Integrating Faith and Psychiatry, Part 4: Work & the Self

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Integrating Faith and Psychiatry, Part 4: Work & the Self

Eric had leadership written all over him. Intelligence, good looks, and interpersonal drive had led to an MBA at a major university. When his first business venture failed, he was on to another that succeeded. Several other business successes followed, as did personal leadership projects undertaken at church and in his community.

He was politically active both locally and nationally. His wife and children were also achievers,  but a sense of balance was missing from his life. He suffered two major depressions in his adult life and another as retirement age approached and he was confronted with financial difficulties and the interpersonal consequences of chronic over-extension. His retirement was forced, and he was emotionally adrift.

Disordered Thinking 
“The driver for many who lack balance in their lives is disordered thinking about the relationship of work to self and God,” Laity Leadership Institute Senior Fellow Allan Josephson, M.D. says.

Although he recognizes that striving for a balance between personal and professional domains facilitates development in both, Josephson has something else in mind when he considers this kind of disordered thinking.

It is not uncommon, he says, to ask a young child, “What do you want to be when you grow up?” But the child would have every right to say, “I am something right now!” because the question reflects a deep assumption that identity is tied up in vocation, that our being is synonymous with our doing.

“This over-investment of self occurs in other areas beside work,” he says. “Individuals can over-invest in the parent role, their physical appearance or a close personal relationship. The problem of ‘putting all your eggs in one basket’ is that one is vulnerable when that area is gone.”

In the Handbook of Spirituality and Worldview in Clinical Practice, Josephson tells the story of a 45-year-old Christian social worker who was depressed and increasingly burdened with his responsibilities and with his inability to meet the world’s needs. He described himself as controlling in personal relationships and as someone who always tried to “make things right,” especially when situations got out of control.

Distorted Perceptions 
The social worker often felt guilty and anxious that he couldn’t do more for others, but he also fought considerable rage about his “subservience.” With therapy, he was able to accept that he couldn’t solve all the world’s problems, and with clergy consultation, he was able to recognize something even more subtle: although his commitment to selfless living was rooted in his Christian faith, his perception of this calling was distorted.

“With time, he came to see that he could still be the giving, loving person he believed he should be—crucial aspects of his professional and religious identity—yet also ‘take care of myself,’” Josephson wrote.

We bring our personalities and family stresses to work and, likewise, bring home job stresses that can encroach on family life, he says, and the need for balance between work and family and between work and rest is essential. We can’t truly flourish if we are only developing a single area such as in our vocational pursuits. Sometimes we are vulnerable to the temptation to over-invest in work because those successes are public, whereas home successes are private, but personal success can create a buffer for stress at work.

Healthy and Dysfunctional Systems
Additionally, in a healthy social system (family, workplace, church), each action is balanced by a compensatory reaction, enabling the system to maintain stability, Josephson says. “Individual behavior is often mediated by personal characteristics but also by factors within a systemic or organizational culture. Individual actions influence and shape the system, yet at the same time individual differences can be trumped by the ‘strength of the social system,’” he explains.

On the other hand, dysfunctional individuals impact and shape systems in negative ways. For example, Eric’s coworkers said he didn’t listen and his chronic over-extension meant they had to often cover for him, leaving them feeling disgruntled. And, the depressed social worker who struggled with rage had difficulty building and maintaining the kinds of healthy relationships with clients and coworkers that would have benefited all parties and his institution.

These individual and systemic factors can play out in families too, Josephson says. The “workaholic” father, for example, creates an emotional distance between himself and his wife. She compensates by investing excessively in their two children. They  lose on two counts: they get too much of mom and not enough of dad. The system adjusts, however. Often when the father sees the error of his ways and wants to reconnect with his family, he finds that the system has adjusted without him and he is marginalized.

Questions to Ask Ourselves

So how do we discern if our sense of self in relationship to work is out of balance? Josephson suggests the following self-evaluation questions as a place to start:

  • How much of your “self esteem” is determined by your work success?
  • When you experience a work related “failure”, what is your response?
  • How do you cope with this?
  • Do you feel you are running “too fast”?
  • Do you make interpersonal, or technical, errors because you are multitasking?
  • Do you have any solitude in your life?
  • Do you feel you need this time?
  • Is that time psychological or spiritual, or both?
  • Do you feel you can’t keep up with the pace of your workplace? If so, what are your coping strategies to deal with feelings of “falling behind”?
  • Can you say “No”? When you do, are you concerned with the consequences on interpersonal relationships?
  • Do you feel you are running out of time in achieving your goals?
  • Most individuals have an ideal of who they want to become/what they want to achieve. How close are you to achieving that ideal? If you don’t make it, how will you deal with it?
  • In what way has your family of origin experience influenced your vocation choice and current work behaviors?

Creating Space for Answers
“What Laity Leadership Institute has tried to do is be open to supporting organizations and individuals where things don’t work as well, where there is brokenness and there is healing that can come through psychological work and through spiritual means,” Josephson adds.

He has long been interested in the relationship between spiritual and psychological issues and wonders if the over-investment of self in work, with its subsequent psychological stress, is akin to Jesus’ powerful query in the gospels: “What does it profit a man if he gains the whole world yet loses his soul?” (Mark 8:36).

What do you think? Is your sense of self too tied up in your vocation? If so, what will you do about it?

Read other parts in our series on Integrating Faith and Psychiatry:

 
 
 
Allan JosephsonM.D. is Vice Chairman for Adolescent Psychiatric Services at the University of Louisville School of Medicine and author of three books, including the Handbook of Spirituality and Worldview in Clinical Practice, a text he edited and contributed to that is used in psychiatric residency programs to help psychiatrists understand the diagnostic and therapeutic implications of their own and their patients' worldviews.