very popular topic up for conversation in … especially in the non and the American countries. I don’t know whether a lot of people talk about burnout in the US but, I would say in the UK the discussion tends to revolve around stress, which is much more about personal resilience and personal work/life balance management.

But, burnout in the way it is discussed in Germany for example, and also in some of the Scandinavian countries, has a dimension that we haven’t seen so far. That is that it includes social structures. It includes the idea of working environments that can make us ill. That’s something quite new in the discussion.

Burnout has been defined as basically a reaction to too much work stress, and the idea is that burnout entails three components. That is: exhaustion, that is an inability to perform one’s job, and it is also a cynical attitude towards the people with whom one works. I think that last dimension has to be explained because originally the burnout diagnosis emerged in the 1970s in America in the context of care workers.

So, the idea was really that people who are in the caring profession, so teachers, social workers, nurses, and so tend to at some point become very disillusioned because they invest so much emotional energy in their work. Then, often they don’t get enough back, or else they work in an environment that you know, really exploits them, and that means that they can not continue to give quite that much emotional energy.

Then, in the 1980s and 90s sort of diagnosis of burnout became democratized again, and expanded to encompass all kinds of work. Ultimately burnout is a chronic state of stress, but it is more specific than depression in that it relates particularly and very specifically to one’s working environment.

Now, a lot of people are happier to diagnosis, self diagnosed as burned out, rather than depressed because depression is still very clearly a mental health issue. Whereas burnout can be actually termed into something positive. You know, like neurasthenia in its early days because you can only burn out if you give too much, if you work too hard. Working too hard is, of course, something that is validated in our society, that has very, very positive connotations.

So, in a way, you will find that people, you know top managers, might be quite happy to self diagnose as burned out because in a way, it’s almost a badge of honor. You have worked so hard, you have given so much, you have given so much more than you actually have that you now need to rest. So, that you now have earned your right to rest, and to take a break.

Brett McKay: So, there we go again. Exhaustion being a status symbol again. What I think is interesting too is you see throughout human history with how we deal with exhaustion, like the cures, they’re pretty much the same. Even today, when we say I’m tired, I’m not talking about chronic fatigue syndrome, but just say you’re just burnt out, you’re feeling exhausted or you’re stressed out. What would we do? Okay, eat better food. Get more sleep. We might … we even do things like hydrate. People are taking cold showers, or they’re doing saunas, or what are those pods? Where you sit in and you … the float tanks.

Anna Schaffner: Yeah.

Brett McKay: Right? Or mindfulness, I’m going to meditate. I mean, it’s different but it is the same thing that Gailand was doing basically 2000 years ago.

Anna Schaffner: Absolutely. It’s all about restoring some kind of balance. But, I think what is also really interesting is that burnout can be read in two ways. I find that in Germany and in some Scandinavia countries it has a more overtly political dimension because basically people expect the state to step in, and to protect workers against hostile working environments.

So, there’s an expectation that somehow legislation will be changed in order to avoid these kind of epidemics of burnout amongst the workforce. So, there is a very kind of specifically political spin to the burnout argument as well in sociological arguments in particular, which concern the terrible neoliberal working environment in which we are expected to give permanently, in which we are expected to engage with our full being emotionally, cognitively, creatively and of course, the boundaries between work and ledger are constantly being eroded. We have to be reachable 24/7, and so on and so.

In Germany for example, quite a lot of companies have put into place measures to prevent staff burnout. For example, you know saying it’s not possible to send work emails after 7:00 PM. So, some companies have even manipulated their company email accounts to such an extent that you can not send after hour emails. You can not send or receive them, or if you go on holidays your email deletes so that you can actually really properly relax on holiday. And, you won’t come back to a mountain of unanswered email.

So, for example, my brother works at Mercedes and they have this wonderful bounce back holiday email system and operation. Everyone was on holiday, they basically send an automatic message that says “I’m on holiday. If your concern is still of importance after two weeks, please get back to me.” But, everything bounces back. So, that’s just one example of how … basically it brings us back to the question of responsibility.

In a lot of burnout discussions, responsibility is moved away from the individual and, is basically placed in the court of the state, or the company for which one works. So, there is sort of responsibility of care for the workers’ mental health and work/life balance.

I find that in Anglo American discussions, the focus is much more in personal resilience, which is all about personal responsibility. If you’re too stressed, if you get exhausted at work, it’s your fault because you allow yourself to get so stressed. So, you need to work on your own resilience. You need to eat more greens. You need to meditate. You need to do yoga. It’s all up to you. So, I find that very interesting, the kind of responsibility question that is attached to the different pures.

Brett McKay: Right, and so instead of saying, “Maybe I shouldn’t get email after 7:00.” Americans are like, “Well, I just need to meditate so I can handle those emails after 7:00.” I mean, that’s interesting because you do see companies in American introducing these meditation programs, nap rooms, and we had a guest on the podcast talk about this. Like, the happiness industry. He says, “Yeah, I mean it looks like they’re helping you out, but really, it’s helping their bottom line, right, because they want you to be well rested, and not stressed out because that means you’ll be more productive for them.”

Anna Schaffner: Yes, exactly. It’s all about enhancing productivity. Not really a concern about well being. It’s about, we want you to be able to keep on working.

Brett McKay: As long as you can. So, if you got to take a 20 minute nap, we’re okay with that. So, what do you think is the big take away from this research project? Is exhaustion just some part of the human existence that we just have to deal with?

Anna Schaffner: I absolutely think it is. I think exhaustion is a wonderful sort of both end phenomenon in that it’s timeless and ubiquitous, but it always put on new clothes. So, it’s like an ancient beast that keeps appearing in new outfits. And, I would say it hooks into really basic psychological anxieties about illness, the raining of our energy when we die, and when we grow old. And, ultimately its about a fear of death. You know, losing energy is associated with a loss of control, a loss of our health, a loss of our powers, and you know, we only become concerned about exhaustion when we do feel that our energies are on the wean.

So, it’s about illness, and the process of aging, and fear of death. But, at the same time what I find so fascinating about exhaustion series is that every age maps its own discontents onto the condition. So, every age really projects whatever it wants to onto this sort of basic template. Every age kind of reassigns responsibility, and rethinks the mind, body, social nexus in a very unique and special way.

I have also found that exhaustion theories are often a form of culture or criticism. So, people will critique social developments with which they disagree. For example, in the burnout debates you have a lot of people complaining about neoliberal, techno capitalist developments that they don’t like, and they say these are the cause of our exhaustion. Or, in the 19th Century you had people saying women becoming emancipated and joining the workforce is terrible, and it makes them exhausted.

So, exhaustion theories are often used as a sort of cultural weapon. You know, they’re weaponized in the sense that they underpin very specific ideological agendas.

Brett McKay: Well Anna, this has been a great conversation. Thanks for coming on.

Anna Schaffner: Thank you very much for having me.

Brett McKay: My guest today was Anna Schaffner. She’s the author of the book, Exhaustion. It’s available on Amazon.com and bookstores everywhere. You can also check out our show notes at AOM.IS/exhaustion. Or you can find links to resources, or you can delve deeper into this topic.

Well that wraps up another addition of the AOM podcast. Check out our website, ArtOfManliness.com where you can find thousands of in depth, well researched articles on just about anything. Personal finances, habit formation, how to be a better man, how to be a better family man. You name it, we’ve got it. If you haven’t done star rating yet, I’d appreciate it if you take one minute to give us a review on iTunes, or Stitcher. It helps out a lot. If you’ve done that already, thank you. Please consider sharing the show with a friend or family member you think would get something out of it.

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Isaac

Submitted by: Isaac in New York, USA