Emotional Labor and Burnout:
A Review of the Literature
Da-Yee Jeung1,2, Changsoo Kim3, and Sei-Jin Chang1,2
1Department of Preventive Medicine, 2Institute of Occupational and Environmental Medicine, Yonsei University Wonju College of Medicine, Wonju;
3Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
is literature review was conducted to investigate the association between emotional labor and burnout and to explore the role
of personality in this relationship. e results of this review indicate that emotional labor is a job stressor that leads to burnout.
Further examination of personality traits, such as self-ecacy and type A behavior pattern, is needed to understand the relation-
ships between emotional labor and health outcomes, such as burnout, psychological distress, and depression. e results also
emphasized the importance of stress management programs to reduce the adverse outcomes of emotional labor, as well as cop-
ing repertories to strengthen the personal potential suitable to organizational goals. Moreover, enhancing employees’ capacities
and competence and encouraging a positive personality through behavior modication are also necessary.
Key Words: Emotional labor, burnout, self-ecacy, type A behavior pattern
Job stress is now a much-discussed topic and has drawn the
focus of popular media. It can lead to negative physiological,
psychological, and behavioral responses among employees.1-3
With the expansion of service industries, emotional labor has
emerged as a new job stressor. When employees regulate or
suppress their emotions in exchange for wages, they are con-
sidered to be performing emotional labor.
The service industry plays a crucial role in today’s world
economies. Indeed, service activities now exceed approxi-
mately 70% of the gross domestic product (GDP) in the United
States, as well as in European countries.4 us, emotional la-
bor is likely to be common among most employees across
several vocational elds, not just those that entail services to
the public. Morris and Feldman5 indicated that the signifi-
cance of emotional labor has been acknowledged in a variety
of occupations. Today, most organizations manage or regulate
employees’ emotions in order to accomplish their organiza-
tional goals. These regulations and requirements have been
found to be more prevalent in jobs that demand constant in-
teractions with customers or clients.
is literature review was performed to demonstrate the as-
sociation between emotional labor and burnout and to inves-
tigate the role of personality traits, such as self-efficacy and
type A behavior pattern (TABP), in this relationship.
DEFINITIONS OF EMOTIONAL LABOR
Beginning with the work by Hochschild,6 literature on emo-
tional labor has grown immensely in the last three decades.7,8
The term “emotional labor” is appropriate only when emo-
tional work is exchanged for something, such as wages or
some other type of valued compensation. Wharton9 remarked
that such work is not only performed for wages, but also under
the control of others. However, despite remarkable progress in
academic research on emotional labor, some important ques-
tions remain unsolved.
Previous research has demonstrated that emotional labor
contributes to negative attitudes, behaviors, and poor health
Received: October 26, 2017 Revised: January 4, 2018
Accepted: January 8, 2018
Corresponding author: Dr. Sei-Jin Chang, Department of Preventive Medicine
and Institute of Occupational and Environmental Medicine, Yonsei University
Wonju College of Medicine, 20 llsan-ro, Wonju 26426, Korea.
Tel: 82-33-741-0343, Fax: 82-33-747-0409, E-mail: firstname.lastname@example.org
•The authors have no ﬁnancial conﬂicts of interest.
© Copyright: Yonsei University College of Medicine 2018
This is an Open Access article distributed under the terms of the Creative Com-
mons Attribution Non-Commercial License (http://creativecommons.org/licenses/
by-nc/4.0) which permits unrestricted non-commercial use, distribution, and repro-
duction in any medium, provided the original work is properly cited.
pISSN: 0513-5796 · eISSN: 1976-2437
Yonsei Med J 2018 Mar;59(2):187-193
Emotional Labor and Burnout
of the employee.5,6 To highlight its constituting components,
comprehensive denition and a theoretical model have been
performed, which are expected to explain negative outcomes,
such as individual stress and adverse health outcomes. ere
are various conceptualizations of emotional labor as a strate-
gic model,6 a job characteristics model,5 and a mixed model
proposed by Grandey.10
Hochschild6 dened emotional labor as “the management
of feelings to create a publicly observable facial and bodily dis-
play (p. 7).” According to this perspective, managing emotions
is recognized as one way for employees to achieve organiza-
tional norms or goals. Ashforth and Humphrey11 dened emo-
tional labor as “the act of displaying appropriate emotions,
with the goal to engage in a form of impression management
for the organization (p. 90).” ey proposed that emotional la-
bor should be positively associated with task effectiveness,
provided that the clients perceive the expression as sincere.
ey also suggested that if employees are not expressing genu-
ine emotions, emotional labor may not become detrimental for
them by creating a need to distinguish from their own emotions.
Morris and Feldman5 dened emotional labor as the “eort,
planning, and control needed to express organizationally de-
sired emotion during interpersonal transactions (p. 987).” is
definition includes the organizational expectations for em-
ployees concerning their interactions with the clients, as well as
the internal state of tension or conict that occurs when em-
ployees have to display fake emotions, which is known as emo-
tional dissonance. Grandey10 dened emotional labor as the
process of managing emotions such that they are suitable to
organizational or professional display rules. is conceptual-
ization assumes that some organizations or professions have
their own limited or typical set of emotions that are to be dis-
played while interacting with clients.
HEALTH CONSEQUENCES OF
ese approaches indicate that emotions are being managed
and regulated in the workplace to meet an organization’s dis-
play rules, and suggest either individual or organizational out-
comes of emotional labor. For example, Schaubroeck and
Jones12 found that emotional labor was more likely to elicit
symptoms of ill-health among employees who identied less,
or were less involved, with their jobs. Several studies of emo-
tional labor in particular occupations have documented that
it can be exhausting, be considered as stressful, and increase
the risk of psychological distress and symptoms of depres-
sion.9,13,14 Hochschild6 and other researchers have proposed
that emotional labor is stressful and may lead to burnout.
Emotional labor has been linked to various job-related neg-
ative behaviors and adverse health outcomes, such as job dis-
satisfaction, loss of memory, depersonalization, job stress, hy-
pertension, heart disease, emotional exhaustion, and burnout,8
and has even been shown to exacerbate cancer.15 For exam-
ple, Zapf8 revealed that emotional labor in combination with
organizational problems, was related to burnout.
In addition to the negative effects of emotional labor, it is
well known that emotional labor itself is closely related to
workplace violence. Employees working in service sectors are
more likely to be exposed to occupational violence from their
clients while performing their duties, compared to those of
other industries, such as manufacturing, and those who en-
gage in white-collar jobs. Client violence is very common in
today’s modern industrialized society and includes client-,
patient-, customer-, and prisoner-initiated violence.16 In West-
ern countries, high risk jobs of client violence were found to
be “caring jobs,” such as police; reghters; teachers; and wel-
fare, health care, and social security workers.16 Approximately
10% of health care workers in the United Kingdom had re-
ported a minor injury, while 16% of them had been verbally
abused.17 In the United States, 46–100% of health care provid-
ers are estimated to have been assaulted while performing
their duties.18 Accordingly, when researchers try to examine
the relationship between emotional labor and its negative
consequences, such as health problems and work disabilities,
it is recommended that the combined eects of emotional la-
bor and workplace violence including verbal abuse from the
clients be considered.
Burnout research has its roots in service industry sectors, such
as caregiving, in which the core aspect of the job is the rela-
tionship between provider and recipient.19 Burnout is a state
of emotional, mental, and physical exhaustion caused by exces-
sive and prolonged stress.20 Maslach and Jackson21 dened it
as “a syndrome of emotional exhaustion and cynicism that oc-
cur frequently among individuals who do ‘people-work’ of some
kind (p. 99).” In contrast to the approach proposed by Maslach,
et al.,19 other researchers have argued that job burnout might
be reduced to a single common experience, namely exhaus-
tion.22 Studies of psychological burnout have been conducted
in several countries, including Norway,23 Israel,24-26 Canada,27
the United States,28 and Korea,29 and have produced remark-
ably similar ndings.
BURNOUT AND HEALTH OUTCOMES
Burnout from work-related demands or tension is of utmost
concern for organizations because they incur high costs in the
form of negative outcomes.30 Burnout is a negative emotional
reaction to one’s job that results from prolonged exposure to a
stressful work environment.19,31 It is a state of exhaustion and
Da-Yee Jeung, et al.
emotional depletion that is dysfunctional for the employee
and leads to absenteeism, turnover, and reduced job perfor-
mance.32-34 Moreover, these eects are particularly problemat-
ic for health care professionals, whose lower job performance
can also have an adverse eect on their patients’ health.35
e importance of burnout is suggested by its relationship
with such outcomes as decreased job performance and physi-
cal/mental health problems.36 According to the conservation
of resources (COR) theory, burnout occurs over prolonged pe-
riods of having few resources, which causes other resources to
become compromised as well.37 Unfortunately, the extent to
which employees engage in the regulation of their emotions is
related to stress-induced physiological arousal,38-40 as well as
with job strain, which are manifested in the form of poor work
attitudes and burnout.12,41-45 However, the specic mechanisms
to understand the relationship between emotional labor and
stress outcomes have not yet been claried.
Several studies on the relationships between emotional la-
bor and burnout have been based on “the dissonance theory of
emotional labor.” According to this theory, emotional disso-
nance is considered a cornerstone of emotional labor.46 It is
conceptualized as a conict between felt and displayed emo-
tions, encompassing both potential and actually manifested
emotions.47 Morris and Feldman5 found that employees grad-
ually begin to experience burnout when their capacity for emo-
tional dissonance is exhausted as a result of emotional labor.
Zapf8 also suggested that emotional dissonance is found to be
positively associated with burnout.
In particular, employees are depleted of energy and become
fatigued if they are continuously exposed to situations requir-
ing emotional regulation (e.g., adherence to excessive display
rules). As a coping strategy with this emotional exhaustion, they
may demonstrate negative and cynical attitudes toward others
and express dehumanizing and indierent responses, which,
in turn, can result in poor productivity and, nally, in a nega-
tive evaluation of themselves.48 Burnout manifests dierently
depending on the job, although it appears to be much more
common among workers involved in customer service than
among those in the manufacturing industry.49 Taken together,
these ndings suggest that greater attention should be paid to
burnout among caregivers, given their high degree of emo-
tional labor.50 Indeed, it is especially important, given that the
eects of burnout span beyond individual members and can
aect entire organizations. In other words, burnout is inimical
to the productivity and eciency of the organization, thereby
increasing turnover, facilitating negative job attitudes, and de-
creasing performance.28,51,52 While there is a growing body of
evidence that emotional labor can be stressful and lead to burn-
out symptoms, research has not sufficiently addressed the
diering factors of emotional labor as predictors of burnout.
BURNOUT AS A NEGATIVE
CONSEQUENCE OF EMOTIONAL LABOR
Due to global competition and the spread of the service sec-
tor, today’s world of work is rapidly changing.53 is transfor-
mation leads to increasing mental workloads and demands.54
Although previous literature has revealed that burnout can
occur both within and outside human service sectors,55 care-
giving service professionals are more likely to face a relatively
higher risk of burnout.56 e occupational perspective regards
occupational grouping as being relevant in and of itself,
meaning that workers employed in “high emotional labor”
jobs6 and “high burnout” jobs48 report higher levels of stress
than those in other jobs.
It has been generally assumed that there is something unique
about “caregiving” professions that make their jobs more likely
to feel burnout.28,57-59 Interactions with clients that are frequent
and long-lasting have been regarded as antecedents to burn-
out.48 Researchers have documented differences in the di-
mensions of burnout for various service and caregiving pro-
fessions,60 and have developed taxonomies of “high-burnout”
jobs based on the frequency of interactions48 and the emo-
tional control needed while interacting with clients.
The literature on emotional labor is focused on customer
service, where interactions are less spontaneously “emotion-
al” despite the necessity of high levels of emotional manage-
ment or regulation to maintain positive relationships to cus-
tomers.6,61 Hochschild6 proposed a list of “emotional labor
jobs” that involve frequent customer contact and control over
the emotional displays of the employees by their organization.
However, comparing the occupations on Hochschild’s list to
non-emotional labor jobs has not been very useful in deter-
mining stress and burnout.12,14,62 Employees in the “high emo-
tional labor” grouping do not feel higher levels of emotional
exhaustion than those in the “low emotional labor” grouping.
is nding could be attributed to the fact that emotional la-
bor is not a dichotomous variable; there may be a wide range
of emotional labor demands with many jobs having some level
of these demands.5,45
High levels of job demand may contribute to numerous
stress reactions, such as burnout and depression, which may
nally result in absenteeism, work disability, and turnover.63
For, example, Jeung, et al.64 reported that sub factors of emo-
tional labor are positively related to burnout. ese results in-
dicate that conicts and tensions occurring in the process of
interactions with clients, and experiencing emotional disso-
nance are more likely to increase the risk of burnout. In addi-
tion, a shortage of supportive and protective systems in the
organization also contributes to job burnout.
Emotional demand and regulation are more common in
the human and public service occupations wherein custom-
ers constantly demand attention.65 People who are frequently
faced with other people are more likely to feel burnout.66
Emotional Labor and Burnout
REASONINGS FOR THE EFFECTS OF
EMOTIONAL LABOR ON BURNOUT
Some mechanisms provide theoretical explanations about
whether emotional labor contributes to burnout.42 According
to the COR theory,67 when individual resources are threatened
or lost, these losses cause anxiety and distress, thereby in-
creasing physiological arousal and health problems.68 Experi-
encing interpersonal stressors is recognized as one of the
most threatening sources of stress, posing a threat to self- im-
age and resulting in increased cortisol response and perceived
distress than other stressors.69 Previous research has reported
that employees are likely to respond to angry or rude custom-
ers by suppressing genuine emotion.70 Such frequent self-reg-
ulatory eorts may lead to a loss of resources. First, the inau-
thenticity of faking expressions, or surface acting,42 reduces
one’s self-worth and self-ecacy. Such acts of strategic modi-
fication of one’s emotions, thoughts, and behaviors require
cognitive eort.8 is reduction of resources may play a cru-
cial role in enhancing the stressful situation. Moreover, the
loss of resources due to cognitive eort is more likely to con-
tribute to strained or impaired well-being.71 Second, suppress-
ing emotions requires energy resources, as exhibited by in-
creased physiological arousal, higher levels of glucose, and
decreased motivation.72 Consequently, continuous exposure to
stress due to excessive emotional demands might activate the
stress system, including the hypothalamic pituitary adrenal
axis and the sympathetic nervous system. Furthermore, ex-
cessive and long-lasting emotional demands could contribute
to depression or anxiety and behavioral problems, such as al-
cohol abuse or physical inactivity.73 ird, suppressing genu-
ine emotions results not in actually showing or directly chang-
ing those feelings, but in fewer social connections with others,38
which consequently reduces social resources.
A second explanation for the mechanisms of the causal rela-
tionship between emotional labor and burnout has focused on
emotional acting: surface acting. Surface acting is more likely
to cause emotional exhaustion due to the eort required to fake
or suppress negative emotions.41 Surface acting consistently
produces emotional exhaustion that results in diminished well-
being.74 Research suggests that surface acting is likely to deplete
energy, as it involves long-lasting internal tension between
one’s displayed (suppressed) and true feelings, which in turn
causes emotional dissonance. According to the person-cen-
tered concept of authenticity, conforming to external expecta-
tions leads to self-alienation and compromised feelings of au-
thentic living.75 Empirical research has revealed that accepting
external inuences and acting against one’s internal emotions
has a signicant association with anxiety, stress, and dimin-
ished subjective and psychological wellness.75 e continuous
experience of emotional dissonance is more likely to increase
the risk of high levels of psychological eort, thereby leading
to loss of resources76,77 and nally resulting in burnout. Surface
acting involves displaying inauthentic emotions that can pro-
duce negative responses from others. Scott and Barnes78 exam-
ined the relationship of emotional labor with work withdrawal,
and they found that surface acting is signicantly associated
with negative eects and work withdrawal.
Overall, research has documented that faking or suppress-
ing one’s genuine emotions is linked to stress, resource deple-
tion,72 and burnout.79
RELATIONSHIP BETWEEN PERSONALITY
TRAITS AND BURNOUT
Experiencing frequent and chronic job stress, combined with
a low sense of ecacy for managing job demands and lack of
social support when faced with dicult situations and envi-
ronments, is more likely to increase risk of burnout.80,81 Indeed,
over the last two decades, several studies have demonstrated
that individual dierences may play an important role in de-
veloping burnout. Several systematic reviews and meta-ana-
lytical studies examining the predictors of burnout emphasized
the role of some individual characteristics.82-84 Jeung, et al.64
revealed positive associations between the three sub-factors
of emotional labor and TABP to burnout, and a negative associ-
ation between self-ecacy and burnout among Korean den-
tal hygienists. A growing body of research is proposing that
self-ecacy and TABP operate as personal modiers against
job burnout caused by emotion regulation.
Although much research on burnout has concentrated on
working environments, personality traits were also found to
play a pivotal role in the development of job burnout.19 Recent-
ly, several investigations have documented that job autono-
my, organizational climate, and some personality traits play
signicant roles as modiers or mediators in the relationship
between emotional labor and job burnout.85 Numerous works
have emphasized the importance of personality traits; they
have stressed the personal experience of emotional labor over
time and identied personality traits as moderators.
Unfortunately, research on job stress has ignored the role of
individual differences in the stress process. One personal
characteristic that is likely to play an crucial role in the rela-
tionships among work stress, work control, and employee ad-
aptation is self-efficacy.86 Beyond the environmental factors
inuencing burnout, it is also important to consider individu-
al and self-regulatory factors that result in useful resources.
Self-ecacy refers to an individual’s belief in his or her ca-
pability to organize and execute a course of action needed to
meet the demands of a situation,87 and it refers to judgments
that employees make concerning their ability to do what is
needed to successfully conduct their jobs.88 As expected, work
control and autonomy decreased the adverse effects of job
stress on outcome measures only for employees who recog-
nized themselves as having high levels of self-ecacy in the
Da-Yee Jeung, et al.
Workers who have high levels of self-efficacy believe they
have the potential for mastering stressors more eectively than
those with lower self-ecacy. A range of self-ecacy levels is
likely to be associated with variance in employees’ reactions
because self-efficacy affects the choice of coping behaviors
and the level of persistence in overcoming job-related barriers
and stressors.89 Most research studies have emphasized the
individual perceptions of one’s social capital, such as self-e-
cacy and job autonomy, which can reduce or buffer against
the tension of emotional labor.77,90
Behavior patterns as a protective factor have long been im-
plicated as a health risk factor. People with TABP as conceptu-
alized by Friedman and Rosenman91 are described as “impul-
sive, competitive, aggressive, impatient, and more susceptible
to developing the symptoms of coronary heart disease.” Con-
sequently, these individuals are less likely to have a possibility
of coping with job stress. Numerous studies have reported a
signicant relationship between job strain and a linear com-
bination of TABP and job characteristics. Froggatt and Cot-
ton92 revealed that type A individuals experience more stress
when their work load increases, and Choo93 found a positive
relationship between job stress and TABP. Fisher,94 however,
did not nd a moderating eect of TABP on the relationship of
role stress to job satisfaction and performance.
Nevertheless, little is known as to why people with TABP are
more susceptible to adverse health outcomes. Abush and Bur-
khead95 analyzed the relationship between TABP, perceived
job characteristics, and feelings of job tension, and they found
a significant relationship between job tension and a linear
combination of TABP and job characteristics. us, research
shows that the tendency to experience burnout cannot be sep-
arated from personality or behavior pattern.96
The results of this review suggest that emotional labor, as a
new job stressor in modern society, leads to burnout and that
an examination of some personality traits, such as self-ecacy
and TABP, is needed to understand the relationship between
emotional labor and its consequences, such as burnout. ese
results also emphasize the importance of stress management
programs to reduce the adverse outcomes caused by emo-
tional labor and of coping repertories to promote the personal
potential suitable to organizational goals and norms. More-
over, enhancing individual capacities and encouraging a
healthy personality through behavior modifications are re-
quired. Furthermore, legislation at the state level is needed for
the protection of negative impacts caused by emotional labor.
is research was supported by the Fire Fighting Safety & 119
Rescue Technology Research and Development Program
funded by National Fire Agency (“MPSS-2015-80”).
Da-Yee Jeung https://orcid.org/0000-0003-4730-8814
Sei-Jin Chang https://orcid.org/0000-0001-9347-3592
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