Workplace phobia
Encyclopedia
According to the general definition of specific phobia
s in DSM-IV or ICD-10
, workplace phobia can be stated when an actual or imagined confrontation with the workplace or certain stimuli at the workplace (e.g. persons, objects, situations, events) causes a prominent anxiety
reaction in a person. Secondly, avoidance behaviour towards the workplace or associated stimuli has developed. In some cases Workplace phobia may be a kind of social phobia
or social anxiety
or extreme shyness
.
.
When avoiding or leaving the feared workplace, arousal and anxiety decrease. This functions as a classical negative reinforcement
: The avoidance reaction works rewarding as it reduces anxiety. Simultaneously avoidance behaviour is being reinforced.
” certified by a medicine is a regularly found phenomenon.
There is a tendency for generalisation of avoidance behaviour, like avoiding passing the street where the workplace is situated, avoiding going to public places (like the supermarket) where one could meet colleagues or superiors, or even developing panic attacks and anxiety when only speaking of the workplace.
“, experiencing a traumatic event, sudden changes in work organisation or work content, workplace environmental factors). On the other hand, it can also be the consequence of a primary conventional mental disorder (especially anxiety disorder) which was primarily not related to the domain of work. In this case, anxiety manifests at the workplace in a specific quality. Mostly there are interactions between a general level of anxiety and workplace-related anxiety. Workplace phobia often develops after structural changes in the work environment or in work contents, or after changes in personnel and social conflicts at work.
More adequate treatment methods are descriptions and analysis of situation and behaviour, development of coping strategies for reducing the general feeling of insufficiency, reframing and symptom management, clearing conflicts and exposition in sensu.
A specific therapeutic instrument is the "vocational capacity test“ recently developed in the context of psychotherapeutic rehabilitation clinics. Hereby inpatients attending a rehabilitation therapy are sent to cooperating firms for hospitation for some days, under therapeutic supervision. By this, patients who have been away from work for a longer period can do first steps into a public work environment, may carefully test and be observed concerning their capacities at the same time.
("social phobia"), obsessive-compulsive disorder
and post traumatic stress disorder. Due to the specific characteristics of workplace phobia, especially its clinical and socio-medical consequences and the requirements for treatment, it seems to be senseful to treat and name it as a proper disorder. This can be understood in analogy to a heart attack which does also appear “only” as an additional symptom within a metabolic syndrome, but nevertheless gets an own status of disease because of special symptomatic, consequences for participation and prognosis, and therapeutic requirements.
Specific phobia
A specific phobia is a generic term for any kind of anxiety disorder that amounts to an unreasonable or irrational fear related to exposure to specific objects or situations...
s in DSM-IV or ICD-10
ICD-10
The International Statistical Classification of Diseases and Related Health Problems, 10th Revision is a medical classification list for the coding of diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases, as maintained by the...
, workplace phobia can be stated when an actual or imagined confrontation with the workplace or certain stimuli at the workplace (e.g. persons, objects, situations, events) causes a prominent anxiety
Anxiety
Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...
reaction in a person. Secondly, avoidance behaviour towards the workplace or associated stimuli has developed. In some cases Workplace phobia may be a kind of social phobia
Social phobia
Social phobia may refer to any of the following conditions:* Social anxiety disorder – a diagnosis referring to clinically excessive social anxiety...
or social anxiety
Social anxiety
Social anxiety is anxiety about social situations, interactions with others, and being evaluated or scrutinized by other people...
or extreme shyness
Shyness
In humans, shyness is a social psychology term used to describe the feeling of apprehension, lack of comfort, or awkwardness experienced when a person is in proximity to, approaching, or being approached by other people, especially in new situations or with unfamiliar people...
.
Symptoms
When approaching or being at the workplace, or even when intensively thinking of the workplace, anxiety rises. This goes along with increased physiological arousal, typically with symptoms of accelerated heartbeat, sweating, trembling, hot flushed, chest pain, which might even result in a panic attackPanic attack
Panic attacks are periods of intense fear or apprehension that are of sudden onset and of relatively brief duration. Panic attacks usually begin abruptly, reach a peak within 10 minutes, and subside over the next several hours...
.
When avoiding or leaving the feared workplace, arousal and anxiety decrease. This functions as a classical negative reinforcement
Reinforcement
Reinforcement is a term in operant conditioning and behavior analysis for the process of increasing the rate or probability of a behavior in the form of a "response" by the delivery or emergence of a stimulus Reinforcement is a term in operant conditioning and behavior analysis for the process of...
: The avoidance reaction works rewarding as it reduces anxiety. Simultaneously avoidance behaviour is being reinforced.
Avoidance
In consequence of workplace phobia avoidance of the workplace through “sick leaveSick leave
Sick leave is time off from work that workers can use during periods of temporary illness to stay home and address their health and safety needs without losing pay. Some workplaces offer paid sick time as a matter of workplace policy, and in few jurisdictions it is codified into law...
” certified by a medicine is a regularly found phenomenon.
There is a tendency for generalisation of avoidance behaviour, like avoiding passing the street where the workplace is situated, avoiding going to public places (like the supermarket) where one could meet colleagues or superiors, or even developing panic attacks and anxiety when only speaking of the workplace.
Aetiology
Anxiety related to the workplace can be released through situational factors at the workplace itself („MobbingMobbing
Mobbing in the context of human beings either means bullying of an individual by a group in any context. Identified as emotional abuse in the workplace, such as "ganging up" by co-workers, subordinates or superiors, to force someone out of the workplace through rumor, innuendo, intimidation,...
“, experiencing a traumatic event, sudden changes in work organisation or work content, workplace environmental factors). On the other hand, it can also be the consequence of a primary conventional mental disorder (especially anxiety disorder) which was primarily not related to the domain of work. In this case, anxiety manifests at the workplace in a specific quality. Mostly there are interactions between a general level of anxiety and workplace-related anxiety. Workplace phobia often develops after structural changes in the work environment or in work contents, or after changes in personnel and social conflicts at work.
Socio-medical meaning
Workplace phobia is a complex clinical phenomenon with an own clinical value, with specific aetiology factors and specific requirements for therapy. This is due to the special characteristics of the anxiety-provoking stiumus:- The workplace is not a simple stimulus like a spider or the tube. In contrast, we find it to be a very complex stimulus containing both situative as well as interactional elements.
- Avoiding the workplace regularly means negative consequences for the biographic development of the concerned person (long-term sick leave, loss of the workplace, endangerment of work ability and early retirementRetirementRetirement is the point where a person stops employment completely. A person may also semi-retire by reducing work hours.Many people choose to retire when they are eligible for private or public pension benefits, although some are forced to retire when physical conditions don't allow the person to...
) - Avoiding the workplace may lead to chronification of the primary disorder. Cognition of own insufficiency, and fantasies about possible endangerments manifest the dysfunctional ideas the patient has developed while staying away from work.
- In contrast to the street or the tube, the workplace cannot be entered for exposition anonymously and at any time. Therapeutical exposition trials at a workplace are therefore extremely resricted.
Therapy
The special problem about workplace phobia treatment is that a controlled stepwise exposition to the anxiety-provoking stimulus is hardly possible. The situational conditions cannot be controlled therapeutically, the workplace cannot be entered anonymously, events happening there cannot be foreseen. With such great variety of possible disturbing factors, an exposition might even result in strengthening the phobic disorder.More adequate treatment methods are descriptions and analysis of situation and behaviour, development of coping strategies for reducing the general feeling of insufficiency, reframing and symptom management, clearing conflicts and exposition in sensu.
A specific therapeutic instrument is the "vocational capacity test“ recently developed in the context of psychotherapeutic rehabilitation clinics. Hereby inpatients attending a rehabilitation therapy are sent to cooperating firms for hospitation for some days, under therapeutic supervision. By this, patients who have been away from work for a longer period can do first steps into a public work environment, may carefully test and be observed concerning their capacities at the same time.
Diagnostic status
It can be discussed whether workplace phobia may be seen as a proper mental disorder for itself or as a symptom of another conventional (i.e. not work-related) disorders, such as social anxiety disorderSocial anxiety disorder
Social anxiety disorder , also known as social phobia, is an anxiety disorder characterized by intense fear in social situations causing considerable distress and impaired ability to function in at least some parts of daily life...
("social phobia"), obsessive-compulsive disorder
Obsessive-compulsive disorder
Obsessive–compulsive disorder is an anxiety disorder characterized by intrusive thoughts that produce uneasiness, apprehension, fear, or worry, by repetitive behaviors aimed at reducing the associated anxiety, or by a combination of such obsessions and compulsions...
and post traumatic stress disorder. Due to the specific characteristics of workplace phobia, especially its clinical and socio-medical consequences and the requirements for treatment, it seems to be senseful to treat and name it as a proper disorder. This can be understood in analogy to a heart attack which does also appear “only” as an additional symptom within a metabolic syndrome, but nevertheless gets an own status of disease because of special symptomatic, consequences for participation and prognosis, and therapeutic requirements.
Further reading
- Haines J, Williams CL, Carson JM (2002). Workplace Phobia: Psychological and Psychophysiological Mechanisms. ´´International Journal of Stress Management´´, 9: 129-145.
- Linden M, Muschalla B (2007). Arbeitsplatzbezogene Ängste und Arbeitsplatzphobie. ´´Der Nervenarzt´´, 78, 39-44.
- Linden M, Muschalla B (2007). Anxiety disorders and workplace-related anxieties. ´´Journal of Anxiety Disorders´´, 21, 467-474.
External links
- Dissertation: Workplace-related Anxieties and Workplace Phobia: http://opus.kobv.de/ubp/volltexte/2008/2004/
- Review Article: Workplace Phobia http://www.gjpsy.uni-goettingen.de/gjp-article-muschalla.pdf