Let's say an attractive, nicely dressed, 45-year-old woman comes in to see you. She's a market- research analyst, or a public relations administrator, or a bank-loan manager, or a pharmaceutical company sales rep, or a medical-records specialist—one of those myriad occupations you know nothing about. She complains of being depressed, anxious, and exhausted all the time. She and her husband aren't getting along, and her teenage son seems to get surlier by the day. Not that she sees much of either one—her workday begins at 6:00 a.m., when she gets up, and ends at 7:30 or 8:00 p.m., when she finally opens her front door, carrying a heavy briefcase in one hand, a bag of takeout food in the other.
During the first few sessions of therapy, you focus on her mood and emotions, personal history, marriage and family, sleeping habits, possible substance abuse. You don't ask her much about her job. She mentions it's stressful and there's been downsizing, but she doesn't seem to think it's relevant to her problems, so why should you?
In fact, however, her stressful job may be a vital key to all her complaints. By not fully investigating her work life, you might be neglecting the most important clinical issue of all. You'd also be missing a profound shift that's taken place in the commercial world in the last couple of decades, which has profound consequences for our clients' lives and our entire culture: the increased intensity of workplace demands and the overwhelming intrusions of "the job" into our home and personal lives. While we may be hearing complaints of depression, anxiety, mood changes, fatigue, sleep problems, and tranquilizer and/or alcohol abuse, what we're likely seeing is the toxic impact of the workplace on our clients' overall well-being.
Work has always been hard for most people, at least since the Garden of Eden was closed by its proprietor. What makes it so different today? The short answer is the astounding spread of information technology into every aspect of the modern workplace. This revolutionary development—only about 20-odd years old—has dramatically changed the way work is done, the way it's organized, and the speed at which it must be accomplished, producing enormous, unintended effects on us, physically, mentally, and emotionally. Just how enormous, nobody really knows. According to a report by the National Institute on Safety and Health (NIOSH) published in April 2002, "Revolutionary changes in the organization of work have far outpaced our knowledge about the implications of these changes for the quality of working life and for safety and health. . . ." What does seem clear is that since the '80s, the fierce competitive global marketplace and the information technology that feeds it have resulted in a grinding mismatch between the ever-accelerating pulse of work and our inborn biological rhythms.
The pressure is everywhere and often worst for those working on the bottom tier. Statistics show, for example, that call centers—those electronic sweatshops of round-the-clock, timed, automatically paced phone calls—show a 30-percent absentee rate on any given day, compared to 5 to 20 percent in other businesses. The call center may be the most perfect incubator of what we call "technostress." In this case, it's stress engendered by the automated and incessant pace of calls that the employee can neither manage nor control. But technostress certainly isn't limited to call centers. It's now a phenomenon that extends throughout the working world, as tens of millions of employees must do more work in less time while being expected to constantly master new and ever-changing technical skills without adequate training.
The same technology that's created millions of new jobs and new kinds of jobs, as well as changing the way we do familiar jobs, forces us to change ourselves, too, but in ways that outpace our physical, mental, and emotional ability to cope. A 1999 NIOSH report documented that, in 1990, 40 percent of workers self-reported high stress. In 2000, 62 percent thought stress was a significant problem, according to the "Attitudes in the American Workplace VI" Gallup Poll sponsored by the Marlin Company. By 2005, 80 percent reported feeling stressed at work. Stress is further compounded by the increasing hours spent at work. The American Psychological Association survey on work stress conducted in 2004 noted that one in four workers on average in all businesses has taken sick days for their mental health, to get a break from stress and because sick days are the only time they feel they can be absent from the job.
Realistically, there isn't much we can do to transform corporate and bureaucratic cultures or the economic pressures behind them, so how can we help our clients become healthier workers in admittedly unhealthy work environments? To begin with, it's imperative for therapists to understand the features and demands of the 21st-century workplace that are having unprecedented impacts on the well-being of workers.
The Sources and Effects of Technostress
As might be expected, computers are at the top of the list of stress producers, with their chronic malfunctions and crashes, and the constant demands on employees to keep up their skills with increasingly complicated systems. The amount of stress malfunctioning computers create may be glimpsed from the revealing statistic that one in four computers has been physically assaulted, notes Peter Brillhart in his 2004 article "Technostress in the Workplace."
Other technologies that generate stress include cell phones, PDAs, blackberries, iPods, other wireless gizmos and gadgets that connect us to the Internet, and the networks that these devices enable. Even if we know how to use all of this cyberstuff, we're often not good at fixing glitches and can rarely repair the devices themselves. Of course, it's virtually a maxim that technogadgets fail at a rate directly proportional to the urgency of the task they're needed to perform.
Technostress becomes technodistress when the problems of using technology exceed the user's coping ability. Technodistress makes us irritable, confused, ineffective, frustrated, and anxious. When people are frustrated, they feel it physically first in elevated heart rates and high blood pressure and then also in the surge of the stress hormone, adrenaline. When we've got enough adrenaline flowing through our bodies to run a marathon, but no way to expend it, we end up feeling exhausted and drained, body and mind.
The heightened activity of the sympathetic nervous system that goes on for hours in such an environment contributes to anxiety, hypervigilance, and the inability to turn off stress to rest or sleep. Chronic, unalleviated stress of this kind not only compromises cognitive and emotional function, increasing the risk of mental illness and addiction, but also undermines the autonomic nervous system and brain stem, affecting vital signs and predisposing workers to mental and physical illness.
A term coined a decade ago, datasmog is basically a more colorful synonym for information overload, a pervasive byproduct of the Information Age. It refers not only to the condition of being overwhelmed by vast seas of Internet-generated information, but to the complex and often confusing processes of storing and retrieving it.
In today's work world, even the simplest decisions, communications, or projects are engulfed in this cloud of data, much of it caused by the sheer volume of e-mail messages. Brillhart's "Technostress in the Workplace" reports on a study of Fortune 1000 workers by the Institute for the Future that showed that each office worker in those companies generates an average of 178 messages per day—impossible to do by telephone or in person, but easy when one person can instantly send a message to one hundred or one thousand different people.
Datasmog taxes the brain by overloading it with a vast quantity of information lacking sufficient markers denoting what data is worth storing and what isn't. The human brain stores and retrieves information through associative networks, which link specific experiences with time, place, people, mood, and a host of other factors. If you think about how you learned to tie your shoes, you probably remember it in the context of who was there and when you learned it. If you're trying to remember something about the continent of Africa, chances are you'll associate first to the social studies teacher in junior high school who taught the class, or perhaps just the classroom itself. This associative process seems necessary to human memory. Being smothered in quantities of data, each bit unattached to any place, person, or event, makes it far more difficult to discriminate the vitally important from the merely trivial. We must concentrate harder to separate the grain from the chaff, and even so, we still make mistakes, resulting in confusion, wasted time, difficulty making decisions—and more stress.
Almost nothing increases technostress like the accelerated pace and increased hours of work, both perverse products of supposedly "streamlining" and "time-saving" technology. By some strange alchemy, the fact that technology allows more work to be crammed into fewer hours has resulted in extended work hours.
When one client, Mary, tried to discuss how many hours per day she was expected to spend at work completing a project, her boss brushed her query away, saying "The eight-hour workday is dead!" Just recovering from a stress-induced anxiety disorder, she was now hearing that she had to stay at her desk "until the work is done" if she wanted to keep her job. Predictable, reasonable hours are critical to managing energy output and restoration, but, as far as Mary could tell, her work was never done—one project merged with another, her workday and workweek never really "ended," and life became an endless treadmill of physical and psychic depletion.
Perhaps no endemic workplace condition causes more anguish among employees than the culture of contrived urgency, the ginned-up atmosphere of crisis, in which everything—every project, every report, every meeting—is an urgent priority, superseding all the other urgent priorities before it in the long queue. Economic pressures produce a high, steady degree of frenzied fear at the top of an organization, which cascades down to individual employees. The general hysteria creates an ersatz state of emergency that simulates a hospital emergency room, where every decision is a question of life or death—in spite of the fact that, as far as we know, nobody ever died from a missed deadline or a dissatisfied customer.
Employers, whether intentionally or unintentionally, intensify the contrived urgency by providing employees with blackberries, laptops, pagers, at-home faxes, and/or access to workplace computer data via the Internet. Setting aside the issue of boundaries for a moment, the clear message this sends is that the work can't and must not wait—it must always take precedence. The constant "ping" of instant messaging, paging, texting, and e-mailing gives a sense of urgency to the most mundane of messages.
The pinging of e-mail is only one of the interruptions that generate technostress in the workplace. Interruptions increase work time dramatically. According to research at the University of California done in 2004 by Gloria Mark, a scientist of "human-computer interactions," with two California high-tech firms, employees were interrupted roughly every 11 minutes by an e-mail, a visitor, or a telephone call. Mark found that, once interrupted, it took people about 25 minutes to get back to the original task, if they managed to do so at all.
It's easy to see how continual interruptions affect good cognitive functioning. Concentrating, analyzing information, making decisions—anything requiring full attention—are virtually impossible to do adequately in the face of constant intrusions. Take multitasking. The term was originally applied to computers, which can do two or more tasks simultaneously. The human brain, which is superior to a computer in many ways, can't multitask, regardless of hype to the contrary. We can toggle quickly back and forth between two relatively simple tasks, but as study after study has demonstrated, our mental efficiency plummets when we try to work on two complicated things at once. A recent study by mathematician Sergei Bezrukov cited by Peter Brillhart demonstrated that when subjects attempted to do two jobs at the same time, each job took 50 percent longer to accomplish than if one was completed before going on to the next. Worse, with multitasking, a person gets the sense of never being finished and always being "on."
Continual partial attention is another ubiquitous and insidiously exhausting form of low-level interruption brought to us by communications technology. While at a concert, ballgame, restaurant, or at the beach, we're simultaneously scanning the "periphery" for incoming messages from one of our hand-held devices. The constant pull for our attention makes us feel needed, connected, at the hub of the action, but scanning is tiring and radically degrades the quality of the attention we give to the people and activities right before our eyes.
The ping of an incoming message causes a reflexive need to respond. Your emotional brain hears a cell phone ring or a "you've got mail" indicator and sounds the alert. There's something there waiting, and the alert doesn't release until you respond. Again, the urgency is contrived. Real urgency is a fire alarm, but your autonomic nervous system responds to that chiming tone of the blackberry as if a fire were raging and must be put out immediately.
As endocrinologist Hans Selye's groundbreaking research first demonstrated in the 1950s, people can only adapt to serious stress for a time before becoming physically, mentally, and emotionally exhausted—beyond which point, no further adaptation is possible. That point is informally referred to as burnout, which stress researcher Arie Shiron calls "vital exhaustion."
Burnout is characterized by constant fatigue (a symptom that could be interpreted as depression) and poor utilization of coping skills (people get easily upset, frustrated, tense, and nervous), which resembles clinical anxiety. In a state of chronic hyperarousal, people often can't sleep (so their energy isn't restored at night), they develop addictive behaviors to cope, get ill, become more susceptible to physical injury, and may even die if the stress is severe and lengthy enough. All these symptoms may look to us like typical mental health issues, but, if we don't address their fundamental cause—workplace stress—all the psychotherapy in the world (assuming the stressed-out person even has time for therapy) won't fix the problem.
What Therapists Can Do
Of course, no matter what the issue—bad marriage, bad family background, bad job—therapy can always help people become psychologically more grounded, more self-confident, and less vulnerable to letting other people tap dance on their heads. More specifically, however, we can teach our clients how to set reasonable limits at work in ways that all but the most psychopathic employer can accept. Some of what we tell clients to assist them in dealing with workplace stress and anxiety includes the following:
Energy Management: Sprints, not Marathons
Even though many clients are worried about rocking the boat and appearing to try to bring about radical change at work, most will accept being educated about how to take charge of their own personal energy management. The basic principle, as described by James E. Loehr and Tony Schwartz in "The Making of the Corporate Athlete," published in the Harvard Business Review, is that energy expenditure must be followed by energy recovery.
The workplace subtly (and sometimes not so subtly) pressures employees to run marathons day in, day out, by skipping breaks, eating lunch at their desk, staying late into the evening, and taking paperwork home to finish before the next day. We must help our clients learn to run sprints instead. How long should each sprint last? Studies of energy oscillation suggest a 90-minute cycle within the daily circadian rhythm. This means that people need to restore their physical, mental, and emotional energy not just every day, but every 90 minutes during the day, to function well.
An effective stress-recovery plan that's adaptable to virtually any workplace is to establish 2-minute recovery drills to follow each 90-minute sprint of energy. Those who work at computers can program pop-up reminders to prompt them to engage in their recovery rituals. Physical recovery rituals to suggest to clients can include the following:
Doing 2 minutes of relaxation at their work station or on their break. For example, they can take a 2-minute mental vacation by closing their eyes, thinking of a pleasant experience, and calling to mind how each of their senses was involved. Clients less oriented to imagery can learn to calm down and check their own biorhythms by using computer-generated biofeedback mechanisms, such as Heartmath, Stress Eraser, or Wild Devine.
- Doing desk stretches or desk yoga, going quickly through each part of the body.
- Getting up and getting a glass of water.
- Going for a 2-minute walk.
- Getting outside for a breath of fresh air.
- Of course, the most important way of replenishing energy is going home—without work.
Clear Out the Datasmog
We can help our clients minimize energy lost to interruptions or inefficient multitasking by teaching them to subdue their own tendency to respond immediately every time an e-mail message or call comes through. More specific datasmog recovery tips include:
- Making clear distinctions between "answering times" and work-production times.
- Programming a mailbox manager system in the computer to delete messages after 30 days.
- Creating uninterrupted stretches of time for concentrated, focused work. Finishing a task without interruption is the biggest time/energy saver and anxiety reducer of all.
- Refraining from doing personal work at the office and vice versa.
- Working at the desk for an hour each morning before reading e-mail.
- Not copying everyone in a group on messages that only one person needs to respond to.
- Turning off auditory indicators (pings and dings) that announce messages accumulating on the phone or e-mail.
- Turning off communication devices in work meetings.
Rethinking Work Attitudes
There's some evidence that corporations in the United States are beginning to understand that high workplace stress leads to rapid turnover, absenteeism, illness, short-term disability, poor morale, and—worst of all—low productivity. The 2007-08 report from the National Business Group on Health, "Building an Effective Health and Productivity Framework," demonstrates that some companies understand the rising financial costs caused by workplace stress and are aware of the emerging research showing lower disability and health care costs when workers are healthier.
While we wait for industry in general to make an attitude shift about the importance of stress reduction in the workplace, we can help our clients change their relationship toward employment in a way that'll relieve their burnout-generated anxiety, depression, sleep, or relationship problems. The shift includes changing three basic attitudes that'll allow them to incorporate the technostress reduction and energy-management ideas they need.
- Take control over what's in their control and don't try to control what isn't.
- Create boundaries between work and personal life.
- Decide what's meaningful and make time for it, whether at work or away from work.
Take Mary, whose boss didn't believe in the eight-hour day. One of his most maddening habits was to give her an assignment, but never actually say when it was due, only telling her, when she asked, "As soon as possible—it's vitally important!" But was it more or less "vitally important" than the task he'd handed her earlier that same day? She couldn't get him to help her prioritize her assignments or give a firm due date. So, having been bolstered by some assertiveness training, she changed her approach and began assessing the importance of a new task herself, then announcing to him when she could get it done and what other assignments would have to be set aside in order to do it. To her amazement, she wasn't instantly fired. He'd simply say, "Okay," and walk away!
John's problem was a perceived lack of meaning in his work. He felt his job as an accountant was okay, but he yearned to do something more "socially meaningful." As we talked about his situation, his attitude began to change and he realized that his job could support him while he did what he really wanted to do. He started volunteering as a tutor for an English as a Second Language course, and soon enjoyed it so much and got such a sense of accomplishment from it that his satisfaction began to spill over into his work.
As psychotherapists, we aren't going to stop the techno-behemoth from transforming the workplace in ways that aren't good for human beings. But we know better than either industry or government how to assess the impact of work on people and, more important, how to help them find ways of surviving in toxic workplaces. As we help clients deal with burnout, we'll be impacting the mental health problems it causes. Of course, we shouldn't stop assessing the underlying causes of mental health problems—people suffering burnout from technostress can still have histories of trauma, relationship problems, depressions, or anxieties unrelated to their jobs. But if we stop ignoring how much work has become a highly toxic influence on mental health, we can become a resource for increased well-being that workers can't find anywhere else.
Margaret Wehrenberg, Psy.D., has been in private practice as an addictions counselor and a psychologist for more than 20 years. She specializes in anxiety treatment, using a holistic approach for symptom management. She's the author of The Anxious Brain: The Neurobiological Basis of Anxiety Disorders and How to Effectively Treat Them. Contact: firstname.lastname@example.org.
Laurel Coppersmith, L.C.S.W., is a Pittsburgh-based psychotherapist who specializes in anxiety, addiction disorders, trauma recovery, and workplace distress. She consults with organizations ranging from family-owned businesses to Fortune 500 companies on stress management and leadership development. Contact: laurel email@example.com.
Letters to the Editor about this article may be e-mailed to firstname.lastname@example.org.