By Ruth P. Wachter
Workaholism A Holistic Approach Individual health cases or the unavoidable result of progressively increasing competitive pressure? Let‘s look a bit closer at the causes of this excessive work effort and which disorders can occur. This paper seeks to explain the biopsychosocial model based one the case study which is illustrated at the article „Workaholism: A New Challenge For Organisation Management“. This article is dealing with work addiction and its influence on workaholism. Nistor (2013, pp. 296-297) used the case study of Raluca S. who is a young woman, working as a financial auditor manager in Romania. She grew up in shattered family relations and became inspired by her grandparents to use her painting talent. So she studied art and finally focused on economics like her grandparents. After her graduation she started working for one of the Big4 financial consultancy multinational companies (appellation for PWC, KPMG, Ernst & Young and Deloitte). In the year 2004 the company was struggling with the flow of personnel and accepted her as a senior although she had no experience. She started to compensate this lack of experience with extra working hours and got the audit manager’s position in the year 2006. Relationships to friends decreased dramatically because some of her friends she met only seldom, others confronted her with the fact that she was working too hard she became distant with them. Although she felt more and more run down, she postponed her medical exam until she passed out at work. Coworkers took her to the private medical clinic where she was stabilized and examined. After not picking up the phone for two days, the specialised service found her dead. The pathologist found out that her heart had stopped beating due to a state of exhaustion and chronic exhaustion.
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MSC of Applied Psychology
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If the employee is highly involved in his/her work, and has a high activity that could be forced by an internal driver plus the pleasure of his/her work is low, the employee will suffer (most likely) from workaholism which could result sooner or later in a burnout. Already being in the stage of workaholism has a negative impact on mental and physical health (Fujimoto, 2014). For this reason I am completely convinced that workaholism falls into the category of mental health. My second assumption is that workaholism needs to be analyzed by the biopsychosocial model. The biopsychosocial model was developed by George Libman Engel.
Stress Inventory An event or activity arouse stress if one of following conditions is present: (1) the outcome or activity is important to you, (2) the outcome or consequence is uncertain, (3) you are being observed or evaluated, (4) someone angered or upset your. Review your activites of last week - if you were so stressed that you can‘t remember, give yourself a score of 100. Otherwise count the number of events up for (1) waking up with trouble in mind, (2) delays in getting to work, (3) somebody frustraded you or caused a problem, (4) having to work later than planned, (5) meetings, calls or emails that have stressed you. Boyatzis, R., Smith, M. (2012). Positive Renewal. Leadership.
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My first assumption is that workaholism falls into the category of mental health. The World Health Organisation (WHO) defines: „Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.“ Mental well-being is used synonymously to mental health in this perspective. Another possibility is finding the definition by separation from mental illness. According to Manderscheid (2010) the definition of mental illness is that emotions, behaviors and cognitions are negatively affected by given factors (Manderscheid, 2009) Both, mental illness as well
as mental health can be affected by several factors e.g. social support, income, educational level, social exclusion, lack of resources, experiences, stress and professional life (Primm et al., 2010). Spence and Robbins (1992) defined three factors which can be used to separate a „workaholic“ (person that suffers from workaholism) from ordinary employees: A workaholic is highly involved in his/her work, has an internal driver that forces him/her to work with high activity and cannot get any pleasure out of his/her work. Shimazu (2013) shows the connection of activity level and pleasure. According to the high (+) activity level and low (-) pleasure results in workaholism. This assumption is similar to the approach of Spencer and Robbin.
Engel (1977) explained that „disease“ is the term for a biological disorder and reserved for medicine, whereas „illness“ can be used for sociocultural and psychological disorder. Barondess (1979) wrote: „Illness, on the other hand, is not a biological, but a human event“. Moreover Barondess defined that „Illness“ is an individual event that is often stimulated by a human‘s environment e.g. recurring stressful life events or individual reactions to ongoing threat. McMillan and O’Driscoll (2004) reported based on their study three negative outcomes of workaholism: burnout, job stress and subjective health complaints. Burnout that is explained as the opposite of work engagement is defined as „a syndrome of emotional exhaustion“ (Maslach, 1982). According to Ursin and Eriksen (2004) job stress has been linked to enthusiasm. While enthusiastic workaholics expected to have a low stress level, nonenthusiastic workaholics may feel hopeless and helpless which predicts a higher stress level. Subjective health complaints are defined as complaints with just few or no biological finding e.g. headache, sleeplessness, gastritis or/and symptoms of fatigue (Ursin & Eriksen, 2004).
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Engel‘s approach (1977) was the crossroad from reductionism as well as mind-body dualism. In theory Engel‘s biopsychosocial model is based on the General System Theory (GTS) from Ludwig von Bertalanffy. GTS as well as the biopsychosocial model are open systems without isolation, but just the biopsychosocial model is taking into consideration the system of biology, psychology as well as sociology. The social system of workaholism includes the negative aspect of the social stigma by admitting the mental illness of workaholism (Kudlow, 2012). A positive aspect in the social system could be social relationships which help to reduce work addiction. In the case of Raluca S. the stigma of losing her job due to not achieving the expectations of her employer boosted by cultural background of Romania was maybe not the best environment for admitting a mental illness. It is like an express train that is driving non-stop across Europe. If somebody puts on the hand brake the passengers would ask for the reason and you would have to explain yourself. In the biological system workaholism could lead to sleeplessness, high blood pressure, exhaustion etc. (Berth et al., 2008). In the case of Raluca S., Nistor mentioned in her article that she was postponing her medical exam for a long period although she felt exhausted and lost weight. It can be supposed that the medical exam would not lead to any biological reason. In the psychological system possible disorders could be: frustration, lack of concentration, etc. Raluca‘s diagnosis after her blackout was her evidence in biological system. According to the biopsychosocial model two more levels of diagnosis were missing. Nobody cared about her work addiction, and addiction that was the reason for her biological disorder and ongoing decrease in her social relationships outside of the organisation. As singular disciples, neither psychology nor medicine or social sciences have been able to find a treatment plan for workaholism. However together using a holistic approach they would have been successful.
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The approach of Spence and Robbins (1992), Shimanzu (2013) and Fujimoto (2014) is a rather reductionistic one, because it is not taking into account the social condition, childhood experiences or educational level. The case study of Raluca S. can falsify this approach: She spent a lot of extra hours compensating for her lack of experience (internal driver) and had lost most of her social relationships (due to high work activity), but a friend of
Raluca recounted „For her, everything was a race, she wanted to be first and succeed at everything”. This quote does not sound displeasured or bored. Taking into account that she grew up in shattered family relations and the fact that she had to work already during her High School time for financing her eduction, the internal driver becomes another meaning. Nistor takes additional factors into account. In her article the individual factors like „an unhappy childhood, lack of affectivity, dysfunctional family of origin, wish to promote, great flow of personnel in the company, lack of management control, poor delegation of tasks“ confirm her mentioned theories of work addiction. She refers (among others) to Andreassen (2012) who presented a new view on workaholism. Andreassen argues that workaholism is a pattern of behavior nurtured by „underlying narcissistic traits“ that have been developed in early life. According to the approach of Andreassen narcissism leads to an huge internal driver for climbing the social or/and organizational ladder (Andreassen, 2012). Nistor‘s system approach is distinguishable due to his assumption of cause and effect, the functionalism approach as well as
the assumption that work ethics and organizational culture are the reasons for the touching ending of Raluca S. In my opinion Nistor started the article in a systemic way, but her conclusion is just focused on minimizing the addiction risk requested from the managers of the organizations. This is a very reductionistic conclusion which places the responsibility of employee‘s mental health at the end of the door of organizations with without taking into consideration individual‘s responsibility to his/herself. In conclusion, using the biopsychosocial model takes many live systems into account but it has a major issue: Up until now neurobiological research has not been able to isolate any place in the brain where biological, social and psychological systems actively interact with one another (Richter, 1999). It demands a holistic approach of uniting the various sciences which in turn creates a dilemma: Implementation in the case of emergency. Which professional advisor should be consulted first to ensure that the disorder of each system leads to a holistic diagnosis? In the case of Raluca the holistic inquiry by the medical advisor was missing that could have saved her life. References Andreassen, C. (2012). The Relationship of Narcissm with Workaholism, Work Engagement, and Professional Position. Social Behaviour And Personality An International Journal, 40 (6) Richter, D. (1999). Chronic mental illness and the limits of the biopsychosocial model. Medicine, Health Care and Philosophy, 2, 21-30. Baroness, J. (1979). Disease and Illness - A Crucial Distinction. American Journal of Medicine, 66(3), 375-376. Engel, G. (1977). The need for a new medical model: a challenge for biomedicine. Science, 196 (4286), 129-136. Engel, G. (1980). The Clinical Application of Biopsychosocial Model. The American Journal of Psychiatry, 137, 535-544.
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