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Sociological Analysis 1984, 45, 4:373-382

The Myth of Clergy Burnout


Joseph H. Fichter, S.J.
Loyola University of the South Research studies by Selye, Sarason and Machlowitz indicate that the "burnout syndrome" is neither as novel noras prevalent as popular journalistic writers suggest. This mailed questionnaire survey was made at the request of the American Bishops who are concerned about the health and welfare of the overburdened clergy. The data from the national sample of 4,660 Catholic priests (both diocesan and religious) reveal that a minority of 6.2% may be termed "candidates" for burnout. They fit this category because they report being regularly overworked and also experiencing a great deal of emotional stress. The men most likely to fit this definition ate diocesan parish priests in their mid-fiflies who exhibit a high incidence of tension, worry and anxiety, have more physical ailments than other priests, are overweight and do not get enough physical exercise or restful sleep. The comparative statistics of this study clearly demonstrate, however, that the great majority of American Catholic priests are in good health of mind and body.

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Dr. Hans Selye (1978:60-69), the father of stress research, o wrote "We hear a great deal these days about the dangers of overwork and excessive striving, and of being the so-called Type A personality. But I think in many ways this is exaggerated and arouses unnecessary anxiety" Even though much of the propaganda about clergy burnout can be dismissed for lack of evidence or for conceptual confusion, we should deal seriously with it for two reasons. The first is that Bishops and religious superiors are disturbed by this phenomenon and think it is a cause for alarm. We owe them some reassurance. The second reason is the need to deflate the pop-psychologists and human relations experts who spread worrisome rumors. Every fad has to run its course, but we may be able to dampen some of this overheated enthusiasm. I bring both scepticism and open-mindedness to the study of stressful working conditions among the priests. The term itself is suspect by researchers. Seymour Sarason (1980) is right when he remarks that "professional burnout is a phrase that in a few short years has become part of our jargon. Some use it as an excuse, some as a badge of honor, and others a s a negative symptom of our times a n d a fast changing society" I am confident that the American Catholic clergy are not suffering an epidemic of overwork. As a group, the clergy probably work as hard and as long as men in other professions, but this does not mean that most of them are workaholics. When Marilyn Machlowitz (1980:6) began her study of workaholics in the late 70s she said "it wasn't easy" to find them. Her "best estimate suggests that workaholics comprise no more than five percent of the adult population" It appears to be no accident that we found only 6.2 percent ofour clergy respondents who could be termed candidates for burnout. When I say that the concept of clergy burnout is a "myth" I do not belittle the anxiety expressed by the Bishops or the discomfit of the men who experience burnout. The notion that overworked people who worry are heading for a nervous breakdown has been wellknown for a long time. The man who first popularized the term, Herbert Freudenberg (1974), said it means "to fail, to wear out, or become exhausted by making excessive demands on energy, strength, or resources" Perhaps our research findings can help to demystify

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the subject, to recognize it a s a legitimate concern of limited application, but n o t a s a problem of epidemic proportions.

An Ancient Malady
Pasting a new label on an old package does nothing to change the contents. All through history and in all cultures-and long before the art of psychiatry was discovered-people have had old-fashioned nervous breakdowns, have cracked up and burned out. As Hans Selye (1956:263) remarked, "the existence of physical and mental strain, the manifold interactions between somatic and psychic reactions, as well as the importance of defensiveadaptive responses had all been more or less clearly recognized since time immemorial" Frustration is nothing new, nor is stress, nor is burnout. Perhaps Caligula was one of the early examples, and Judas Iscariot, and more recently the singer, Elvis Presley and the comic, John Belushi. The most obvious flameouts become the most notorious burnouts. Graham Greene (1961) gave meaning to the label in his best-selling novel, A BurntOut Case. E Scott Fitzgerald recognized that he had all the modern symptoms when he "cracked up" at the "premature" age of thirty-nine years (Wilson, 1931). Wesley Shrader (1956) wrote a popular article for Life magazine explaining "why ministers are breaking down~' and described the same experiences that are now being rediscovered among the Catholic clergy. Veninga and Spradley (1981) suggest that "everyone from clock puncher to chairman of the board is a potential victim of job burnout, a debilitating physical and psychological condition brought about by unrelieved stress on the job." Alfred Kammer (1978) who is a "social activista' is more selective of social-service professionals who burnout like "poverty lawyers, physicians, prison personnel, social-welfare workers, clinical psychologists and psychiatrists in a mental hospital, child-care workers, and psychiatric nurses." If every person in every conceivable work situation is a candidate for burnou~ the definition probably has room for all of us. A lengthy litany of "signs and symptoms" that is said to emerge from clinical experience and research, is recited by psychologist James Gill (1980): "physical fatigue, exhaustion; insomnia; body tension; frequent sickness; backache or neckache; increased perspiration; migraine headaches; serious illness; worry about work or clients; difficulty making decisions; guilt feelings about work performance; preoccupation with problems; griping, cynicism; feeling frustrated, overwhelmed; loss of enthusiasm, feeling of stagnation; anger, resentment; blaming others and organizations; accident prone; hostile thinking and speech; yelling; impatient; irritated; uncharacteristic behavior; loss of concern for others; treating clients coldly; stereotyping clients; communicating with clients impersonally; reduction of time spent with clients; mechanical performance ofduties; excessive intellectualization; repression of feelings" When an illness exhibits this enormous variety of signs and symptoms, it is either impossible to diagnose precisely, or it afflicts all of us at one time or another and in some form or other. Whatever else may be said of human beings in the work place there is no question that stress and frustration are characteristic of everyone's life. Psychiatrist Paul Qualben (1982; Selye, 1969), writing for Lutheran clergy, wisely argues that stress in not the reason for burnout. Everybody is under stress. "Most of the work in the Church and elsewhere is done by people under stress. Stress is not the issue. The problem is rather distress. Distress is the product of frustration and repeated disappointment" The tendency among psychologists and psychiatrists is to emphasize both the novelty and the subjectivity of the burnout experience. The victim is often advised that he must

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cope with this subjective condition by learning to develop behavioral adequacy, or if this is not possible, simply to quit the job. The sociological perspective, however, encompasses the shifting environmental conditions of work as an important factor in burnout. Even Henri Nouwen (1972), without any data, suggests that the alienation of the clergyman is especially painful because "he feels an added loneliness from the changing meaning of the ministerial profession itself" Social science researchers have also found that "in the vast majority of cases of burnout the major cause lies in the situation" (Pines and Aronson, 1981) Some of the more conservative Catholic critics go even further when they trace the source of clergy stress and burnout to the aggiornamento introduced by the Second Vatican Council. They blame the American bishops for allowing environmental changes to "take their toll on the physical, emotional and spiritual wellbeing of all the faithful, and in a distinct way, of the priest" In a sharply critical article, Eugene J. Sweeney (1983), retired priest and ex-army office, argues that the priest "is suffering stress because he feels that the whole sense and direction of this priesthood has been changed, that for all practical purposes the priesthood for which he was ordained no longer exists in the United States:'

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Sociological Data Base


The information we have here on so-called "burnout" is really a spin-off for a survey conducted under the auspices of the National Conference of Catholic Bishops. Our mailed questionnaires were answered by 4,660 priests (a return rate of 58%). This is the first survey ever undertaken of the physical health of the clergy. Previous studies looked for psychoses and neuroses. King and Bailar (1969) searched through the literature and remarked that "studies on illness among the clergy are almost entirely limited to mental disorders among priests" Our current fixation on burnout falls into this tradition of psychological problems among the priests. This research project is a sequel to the study on The Priest and Stress (1982:9) as the "initial phase" of the American Bishops' concern for the physical and emotional health of priests. "It is evident that the high median age of priests and the demands made on their ministry posit the need for good health care in all facets of the life of the priest person: physical, emotional and spiritual" The focus of the present survey is on the physical health of the clergy, but it quickly becomes apparent that emotional stress and physical fitness are closely interwined. The Bishops remark that "the demands on a priest's time are burgeoning. Many over-zealous priests run great risks of suffering 'burnout~ or emotional or physical illness" We did not ask the direct question: "Have you been, are you now; or do you expect to become, a victim ofburnout?" We did probe for signs ofemotional stress and psychological disorders, and found a very small proportion (3.8%) of all respondents who report that they are troubled with "mental illness~' mainly in the forro of depression. Other factors are mentioned that may have an association with mental illness, or even nervous breakdown, but attention is now fixed on the inter-relation of stress and burnout. We are reminded by the Bishops that "the growing awareness of the problem of stress among American priests has prompted many in the Church to examine the extent of the problem, its threat to effective priestly ministry, and the critical importance of recognizing the danger and taking positive steps to resolve it" (1982:3) A quick overview of the research findings shows that the great majority of the priests consider themselves pretty healthy and are not likely

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candidates for burnout. Only one out of ten (9.8%) says that his health is worse now than it was two years ago, a n d a much smaller minority (3.2%) remark that ill-health "greatly" affects the amount and quality of their ministry. If they are fairly healthy we may expect that they work fairty hard. The average work week reported by these priests is fifty-six hours, which seems to be normal for most professional men. Approximately one-quarter of them (24.1%) say they work seventy hours or more a week, while a minority (14.4%) mainly the sick and elderly, work less than forty hours. The pressures of the ministry are not measured only by hours worked. Almost one-fifth (18.3%) report that they are "regularly" overburdened (or "swamped") by the work demands of their ministry, but less than ten percent (7.9%) say their current assignment is "more than they can handle" Aside from physical fitness and work activities there are also the psychological anxieties that are said to accompany burnout. About one-fifth (21.4%) of these priests say that a "great deal" of emotional stress is associated with their life style and ministry, but less than ten percent (8.2%) experienced severe personal, emotional, or behavioral problems that required professional therapy. Stress is manifested in various ways, but we found that only a minority of priests say they "often" have the following symptoms: worried about things (18.7%), were tense and nervous (16.5%), felt lonely (11.8%), or had feelings of depression (7.2%).

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Candidates for Burnout


Bishops and religious superiors are generally concerned about the health and fitness of their priests, but they have been led to believe that work and worry are threatening their men with burnout. Even though the demographic findings of this survey reveal a quite favorable state of physical fitness among Catholic clergy, there is a rec and popular tendency to emphasize the strain and tension under which the priests live and work. It is thought that stress arises not only from overwork but also from an inability to cope with the demands of their assignment. The priest is trying to do too much, or is worrying about not doing enough, or is simply "fed up" and ready to quit. There were many reasons given for the large exodus of Catholic priests in the decade following the Second Vatican Council, but there was no talk of"burnout" and hardly anyone suggested exhaustion from overwork and overstress. The phenomenon of the "second career" has been noted when men leave one occupation for another, as many business and professional men did when they entered the seminary to become Episcopal priests. One does not necessarily say that they failed, or were burnt out, in the occupation they abandoned. Similarly we no longer speak of failure, or defection, among the many Catholic priests who turned to alternative careers in recent years. Following the lead of the Bishops we speculated that if there are any prospective, or actual, burnout victims among our clergy respondents, they ought to be found among the stressful hardworkers. If the Bishops correctly interpret burnout as the consequence of"burgeoning" demands on the "overzealous" priest, they may well accept the definition provided by Cary Cherniss (1980:21) "Burnout is a process that begins with excessive and prolonged levels ofjob stress. This stress produces strain in the worker (feelings oftension, irritability and fatigue.)" Almost one-fifth (18.4%) say they are "regularly" overburdened with work, and a slightly higher percentage (21.4%) report that a "great deal" of emotional stress is associated with their life and ministry. It is only when these two variables are

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combined that we can identify candidates for burnout. Most of those (66.0%) who are overburdened are not in great stress and most of those in stress are not overburdened. These combined criteria reveal a small minority of 291 priests, about one in sixteen (6.2%) of all respondents, who may be termed potential candidates for burnout. The burnout candidates we uncovered in this research study do not fit the description given by Father Norbert Brockman (1978:809) in Review for Religious writing about priests who "find themselves depleted, run out of energy, unable to reanimate themselves" These priests are just the opposite. They are "on the go" all the time. They are not the victims of the rapid pace of change and transition which is said to leave some Church personnel bewildered and frustrated. It seems erroneous, or at least misleading, to suggest that stress and burnout inevitably accompany the adaptations required in a developing ministry and modernizing Church. The dynamic dedicated up-to-date priest thrives in this kind of situation. We are reminded by experts (Johnson and Goldfinger, 1981) that "the person who works long hours and leads a busy life may be far less frustrated than the person trapped in a limited position with no sense of release or accomplishment" There is much supportive data to confirm their claim that they are regularly swamped with work, but we cannot tell whether this volume of work is imposed on them in their current assignment, or is the consequence of their own "overzealous" choice (as the Bishops suggest). Perhaps many of them are the type of voluntary "workaholics" who, says Machlowitz (1980:16), area "surprisingly happy" group of people "doing exactly what they l o v e - w o r k and they can't seem to get enough of it" From the perspective of sheer time devoted to their ministry, these busy priests are much more likely (73.8%) than the other priests (48.7%) to report that they work sixty hours or more a week; indeed, half of them Say that their work week lasts seventy hours or more. The median for all respondents is 56.2 hours, but for these "workaholics" it is 65.8 hours. Two-thirds of them (65.3%) claim that they work harder than other professional men oftheir acquaintance (like engineers, lawyers, physicians.) They are also much more likely than the others (47.0% to 21.3%) to report that the work they are expected to do is "more than they can handle" The comparative statistics of Table 1 demonstrate that in the most pertinent types of psychological experiences they are enormously different from their fellow priests. Nine out of ten (91.8%) report that they are "often" tense and nervous, and approximately the same percentage (89.7%) say that they are "often" worried about things. Approximately eight out of ten (78.3%) have had some severe personal behavioral problem during the

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TABLE 1

PROPORTIONAL CATEGORIES OF "BURNOUT" CANDIDATES AND OTHERS ON SELECTED MANIFESTATIONSOF EMOTIONAL STRESS

Burnout
Tense and nervous Worried about things Severe personal problems Feelings of loneliness Feelings of depression Not happy 91.8 89.7 78.3 46.4 44.0 42.6

All Others
16.6 18.8 39.8 11.0 7.3 9.8

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past twelve months, some ofthem (22.0%) so serious that they sought professional therapeutic counsel. They are also significantly more likely (46.4%) to admit that they "often" have feelings of loneliness, and of depression (44.0%), and finally that they are not happy (42.6%). These research data, which show a definite correlation between overwork and overworry, are simply the logical demonstration of the fact that we selected the category of respondents who combine the criteria of"regular" overburden of work and of"great" emotional stress. At this point we have a kind of"internal" verification of the validity of the survey responses. From one point of view this is an "artificial" construct of a clergy type based on a deliberately contrived definition built on two selected criteria. From the point of view of the experts on burnout, however, this is simply a clear proof of their general speculation that too much work and too much worry combine to produce this "debilitating psychological condition." It helps to explain also why the handling of burnout victims has been the concern of psychologists and psychiatrists rather than of medical doctors.

Physical Illness and Burnout


The psychosomatic interpretation of illness tends to be "holistic" in the sense that the total human being is affected by any disorder or disability, whether psychological or physiological. Concepts like stress and burnout ate so imprecisely used to cover a wide range of social and psychological phenomena that many medical doctors seem reluctant to deal seriously with them. The practicing physician who keeps office hours is sometimes annoyed by the large number of patients who "have nothing wrong with them" that is diagnosable by an internist. (Fichter, 1981:30-32) As early as 1914, however, the Harvard physiologist, Walter B. Cannon, recognized physiological response to external threats, and three decades later (I946) Hans Selye proved that "psychological strain itself could cause dramatic hormonal changes and hence physiological symptoms." (Seyle, 1975) He showed that these biochemical changes then lead to a series of physical ailments which are now seen as symptoms of burnout. One of the central concerns of Church leaders is the causal connection between the physiological and psychological, how the physical exhaustion of overwork leads to emotional stress, and how this stressful condition then becomes the cause of physical ailments. A small proportion (7.6%) of the prospective burnout victims are free of all the ailments listed in the questionnaire, but the whole category reports an average of 3.2 maladies each while the other priests average 2.4 each. Other comparable statistics point to further manifestations of physical ill health. They are almost four times as likely (30.9% to 7.7%) to say they are insomniacs. They are twice as likely (30.1% to 15.3%) as the others to have had three or more colds during the past year; and also twice as likely (42.3% to 20.6%) as the others to have suffered three or more severe headaches. They also have a higher percentage (40.8% to 25.1%) who report that they were confined to bed three or more days because of illness or injury. While there continues to be much confusion in the literature on "burnout~' and while false diagnoses may be made in specific cases, there can no longer be doubt about the mutual influence ofpsychological processes and somatic processes. (Levi, 1967: ch. 3) Without attempting to fix causality-much less explain i t - w e have several clear examples in Table 2 that the stressful hardworkers among the priests manifest a higher incidence of certain ailments; back pains (52.2% to 38.3%), sinus trouble (46.8% to 35.0%), allergies (44.4%
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to 34.5%) and hemorrhoids (44.4% to 35.8%). Everyone knows that ulcer of the stomach may be caused by emotional upset but in this study the differential incidence is only 19.3% to 14.1%. Perhaps the least we can say is that emotional stress is related to these physical ailments, if n o t a s a cause, then as having a role in making things worse for the individual. Some of our research findings, however, may help to restrain the exaggerated claims of burnout enthusiasts. We may legitimately raise the same kind of doubts that ultimately surrounded the popularity of the "Type A Personality" In fact, some studies have shown that business executives with Type-A behavior may have "fewer heart attacks than less stressful employees at lower levels of the company." (Johnson and Goldfinger, 1981:100) The same kind of doubt arises about the physical effects of burnout that allowed us to question the hypothesis of the "Type A?' personality. We note in Table 2 that the same proportion (30.6% to 29.5%) of both categories report high blood pressure, a fact that allows us to accept the caution that "it would be misleading to automatically equate highstrung with high blood pressure." The hypothesis becomes even more questionable when we note that the burnout candidates ate even less likely (8.5% to 13.4%) to report having heart disease.
TABLE 2

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PROPORTIONAL CATEGORIES OF "BURNOUT" CANDIDATES AND OTHERS ON THE INCIDENCE OF SELECTED PHYSICAL AILMENTS
Burnout All Others

Back pains, or spine Sinus Trouble Allergies Hemorrhoids, or piles High blood pressure Stomach ulcers Mental illness Heart disease
Portrait of the Burnout Candidate

52.2 46.8 44.4 44.4 30.6 19.3 10.0 8.5

38.3 35.0 34.5 35.8 29.5 14.1 3.8 13.4

We have no reliable statistical answer to the question how these particular priests will ultimately respond to the threat of burnout, and whether they are more able than other professionals to cope with this "debilitating psychological condition" In the absence of comparable data about other adult males we may presume that the proportion (6.2%) of potential clergy burnouts compares favorable with men in other professions. Our findings, compared with the general health statistics for educated adult males in the National Health Survey of 1979, indicate that the Catholic priests are in better health. Certainly we know that the clergy live longer than men in other professions. Given the superior spiritual and psychological training of the clergy we may expect that they are better able to cope with the symptoms of burnout. After all, they are not routine job-holders; they are well-educated; they have long ago learned to exercise self control. It seems to me that we are selling the Catholic clergy short when we suggest that large numbers of them have not learned self control, are unable to cope with stress, that they let things get out of hand.

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If we can safely extrapolate our statistical proportions to the total priest population in the United States, we estimate that there are about 3,500 Catholic clergymen who are potential victims of the burnout syndrome. The proportion of Diocesan priests who fit this category is higher (6.7%) that the (5.2%) of religious order clergy. The diocesan clergy in much larger percentages are assigned to parish duties, and it is in the parish setting that we find a much higher incidence (7.5%) ofburnout than in all other priestly ministries combined (4.5%). Since most clergymen do pastoral work in their congregations it is logical that anecdotes about clergy breakdown center on the parish minister. (Veninga and Spradley: 22-23, 138-141) The popularizers to the burnout syndrome like to focus attention on people at their most active stage in the so-called helping professions-and are themselves mainly psychologists in the human services. Their case studies do not include stories of elderly men and w o m e n - a s though age is a variable of little consequence. In the present study we found a very low incidence (2.1%) of burnout candidates among the priests, age sixtyfive and older. Even for the minority of candidates the "hazardous" years are during the first quarter century after ordination when the rate is 9.6%, which drops to 4.9% in the age category fifty to sixty-four years. Their average age is 44.7 years, an indication that they are over-worked and overstressed in the most active period of their priestly life. One final question we may put to the research data is to ask whether these candidates for burnout take the normal precautions to preserve their health, or even to restore health. Burnout is n o t a fatal illness and the assumption is that in all but the most extreme cases of clinical depression, the victim not only survives but has a good chance to recuperate. The research data allow us to investigate the so-called "health habits" of the clergy without judging whether these habits are either cause or effect of the psychological condition of the burnout candidate. We are not willing to judge whether their neglect of th Alameda health practices contributed to their stressful condition, or resulted from it. (Wiley and Camacho, 1980) Our logical hypothesis is that the burnout syndrome is associated with general ill health and that a partial explanation-aside from work and stress-may be the extent to which these priests fail to observe the basic critieria for good health. In the comparisons of Table 3 this means that the candidates for burnout ought to manifest a much lower incidence of the characteristic practices found among the physically fit. The most unexpected comparison is in the "dangerous" practices of smoking and drinking. Almost seven out of ten (68.8%) of the burnout candidates do not smoke cigarettes, as compared to three quarters (76.0%) of the others. There are less than three percentage points difference (34.7% to 37.4%) between them in abstinence from alcoholic beverages. It appears, therefore, that the stress and strain of overwork do not generally drive the clergy to these two common addictions. The three remaining health habits listed in Table 3 show a considerable difference between these two categories of priests. A much larger proportion (63.5% to 38.5%) appear to be insomniacs, reporting that they "often" or "sometimes" have trouble sleeping. The statistics show that only half of them get as much as seven or eight hours sleep a night. They are also three times as likely (15.3% to 5.2%) to say that they "regularly" or "occasionally" take sleeping pills or tranquilizers. Only half of them (49.8%) exercise regularly, and even fewer (45.0%) are able to maintain a normal bodyweight. We have seen in Table

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THE MYTH OF CLERGY BURNOUT


TABLE 3

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PROPORTIONS OF BURNOUT CANDIDATES AND OTHERS WHO OBEY THE FIVE ALAMEDA HEALTH PRACTICES Burnout No cigarettes 7-8 hours sleep Sufficient exercise Average bodyweight No alcoholic drinks 68.8 50.1 49.8 45.0 34.7 AU Others 76.0 69.0 66.4 56.1 37.4

1 that they exhibit an extremely high incidence of tension, worry and anxiety. These manifestations of psychological distress combine with the facts of Table 3 that they are overweight, do not get enough physical exercise, and do not get enough sleep. In summary, we may claim in this research project to have placed the problem of clergy "burnout" in proper perspective and have allayed the fears ofbishops and religious superiors about the extent and intensity of the problem. We all know that some priests have a nervous breakdown, or a crack-up, and they deserve our deepest sympathy, but we have found them a relative minority (6.2%) and we deal with them in this study as candidates moving toward burnout, rather than as actual victims of the illness. The priest most likely to fit this category is a diocesan parish priest in his mid-forties who has more psychological problems than physical ills. We recognize him as fitting the definition accepted by the Bishops: he is overburdened with work, putting in a longer work week than other priests and admitting to a great deal of emotional stress. The great majority of priests, however, are not in such dire straits. Like other adult Americans they are subject to the cultural and economic pressures of a narcissistic, consumer society. The notion that clergymen are suffering the fearful consequences of stressful overwork persists in the face of clear evidence that most Americans have long since abandoned the so-called "Protestant work ethic" We have outlived our traditional reputation a s a nation of industrious production workers and have moved toward an ethic of consumerism. Nevertheless, the normal and necessary work of the ministry goes on in the world's oldest institution that has survived many other fads over the centuries.

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REFERENCES
Brockman, Norbert. 1978. "Burnout in Superiors" Review for Religious 37, 6:809. Cherniss, Cary. 1980. Staff Burnout: Job Stress in the Human Services. Beverly Hills: Sage. Fichter, Joseph. 1981. Religion and Pain. New York: Crossroad. Freudenberger, Herbert. 1974. "Staff Burnout" Journal of Social Issues 30, 1:159-165. Gill, James J. 1980. "Burnout: A Growing Threat in Ministry:' Human Development 1, 2:21-27. Greene, Graham. 1961. A Burnt-Out Case. New York: Viking Press. Johnson, G. Timothy and Stephen E. Goldfinger eds. 1981. The Harvard Medical School Health Letter Book. Cambridge: Harvard University Press. Kammer, Alfred C. 1978. "Burnout: Contemporary Dilemma for the Jesuit Social Activist:' Studies in the Spirituality of Jesuits X, 1:1.

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King, Haitung and John Bailar. 1969. "The Health of the Clergy: A Review ofDemographic Literature" Demography 6, 1:27-43. Levi, Lennart. 1967. Stress: Sources, Management and Prevention. New York: Liveright. Machlowitz, Marilyn. 1980. Workaholics: Living with Them, Working with Them. Reading: Addison-Wesley. Nouwen, Henri J.M. 1972. The Wounded Healer: Ministry in Contemporary Society. Garden City: Doubleday. Pines, Ayala M. and Elliot Aronson. 1981. Burnout: From Tedium to Personal Growth. New York: Free Press. Qualben, Paul A. 1982. "A Psychiatrist Looks at Burnout" Parmers 4, 6:13-16. Sarason, Seymour. 1980. "Foreword" in Cary Cherniss. Professional Burnout in Human Service Organizations. New York: Praeger. Selye, Hans. 1956. The Stress of Life. New York: McGraw-Hill. --. 1975. "Confusion and Controversy in the Stress Field" Journal of Human Stress 1, 1:37:44. --. 1978. "On the Real Benefits of Stress." Psychology Today 1:60-69. Interview with Laurence Cherry. Shrader, Wesley. 1956. "Why Ministers Ate Breaking Down" Life 41:95-104. Sweeney, Eugene J. 1983. "The Priest and Stress" Homiletic and Pastoral Review 73, 10:9-16. Time Magazine, Cover Story. June 6, 1983. "Stress: Can We Cope?" 48-54. United States Catholic Conference. 1982. The Priest and Stress. Veninga, Robert and James Spradley. 1981. The Work/Stress Connection: How To Cope With Job Burnout. Boston: Little Brown. Wiley, James A. and Terry C. Camacho. 1980. "Life-style and Future Health: Evidence from the Alameda County Study." Preventive Medicine 9, 1:1-21. Wilson, Edmund, ed. 1931. The Crack-Up. New York: Scribner's.

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