Ericka Martin, LMHC, LPC, Author at Star Meadow Counseling

Workaholism: The Hidden Epidemic

I didn’t need to use drugs because my bloodstream was manufacturing my own crystal meth.

— WORKAHOLICS ANONYMOUS MEMBER

Workaholism is described by some as the “respectable addiction,” though its affects can be destructive and even deadly to those who are compulsively addicted to work.

How can you tell if you are a workaholic?
How do we distinguish workaholism from “hard work?”

In his book, “Chained to the Desk,” Bryan Robinson describes workaholism as “an obsessive-compulsive disorder that manifests itself through self-imposed demands, an inability to regulate work habits, and an over-indulgence in work to the exclusion of most other life activities.”

How is a person diagnosed as a workaholic? Actually, workaholism is NOT a recognized mental health diagnosis in diagnostic manuals, though it might be a symptom of something bigger at play, as Dr. Robinson suggests. The urge to overwork can feel compulsive and anxiety provoking. A person with workaholism might not be able to clock-out mentally, even when they’d like to. It is a brand of achievement-oriented perfectionism, mixed with some rigidity, anxiety, and preoccupied thoughts.

The following is a checklist from Workaholics Anonymous (WA), useful for assessing workaholism.

Do you get more excited about your work than about family or anything else?
Are there times when you can charge through your work and other times when you can’t?
Do you take work with you to bed? On weekends? On vacation?
Is work the activity you like to do best and talk about most?
Do you work more than 40 hours a week?
Do you turn your hobbies into money-making ventures?
Do you take complete responsibility for the outcome of your work efforts?
Have your family or friends given up expecting you on time?
Do you take on extra work because you are concerned that it won’t otherwise get done?
Do you underestimate how long a project will take and then rush to complete it?
Do you believe that it is okay to work long hours if you love what you are doing?
Do you get impatient with people who have other priorities besides work?
Are you afraid that if you don’t work hard you will lose your job or be a failure?
Is the future a constant worry for you even when things are going very well?
Do you do things energetically and competitively including play?
Do you get irritated when people ask you to stop doing your work in order to do something else?
Have your long hours hurt your family or other relationships?
Do you think about your work while driving, falling asleep or when others are talking?
Do you work or read during meals?
Do you believe that more money will solve the other problems in your life?

Did you answer “yes” to 3 or more questions? According to Workaholics Anonymous, a person can be considered workaholic if they answer affirmatively to three or more of the questions.

Is work addiction really that dangerous?

In Japan alone, thousands people die annually from karoshi (“death by overwork”). Over-work affects people holistically. Physically, they may experience ulcers, chest pain, heart attacks, asthmatic attacks, or urges to binge eat. Psychologically, workaholism has been connected to depression, anxiety, perfectionism, stress, anger, burnout, low self-worth and low self-esteem. Socially, workaholics may be isolated from friends, family, or co-workers. In addition, their behavior can potentially lead to marital discord, divorce, or job loss. Children of workaholics are negatively affected too; research indicates that adult children of workaholics are at higher risk for depression, anxiety, and feelings of low self-worth.

What happens in the workaholic brain? Work addiction alters the physiological and chemical nature of the brain. Workaholics attain an adrenaline high from binge-working. After the high, the person is left with a “work hangover,” which may involve heightened anxiety, irritability, or suicidal ideation. Akin to substance use disorders, workaholics often experience cognitive distortions that complicate their adrenaline addiction.

How is workaholism different from hard work?

The big distinctions are balance and boundaries. In order to have a balanced life, a person must be engage in healthy relationships, maintain outside interests and hobbies, and demonstrate overall self-care (ex. Slowing, family time, adequate sleep, etc.). Boundaries allow a person to distinguish their work life from their home life and social life and so forth.

Thomas Merton, in his book “Conjectures of a Guilty Bystander” described workaholism and its threat to inner peace:

“There is a pervasive form of contemporary violence to which the idealist most easily succumbs: activism and overwork. The rush and pressure of modern life are a form, perhaps the most common form, of its innate violence. To allow oneself to be carried away by a multitude of conflicting concerns, to surrender to too many demands, to commit oneself to too many projects, to want to help everyone in everything, is to succumb to violence. The frenzy of our activism neutralizes our work for peace. It destroys our own inner capacity for peace. It destroys the fruitfulness of our own work, because it kills the root of inner wisdom which makes work fruitful.”

If you are feeling burned out from over-work and are ready to begin a journey toward recovery, a counselor at Star Meadow Counseling might be able to help.

References:

Healthyplace.com. (2018). Work Addiction Treatment | HealthyPlace. [online] Available at: http://www.healthyplace.com/addictions/work-addiction/treatment-workaholic/menu-id-54/ [Accessed 18 Sep. 2018].

Merton, T. (2014). Conjectures of a guilty bystander. Garden City, N.Y.: Image Books.

Robinson, B. (2014). Chained to the Desk. 3rd ed. NYU Press.

The Japan Times. (2018). The government’s ‘karoshi’ report | The Japan Times. [online] Available at: https://www.japantimes.co.jp/opinion/2016/10/12/editorials/governments-karoshi-report/#.W6GQkehKiUk [Accessed 18 Sep. 2018].

Treatment4addiction.com. (2018). Work Addiction. [online] Available at: http://www.treatment4addiction.com/addiction/behavioral/work/ [Accessed 18 Sep. 2018].

Workaholics-anonymous.org. (2018). Home. [online] Available at: http://workaholics-anonymous.org/ [Accessed 18 Sep. 2018].

7 Great CBT Websites

by Ericka Martin, LMHC, LPC | CBT

Are you interested in learning more about Cognitive-Behavioral Therapy as a mode of counseling or self-help? Check out these 7 amazing online resources:

https://llttf.com/ Living Life to the Full

Living Life to the Full is an interactive CBT website. This free online course incorporates audio and video clips throughout the learning modules. The site includes handouts for each course topic, a moderated discussion forum, assessments tools to track progress, and an array of other self-help materials. Users can also invite a mental health practitioner to view your progress and provide feedback.

http://www.cci.health.wa.gov.au/ Centre for Clinical Interventions

The Centre for Clinical Interventions provides information on struggles (ex. Anxiety, Assertiveness, Depression, Panic, Perfectionism, Sleep, etc.) and gives access to free downloadable workbooks, customized to that area. Each topic includes 7-12 user-friendly chapters. It is an instantly practical resource. Click on “Resources” and “Looking After Yourself” to find the resource best suited to your needs.

http://www.suffolkcognitivetherapy.com/web/resources/worksheets/ Suffolk Cognitive Therapy

This website provides free audio recordings of mindfulness instruction, including “Progressive Muscle Relaxation,” “Watching Thoughts Drift By,” “Acceptance of Anxiety,” and “Acceptance of Thoughts and Feelings.” They also provide clinical forms for practicing cognitive therapy, including a Thought Record, an Objective Thought Exercise & Worksheet, and a Values Exploration Worksheet.

https://www.academyofct.org Academy of Cognitive Therapy

The Academy of Cognitive Therapy shares CBT outcome studies, describing conditions that are treatable with CBT, including a spectrum of anxiety and mood disorders, eating disorders, and a surprising amount of medically related disorders (including insomnia, IBS, chronic fatigue, and chronic pain).

http://threeminutetherapy.com/ Three Minute Therapy

This website has an entire book online, free of cost. The book is “Three Minute Therapy: Change Your Thinking, Change Your Life” by Dr. Michael Edelstein. The book includes an explanation of cognitive therapy, CBT applications for a variety of topics (i.e. worry, self-esteem, anger, and overeating), and a three-minute exercise that walks users through the A-B-C-D-E-F approach to cognitive re-framing.

http://www.rebtnetwork.org/ REBT Network

The REBT Network elaborates on Albert Ellis’ ABC Model of rational-emotive-behavioral therapy, explaining how beliefs are connected to our emotional and behavioral reactions. This website also includes forms for disputing irrational beliefs and walking yourself through REBT therapy. You can also download free copies of “How to Conquer Your Frustrations” by Dr. William J. Knaus and “Rational Emotive Education” by William J. Knaus.

https://moodgym.com.au/ Mood Gym

Mood Gym is an interactive website that uses cognitive therapy to treat depression or anxiety. This low-cost site ($28.15 annual fee) incorporates quizzes, worksheets, animated demonstrations, and skill building into its program. It also tracks your progress through the workbook and helps you measure your results.

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Understanding Cognitive Therapy: The Basics

by Ericka Martin, LMHC, LPC | CBT, Counseling

Have you ever wondered how your feelings are generated? Do you understand what it is that triggers your emotions?

The fact is, there are many different answers to these questions in the field of psychology. Let’s take a look at just one of those approaches from the world of cognitive therapy. Cognitive-behavioral therapy (CBT) teaches that all moods are generated by our thoughts and reinforced by our behaviors.

Most thoughts that occur in the heat of an emotional moment are automatic. Often, these thoughts occur spontaneously, without conscious intent; hence the term “automatic.” Thoughts that are skewed negatively can lead to amplified emotional pain (ex. Sadness, anger, anxiety, or hopelessness), which is often what prompts people to come to counseling to begin with.

A cognitive approach to counseling helps people with uncovering and re-framing negative thoughts with the assumption that changing these thoughts changes the intensity of the feelings.

What happens in cognitive therapy?

A counselor that uses cognitive therapy or CBT might start by asking you to describe the context in which particularly strong feelings are being triggered. What is happening? Where are you? Who are you with? What happened first?
The counselor might prompt you to name the different emotions happening in that specific situation. Sometimes there is more than one emotion happening at the same time. You might even rate the intensity of the feelings (Example: Shame 90%; Anxiety 55%).
A cognitive counselor will be especially interested in helping you identify the automatic thoughts that happened before, during, or after the situation you’re discussing. To help with this, they might ask questions like: What was running through your mind when you started feeling ashamed/anxious/sad/guilty? Sometimes there are several automatic thoughts related to a particular situation. Maybe you’ve experienced a flood of negative thoughts one after another. Sometimes thoughts can swirl around so quickly that they feel like a hurricane of negativity. When that happens, the therapist can help you address them one at a time. You might start with the thought that evokes the most painful or intense emotions.
You might be asked to identify and confront any distortions in your thought process. For example, noticing thoughts that are all-or-nothing, overly catastrophic, attempt to tell the future, attempt to read someone’s mind, or overly personalize things.
You might be asked to examine evidence that your automatic thought is not 100% true. The workbook, “Mind Over Mood,” has a wonderful Thought Record worksheet that can help with challenging those emotionally heated thoughts.
After examining the thought (and the evidence for/against the thought), you might be asked to try out a new thought. The new thought might not be all rainbows, unicorns, and false positivity. Instead, the new thought might be experienced as neutral, balanced, fair, and more reflective of a truth apart from emotional reasoning.
After trying out the new line of thinking, a cognitive counselor might check in to see how the intensity of the emotions changed as a result of changing thinking.
Perhaps, then, you might begin to explore how you would behave differently if the new thought were to take root.

Cognitive theory teaches that long-term thought change requires a re-examination of core beliefs.

After evaluating automatic thoughts over a period of time, many people find patterns in their thinking that reflect deeper beliefs that are at the center of their distress. Once exposed, you can dispute those beliefs and act against them. This is when “schema” change takes place. According to Dobson & Shaw (1995), cognitive schemas reside in the long-term memory, serving as a “vulnerability factor” for their negative thinking. In order for enduring change to take place, individuals must create new lenses from which to see themselves, others, and their environment.

Cognitive counseling helps people develop an awareness of the unhelpful thoughts that are contributing to intense feelings. People really can learn to replace destructive thoughts with more functional thinking. In cognitive therapy, there is hope for a new perspective on life.

Interested in learning more? Check out the resources listed below or read additional articles on our Cognitive Behavioral Therapy page.

References

Burns, D. (1980). Feeling Good. New York: Signet.

Dobson, K. & Shaw, B. (1995). Cognitive therapies in practice. Comprehensive Textbook of Psychotherapy: Theory and Practice. New York: Oxford University Press.

Dozios, D., et al (2009). Changes in self-schema structure in cognitive therapy for major depressive disorder: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 77 (6).

Froggatt, W. (2005). A brief introduction to rational emotive behaviour therapy. Handout.

Greenberger, D. & Padesky, C. (1995). Mind Over Mood: Change How You Feel by Changing the Way You Think. New York: Guilford Press.

Jones, S. & Butman, R. Modern Psychotherapies: A Comprehensive Christian Appraisal. Illinois: InterVarsity Press.

Wenzel, A, et al (2009). Cognitive Therapy for Suicidal Patients. Chapter: Cognitive therapy: General principles. Washington, DC: American Psychological Association.

Answers to 3 Questions about Boundaries in Counseling

by Ericka Martin, LMHC, LPC | Counseling

1. How does confidentiality work in therapy?

Seeing a counselor is sort of like being in the witness protection program. Even the fact that the counselor knows you is kept private and confidential. That means that when they run into you out in public, the counselor does not flag you down and say– “Hey! It’s me, your therapist! Remember me from counseling?” (How awkward would that be!?)

Instead, therapists wait for you to initiate “hellos” and are usually glad to say “hi” right back. Counselors don’t ever want to put you in that uncomfortable position where you have to explain how you know them to the people you are with.

As you may have heard, there are some exceptions to confidentiality, especially when safety is at risk.

If you talk about children, elderly people, or disabled people that are being abused or neglected, your counselor is considered a mandatory reporter.
Your counselor would also break confidentiality if you disclosed plans to harm someone else. Counselors really don’t want anyone to be murdered! (That’s a good thing, right?!)
Counselors often see clients with thoughts of suicide. That really doesn’t freak us out. It’s more common than you’d think! When we DO break confidentiality is when that person is losing the ability to keep themselves safe. Because teens are a high risk population when they have thoughts of suicide, it’s common for therapists to seek coordination with family supports whenever risks of harm are involved.
Counselors are required to provide you with a copy of their privacy practices where you can read in more detail about how confidentiality works in this unique setting.

2. Why can’t I be Facebook friends with my counselor?

Counselors have to abide by professional standards and ethical guidelines. The 2014 ACA Code of Ethics introduced a requirement asking counselors to separate their professional and personal social media profiles. Those ethical guidelines do not permit counselors to communicate with clients via personal social media accounts. Counseling is unlike other relationships in your life, different from friendships and different from family connections. Part of what makes it effective is that separation and neutrality. Those boundaries help make therapy a safe place to express yourself without worrying about what your therapist is going to think, which can be triggered by social media comparisons. It’s for these reasons that your counselor cannot connect on Facebook or similar platforms.

3. What should I get my counselor for Christmas?

Okay, this was a trick question. Please don’t get your counselor anything for Christmas (or any other special occasion). Our ethical codes discourage counselors from receiving gifts from clients. We see some very generous people come through the door who love to show appreciation and gratitude by gift giving. When counselors decline your gift, know that it is not a personal rejection. It is instead another one of those professional boundaries drawn from the ACA Code of Ethics, which advises counselors to remain mindful of putting the therapeutic relationship first. More than anything, your counselor wants to avoid any situations that may cause a conflict of interest.

Authentic vs. Inauthentic Shame: Why It’s Essential to Know the Difference

by Ericka Martin, LMHC, LPC | Body Image, Depression, Self Acceptance, Self Worth

The feeling of shame has a reputation of being the vampire of emotions–the feeling that will suck the life right out of you. Because it comes with it a very physical discomfort, heat, and pain, it’s probably on your list of emotions to be avoided at all costs.

In this blog, I’m going to ask (and attempt to answer) the hard questions: Why do we experience shame? What utility does it have for us? What’s a person to do when they’re feeling trapped in a shame spiral?

First, to understand why we experience shame, we have to explore what triggers it.

Shame happens when you’ve broken an agreement that you’ve made with yourself. It is a faithful (and loud) reminder that you’ve strayed out of bounds and broken an internal “rule.” Sometimes shame goes ahead of you, before you’ve actually done the “wrong” deed, preventing you from taking an action that would be out of alignment with your values.

Our internal “rules” are a mixture of AUTHENTIC and INAUTHENTIC shame, a concept pioneered by Karla McLaren in her book, “The Language of Emotions.”

AUTHENTIC SHAME:

AUTHENTIC shame happens when you’ve broken the code of your character or integrity. These “rules” are the moral code that you would apply NOT ONLY to yourself but to other people as well. For example, a part of my moral code is to not gossip. Every single time I find myself participating in gossip with a friend, a feeling of shame creeps up, informing me with its icky feeling that I’m out of line. My “rule” about gossip is one I would teach my children and one I’d hope all people would embrace.

AUTHENTIC shame helps you live a value-drive life. It acts like a curb, nudging you back to alignment with your deepest sense of integrity.

INAUTHENTIC SHAME:

On the other hand, INAUTHENTIC shame happens when you’ve broken internalized rules that apply ONLY to you. Here are several examples:

A student to has to get all A’s and feels shame for that lone B+ on their transcript.
A teen girl feels shameful disgust for the fat on her body because she’s taken in messages that fat is abnormal/wrong/shameful
A woman has a miscarriage and feels shame, believing this wouldn’t have happened to her unless there was something bad/wrong with her.
A man looks in the mirror at his receding hairline and feels a twinge of shame, as if he’s broken the rule that a man must have a full head of hair.
A professional’s voice shakes while giving a presentation at work, feeling shame because they believe it’s bad/wrong to display any form of anxiety in public.

INAUTHENTIC shame is triggered by breaking the “rules” you have for yourself that you would NEVER intentionally pass on to other people.

With INAUTHENTIC shame, there is likely a part of you that recognizes the harmful nature of your “rules.” You might recognize that it contributes to your experience of depression, low self-esteem, poor body image, or toxic perfectionism. AND, you might still feel stuck, buying into those “rules” despite your recognition of the double standard at play.

HOW DOES INAUTHENTIC SHAME DEVELOP?

INAUTHENTIC shame springs forth from messages you’ve received from the outside (a critical comment from someone or maybe even messages from the media about what an ideal person is like). It’s as if you’ve taken someone else’s garbage home with you, accepted it as your own, and lived with its stench day after day.

THE REALITY IS: Whether your experience of shame is AUTHENTIC or INAUTHENTIC, 100% of the time it is informing you about internal rules that you are breaking.

4 STEPS FOR BREAKING OUT OF INAUTHENTIC SHAME

Start by labeling the shame as INAUTHENTIC, as something that has been applied to you and caused you harm.
Identify clearly what “rule” you are breaking. What are the specific details of the rule? For example: The rule that I’m not allowed to make mistakes OR The rule that I have to do X, Y, and Z by the time I’m 30 or else I’m a failure.
Ask yourself: Where did this rule come from? What has allowed this rule to take root in you over time? Whose garbage is this?
Try out Karla McLaren’s CONTRACT BURNING visualization skill for a powerful and effective way of releasing that old “rule.”

If you’d like help shifting out of INAUTHENTIC shame, a counselor may be able to help. The counselors with Star Meadow Counseling love helping clients explore and alter the “rules” that have kept them stuck.