Workaholism: Current Trends in Conceptualization, Nosology, Etiology, and Treatment

1. Workaholism:Current Trends in Conceptualization, Nosology, Etiology, and Treatment Erich Robert Merkle School of Family & Consumer Studies Counseling & Human Development Services Kent State University

2. Concept Orientation Questions: 1. How would you define workaholism? 2. What is the etiology of workaholism? 3. What are the consequences of workaholism on the individual, family, and organizational environment? 4. As a therapist, how would you treat the condition?

3. Review of Work in Western Society: Hallmark of American and many Western societies is prominence given to work. Americans are socialized to believe in the �American Dream� of having a house, marriage, and children that is accomplished through hard work. Historically comes from our founding fathers, setting the �West,� and Calvinist doctrines that success was evident of predestined salvation.

4. Postmodern America still espouses the Protestant Work Ethic & �American Dream� as justifications for work. Commonality of word work in vernacular attests to its magnitude. �working� to earn a living �working� to have fun, etc.

5. Presentation Outline:

6. But First, Are You a Workaholic? Work Addiction Risk Test (WART) Scoring: 25 to 56: low risk for work addiction 57 to 66: medium risk for work addiction 67 to 100: high risk for work addiction

7. Conceptualizing Workaholism

8. Conceptualizing Workaholism: People teasingly refer to themselves as workaholic in social gatherings. Business promotes workaholism: �[workaholics are] dedicated employees who are impassioned and enamored of work.� Formal academic inquiry only conducted within the latter decades of the twentieth century.

9. Conceptualizing Workaholism (con�t): First effort by Wayne Oates in 1971. Coined workaholism as an equivalence to alcoholism believing that etiology and syndromal presentation were similar to alcoholism. BUT, workaholism does not carry the societal stigma found in psychopathologies such as alcoholism, eating disorders, personality disorders that are believed to be characterological defects.

10. Conceptualizing Workaholism (con�t): Little academic research to clarify or validate Oates� findings until latter 1980s. At this point, workaholism was re-identified as a �serious and legitimate type of addictive-compulsive disorder� affecting at least 10% of society. Etiology believed to involve family dysfunction.

11. Conceptualizing Workaholism (con�t): Research took flight with idea of workaholism because of comorbidity with familial dysfunction. Work addicts were once again conceptualized as showing signs consistent with alcoholism: �Workaholics are clinically noted as deriving adrenaline highs from their work binges and experience subsequence hangovers as they come down�Includes a pattern of withdrawal, irritability, anxiety and depression� that is consistent with physiological experiences of alcohol dependence.

12. Conceptualizing Workaholism (con�t):Recent Theories Scott, Moore, Miceli (1997): discretionary time spent in work activities thinking about work when not at work working beyond organizational/economic requirements. Typological & Dimensional Theories: Naughton (1987): commitment to work and obsession-compulsion dimensions Killinger (1991): perfectionism, obsession-compulsion, and narcissism. Scott, Moore, Miceli (1997): behavioral dimensions of compulsive-dependent workaholics, perfectionist workaholics, and achievement-oriented workaholics.

13. Conceptualizing Workaholism (con�t):Psychiatric Nosology The DSM-IV (1994) and ICD-10 (1996) do not include a workaholic disorder. Many suggest that it is a feature of other psychopathological conditions such as obsessive-compulsive personality disorder, impulsive-control disorder NOS, or obsessive-compulsive disorder.

14. Conceptualizing Workaholism (con�t):Psychometric Assessment Currently only two instruments available to quantitatively assess the disorder: Work Addiction Risk Test (WART), 1992 25 item self report inventory from Brian E. Robinson, Ph.D. work habits are used as criterion to establish workaholism Test-retest reliability and face validity WAC, 1992 From unpublished doctoral dissertation 72 item self report survey Content established through discriminatory factor analysis As in WART, higher score indicates presence of work addiction Minimal psychometric validation; although does have concurrent validity with WART

15. Conceptualizing Workaholism (con�t):A Functional Definition No consistently agreed upon definition in clinical literature. Varies according to psychopathological presentation and researcher conducting study. Robinson (1996) posits: �[A workaholic] is a person that is addicted to the process of working, the result of which leads to family disintegration and increased unmanageableness of work habits and all other areas of life.�

16. Multiple Etiologies of Workaholism

17. Multiple Etiologies of Workaholism: A number of plausible etiologies are found in the literature to account for workaholism: Opportunistic defense to escape unpleasantries of life. Affords the opportunity to avoid and control negative life problems while reaping the bounty from success in the workplace.

18. Multiple Etiologies of Workaholism (con�t): Control is important as workaholic seeks to build �empires of success� to thwart off concerns of domination by life. Striving for Success is likely a remnant from a childhood plagued by economic, cultural, and emotional deprivation. Feelings of inferiority, fear of failure, and a defense from unresolved anxiety which all relate back to a dysfunctional childhood.

19. Multiple Etiologies of Workaholism (con�t): Oates (1971) speculated that workaholism was a trait modeled to children by parents who were either workaholics or otherwise believed in the Protestant Work Ethic. Socialization in a society which places competition and survival of the fittest as primary objectives.

20. Multiple Etiologies of Workaholism (con�t): Type A personality developed over childhood Provides support for obsessive-compulsive theories of workaholism.

21. Consequences of Workaholism

22. Consequences of Workaholism Workaholism affects every element of life: Individual functioning and wellness Organizational climate in workplace Familial and interpersonal relationships

23. Consequences of Workaholism:Individual Effects Individual workaholics are likely to suffer from a number of aversive conditions in their lifestyle and physical health. Role strain from trying to over-participate in many roles Diminished performance and satisfaction Comprising of occupational and interpersonal life which leads to depression, feelings of isolation and failure Decline in libido Comorbidity of other pathological conditions including psychosomatic illness, weight loss, anhedonia, excessive fatigue, burnout, and interpersonal conflict

24. Consequences of Workaholism:Organizational Climate A workaholic individual can �suck the spirit right out of the team�causing destructive competitiveness among coworkers.� Characteristics of the workaholic employee: Has difficulty working with others Avoids of delegating tasks to others Harbors demanding and critical attitudes towards employees and subordinates Creates self-imposed stress which can to the individual to become unproductive and inefficient

25. Consequences of Workaholism:Organizational Climate (con�t): Features of a workaholic manager: Promotes resentment, frustration, and anger in personnel Conflicted relationship with subordinates Poor office morale The cumulative effect is a systemic breakdown of the organizational climate that leads to drastic reduction in productivity and an aversive working environment.

26. Consequences of Workaholism:The Family Research is remarkably consistent that effects associated with workaholism can be pervasive and destructive to the family members of the workaholic. A �workaholic relationship pattern� emerges from a spouse relentlessly pursuing the �American Dream�.

27. Consequences of Workaholism:The Family (con�t) Workaholic relationship pattern: Spouse of workaholic loses goals and dreams while supporting the his or her workaholic spouse Workaholic becomes further disengaged from family system which leads to a disruption and breakdown of roles and communication Subjugated spouse is likely to become resentful, depressed, and angry towards the partner Results in systemic relationship discord and divorce Children and spouse can suffer from neglect (emotional, financial, etc.)

28. Consequences of Workaholism:The Family (con�t) Spouse of workaholic can develop a mirrored work addiction or become overly involved in numerous activities outside the home (clubs, service organizations, PTA, etc.) Comorbidity of substance addiction, especially alcoholism, in spouses of workaholic. Likely an attempt for self medication as the spouse tries to find solace from the isolation of the dysfunctional and disengaged relationship

29. Therapeutic Interventionsfor Workaholism

30. Therapeutic Interventions With Workaholism: Prognosis is moderate, and guarded, at best for ameliorating the condition. Two challenges face the significant others and counselors working with workaholics: Denial Stability of obsessive-compulsive and other personality traits

31. Therapeutic Interventions With Workaholism (con�t): Treatment: Because of the enduring nature of the personality traits, teach significant others about and how to live with the disorder Employ psychotherapies aimed at both the individual and the family system

32. Therapeutic Interventions With Workaholism (con�t): Unlike alcoholics who must practice abstinence from alcohol, a workaholic cannot abstain from work. Instead treatment can begin with two approaches: Teach work moderation Encourage balance in all areas of life, instead of devoting the majority of time to work endeavors

33. Therapeutic Interventions With Workaholism (con�t):The Role of the Significant Other The significant other: Assist the workaholic to develop a self-care plan that includes abstaining from excessive work and developing outside interests that provides a fuller life experience. Work moderation techniques: Setting regular work hours instead of bingeing and purging Planning ahead for deadlines Spread projects over a realistic span of time

34. Therapeutic Interventions With Workaholism (con�t):The Role of Professional Intervention Professional Intervention: First: use a variant of individual cognitive therapy to focus on the workaholic�s cognitive distortion of perfectionism, feelings of insecurity, rejection, and worthlessness. Second: incorporate community self-help groups and encourage attendance at Workaholics Anonymous (WA) meetings. Workaholics Anonymous P.O. Box 289 Menlo Park, CA 94026-0289 Third: employ systemic family counseling to begin the process of healing the family

35. Therapeutic Interventions With Workaholism (con�t):The Role of Professional Intervention Family Therapy: Explore family dynamics to determine if previous family constellation helped to contribute to the workaholic�s lifestyle Support family members as they address their resentment, pain, and feelings of neglect Enlist the family�s support for the workaholic in helping him or her to assume a more functional life

36. Therapeutic Interventions With Workaholism (con�t): Treatment outcomes are enhanced in situations where both the workaholic�s family and workplace are involved in treatment. Include an EAP professional to address the organizational issues of the workplace.