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A close acquaintance of mine has had post-traumatic stress syndrome (PTSD) for the better part of a decade. Recently, this person referred to their condition to a relative, only to receive the reply, “Aren’t you over that yet?”

The response highlights one of the many misunderstandings of this condition. In fact, from its origins to its symptoms, treatment, and long term prospects, probably no other mental condition is so misunderstood. Nor is understanding encouraged by the fact that the words “trauma” and “stress” are bandied about by people to refer to normal reactions to daily events or merely mild upsets.

So what is PTSD? Contrary to popular perceptions, it is almost never the anxiety caused by financial or romantic concerns, or by grief. All these circumstances can be stressful, but do not result in PTSD unless other factors are at play as well.

Nor is PTSD simply a reaction to physical trauma, such as combat or rape. Many people go through both and do not develop PTSD, while some people develop it because of psychological sufferings, such as interactions with unsympathetic authorities or the suicide or random deaths of people around them.

Just as importantly, there is no way of predicting what will cause PTSD. What triggers the condition in one person may seem trivial to another, and some cases of PTSD are caused by a single episode while others are caused by a continuing sequence of events. Contrary to the way that “shell-shock” was once regarded, it is not a matter of cowardice, but of being overwhelmed and rendered powerless by events.

Similarly, while some studies suggest a genetic predisposition to PTSD, what matters is whether a person ever encounters circumstances that will cause the condition in them.

Another reason to downplay any genetic tendency is that the cause of PTSD seems primarily psychological. What all cases of PTSD seem to have in common is a loss of world-view – in particular, an individuals’ ability to control their own life.

Faced with a loss of meaning and control, those with PTSD develop what psychologists refer to as “hypervigilance” — a more or less continual condition of extreme alertness. This condition generally includes permanent physiological changes to the body, including an exaggerated startle response, and permanently higher pulse rates, and higher blood pressure. A PTSD sufferer is always far closer to fight or flight than the average person, or than what they were when they were healthy.

These physiological changes explain the images of PTSD in popular culture, in which the crazed war veteran goes berserk, or the badly stressed resort to alcoholism or drug addiction. And, in fact, sometimes those with PTSD do act in this way. However, more common symptoms are depression, loss of purpose and direction, nightmares, and a distancing from social contacts. Perhaps the most common symptom is a sense of existential angst (in fact, it may not be a coincidence that existentialist philosophy emerged out of France around the end of World War 2).

All of these symptoms may be reinforced by a person’s reluctance to disclose their problem for fear of appearing vulnerable – after all, to the hypervigilant, to appear weak means that they are risking attack.

Contrary to the response my friend received, PTSD is not something you “get over.” It makes permanent changes to the body, and probably the mind as well. It can flare up at any time, even after many years. In this respect, PTSD is similar to malaria – it is something that you learn to live with, but never move beyond.

Treatment of PTSD is two-fold. In the short term, those who suffer from it can minimize its effects by reducing the stress in their lives. Eating a balanced diet, staying physically fit, and getting rest all help. Even more importantly, those with PTSD need to develop a routine that minimizes the stress in their lives. They may need to find less stressful work, or have more flexible hours, or even work from home.

For example, the poet and novelist Robert Graves, who suffered shell-shock in World War I, eventually fled to the quiet of Majorca after over a decade of unsettled life in England. When people congratulated him on his apparent recovery, he explained that all he had done was to organize his life to deal with his problems.

In the longer term, the most successful coping mechanism seems to be to find a way to reaffirm the world view and values that PTSD have shattered. A classic example is the Canadian general Romeo D’Allaire, who suffered PTSD from what he perceived as his failure to do his duty as a soldier and stop the genocide in Ruanda while he commanded United Nation forces there. After a period of adjustment in which he was often drunk, D’Allaire managed to re-assert his ethics by becoming a strong advocate for peacekeeping by both Canada and the United Nations. He has also spoken frequently about PTSD and become something of an advocate for Canadian soldiers who suffer from his condition.

This sort of compensation can mean that, despite their condition, many people with PTSD can lead highly purposeful and accomplished lives. The catch is that they generally have to continue their accomplishments in order to reassert their world view against the trauma that has physically and mentally transformed them.

Finally, perhaps the most important point to make is that PTSD is not a mental illness in the sense that schizophrenia is. Instead, it is more accurate to compare it to an injury such as breaking a leg that permanently changes regular functioning. A person with PTSD is sane by any legal or common sense definition, but, like someone in whom an injury has left one leg shorter than the other, they have some troubles with ordinary functioning.

The next time you see someone with PTSD, try to keep these points in mind. And remember – the only reason that you haven’t suffered from the same condition may be that you have been lucky.

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Most articles about reducing stress in the workplace start with the assumption that you can do something to affect your circumstances. But unless you’re a company officer or director, you probably can’t do very much. You’re subject to the whims and cluelessness of the upper echelons, and the company’s main concern is usually to squeeze the most work out of you for the least amount of renumeration — and that means too much work to do, unpaid overtime, and most of the other immediate sources of stress.

At times, you may be tempted to beat yourself senseless, or even chew a leg off to escape these conditions. However, I have to warn you that the last one especially can ruin your chances of doing that half marathon you’ve always dreamed about. Besides, you will still need money, and a handicap pension isn’t enough for anyone to live on.

Instead, here are seven less drastic if cynical ways to minimize work stress. These are ways that the average career expert won’t tell you, because to do so is to admit that most of us work because we have to, not because we have a passion:

1. Never take a full time job when you can be a contractor instead:

Employers may dangle benefits before you in the hopes of enticing you to become a full-time employee. And, at first, you might be lured into agreeing for the sake of security. But, as I like to say, the main difference between contract and full-time work is that, as a contractor, you know when your job ends. You may even have a kill clause in your contract. By contrast, full-time employment can end without warning or any more compensation than required by local laws. The ugly truth that nobody likes to mention is that full-time employment is not much more secure than consulting. It also dulls your instincts for survival besides, so that layoffs hit you harder. Consultants know they can survive, because they’ve done so before.

Another big advantage of being a contractor is that you’re usually paid by the hour. That means that managers think twice about asking you to stay late, and that, when you do, you’re being paid — unlike everyone around you. You may still have to put in long hours, but at least you’re receiving hardship pay.

2. Avoid managers and company officers as much as possible:

The most productive and fulfilled people at most companies are those who are actually building the products that the company sells — the computer programmers, graphic designers, and other manufacturers. But somewhere about midway up the management hierarchy, employment stops being about productivity and starts being about ego. That means that, the more remote managers and directors are from what the company sells, the more likely than an encounter with them will be about making them feel good, and not about helping you with any problems.

You may be flattered if such people ask you for details about your work — but, believe me, they won’t remember. They’re not asking because they want to learn more and do their jobs better. Most of the time, they’re looking for a way to kill time. Granted, you might get some wicked stories to tell your co-workers about their ignorance, but that’s a poor return for the time you’ve lost.

3. Keep away from meetings:

Meetings are for those who have reached exalted positions where they are no longer productive. If you haven’t reached that stage, the average meeting will simply cut into your already too-short work time. Should anything important actually happen at a meeting, you can always read about it when the minutes are circulated in an email.

True, by missing meetings, you miss free food. But donuts and other typical meeting fodder only give you a sugar rush to leave you all the more attenuated after you come down. That process is a physical stress in itself.

4. Avoid company functions:

Career experts tell you that company events are a way to network. In fact, they’re a way for human resources managers to look busy (see #2). For others, they are an annoying interruption in a busy day. So, even though you’re dying for an excuse to knock off work, remember that what you’ll be doing is playing ring-toss in the hall or dressing up in a clown suit, and that embarassment is a form of stress in itself. If you’re shy, you’ll suffer agonies, and ditto if you have any empathy at all. Rather than attending a function, book off sick or claim an important task is waiting. Schedule a root canal for the time of the function. If all else fails, duck out early.

5. Go for walks at lunch, or eat out

Eating in a cafeteria — or, even worse, at your desk — only means that people can find you more easily and dump work on you, adding to your stress. Even if someone just want to ask you a question, you’re losing time that belongs to you.

Instead of making yourself a target, go out and remind yourself that there’s a world beyond work. Remembering this fact is one of the most reliable ways to put the pressures of work into perspective. But be sure to vary your walking routes or restaurant, or somebody might still be able to find you.

6. Don’t volunteer for extra work

If you’re feeling stressed because of your workload, the last thing you should do is take on extra work, no matter how good you think volunteering will make you look. This advice especially applies to taking work home on evenings or weekends.

Contrary to what the brainwashed and the ambitious believe, such volunteering rarely helps you get ahead. But it is almost guaranteed to age you prematurely. Even worse, it frequently means you are compensating for the fact that there’s too few staff members, and enabling management to dodge the problem.

Anyway, unless there’s a genuine crisis, you won’t have cleared your To Do list — you’ll simply have removed some items so that they can be replaced by new ones. Unless your company is heavily overstaffed, there’s always more work to do, and, for a surprising amount of it, whether you do it today or tomorrow doesn’t matter very much.

7. Don’t expect that working hard will lead to a promotion

The official myth in our society is that hard work is rewarded with promotion. That’s true in a handful of first-rate companies, but, in most work places, the better you are in your position, the harder time people have of imagining you in another one.

I’m not saying that you should slack off — after all, presumably you need the money, and losing your self-respect will only add to your stress. But if you insist on working hard, make sure that it’s for your own reasons and not for any expectation of reward. The chances are overwhelming that you won’t get one.

You’ll notice that none of these steps actually involve your workflow or work habits. That’s because stress at work is rarely about the work itself, so much as the conditions that surround it. In other words, getting organized, disciplining your email reading habits or any of the usual suggestions you get won’t do much for you.

Instead, recognize that you may be in an impossible position, and that the problem is just as likely to be in what’s around you than in you or your habits. And if that sounds cynical, reflect that, in a bad situation, cynicism is not a negative trait, but a successful survival mechanism. In this case, knowing why a situation is stressful can sometimes help you feel less stressed.

And if the situation continues, or gets worse, remember that sometimes the best way of dealing with stress is to move on. Just looking for work can help you endure your present situation a while longer (so long, of course, as you don’t let your managers know that you’re looking for work by slipping up and leaving your resume by the copier or by taking long phone calls with recruiters at work). Rather than enduring stress because you’re afraid of the unknown, have the courage to actively look for alternatives. If you’re like most full-timers, you’ll probably find that finding new employment is easier than you feared.

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