June 3, 2004
A Case Study from the St. Luke’s Institute in Silver Springs, MD
Sister Fran, age 48, frequently arrives home too late to join her community for prayer and the evening meal. As director of an agency that assists individuals with chronic mental illness, she often works evenings and weekends. Even when she has free weekends, Sr. Fran goes to her office to complete paperwork. She works on her laptop in her room after midnight to complete grant proposals and other projects. Sr. Fran has received numerous awards for her work and is widely respected for her tireless service to others. Though her staff admire her dedication, they also feel that no matter how hard they work, they can never meet Sr. Fran's high expectations. She can become very critical and at times angrily confronts staff about their performance. Staff turnover is high, as the stress of keeping up with Sr. Fran leads to burnout. Recently Sr. Fran's doctor referred her for tests to determine the cause for her chronic digestive problems. Sr. Fran decided to put off the testing until after her agency's annual fundraising campaign, which is behind schedule.
The sisters with whom Sr. Fran lives feel that something is missing in her involvement in their community life. Though she has been living with the same sisters for five years, they feel that they do not know her well. She seems uncomfortable in personal conversation and quickly turns the topic to her work. At community social gatherings, she often works behind the scenes, thereby missing opportunities to relax with others. When the sisters raise their concerns about Sr. Fran's constant work, health problems, and lack of participation in community events, she cites the hectic pace of her workplace and the overwhelming needs of her clients. She defensively reminds them that her work embodies the community's mission to care for the poor and marginalized. Though community members are concerned, they feel at an impasse. Is Sr. Fran's hard work and dedication a healthy expression of her social concern or is it workaholism?
Recognizing WorkaholismWhen individuals describe themselves as "workaholics," they usually mean that they work hard. Frequently the description is given as a matter of pride. Since our society encourages and rewards workaholic behavior, identifying work addiction is difficult. However, several factors help us to distinguish between the hard worker and the workaholic. The workaholic not only works hard but also sets impossibly high standards and is beset by a sense of never being good enough. Her need to please others is a driving force that prevents her from noticing the impact of overworking on her own health and well-being. She has a strong need to control other people and situations, and she finds it difficult to delegate responsibilities. "If I want it done well, I have to do it myself," is a characteristic workaholic belief.
The workaholic life is characterized by a striking lack of balance. The workaholic gives herself little time to develop and enjoy personal relationships. Caring for herself is low on her priority list, and health problems are often ignored until they become debilitating. Moving from task to task, deadline to deadline, the workaholic feels most alive when totally immersed in a project or dashing between several projects. The workaholic may become addicted to the adrenaline rush generated by dealing with a crisis. The workaholic uses work to escape from difficult feelings and in this process loses awareness of her desires and needs. The family members and friends of the workaholic experience themselves as a lower priority than her work, and this experience frequently erodes relationships.
Treatment OptionsConfronting the workaholic will generally meet with denial. Community members may need to engage in some type of an intervention with Sr. Fran to communicate the effects of her behavior on them. Community members may enlist the help of a therapist who works with workaholics to assess the sister and recommend treatment options.
Therapymay begin by exploring childhood experiences, since the workaholic's rigid beliefs and behaviors are formed in childhood. The workaholic has often taken on parental responsibilities as a child to manage a chaotic family life or to take refuge from emotional storms, or physical or sexual abuse. An important step is to establish the workaholic's right to give attention to her own health and well-being, rather than constantly responding to others' needs.
Cognitive-behavioral therapy will assist her to examine the rigid beliefs and attitudes that fuel overwork. A core belief such as "I am only lovable if I succeed" may be replaced by the more functional belief, "I am lovable for who I am, not for what I accomplish."
What constitutes sobriety from workaholism? Clearly abstinence from work is not a realistic goal. Sobriety involves changing one's attitudes and behaviors. The workaholic develops a moderation plan that introduces balance into life, including a schedule that allows time for physical health, emotional well-being, spiritual practices, and social support. Setting boundaries between home and work is critical, as is scheduling daily and weekly time for self-care, friendships, and play. Each day, the recovering workaholic makes time for a quiet period, for prayer or meditation, listening to music, or engaging in another "non-productive" activity.
Meetings of Workaholics Anonymous, a 12-step program, can provide support and tools for recovery. Medication may also be helpful. In some cases, Attention Deficit Disorder (ADD) underlies workaholism. Assessment by a psychologist can clarify whether ADD is a factor. If anxiety or depression is a contributing factor, medication may help to provide a more stable emotional climate as the workaholic makes the needed behavioral changes.
The work addiction of a community member can also provide an occasion for the community to examine itself. The local community, possibly with the help of a therapist, may participate in group sessions where they reflect on ways that they may be encouraging Sr. Fran's overworking. Do tensions exist in the community's life that Sr. Fran and others avoid by overworking or other addictive behaviors? Does the community hold an ideal of "the good sister" that does not allow for the normal successes and failures of human life? As the community examines its life, members will be more able to support Sr. Fran as she continues her recovery.
Martha Keys Barker, LCSW-C is a therapist in the Talitha Life Women's Program at SLI.