Workaholism

It's no longer seen as a respectable vice, but as a serious problem that can have life-threatening consequences

After a lifetime of denial, one pivotal moment forced Dan G. to confront a painful truth: He was addicted to his work. Exploding in rage after some bad news delivered by his boss, he snapped, screaming at his secretary and punching the walls of his office with his bare fists.

"I knew I was cracking up," he says now. Dan had been saddled with starting a new business venture for the large East Coast computer corporation that employed him. But his routine 16- to 20-hour workdays were not yielding the results he wanted, and Dan was pushing himself and his staff to the point of exhaustion. "I felt like I was under compressed steel all the time, pressing down on me," he recalls. "I was under tremendous pressure and really feeling it." Worse, he said, "I realized how addicted I was to work, but the fun was gone, the adrenaline high was gone."

Stripped of the illusion that he was in control and functioning at a high level at his job, Dan was afraid. "I knew I had to change or die, that I would have a mental or physical breakdown," he says. "I knew I was at a turning point, that I couldn't go on. That was my bottom."

Dan describes himself as a workaholic, a condition that some psychologists view as a serious affliction -- and unfortunately, one that's socially sanctioned. Many firms expect employees to exhibit more than just dedication to their jobs. Corporate and startup culture rewards single-minded workers with fat paychecks, awards, and promotions -- and the status that accompanies success. Yet despite these social and business pressures, workaholism is slowly losing its cachet as a respectable vice. Instead, it is increasingly recognized as an insidious problem that can have life-threatening consequences.

"A workaholic will die faster than an alcoholic any day," says Diane Fassel, PhD, an organizational consultant in Boulder, Colorado, and author of Working Ourselves to Death.

Elements of workaholism

Despite numerous books and magazine articles on the issue, however, there's a simmering debate in the therapeutic community over workaholism. For starters, it's not a recognized psychiatric disorder, and many medical professionals still relegate it to the realm of pop psychology. The term "workaholism" was not coined until the late 1960s, and it has begun to be taken seriously only in the last 25 years or so, say experts. Indeed, the bible of the American Psychiatric Association -- the Diagnostic and Statistical Manual (DSM) -- does not classify workaholism as an official diagnosis or an addiction. Instead, it's considered a symptom of obsessive-compulsive personality disorder, a broader obsession with orderliness, perfection, and control at the expense of flexibility, openness, and efficiency.

"Workaholism is a coping strategy," says Jeffrey P. Kahn, MD, a Manhattan psychiatrist and a consultant for the American Psychiatric Association committee on psychiatry in the workplace. "It's often a symptom of a variety of emotional problems, including underlying anxiety disorders and depression, shaped by obsessive-compulsive personality traits. The core diagnosis is often chronic mild depression." Kahn, a psychiatric faculty member at Weill Cornell Medical College in New York City, says that other professionals who think workaholism is an addiction or a diagnosis in and of itself are "missing the boat."

But the reluctance of the medical mainstream to consider workaholism an addiction angers some experts, among them Bryan E. Robinson, PhD, a psychotherapist and professor of counseling, special education, and child development at the University of North Carolina. He notes that it took many years for the medical establishment to accept alcoholism as an addiction. The paucity of research on workaholism frustrates him as well.

"Workaholism is the best-dressed addiction in the country," says Robinson, author of Chained to the Desk: A Guidebook for Workaholics, Their Partners, Their Children, and the Clinicians Who Treat Them, and himself a recovering workaholic. "It's a good-looking addiction to have -- that's the paradox and what makes it so difficult to study and treat."

The number of studies on workaholism is paltry in comparison to the slew of studies on alcoholism, eating disorders, or gambling, says Robinson. "We haven't even scratched the surface. Workaholism is extolled in this society. Why investigate something that is considered so good?"

Whether therapists consider workaholism an illness, an addiction, or a symptom, however, they do agree on one thing: It's unhealthy. People suffering from workaholism, says Merra Greengrass, a spokesperson for the American Psychological Association, "should definitely seek treatment."

What is workaholism?

If you often find yourself staying late at the office and working weekends, you may have wondered whether you're a workaholic. If that's what it takes to get the work done, how can you tell whether you've become "addicted" to your job?

Here's a rule of thumb: Can you enjoy life and feel energetic and purposeful when you're not at work? If the answer is no, you may be in the danger zone. Since workaholics get high from the fix of deadlines, long hours, and single-minded focus on work, other parts of their lives tend to fall by the wayside.

Experts say the incessant work-related activity masks anxiety, low self-esteem, and intimacy problems. And as with addictions to alcohol, drugs or gambling, workaholics' denial and destructive behavior will persist despite feedback from loved ones or danger signs such as deteriorating relationships. Poor health is another warning sign. Because there's less of a social stigma attached to workaholism than to other addictions, health symptoms can easily go undiagnosed or unrecognized, say researchers.

Manic overwork creates huge surges of adrenaline, which floods the body and taxes every physical function, especially that of the heart, according to Robinson and other researchers. The adrenaline can contribute to high blood pressure and to the buildup of plaque in heart vessels, increasing the risk of heart attacks and strokes. Workaholics can also suffer from a host of stress disorders, including anxiety attacks, ulcers, and burnout, as well as depression that can lead to suicide, Robinson says. Workaholics, in fact, can become physically dependent on the adrenaline coursing through their bodies -- sometimes with dire effects. "The role of adrenaline is to give the illusion that you have an unusual amount of strength, resilience and energy," says Fassel, who also co-authored The Addictive Organization. "You're not aware that you're really tired or worn down or have physical symptoms. Workaholics are usually taken out by a heart attack or stroke, or collapse with a really catastrophic illness."

(Overwork can cause many of the same health problems; however, it's not the same as workaholism. Most people forced to work two jobs to make ends meet are not in the grip of a compulsion, because they would gladly work less if they could.)

Overwork, which is rampant in Japan, is responsible for an estimated 10,000 deaths of working men in the country each year, according to Japanese occupational health researchers. The Japanese even have a word for death from overwork: karoshi. In the United States, there is no reliable method to track the number of workaholics, despite the prevalence of stress-related illnesses at the workplace.

Work addicts are not the same as hard workers

Yet work addicts should not be confused with people who are simply hard workers, say experts. There is nothing wrong with loving your work, going the extra mile to meet a deadline or finish a project, and feeling satisfied with your achievements. Workaholics' lives, in contrast, are out of control. They think about work constantly and if unable to work, feel panicky or depressed. They resist taking breaks or rewarding themselves with vacations. If they must take vacations, they're likely to be highly scheduled and goal-oriented. "A workaholic needs to work," says Kahn, who is also president of WorkPsych Associates Inc. in New York City. "He needs goals to aim for. He pushes and pushes, and as he's approaching his goal, he needs the next goal. A workaholic is not able to stop and enjoy his accomplishments." Ironically, being a workaholic can be detrimental to work itself. Workaholics resist collaboration, have trouble delegating tasks, and like to run the show themselves. They're often difficult to get along with and push others as relentlessly as they push themselves. While people addicted to work see themselves as under-functioning, everyone else sees them as over-functioning, according to Robinson.

"If a workaholic won the lottery, he would not stop -- he's not doing it for the money," says Fassel. "Instead, enormous anxiety and unresolved psychological issues are kept at bay by the work addict's incessant activity. The underlying belief is that if I were not always active, I would have no right to exist. Like alcoholism, it's a disease of the soul, a spiritual disease."

According to Barbara Killinger, a Toronto clinical psychologist and author of Workaholics: The Respectable Addicts, the workaholic's perfectionism leads to obsession and ultimately to narcissism. "Workaholics are addicted to power and control, but the focus of the obsession is work," she says. "The more chaos you have inside, the more you need to control everything around you. The obsession eventually runs you, you don't run it."

Killinger, an early pioneer in the field, breaks down work addicts into three main groups: "controllers," "pleasers," and "narcissistic controllers." The third group is especially dangerous, she says. Cut off from their feelings, narcissistic controllers have no empathy for others or insight into how their actions are affecting them. Moreover, the longer they are in charge, the more tyrannical and harmful their behavior becomes.

Workaholics' families, of course, are at particular risk for fallout from the addiction. A leading researcher on workaholism, Robinson has focused two recent research efforts on the effects of work addiction on the family. In a study published in the Family Journal, Robinson found that children of workaholics are more depressed and exhibit more symptoms of "parentification" -- behaving like responsible adults in place of their absent parent -- than children of alcoholics. The first national survey of women married to workaholics, published in the American Journal of Family Therapy, revealed that these women experienced greater marital estrangement, had higher divorce rates, and felt less in charge of their marriages and lives.

As they enter the workforce in ever greater numbers, some women are also suffering from workaholism. In dual-income homes, many women find themselves in the unenviable position of working hard at their jobs while also shouldering much of the burden of family and child-raising. According to a paper in Sex Roles: A Journal of Research, both men and women responding to a survey had similar levels of workaholism in several key areas -- perfectionism, job involvement, and inability to delegate tasks -- but women reported higher levels of job stress, perhaps due to conflicts between family and work.

Ted Smith,* a retired San Francisco Bay Area physician, says his family suffered from his many years of unrestrained workaholic behavior, including 70- to 80-hour workweeks and work on weekends. His wife suspected he was having an affair; his young children lost a father to his obsession with his practice. "Looking back, I wasn't able to remember any memories of my children in those 'raising' days, the older baby days to pre-teen years," he says now. "I can't remember any interaction with my kids. All three have told me that at some point they wanted to leave home. I was so busy completing the process of each day, I didn't realize I wasn't present for my family."

Smith, now 73, believes the roots of his workaholism stretch back to his childhood, a scenario that experts agree is common. If he went to his mother with a problem, he says, she would tell him he'd feel better if he found something to do. If something was worth doing, she'd say, it was worth doing well. Smith learned to fear making mistakes; he became a perfectionist, even if it meant habitually doing his medical dictation at 3 a.m. or drifting off to sleep while talking with his patients. "I didn't know I had a problem; I didn't realize I was screwing up my life," he says.

The main task in treating workaholics, Killinger says, is the same as in other addictions: helping them reconnect with their feelings, which can be a slow and difficult process. But recovery is possible. After his meltdown, Dan G. told his boss he needed to quit his all-consuming assignment and take on a more moderately demanding job. The following year he also founded the first chapter of Workaholics Anonymous. "It takes courage to admit you're scared and what you're doing is neurotic," he says.

When he took a close look at 20 years of workaholic behavior, what Dan G. saw was a life desperately out of balance. "I had to be number one at everything I did; I went to extremes in terms of competitiveness and having to work harder and faster than the next guy," he explains. "Inwardly, I was an egomaniac with an inferiority complex. I was overcompensating for feelings of fear and inferiority I've had since childhood, especially a fear of failure. On the surface, I projected an image of confidence, but deep down I felt like a scared kid who was always looking for that pat on the back. The moral of my story is workaholics don't do better than anyone else. They just burn out faster."

* Ted Smith is a pseudonym. As a member of Workaholics Anonymous, Dan G. prefers not to use his last name.

References

All work and no play? Journal of Management. Feb. 16, 2016

Clark, M.A., Lelchook, A.M., and Taylor, M.L. Beyond the Big Five: How narcissism, perfectionism, and dispositional affect relate to workaholism. Personality and Individual Differences, 48, 786-791.

Burke, Ronald J. Workaholism in Organizations: Gender Differences. Sex Roles: A Journal of Research, September

Karoshi: Death from overwork: Occupational health consequences of the Japanese production management, Katsuo Nishiyama and Jeffrey V. Johnson, Department of Preventive Medicine, Shiga University of Medical Science, Japan, and School of Hygiene and Public Health, Johns Hopkins University. Sixth draft for International Journal of Health Services.

Obsessive-Compulsive Personality Disorder Symptoms. MentalHealth Net. Criteria summarized from the Diagnostic and statistical manual of mental disorders, fourth edition, American Psychiatric Association, Washington, D.C.

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