Disability Leave


Workplace stress and time-off: often a losing combination

Let me tell you about a situation that I’ve often seen in my practice. It’s not really one case but an amalgam of many that I have seen repeated over and over again.

The call usually comes from the client or sometimes the spouse. The presenting problem is some symptom of stress such as panic attacks or something related to depression -unremitting fatigue or loss of motivation are common complaints. Whatever the problem, I always get there too late. The individual has usually been struggling at work for months, if not years. The problems could relate to a highly competitive work environment, a tyrannical boss or even a failure to cope with changing organizational demands.

However, when the worker finally comes to see the psychologist, the formative problems have been lost in a sea of medical symptoms and complaints. Now, what dominates the picture are symptoms of panic or insomnia.  The original work problem- the thing that set everything is motion – is eclipsed by the stress or burnout symptoms.

Invariably, the client has seen his or her family doctor, who sympathetic to the suffering of the worker, has prescribed some psychotropic medication along with time-off work. In my experience, exclusive reliance upon this combination can often prolong, rather than solve, the problem.

One other important ingredient, the client often calls just before his or her medical leave of absence is about to run-out. Turns out, the person on psychological leave has spent four weeks, or maybe four months, at home doing not much of anything except worrying. ‘Time-off’ is regrettably not time away from stress.

Although perhaps initially relieved to escape the work situation with the shelter of a medical leave, the inactivity of “resting” deteriorates peoples’ assessment of their own skills and abilities. It reminds me of professional athletes, who out of action due to injury, start to overestimate the moves and abilities of those still playing while slowly losing confidence in their own. In professional baseball, increasing time spent on the disabled list creates the impression that even routine ground balls are tough. Understandably, when the ‘rested’ worker considers returning to the playing field, panic quickly sets in.

Meanwhile back on the farm, the worker’s colleagues have often been forced to carry the extra work of the employee on medical leave. Secretly, many of them know that they too could go to a doctor and present their feelings in such a way to be considered for their own medical leave. Everyone is stressed, and everyone feels the demands of the workplace. As a result, their acceptance of the returning worker is often less than welcoming.

Well, what’s my approach?  Obviously, the symptoms of panic and anxiety have to be addressed.  I often do this with traditional CBT techniques that include relaxation/mediation training, developing healthy habits of living and sleep hygiene etc.  However, I also address the underlying workplace problem with structured coaching. The coaching examines everything from work habits including time and task management.  However, almost invariably, there is an interpersonal issue that needs to be remedied. Often, it is the relationship with the boss or sometimes with colleagues.    In general, I address work-place disability with a problem-solving approach looking for individual or organizational solutions to help the person return to a better work environment.