Pawel Mowlik knows exactly what burnout is. As an international financier working in hedge funds, he was making millions of dollars a month. But by the age of 24, his life was wildly out of control. “Private jets, yachts, parties, going days without sleep... and also constantly working,” he says, reliving his memories with characteristic intensity. “I developed a lot of unhealthy habits: alcohol, cocaine, sedatives.”
For years he had no off button. Then his body and brain found their own. “I developed a kind of depression; there was no satisfaction in my life,” he says. “But how to stop? I knew I couldn’t do it on my own. I just wanted peace.”
Like many of the super-rich, Mowlik learnt that while from the outside life can look like the pinnacle of success, on the inside it can feel like a pressurised nightmare. And the higher you go, the worse the pressure gets and often the greater the crash, imperilling not only individuals but often corporations and dynasties.
The term burnout (taken from New York’s drug-addict argot) was first used by Dr Herbert Freudenberger to describe care workers suffering exhaustion, headaches, stomachaches, insomnia and breathing troubles as a result of overwork. By the eighties, Christina Maslach, a psychology professor at the University of California, Berkeley, had developed a burnout score around three criteria―exhaustion, negativity about work and falling performance―and doctors reported links to strokes, heart attacks and haemorrhages.
By 2014, scientists at the Karolinska Institute in Sweden had reported finding a change in the brain of those suffering from burnout, caused by the enlargement of the amygdala, a region that processes fear, anxiety and aggression. This, Carmine Pariante, professor of biological psychiatry at King’s College London, says is because “the amygdala, which puts you into fight-or-flight mode, becomes hyperactive and keeps telling you you’re in danger. Thus it can become enlarged.”
Medically defined as a process rather than an illness, burnout is often the result of prolonged and relentless stress, during which a person has to stifle their true emotions to keep going, says Dr Rachel Sumner, a psychobiologist at Cardiff Metropolitan University who is conducting a study on 1,700 people’s experience of burnout while working through the pandemic.
“It usually starts with emotional, psychological and physical exhaustion caused by work and life stresses that mean you feel you can’t get through the day,” she says. “This can lead to a sense of inadequacy or inefficacy where no matter how hard you try, you can’t feel that you’re getting enough done, you’re failing. Then comes the chronic cynicism, where people lose hope about life and work, and become suspicious of those around them. This creeps into all aspects of their lives.”
Substance misuse is a common symptom of burnout, Sumner says, particularly among high-flyers “as a coping strategy―to try to escape after all other coping strategies have failed. Clearly it’s maladaptive and harmful. But they distract from stressors that are causing psychological pain, by squashing down feelings or numbing them out entirely.”
One of the most effective ways of dealing with burnout, she says, is “taking a period of time away from their situations, re-evaluating what causes the stresses and how they can better deal with them”. The problem, as Mowlik discovered when he sought help in two traditional rehab clinics in Florida, was finding places with the right treatments. In rehab clinics, he says, “I didn’t have anything in common with the other people. Some were there because courts or probation officers had told them to go.” Which explains the arrival in the past ten years of a number of discreet clinics specifically created to put broken modern titans back on their feet, such as the Paracelsus Recovery clinic, outside Zurich, to which Mowlik turned in 2014.
With its immaculate white walls, its private chefs and maids, its 24-hour live-in personal therapist and clinical nurse, this was a place, Mowlik says, where at last he felt safe. Having planned to stay for only a month, he ended up there for three. Key to helping him change, he says, was the close relationship he developed with his therapist. “We would take lakeside walks and I would share everything with him,” he says.
The clinic was started by Jan Gerber, its chief executive, ten years ago when a family friend sought help for the chief executive of a listed company who was drinking heavily because he was burnt out. “But he knew that the share price of his company would collapse if his treatment became public,” Gerber says. “My dad is a psychiatrist and my mum a clinical nurse specialist, so we had him stay in our living room, and realised that there was a niche clientele here with real needs.”
Today Paracelsus treats up to 40 clients a year. “Burnout is becoming more prevalent as companies grow larger and the world of business becomes ever more complex,” Gerber says. “As people move at ultra-high speed in an increasingly fast-paced world, they become less fulfilled and may reach a tipping point where they’re too exhausted to function. It seems especially common for wealthy high-achievers who may have trouble admitting they’re worn out, or are reluctant to discuss feeling frustrated and hopeless.”
Because Paracelsus treats only one client at a time in a separate residence, no two clients meet. The environment is strictly controlled. “For psychotherapy to work, their stress triggers need to be minimalised,” Gerber says. “They need an environment to which they are habitually accustomed. But we also need to be close to nature; that’s crucial. We couldn’t do this in downtown New York.”
What the clinic isn’t, he insists, is a holiday destination for the tired and wealthy. “Almost everyone comes to us in crisis. The self-narrative of high-achievers is that burnout only happens to other people. But untreated it can lead to self-medication, compulsive behaviours, gambling or sex addictions.”
Although ideally their clients need to take several months off, Gerber says, “for some that would mean losing everything. So sometimes we can allow them to spend hours working while also undergoing therapy. We have had people appear on Bloomberg financial TV from the clinic as though they were working normally.”
At most clinics, the curative model is based around regimes that include psychotherapy, physical exercise, therapeutic surroundings, bespoke dietary supplements and healthy regimes. But not all are clinical nor are all the therapists trained doctors. At Istana bespoke rehabilitation, the thirty-something Agathe Fay looks precisely like how any burnout sufferer wants to feel again: bright-eyed, healthy, energetic, enthused and purposeful.
She leads the teams providing complementary therapies on clinics sited on Ibiza, Bali and Barbados, teaching meditation, yoga and Pilates, as well as hanging out and surfing. In people with burnout, she explains, there’s “an underlying feeling of ‘not-enoughness’and perfectionism, in an environment where there’s a lot of productivity and a lot of noise. It’s really hard to unplug from the cycle that you’re in. Here we help to disconnect and slow down.”
Training people to try new kinds of exercises and learn new ways of enhancing their wellbeing can be viewed by patients with cynicism, she says. “But most recognise they need to invite in other perspectives because their own ones aren’t working for them any longer.” Surfing, for instance, is an ideal way to try to help people disconnect, Fay says. “It’s fun and healing and meditative. Burnout often affects people who feel they need lots of control. You can’t control the waves.”
Ian Ross-Smith, the director of Istana Jiwa and a former heroin addict, has seen exponential growth in burnout patients and says that he never knows what they are going to get until clients arrive. “Some just fall off the plane completely drunk,” he says. “Others are often on Valium and Xanax. But taking out the drug leaves a black hole, so part of the therapy is to get people to rediscover old passions, find new ones and learn to have a laugh again because they probably have been miserable for years.
“We save lives,” he adds. “Most come for just a month, but the transformation―because it’s one-to-one―is extraordinary. We like clients who come with a serious problem and require all of our resources, so that the whole team can flex their muscles and do their work. We love it when clients are fully engaged and willing. It is a privilege to provide a completely customised service and watch the magic happen.”
What happens afterwards is also crucial. Clients usually stay for six to eight weeks at the Kusnacht Practice, Lake Zurich, and before they leave, their post-stay care is meticulously mapped. “Preparing for discharge begins on the client’s first day, so that what happens in here can sustain long-term changes in the real world,” says Dr Laszlo Urogi, Kusnacht’s head of psychiatry, psychotherapy and relapse prevention. When clients return home the continuing-care team goes with them. “In general it’s several months of very intensive aftercare, teaching people how to cope better with stress and have a better life-work balance, to be more compassionate and get in touch with their true self,” he says.
“Initially a live-in companion gets clients to stick to their schedule: waking times, walks, having meaningful conversations, not eating alone and so on. Later the client has to be their own therapist, or be helped to build their own support structures. The aim is not to help someone lifelong.”And if things go wrong, “we don’t panic,” he says. “Sometimes we have to learn to try again.” To help to maintain recovery, Kusnacht can send chefs to teach clients’own staff how to cook specific food and produce only healthy meals. They can also prescribe individualised supplements and even hormone replacement therapy.
At the Balance clinic, which has luxurious private residences in Mallorca, London and Zurich, clients are even offered electrical stimulation of the brain, using approaches called neuromodulation and neurofeedback. Abdullah Boulad, the clinic’s Swiss-Lebanese chief executive, explains that these “support the brain to re-learn and to stop using the damaging pathways of response that it has built through chronic stress and depression”.
Meanwhile, Beran Parry, who styles herself a doctor of natural medicine at the New Life Clinic in Marbella, explains how she analyses clients’ blood, DNA and gut microbiome for deficiencies that may be treated by natural supplements including ayurvedic herbs. She is also investigating psychedelic plants as a way of accelerating recovery.
Few of these approaches are embraced by conventional medicine. Supporters would say they are ahead of the curve; critics would call them placebo at best. However, placebos can be powerful. And research has shown that the more people pay for an inactive placebo pill, the more likely they are to report benefits.
For Mowlik, the relationship with Paracelsus Recovery has grown rather than ended. “The yoga, the acupuncture, it all opened up my brain receptors, making the psychotherapy more effective. Physically they turned my diet around, and mentally I had a lot of time to sit and think through the insights I had gained. My sleeping improved, my anxieties lowered, I did not feel exhausted.”
In fact, he was so impressed with how the clinic turned his life around that he has become a co-owner and managing partner. His job now includes picking up every new client personally. “It’s my way of saying that we care. I understand how crucial it is to give clients a feeling of protection, safety, sanctuary―a home.”
HOW TO KEEP BURNOUT AT BAY
1. CHANGE YOUR THINKING
Adopting a simple mindfulness practice, taking regular pauses to reflect on how you’re feeling, physically and mentally, can make a crucial difference. This cultivates self-awareness so one can catch himself quickly when he is starting on destructively negative thoughts or actions, and remind himself that he is not going down that pattern again.
2. MAKE A FRIEND
It is vital to have close human connection every day. That involves having meaningful conversations with others and making a habit of not eating alone. A Dutch study in The Journal of Psychology in 2016 found that people rate having a close friend among their colleagues as the best burnout-beating morale-raiser of all.
3. EXERCISE DAILY
Medical trials show that taking a 20- to 30-minute walk a day is as efficient as antidepressants in keeping depression at bay," says Dr Antoinette Sarasin Gianduzzo at Kusnacht. “A few focused daily exercise habits or rituals are an efficient way to go forward and rebalance your work, life, mind and body.”
4. BE GENTLY REALISTIC
Keeping physically healthy is a proven burnout preventive, but creating perfect rules for diet and drinking is a recipe for miserable failure. Instead, your changes should be realistically sustainable and fun. Simple things such as never snacking and sticking to drinking only sociably can make a huge difference.