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…