Most of my clients suffering from workplace stress or burnout have symptoms in two areas–clinical and the occupational. As a result, I have to treat the client’s psychological symptoms but I also have to understand how the factors in the workplace might have contributed to the presenting psychological symptoms.  Focusing upon just one provides only a partial solution.

In this post, I’ll describe the clinical.  When stressed workers first come to see me, they are often mired in the symptoms of their workplace problem.  The original problem in the workplace is often secondary to the subsequent emotional distress.  In other words, these workers are not only stressed or depressed, but also worried about their stress or depression.

If depressed, they are likely to wonder if their fatigue will ever lift, if their focus will ever be the same, or if they will ever be able have another night of restorative and uninterrupted sleep.

If anxious, they are worried if their physical symptoms of arousal such as their rapid heart rate or dizziness mean that they are physically sick as well as emotional upset.

Since most of my clients are successful managers or professionals not used to being disabled with psychological issues, it is easy for many of them to extrapolate a catastrophic spiral with imagined outcomes of poverty and unemployment.

Cognitive Behaviour Therapy or CBT offers many useful tools to help individuals in this acute phase of the disability.  As a first step, we work together to comprehensively untangle the jumble of upsetting feelings, ideas, and physical symptoms to produce a rational explanation of what is happening.  Often, in the case of depression, clients are unglued by their own state of lethargy and hopelessness, a reaction that serves to perpetuate their distress by diminishing their confidence.  In the case of stress, often clients have catastrophic interpretations of their physical symptoms or pessimistic scenarios involving their lifelong duration.

In this phase, we teach the importance of the so-called “cognitive model” where one one’s thoughts, especially the most pessimistic and alarmist, promote our upsetting feelings.

All of the above material is relevant grist of the mill of cognitive behaviour therapy; however, it does not address what caused the problem initially. For that, we have to advance to an occupational assessment.

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People are curious.  Office romances, organizational changes, either real or imagined, vie with hockey pools as major themes of work place conversations.  High-up on this water-cool conversational list are sick leaves, especially an absence related to psychological problems.

Whether it be; “There but the grace of God, go I” or “If she’s off with stress, then I should be at home as well” – the imminent return to work of someone with a psychologically-based disability will be on the radar screens of all your co-workers.

Most of my clients who are on the verge of returning want nothing to do with this potential conversation.

They appropriately view their problems as their own business. This privacy is fully endorsed and promoted by all the major players in the disability arena from the patient’s doctor to the company’s HR department.  In fact, in most North American work places, the confidentiality of an employee’s medical disability is legally enforced.  When I managed a hospital department, all I knew was that the employee was “off for medical reasons.”

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Return to Work

In my last two posts, I shared my view on how CEO’s and managers discuss mistakes in their executive coaching sessions with me.  I pointed out how much the discussions focused on the emotional consequences of the mistake and not the underlying cognitive process.  This got me thinking about how my professional of psychology handles mistakes – not too well, since errors are rarely recognized.  Medicine is doing better by changing professional attitudes and teaching about the cognitive biases and traps that often blind a physician’s thinking.

In today’s post, I point to a high-flying example that we can all emulate.

Aviation Industry; a model

There are many admirable aspects about the aviation industry concerning the management of errors, perhaps because the consequences are obvious and dramatic.

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Mistakes · Problem-solving

In my previous post, I shared my view on how CEO’s and managers discuss mistakes in their executive coaching sessions with me.  I pointed out how much the discussions focused on the emotional consequences of the mistake and not the underlying cognitive process.  I offered that my own profession of clinical psychology didn’t do a particularly good job either in handling mistakes. In today’s comments, I’ll examine some of the changes that are reducing medical mistakes before I present a model for us all.

Errors in medicine; torts and traps

In contrast to Psychology, there is more consistence about what interventions will cure or kill a medical patient.  However, the variability in each patient’s presentation with only partial overlap with group-based diagnostic criteria makes the environment ripe for mistaking the condition and providing the wrong treatment. Even the right treatment can initiate a chain of side effects that becomes as serious as the original problem.  Given this inherent complexity plus the fact medical decisions are often split-second decisions made by stressed and tired medical professionals, it is not surprising that errors occur.  We have documented evidence for the magnitude of the problem; the US Institute of Medicine estimated that 44,000 to 98,000 patients succumb to medical errors each year in the US.

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Mistakes · Reacting to errors

We all make mistakes. Lawyers sometimes accept cases that they know they shouldn’t; teachers get into battles with kids that are unwinnable; and executives fail to consider all the variables in their strategic planning analysis. The question is; do we learn from our mistakes?  Regrettably, our current culture stresses apology over analysis.

In my practice of executive coaching I hear about business blunders all the time.  Actually, I don’t often hear about the mistake itself, more likely, I hear about the emotional consequences. I see people berate themselves or reach out for consolation after making a mistake that leads to the unleashing of a tirade from an aggressive boss. I hear people resolve never to do it again or vow to do better in the future.

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Mistakes · Problem-solving