Work-Related Mental Health Issues: How Therapy Can Help
Therapy or counselling can help with issues that arise from work-related stress
Alice McGurran talks to experienced therapists about different workplace mental health challenges
Our attitudes towards work have changed quite dramatically over recent decades. Where older generations may have been more likely to view work as a means to an end, nowadays the majority of us see what we do as a integral component of who we are. Work gives us purpose, satisfies our ambitions, and allows us to be creative and make the most of what we perceive as our talents and skillset.
While having more choice and the ability to pursue work that is meaningful to us is arguably overall a positive phenomenon, it does leave us in a vulnerable position when things aren't going to plan. When our sense of self is tied to our 9-5, what happens if our job makes us feel inadequate, disillusioned, or extremely stressed?
A certain amount of stress is helpful to us: positive stress helps us to meet deadlines and keeps us wanting to do our best. Chronic stress however, or stress that induces anxiety or depression, only damages our wellbeing, productivity, and can lead to burnout. Stress is a physiological reaction that results from belief that demand is higher than supply. Your system under stress is pushed to 'fight or flight' mode, and our resources are inhibited as our primary goal comes to be one of physical survival. We therefore lose our ability to access usual levels of rational thought and manage our emotions successfully. Living with this amount of stress on a daily basis can lead to mental health problems, and physical problems such as headaches, migraine, back pain and skin complaints.
Liz Jeffries, a therapist on welldoing.org, emphasises the importance of addressing chronic stress: "If stress at work is persistent, pervasive and you feel a growing sense perhaps of anxiety, loss of self-confidence and/or depression then it may be time to reflect on your situation. Why for example is your reaction to stress different in this job than it has been in any other? Is there something else happening in your life that has contributed to your reactions in the work environment? Everyone will have a unique set of circumstances and therapy and counselling can help you understand yours, including your experience of stress. In fact, by exploring stress at work, sometimes there may be something deeper which could benefit exploration, and which when resolved gives you greater resilience, a different approach to the work environment, or perhaps even an improved overall sense of wellbeing."
Some recent statistics about problems in the workplace in the UK:
- In a recent survey by Mind, the mental health charity, 32% of men blamed work problems as the root cause of their mental health issues
- According to the Mental Health Foundation, six in 10 of the UK's working population has trouble sleeping due to work-related stress
- In 2015/16 stress accounted for 37% of all work related ill health cases and 45% of all working days lost due to ill health, according to the Labour Force Survey
- According to the HSE's Health and Safety at Work survey (2015/16) 1.3 million working people suffering from a work-related illness
- Nearly a third of people (29%) have been bullied at work and in nearly three-quarters (72%) of cases the bullying is carried out by a manager according to the TUC
Not only can work create stress and mental health problems, these same problems then understandably affect our time in the workplace, having a massive impact on our productivity and leaving many of us unable to go to work at all. The Institute of Director’s Andy Silvester points out: “127 million hours of work were lost in 2015 due to mental health-related absence – the equivalent of around 75,000 individuals losing the entire year. The number of days taken off work with mental health problems has increased 25 per cent year on year, and stress, depression and anxiety together rank as the largest reason for absence in the workplace.”
I spoke to welldoing.org therapists about some common workplace related issues, why they might cause stress, anxiety and depression, and how therapy can help.
"Perfectionism is a huge issue with many of my clients", says therapist Karen Pollock. "This idea of needing to be perfect can cause huge anxiety, and stress, indeed it can become a vicious cycle where we push ourselves to be better, but never live up to impossible to meet standards. Management techniques which rely on bullying, aggression and competition can exacerbate the problem.
The therapeutic space can be the ideal environment to work on this. Firstly simply identifying if the standards and expectations are reasonable: are you worrying unnecessarily, or pushing yourself to meet an ideal no one else expects of you? Sometimes the roots of the need to be perfect lie in the past, sometimes in our self-image and self-esteem. Not every feeling we have needs an "archaeological" delving into our past, sometimes the therapeutic space is about accepting we are 'good enough' in the here and now."
Wendy Bristow, who used to work in a creative industry and now practices as a therapist in London, empathises with feeling insecure at work: "When you create a piece of work, you’re putting your creative baby out there to be criticised. If you’re unusually sensitive you will be hyper-responsive to criticism as well as praise. It can feel so personal. The more you doubt yourself and your talents - we could say the wobblier your sense of self-worth - the thinner your skin will be.
Therapy can help with that. Exploring how and why these things affect you the way you do and looking at the ways in which you dismiss yourself or doubt your abilities can shore up your sense of self. Many creative people find they are more robust once they’ve sorted the feelings and thoughts that go with endlessly worrying about what they've produced."
Welldoing.org therapist Lyn Reed has personal experience of being bullied in the workplace: "Being bullied at work, by your boss for example, may cause you to run yourself into the ground, trying to work longer and harder in an attempt to feel validated through your work and in hope that you will no longer be the target of bullying. This can end in a loss of identity and any sense of a work-life balance.
Therapy may help you gain some perspective on your situation, help you realise that you have been the victim of an abuse of power and that you are not to blame for this situation."
With or without the experience of being bullied by a colleague or boss, you may still feel like you don't fit in at work. Many workplaces, and even jobs, are geared towards extroverts. Indeed, much of our environment in the UK is potentially more challenging for introverted individuals to navigate. Music playing in offices, adult games areas with ping-pong tables, staff parties, presentations - all of this can be extremely draining for someone who gains their energy in a more contained space and is tired by sensory over-stimulation. Therapy is a journey of self-acceptance in many ways, and you might find that you develop healthy coping mechanisms and ways to work with your strengths.
4) Lack of confidence
"Many people are reluctant to admit they may benefit from therapeutic help for work related anxiety, seeing it as a weakness", says hypnotherapist and CBT counsellor Louise Carroll. "However, suppressing it and ‘battling through’ creates a vicious circle of negative thinking that creates more pressure from within. A self-imposed ‘demand’ to perform perfectly or a fear of being exposed as incompetent, or judged as no good by others, are common factors underpinning the dread of public speaking and low self-belief.
Cognitive Behavioural Therapy (CBT) is increasingly recognised as an effective method that untangles emotional states and ‘reprogrammes’ the individual to think and act in a more rational and productive way. Many of my clients are surprised to discover the extent to which deep set beliefs about themselves and others are at the root of their confidence issues. Far from being ‘soft and fluffy’, CBT is strategic and process-driven, working towards creating long lasting changes. Situations that may in the past have triggered the fight or flight response - asking for a pay rise, meetings of any kind, let alone presentations – can be managed by the reinforcement of healthy new perspectives and behavioural techniques."
5) Lack of motivation
Our enthusiasm about going to work can differ day to day, that will be true of all of us. But what if you have fallen out of love with work and it has become something you dread? Despite this you may not feel you are in a position to leave or change jobs. This kind of situation can leave us with a confused sense of identity, depression and can affect our lives outside of the workplace.
Counsellor Anna Storey suggests in may be time to look inwards: "I would maybe invite a client to pay attention to his/her inner dialogue: what is going on inside his head when he thinks about work? Is one part of him wanting to leave - listen to what it is saying. Another part thinks it is better to stay? Again, listen. This technique, originating from transactional analysis/gestalt therapy, is very helpful in finding out where is your Real Self and where is Adapted Self. Further chairwork can help deepen the client's insight."
Perhaps you have been working very hard, for years maybe, to reach a certain position in your career, or to earn enough that you can afford a certain lifestyle. We all have hopes and dreams, and often put a lot of weight on the idea that certain things will ‘make us happy’. It’s a thinking trap - ‘I’ll be happier if…..It will all make sense when...’ - that leaves us vulnerable to disappointment, or even despair, when we do achieve our goal and find that in fact we feel very much the same as we did before.
At times like this, you may feel somewhat forced into a state of self-reflection: why isn’t this job everything you had hoped it would be? Why don’t you feel successful / wealthy / stimulated / satisfied in the way that you were sure you would? These realisations are difficult and encompass the loss of imagined ideals and movement into an area characterised by uncertainty over one’s future and self-doubt.
Counselling can provide the safe space for you to get to the root of why this particular job title or goal had meant so much to you – perhaps this speaks more about deep rooted anxieties, conflicts around self-esteem, and a tendency to measure self-worth by external factors.
7) Setting boundaries
It is difficult to switch off from work, our smart phones and reliance on the internet meaning that we rarely spend any time where some aspect of work might flash, beep or vibrate into what is meant to be our time off. Steps are being taken in recognition of this: in France employees have been given the legal "right to disconnect” avoiding work emails outside working hours. French companies with more than 50 workers must now draw up a charter of good conduct, setting out the hours when staff are not supposed to send or answer emails.
Even if we do manage to successfully disconnect from work out of working hours, it doesn't mean that many of us don't feel guilt or anxiety about doing so. Fear of missing some really important email, or guilt over not helping out with a task when you've been asked to. This kind of self-blame thinking might be indicative of issues around personal boundaries and assertiveness. This is something that can be explored in psychotherapy, where you can be supported whilst looking into areas of guilt and reluctance over saying no.
Never saying no to colleagues and managers can lead to being overworked, burnt out, and to a loss of personal identity. Not being able to say no is often linked to seeking approval from others, and this could be a habit that you set down in childhood. Psychodynamic psychotherapy is characterised by an exploration into family dynamics and childhood experience. Learning about how your early years might shape your present outlook can be invaluable.