Is Work Killing You?: A Doctor's Prescription for Treating Workplace Stress

By David Posen MD

From the bestselling author of Authenticity and The Little Book of Stress Relief comes the definitive guide to treating — and eliminating — excessive stress in the workplace.

Dr. David Posen, a popular speaker and a leading expert on stress mastery, identifies the three biggest problems that contribute to burnout and low productivity: Volume, Velocity, and Abuse. He shares revealing anecdotes and offers clear descriptions of the biology of stress to illustrate how downsizing, economic uncertainty, and technology have made the workplace more toxic than ever. Most importantly, he offers practical advice and easy techniques for managing the harmful symptoms and side effects of stress.

Witty, engaging, and accessible, Is Work Killing You? touches on everything from meetings to tweeting, from fake work to face time, from deadlines to dead tired, and more. With this book, Dr. Posen gives us the tools to stop harming our most valuable resource — ourselves.

• Language: English
• Publisher: House of Anansi Press
• Release date: Feb 2, 2013
• ISBN: 9781770892767

David Posen MD

DAVID POSEN, M.D., is a physician, popular speaker, and the bestselling author of The Little Book of Stress Relief, which sold more than 50,000 copies and has been translated into five languages. His previous books also include Staying Afloat When the Water Gets Rough and the classic, Always Change a Losing Game. His writing has appeared in Canadian Living, Reader's Digest, Men's Health, USA Weekend, and his TV and radio appearances have aired nation-wide. He lives in Oakville, Ontario.

Book preview

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PRAISE FOR DAVID POSEN AND THE LITTLE BOOK OF STRESS RELIEF:

It’s amazing that such a little book can deliver such a huge impact! This is not just a stress guide — it’s a life-skills manual, filled with stories, warmth, and humour. Superb!

— Rita Emmett, author of The Procrastinator’s Handbook

and The Procrastinating Child

"No matter how good you are at dealing with stress, I strongly recommend to you Dr. Posen’s The Little Book of Stress Relief. It provides an excellent framework for stress management and is filled with great tips and insights. And it’s fun to read! I plan to keep it handy, so I can re-read sections as the need arises."

— Peter G. Hanson, MD, author of The Joy of Stress

PRAISE FOR DAVID POSEN AND Staying Afloat When the Water Gets Rough:

David Posen has done it again! His survival guide for changing times is down to earth, reassuring, and fun to read.

— Jack Canfield, co-author of Chicken Soup for the Soul

"David Posen is a very good advisor to anyone in transition. I recommend Staying Afloat When the Water Gets Rough to anyone who’s trying to make it through a bad stretch of white water."

— William Bridges, author of Transitions and Jobshift

PRAISE FOR DAVID POSEN AND Always Change a Losing Game:

This book makes change seem fun rather than a chore. Dr. Posen shows you how to turn dreams into reality. Begin reading any page, you’ll not want to put this wonderful book down.

— Christine A. Padesky, Ph.D., Director of The Center for Cognitive Therapy

and co-author of Mind Over Mood

For a change: a practical book full of the clinical wisdom of an experienced physician.

— Dr. Stanley E. Greben, Professor Emeritus of Psychiatry,

University of Toronto

This book is perceptive, instructive, productive, and written in an entertaining fashion. It is a valuable addition to any growing person’s library.

— Dr. Ron Taylor, Toronto Blue Jays team physician and

former major league baseball player

Also by David Posen, MD

Always Change a Losing Game

Staying Afloat When the Water Gets Rough

The Little Book of Stress Relief

Is Work Killing You?

A Doctor’s Prescription

for Treating Workplace Stress

David Posen, MD

AnansiA.tif

Copyright © 2013 David Posen

All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher.

Distribution of this electronic edition via the Internet or any other means without the permission of the publisher is illegal. Please do not participate in electronic piracy of copyrighted material; purchase only authorized electronic editions. We appreciate your support of the author’s rights.

This edition published in 2013 by

House of Anansi Press Inc.

110 Spadina Avenue, Suite 801

Toronto, ON, M5V 2K4

Tel. [phone]

Fax [phone]

www.houseofanansi.com

Library and Archives Canada Cataloguing in Publication

Posen, David B

Is work killing you? [electronic resource] : a doctor’s prescription for

treating workplace stress / David Posen.

Includes index.

ISBN 978-1-77089-276-7

1. Job stress. 2. Job stress--Treatment. 3. Stress management. I. Title.

RC963.48.P68 2013 616.9’803 C2012-905953-6

Cover design: Marijke Friesen

Cover illustration: Kagan McLeod

pub1.jpg

We acknowledge for their financial support of our publishing program the Canada Council for the Arts, the Ontario Arts Council, and the Government of Canada through the Canada Book Fund.

To my maternal aunt, Freda Manson Bacher,

and my paternal uncle, Aaron Posen, whose unending

love and support will stay with me forever

CONTENTS

Preface: Why I Wrote This Book

INTRODUCTION: WORKPLACE STRESS — SETTING THE CONTEXT

Defining the Problem

What Is Stress and How Do You Know When You Have It?

Why Should You Care? Why Is This Important?

The Futility of It All: When Good Stress Becomes Bad Stress

Six Degrees of Stress: Everyone’s a Victim

Sources of Stress: The Big Three

SECTION 1

VOLUME: THE FACTORS THAT CONTRIBUTE TO OVERLOAD AND WHAT CAN BE DONE ABOUT IT

CHAPTER 1 What Tips Us Over: The Causes of Overload

CHAPTER 2 Too Few Hands to Share the Load

CHAPTER 3 The Elephant in the Room: The Conspiracy of Silence

CHAPTER 4 Belief Systems and Changing the Corporate Zeitgeist

CHAPTER 5 The Fallacy of Face Time: Performance Measurement Has to Change

Chapter 6 The Lunacy of Long Hours and the Need to Work Fresh

Chapter 7 The Slippery Slope to Burnout

CHAPTER 8 Where’s Your Sweet Spot? The Zone for Optimal Performance

CHAPTER 9 Fake Work and Spinning Wheels; Prioritizing and Letting Stuff Go

CHAPTER 10 Slicing Up the Corporate Pie; Restoring the Basic Bargain

SECTION 2

VELOCITY: HOW TO NAVIGATE THE WORLD OF WORK WHEN THE PACE IS FASTER THAN EVER

CHAPTER 11 Unrealistic Expectations: The Mind Trap That Fuels

the Treadmill

CHAPTER 12 Realistic Expectations: Training Your Clients and Customers

CHAPTER 13 The Myth of Multi-tasking; Single-tasking and Focus

CHAPTER 14 Timeouts: The Pause That Refreshes

CHAPTER 15 Overuse and Misuse of Technology and How to Tame It

CHAPTER 16 Meetings; The Need for a New Meetings Manifesto

CHAPTER 17 Bureaucracy and Red Tape: Bumps on the Road to Productivity

CHAPTER 18 The Work-Life Interface: Balance or Blending?

CHAPTER 19 Health Habits and the Staggering Cost of Self-Neglect

SECTION 3

ABUSE: WHAT TO DO WHEN THE PEOPLE YOU WORK WITH ARE YOUR BIGGEST SOURCE OF STRESS

CHAPTER 20 Identifying and Dealing with Problem People

CHAPTER 21 People Don’t Leave Jobs, They Leave Bosses

CHAPTER 22 The Games People Play: Office Politics

CHAPTER 23 The Keys to Employee Engagement and Stress Reduction1

Chapter 24 The Obsession With Numbers

CHAPTER 25 Does It All Have to Be About Money? Must the Rich be

Filthy Rich?

CONCLUSION: PREVENTION

Pay Now or Pay Later: Prevention Is the Best (and Cheapest) Cure

What Companies Can Do to Decrease Workplace Stress

What Managers and Leaders Can Do

Throttling Back to Move Ahead: It’s Time to Recalibrate

Who Will Lead the Charge for Change? Who Will Bell the Cat?

Wrapping Up and Moving Forward

Acknowledgements

Appendices

Resources1

Illustration Credits

Index

PREFACE

WHY I WROTE THIS BOOK

It happened again today. A patient sat down for his first appointment and told me a story of workplace stress that made me want to jump out of my chair, call his employer, and yell, Stop killing this man!

Joe was a smart, no-nonsense, down-to-earth guy with a warm smile and an easy laugh, but when he began to talk about his job, he became animated and upset. His knee started bouncing, his brow was furrowed, and the words poured out of him. As a physician who has done stress counselling for thirty years, it was a scene I’ve watched for decades: agitated or depressed patients who finally get to tell their story at their own pace to a therapist who is eager to listen and help. At times Joe’s voice would rise with indignation and amazement at some of the ridiculous things going on in his company. More than once he said, "They just don’t get it!"

He was a supervisor working thirteen hours a day, six days a week, with only a half hour for lunch and no other breaks. He had no assistant, was required to attend eight to ten meetings a day (most of which were wasteful), had to field fifty to eighty emails a day — even on weekends and vacation — and he said, The volume of work is incredible. He’d had three managers in eighteen months, and each had tried to restructure the department. He had a host of stress symptoms and health problems, among them low energy, insomnia, palpitations, high blood pressure, muscle tension, trouble with concentration and memory, and he was taking four different medications. He also had a spouse, a house, and a mortgage, so quitting his job wasn’t an option. He applied for a transfer, but was told there was nothing available. He felt totally stuck, caught in a vise that was doing him in.

It’s a story I’ve been hearing from patients for most of my career. The people are different, the details vary, but the theme is always the same: Workplaces are making people sick.

In another instance, a woman came to see me about a work situation that involved frank psychological harassment by her boss. Over time, four other patients appeared in my office, all with similar stories. No wonder — they all worked for the same boss! (There’s nothing like word of mouth to keep a stress doctor busy.) Here were five decent, hard-working people who became stressed enough to seek professional help, all because of one abusive manager.

Organizations, and the people who run them, keep ramping up the stress levels of their employees. Some workers wear their stress as a badge of honour, a sign of macho toughness and strength, or they believe that stress is an indication of their level of dedication, commitment, and loyalty. For them, the more stress the better. For others it’s a nightmare. They think they have to suck it up and suffer in silence. They feel they have no choice and are resigned to the new normal. They accept that that’s the way it is as the pace of the work world speeds up, the economy sputters, and jobs are in short supply.

These notions have become a sacred cow that no one is willing to challenge. There’s a chill in the air about even addressing workplace stress. It’s the elephant in the room that people are reluctant to acknowledge, much less talk about — except in hushed tones — lest they be viewed as wimps, weaklings, or whiners.

This book is based on four premises — observations I have made that compelled me to speak out:

Workplaces are making people sick.

Not enough people are talking about it, and when they do, nobody’s listening.

Much of the time and effort put in by stressed-out workers is unproductive.

Many of the solutions aren’t complicated.

I want to shine a light on the situation, offer some constructive ideas and solutions, and stimulate a conversation about how to fix these problems. I don’t pretend to have all the answers, but I do have observations, thoughts, and strategies to share. I’m writing from an informed but external perspective. I can see things that insiders don’t notice anymore because they’ve gotten used to them. I’m also a caring physician who is both saddened and incensed by the damage I’ve been watching for years. I feel a need to speak up, to be an advocate for those who are struggling.

I wrote this book because I have a privileged perspective:

I’m not in the middle of the situation. I’m an outsider and thus an objective observer.

I’m a doctor. I get to see first-hand and up close the psychological and physical damage this is causing. I have a microcosmic view — patients tell me in confidence and in detail what’s happening and how it’s affecting them.

I’m a speaker and a trainer. I work with corporate, government, education, and professional groups who take me into their world when I gather information as part of my speech and seminar preparation. As a result, I get a macrocosmic view of the issues within these organizations.

This is not just a workplace problem. It’s a public health issue because it affects so many people and their families. A 2012 study on work-life balance in Canada (conducted by Professors Linda Duxbury at the Sprott School of Business at Carleton University, and Chris Higgins at the Richard Ivey School of Business at the University of Western Ontario) surveyed 25,000 full-time employees. Fifty-seven percent reported high levels of stress, a third of respondents felt they had more work to do than time permitted, and half said they took work home with them in the evenings and on weekends. A Globe and Mail report on the study noted, Three-quarters reported missing work during the last six months of the survey period because they were sick or mentally exhausted. The same article stated, To top it off, only 23 percent of working Canadians are highly satisfied with life. That’s half as many as in 1991. A 2011 study found that the divorce rate among couples with no workaholic spouse was 16 percent whereas the number for workaholic marriages is 55 percent. We’ve become a stressed-out society with a dramatic increase in stress-related illnesses such as anxiety, depression, and burnout. The most commonly prescribed drugs are for hypertension, heart disease, anxiety, and depression. As I see it, the biggest threats to societal health today are the environment, the economy, and the workplace. I can’t do much about the first two, but I can try to address and help to fix the third.

This book has a twofold purpose. One goal is to help people better handle workplace stress and to cope with their stress. The other is to look at what everyone in the workplace needs to do to stop making people sick. In the past, the onus was put squarely on the shoulders of the workers to help themselves. Each of them was expected, individually, to learn how to deal with stress. I want to shift the focus to the organization as well. Leaders need to sit up, take notice, and find solutions. Companies need to stop causing so much stress in the first place. The shift needs to be away from personal responsibility to include the system itself. It’s like having fifty employees in a hot room, expecting each one to endure the heat or somehow cool off. Wouldn’t it make more sense for their employer to turn down the heat, open the windows, turn on a fan, or crank up the air conditioning? The problems are systemic. The solutions need to be systemic as well.

So, in essence, this book is about what we need to do collectively to ensure that workplaces don’t make people sick.

I’m not suggesting that every workplace is a sweatshop. Many are well-run, happy places. And I am not implying that every high-stress workplace is run by mean-spirited people. The probability is that most employers don’t realize just how stressed out their employees are, or how stress affects productivity. But there are still too many bosses who are cynical and self-interested and really don’t care about the plight of the people who toil in their companies.

I want to laud and reinforce the good employers. I want to raise the consciousness of those who are well meaning but unaware of how bad things have become for their workers. And I intend to vilify the exploiters and abusers and call them out for who they are and the harm they’re causing to untold numbers of people.

I’m not advocating stress-free zones in the workplace. I’m not suggesting that the office should be a mellowed-out spa where people can bask in the lotus land of life. Stress is a fact of life — it’s inevitable. It’s also necessary for top performance. But when it’s excessive, it becomes a problem, and many companies crossed that line a long time ago.

How This Book Is Structured

This book is filled with stories, science, and success strategies. There are elements of physiology, psychology, philosophy, technology, economics, inspiring anecdotes, and as much humour as I can inject to lighten an important and heavy subject. But it’s also practical and reality-­based. It contains field-tested solutions that have worked in my life, in the lives of my patients, and in the many organizations that have already adopted them.

I will summarize the three biggest problems that lead to stress in three sections: (1) Volume, (2) Velocity, and (3) Abuse. I call them the Big Three. Section 1, Volume, considers how the workload has increased to the point of overload; Section 2, Velocity, examines how the speed of the workplace has accelerated to a point where people have to run frantically to keep up; and Section 3, Abuse, examines office bullies and abusers who feel free to wreak havoc with impunity and immunity.

In this book, you’ll learn about the mistakes we’re making, including the Fallacy of Face Time, the Myth of Multi-tasking, and the Lunacy of Long Hours. You’ll also learn about effective solutions. For example:

companies that developed electronic blackout periods from 6 p.m. to 6 a.m. and on weekends, so that employees can disconnect and decompress from the high stress levels at the office

organizations where all employees stop work at noon and eat lunch together in a common dining area

enlightened managers who send workers home if they’re still in the office after 6 p.m. and ensure that employees take vacation time

companies that slashed the number and length of meetings and made attendance discretionary

This isn’t rocket surgery (mixed metaphor intended). Many solutions are logical and simple to implement, but deliver powerful benefits. I invite you to try some of these in your life and in your own organization.

INTRODUCTION

WORKPLACE STRESS —

SETTING THE CONTEXT

DEFINING THE PROBLEM

Every so often, I go into overdrive. I call it blitzing mode. Accountants know this territory well when tax season rolls around. So do retailers in December. It’s intense and stressful, but it’s time limited. It ends by April 15 or 30 (depending on the country), or when the holiday season is over. But what if it never ended? How thrilling would that be?

"This isn't an office. It's hell

with fluorescent lighting."

— Unknown

On occasion, I’m asked to submit a proposal to be a vendor of record for some organization (i.e., to be on their roster of approved speakers). It’s not my favourite thing — there are a lot of details to provide and it’s extremely time-­consuming. During one such marathon, I came home after a very long day, feeling spent and a little spacey. I said to my wife, "Days like this give me a window into what my patients go through. But I can’t imagine every day being like this!" Luckily, I’m self-employed and those days are rare for me.

However, I wasn’t always immune to long hours and high stress. In fact, it was typical of my life for almost twenty years, first as a medical intern and then as a family physician. As an intern, I worked an average of eighty-plus hours a week, including all those delightful nights and weekends on call. Even as a family physician, twelve- to eighteen-hour days were not uncommon. I remember them well, though not fondly. As the evening wore on during my nights on call, I could feel the fog settling in between my ears and I would go home feeling fuzzy-headed and kind of wasted. I would pray that I wouldn’t be called again at 3 a.m. or have a pregnant woman go into labour. Days like that were unpleasant, exhausting, and unhealthy. However, I usually scheduled compensatory time off to recover — again, because I was self-employed, I was able to do that. Unfortunately, most employees in today’s workplace don’t have the autonomy and flexibility that I had.

The Scope and Cost of Workplace Stress

Here’s how I see the problem from my front-row seat:

There is too much work, the pace is too fast, the expectations are too high or unclear, the pressures to perform are too great, and the resources are too few.

The combination of those factors leads to high levels of stress, long hours of work, and self-neglect. Good nutrition, adequate sleep, regular exercise, and time for family, friends, and leisure all go by the wayside.

An indirect consequence of high stress is that people often indulge in poor coping strategies such as overeating (especially junk food), drinking too much alcohol, tanking up on caffeine for short energy bursts, smoking, doing drugs, or playing hours of video games.

All that stress and the unhealthy coping habits lead to fatigue, weight gain, obesity — which is reaching epidemic proportions — physical illness, and mental health problems such as depression and burnout.

There’s an increase in the ambient level of stress in the workplace. With so many people under the gun, the atmosphere becomes tense. Stress becomes contagious. It can pollute an entire workplace if enough people are feeling harried and overwhelmed. Employees are cranky, impatient, and abrupt with one another.

All this can lead to increased conflict and decreased morale. Abusive behaviour is more common in offices where people are highly stressed.

It also puts a strain on families and creates interpersonal stress in the home.

The perplexing result of all this stress is that it’s also inefficient. It actually decreases performance and productivity. People are running harder and faster, yet achieving diminishing returns for their effort. It’s pretty sad when folks are working so hard, struggling so much, and getting so little payoff in return. Simply put, overworked, overstressed people are less productive.

The following diagram summarizes the situation.

Diagram_1.jpg

So there’s a problem with excessive and relentless demands put on workers, made worse by cutbacks and downsizing, and amplified dramatically by the overuse of technology, which keeps staff on a treadmill that speeds up with every new techno-breakthrough.

The second problem is the effect on workers as people. We’ve become a stressed out, unfit, sleep-deprived, multi-tasking society. We eat on the run, get too little exercise, and don’t have much fun. The concepts of leisure and balance are alluring but unattainable.

A third problem is employee disengagement. Instead of feeling enthusiastic and involved, people start to shut down. They go into survival mode, just trying to get through the day and the week.

The net result is a decrease in workplace productivity. That’s the cruel irony: putting in all this time and effort has actually diminished employee output. It’s making people sick, unhappy, and wanting to shout, Stop! You’re killing me.

WHAT IS STRESS AND HOW DO YOU KNOW WHEN YOU HAVE IT?

Given that this book is about stress, and that I’ve suggested we should pay more attention to it, this might be a good time to define the term and to help you recognize when it’s affecting you. There are many definitions of stress and there are even people (and books) who minimize it or claim that there’s no such thing. My response to these skeptics is to ask: If there’s no such thing as stress, what do you call it when your phone rings at 2:30 a.m. and your heart pounds and your hands shake — even before you answer it? What do you call it when students keep running to the bathroom before a big exam? Did all these people suddenly develop cholera? I’ve been working with stressed-out patients for more than thirty years and I can attest to the fact that it’s real, it’s widespread, and it’s getting worse. And the workplace is where it shows up most often.

My preferred definition of stress is from Canada’s Dr. Hans Selye, one of the fathers of stress theory. In an economy of words, he described stress as The nonspecific response of the body to any demand made upon it. There are three important aspects to this definition. Nonspecific reflects the fact that the stress reaction is the same every time, no matter what the cause. Whether you have been asked a question in chemistry class (especially if you don’t know the answer), are watching a suspenseful television drama, are going for an important job interview, have just had a car accident, or are holding your breath with every pitch at the end of a close baseball game, the physiological reaction is always the same. The stress reaction is mediated by more than thirty hormones, which are instantly liberated in the body (adrenaline, cortisol, and noradrenaline being the best known). Your heart speeds up, blood pressure goes up, breathing gets faster and more shallow, muscles tense, pupils dilate, mouth goes dry, senses are heightened, blood sugar increases as do the fats in your blood (including cholesterol) — all to give you quick energy to fight or run away from danger. That’s the classic stress reaction. We inherited it from our primitive ancestors and it has served us well. It’s a survival mechanism intended to protect us in times of true physical danger. That’s why it’s often called the fight or flight response.

The second aspect of Dr. Selye’s definition relates to the body’s response. The stress reaction occurs in our bodies. Stress is not in the environment or in the situation that triggered it. Stress is not the rush-hour gridlock you’re stuck in on your way to a meeting. Nor is it the deadline looming ahead, or the boss who has just berated you. The stress reaction is your response to those situations and it is experienced internally.

The third aspect is any demand made upon it. There are many sources of stress. It can be a true physical threat like someone chasing you down a dark alley, but most of the stresses we experience today are psychological in nature, such as fear of giving a speech, anxiety before a blind date, worrisome thoughts that pop into your head, or fear of losing your job. The demand might be a threat or a challenge, but it can also be something exciting like a roller-coaster ride or a first kiss.

Especially stressful is anything that undermines your self-esteem: embarrassment when you slip up while giving a presentation; feeling inept while learning a new skill; feeling you failed if you missed a deadline; feeling upset at being criticized, yelled at, or dumped on. Anything that makes you feel badly about yourself will be experienced stressfully in your body.

How Do You Know When You’re Having Stress?

What are the symptoms to watch for? This calls to mind my favourite song title, Am I in Love — or Is This Just Asthma? It’s important to know and watch for these signals because many people think that a high level of stress is normal, or they ignore messages from their bodies for too long, often with dire consequences. Early detection is the best way to keep stress levels under control. Stress shows up in four different ways. See how many might apply to you.

Physical symptoms: Headaches; clenching your jaw or grinding your teeth; neck and/or shoulder tightness; low back pain or stiffness; palpitations, pain or pressure in the chest; nausea (or even vomiting); abdominal cramps; constipation or diarrhea; frequent urination; irregular periods; sweating of the palms or soles; cold hands or feet; trembling hands; feeling shaky; fatigue (one of the most common and often overlooked symptoms of chronic stress) and exhaustion; loss of appetite or increased appetite; difficulty in sleeping; and loss of interest in sex (low libido) — Not tonight, I’ve got a headache has now been replaced by Not tonight, I’m too stressed out!

Intellectual symptoms: Do you have trouble concentrating and keeping your mind on things? Are you more forgetful? (If you keep calling your own cellphone to find where you misplaced it, that could be a clue.) Do you have trouble making decisions, even over little things? (If you take more than ten seconds to answer this question, I will take that as a yes.) Have you lost your sense of humour? Is your mind racing or going blank?

Emotional symptoms: Feeling nervous, anxious, tense, irritable, impatient, short-tempered, frustrated, angry, sad, depressed, apathetic (losing interest in things and people you usually enjoy), pessimistic, cynical, or low self-esteem.

Behavioural symptoms: I’ve watched people in restaurants bouncing their knees during half the meal. I’m always impressed by their coordination: jiggling their knee up and down while holding a soup spoon steady is not easy to do. But what they’re actually doing is unconsciously draining off excess stress energy. Other examples include pacing back and forth, feeling restless, agitated, fidgety, or having trouble sitting still and relaxing. My wife calls this feeling like I’m going to jump out of my skin. Nervous habits include fiddling with jewellery, doodling, nail-biting, compulsive eating, smoking, drinking, yelling, swearing, and blaming.

These are the most common stress symptoms that I identify in my patients. It’s important to note that many of the symptoms listed above can also