Dr Rama Prasad

Vocation Virus

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Nicole Kidman said work was her salvation in times of crises, but for many of us work is our crisis. Naturopath Caroline Robertson discovers the ‘vocation virus’ and reveals why finding joy in our job is crucial to contentment.

Does the thought of work make you sick or depressed? Just thinking about work sends stress surging according to a University College London study showing the stress hormone cortisol was highest just before work. No wonder Monday morning’s the most common time for a heart attack.

If you dread work and spend hours clock watching, cyber-surfing for dream jobs or saying “I hate this,” or “Tahiti looks nice,” may you have a dose of vocation virus. Do your health problems go into miraculous remission on holidays only to return with work? My patients suffering from these occupational hazards found that dropping pills for health problems didn’t work as well as dropping their work or job attitude. Could a radical jobotomy help your health?

Freud said love and work are the two essential aspects of a well-adjusted person. Enriching work can keep us sane just as wrong work can drive us insane. Dostoevski remarked, “Deprived of meaningful work, men and women lose their reason for existence; they go stark, raving mad.” After analysing patients I sadly lost to heart attacks and cancer I realised the strong role their draining work life played in their decline. It had literally sucked the life out of them, cases of Honore De Balzac’s observation that “an unfulfilled vocation drains the colour from a man's entire existence.” If only they had undertaken a sincere job autopsy and overhaul while they were alive- things may have ended differently.

The Price of a Paycheck

Long hours, workplace conflicts, unclear roles and unreasonable demands are leading many to question the price of their paycheck. Maggie Hamilton, author of Love Your Work, Reclaim Your Life (Viking), said her work woes motivated her to explore the work dilemma, “I had become suffocated by the stress, the deadlines and the fatigue.”

Work stress is a common contributor to health problems says Graham Burrows, Chairman of Victoria’s Mental Health Foundation, “50% of people in general hospitals are there directly as a response to stress.” According to a 2003 study in ‘Occupational and Environmental Medicine’ the top factors causing work stress and related illness are "long hours, work overload and pressure, the effects of these on personal lives; lack of control over work; lack of participation in decision making; poor social support; and an unclear management and work role." Stress which can be triggered by a multitude of factors such as excessive pressure, poor communication, chaotic organization, bad working relationships or physical strain increases the heart rate, blood pressure and muscle tension.

Worked to Death

According to the Australian Bureau of Statistics almost half a million people experience a work-related illness annually and 2004 Australia Institute research found Australians are suffering higher than usual levels of work-related anxiety, heart disease, depression and stress. NSW Labour Council's occupational health and safety watchdog Mary Yaager warns "Australian employers are literally working their staff to death, with on the job stress, violence and fatigue edging their way up to become major causes of workplace fatalities.”

Working yourself into an early grave is a well-documented phenomenon in Japan where it’s known as Karoshi. Since 1969 the National Defence Council for Karoshi Victims estimates 10,000 workers die each year in Japan from overwork and a recent survey found 40% of all Japanese workers fear they will work themselves to death.

Sure, you think, this may happen to workaholic kamakaze salarymen and sweatshop slaves - but not in the laid-back, lucky country. Not so, according to Australia Institute director Clive Hamilton, "Whilst Australians often think of themselves as living in the land of the long weekend, they are now working the longest hours in the developed world and are at risk of working themselves sick."

Even with an excuse Australians aren’t apt to slack off as much as our beach bludging reputation suggests with only 39% of full time employees taking their full annual leave in 2002, a pitiful entitlement of 4 weeks compared to Germany’s six weeks and the European average of 5 weeks. Though we appear to be luckier than those living the American dream with 2003 US Department of Labour Statistics stating their average leave is only 8 days a year, the stingiest in the industrialised world.

Putting your Heart Into It

Though stress is a fact of life, everyone’s stress stimulus and response differs. Those with sensitive systems will be more affected by stress whereas people with a strong psycho-physiological constitution are more resistant. Some thrive on the extra alertness stress brings, functioning better with a fire under them and knowing how to extinguish tension before adrenaline engulfs them. Others internalise stress, producing hormones like cortisol which may cause phantom aches, fatigue, lowered immunity, poor brain function and heart disease. And then there are those who expel it with extreme behaviour such as violence and addictions, disturbing themselves and those around them.

While short-term stress can kick start motivation, long-term stress undermines every healthy, rejuvenating mental and physical function. It particularly affects the heart according to a recent study from the University of London concluding that chronic stress is six times more likely to contribute to heart disease or cancer than high cholesterol or smoking.
Stressful jobs can be real heart breakers as British Heart Foundation statistics show that employees exposed to stress for at least half their working lives are 25 percent more likely to die from a heart attack and have a 50 percent greater chance of suffering a fatal stroke. At the Chicago Board of Trade there’s a morbid reminder that stress and heart disease travel hand in hand – a paramedic station with a stretcher and defibrillator pads set up just off the trading floor.

Emergency aid Jim Thorpe mans the company perk, "Quite a few of the guys here are on heart medications then there are the ones who have already had heart attacks. We especially keep an eye on them. Fortunately, there's a firehouse with an ambulance just down the block."

When playwright David Williamson experienced heart arrhythmia he noticed it worsened when he overworked and successfully managed the problem by reducing his workaholic hours.

Even those who love their work need to take time out for sleeping, eating and relaxing. A strong connection has been established between long working hours and heart attacks. Prompted by the high number of Karoshi’s due to heart attacks, a 1998 Japanese study found that men working an average of more than 11 hours a day were more than twice as likely to have a heart attack than those averaging 7-9 hours.

Japanese advertising agency employee Mr.Yagi was a typical victim, when after working over 70 hours a week with 3 1/2 hours a day commuting, he died from a heart attack at 43yrs. His poignant personal diary entry said - "We are bought by money and bound to the hours. At least slaves must have had time to eat meals with their families." And in India the Transport Corporation APSRTC called a meeting over concern that employee deaths escalated from 426 in 1995 to 1,653 in 2002, half of them due to heart attacks related to extreme work pressure and management harassment.

Killer Jobs

Many researchers have tried to identify which jobs are the most stressful or have the highest incidence of death due to disease or suicide. A Swedish stress test discovered that jobs which require prolonged effort with emotional distress increase the fright, flight, fight hormones of adrenaline, nor-adrenaline, cortisol and endogenous cholesterol which all contribute to a greater risk of coronary heart disease. 

Manual workers are at greater risk of heart disease according to the British Heart Foundation finding that premature death from coronary heart disease is 58% higher for male manual workers than non-manual workers and 200% greater for female manual workers, this being attributed to increased job strain.

It seems the lower you are down the corporate ladder, the higher your chance of suffering a job related illness. A New York study backed this theory after discovering that “blue collar” worker’s blood pressure rose considerably more under job strain than it did for high status “white collar” workers. The UK "Whitehall II" study supports this theory, concluding that workers with low job control suffered double the risk of a coronary heart event than those with high control, managerial positions. Professor Marmot from University College London agrees with the equation that high status employment brings better health. In his book Status Syndrome he details research revealing that those with higher education, salaries and social status have greater longevity. Men at the base of the office hierarchy had four times higher risk of death than top rung administrators according to Marmot. Education was another factor- "PhDs lived longer than people with master's degrees, and masters lived longer than bachelors," said Professor Marmot, "Position in the social hierarchy is clearly related to health, well being and length of life," This is even reflected in Hollywood where Oscar winners live an average of four years longer than trophyless actors.

So which jobs are the most stressful? A combination of little control, extreme demands and direct customer contact gave paramedics and social workers the dubious title of the most stressful jobs in Britain according to a 2004 survey by business psychology company Robertson Cooper. They found the least stressed were senior business directors as they had less direct contact with customers. Research at the University of Queensland headed by Neal Ashkanasy found that the most stressful jobs are the ones that force workers to hide their true emotions such as air stewards who have to smile or undertakers who have to be sombre. And according to a poll on www.worstjob.com, ‘the place where people with crummy jobs can commiserate with one another,’ the “Worst Job in America Award” goes to a Police Department Custodian who has spent the past 19 years cleaning up intoxicated or insane arrestees bodily excretions from police cars and holding cells. The Jobs Rated Almanac lists the most stressful job as the President of the US with fire fighters coming second. Uniformed Firefighters Association health and safety officer Philip McArdle knows of six suicide attempts by firemen since the Twin Towers tragedy and at least three New York emergency workers involved in 9/11 recovery efforts committed suicide.

Ask anyone the profession with the highest suicide rate and they are likely to repeat the urban myth that it’s dentists. The truth is that there’s no definitive answer to this quandary as it varies greatly according to locale, numbers and accurate coroner’s reports. However, as a generalisation- it seems that the medical profession is most likely to drive people over the edge. Separate British and US studies in 1972, 1988, 1995 and 1997 concurred that those in the medical field had the highest suicide casualties. GP Dr Dawn Harris who killed herself in 2003 was an example of how pressure in the medical field can be a killer. Her widowed husband described her dilemma- "She had become depressed because of the stress of the job she longed to do but also because she couldn't do more to help heal people." The long hours are a major stress factor as a British Medical Association survey of almost 11,000 health consultants found that 77% worked more than 50 hours a week for the National Health Service and 46% more than 60 hours weekly, well within the Karoshi risk zone.

Other professions with a high suicide rate include food batch makers, black male guards, female artists, dentists, miners, farmers, female nurses, teachers, police and builders labourers. English construction union UCATT were so concerned over statistics that 16% of all suicides in East Kent were in the construction industry that they launched an investigation into the matter. Though suicides related to unemployment are higher than those for the employed, workplace problems could explain a high percentage of suicides in Australia with a 2002 Victorian study finding that work was a significant factor in 109 suicides in the years 1989-2000. Small figures compared to Japan where suicide, seen by some as a noble way of saving face, claims 600 lives weekly.

What do you want to do when you grow up?

Work was an exciting prospect when as bright-eyed kids we dreamed about what we were going to do when we grew up…astronaut, nurse, fireman, flight attendant. But somehow many fall victim to workplace angst, trapped in unfulfilling jobs that sap precious time and energy. Rather than following our calling, many are called up to do what others expect or material necessity dictates.

Considering work can consume up to 80% of our waking hours we should do something we love- to serve others and ourselves. The exhilaration of expressing our unique energy can elevate us to a transcendental state as Marsha Sinetar explains in Do What You Love, The Money Will Follow (Dell), “those who work in a state of mindful awareness bring an almost supernatural power to what they do.” Instead of struggling in loveless labour, we thrive when job development and self-development evolve simultaneously. Work is no longer a struggle but an empowering expression of our unique gifts as Oprah Winfrey said, “Your true passion should feel like breathing; it's that natural.”

Though many want to change their work people often lack the courage, confidence, information or inspiration to shift. Some are stuck in ‘The Comfort Trap’ as explored in psychologist Judith Sills book of the same name and limited concepts of one’s options and capabilities cripple a career move. A belief that work is to be endured rather than enjoyed keeps us captive in dissatisfying careers. Though many know what they’d like to do, they don’t do what they know. This creates incredible internal stress as the soul’s true purpose and self-expression is sacrificed in favor of ‘the job of least resistance’. The discrepancy between what we want to do and what we feel we have to do wages an inner war as we struggle to summon to energy to continue or to search for an alternative. This takes its toll on one’s mental and physical wellbeing as Boris Pasternak’s character Dr Zhivago said, “Your health is bound to be affected, if day after day, you say the opposite of what you feel”.

Reality shows like the Apprentice and the Rebel Billionaire reflect a work culture that promotes enormous stress and questionable values as a normal part of professional life. The sadistic initiation “interview process” demands ridiculous risk taking such as repelling a 700-foot building, undignified actions like marrying a stranger, brutal character assassination of co-workers and unethical business practices. When a candidate was admonished for “stopping to take lunch” and another praised for abusing a friend and inflating prices the message was that work has paramount priority over health, relationships and values. But does sacrificing these things for the sake of success really bring happiness?

A very wealthy patient of mine said he would trade all his professional power and prestige if he could regain his health and relationship with his family. In striving for “success” he met ultimate failure with his health and relationships in crumbling disrepair.  Writer Maya Angelou gave a profound definition of success as “liking yourself, liking what you do, and liking how you do it,” not selling your soul or forsaking happiness for loveless labour.

The Yoga of Work  

True happiness arises from contentment at the core of our being, not from external circumstances. Finding balance between work, recreation, rest and relationships whilst appreciating what we have is the real mark of success.  As author Albert Camus pondered, “But what is happiness except the simple harmony between a man and the life he leads.”

Work can devour our quality of life when goals of material gain and aggrandisement take precedence over priorities of health, happiness and self-development. Driven by beliefs that work is a labour rather than a love, an enemy to tolerate rather than an energy to enjoy, a thankless task rather than an enriching endeavor clouds our vision of the liberating potential of fulfilling work.

Our suitable occupation can be an elixir of health as illustrated in a story by Norman Cousins in “Anatomy of an Illness.” Cousins describes meeting the severely arthritic Pablo Casals who’s crippled body transformed while playing Bach and like a miracle he was “no longer stiff and shrunken, but supple and graceful, completely free of arthritic coils.”

The ‘Yoga of work’ as detailed in The Bhagavad-Gita chapter on Karma Yoga explains that work fuelled by loving service whilst detaching from the results gives us pleasure in the process and yields enlightenment. Viewed in this light, work liberates our innate loving energies to enhance our lives and those around us.

Practiced with minimum stress and maximum mindfulness any work can become a meaningful meditation. In this way one may work long hours and feel energised rather then depleted. Pathologically pushing oneself in a loveless job is a workaholic path driven by unbalanced motives, but working passionately for the love of it brings a healthy high as workophiliac Pablo Picasso felt “It is your work in life that is the ultimate seduction.”

Unemployment and retirement studies suggest that health suffers when we don’t have a fulfilling occupational outlet for our energy. Channelling energy and ability into work you love reaps abundant rewards, including financial. As Mark Twain said, “The more enjoyment you get out of your work, the more money you will make.” Naturally there will be challenges and sacrifices in the process but confidence and self-esteem strengthen as we face life’s tests rather than hiding from them. Here are some ways to attract enriching employment.

Ways to Wonderful Work

Dare to Dream
Author Louise Hay advises “saying I hate my job, will get you nowhere. Declaring, I now accept a wonderful new job, will open the channels in your consciousness to create that.” Instead of dissuading yourself with negative dialogue, repeat affirmations such as “work is an expression of love,” “success is self development,” “my work is worthwhile,” “earning money empowers me” and “I enjoy sharing my unique skills.”

Target Talents
Confucius say “Choose a job you love, and you will never have to work a day in your life.” Do some soul searching before you start job searching. Discovering work suited to your talents and temperament may require help from a career counsellor or life coach. To conduct your own work workshop list what you love to do and are good at.

Life’s Work
Barbara Sher’s classic, I Could Do Anything If Only I Knew What It Was (Hodder Headline), discusses why we thrive when doing worthwhile work. To find out where your values lie write two lists 1) Five things I would like to contribute if I only had five years to live, 2) Five ways I would serve others if money and time was not an issue.

Consider your ideal working situation. Write down the hours, workmates, environment, income, and duties. The company you work for effects job satisfaction. Check out the corporate culture of your employer, it’s just as vital as your remuneration.

Work experience
A new career path is forged by a persistent series of small steps rather than a terrifying leap into the unknown. Consider doing volunteer work experience in the area you’re interested in before making a commitment. Talk to role models in the field to understand the pros and cons, accepting every job has its highs and lows. There’s no perfect job, only the job perfect for you.

Immediate start
The ideal time and conditions are now!
Abolish excuses and allocate time to work on your dream.
Observe your inner resistance arise with avoidance tactics. Notice negative feelings and override them with gentle optimism. Surround yourself with supportive people and don’t share your ideas with negative people.

Acknowledge encouraging signals en route. Maintain a vision of your ultimate aim and as you liberate energy into meaningful productivity allow the momentum to carry you onto greater goals. To reinforce progress note down positive moves you made each day towards the direction of your dreams.

Follow your heart
Sting said, “I always had the courage to follow my instinct” when Parkinson asked him about his career success. As Laurence Boldt said in the Zen and the Art of Making a Living (Penguin Arkana), “Your self-expression is your gift to the world. Discovering your life's work is not a mechanical process of assembling facts; it is more a matter of trusting yourself.”

Work it out
Minor adjustments can make a major difference to your current job. Altering location, hours, organisation, stress management, relating skills and pursuing extra training can boost a flagging career.

Mix Business with Pleasure
Incorporating relaxing regimes into the workday melts mounting tension. Take an hourly break for a stretch, a snack or a chat. Power naps revive our energy to tackle work with more enthusiasm and clarity. Schedule a siesta into your daily routine, even if you have to build an under-desk cubby like George in Seinfield. As National Slacker Day spokesperson actor Simon Pegg prescribes, "It is vital to understand the importance of doing nothing. Slacking is a necessity; it is Yin to activity's Yang."

Take time out before PHT, PreHolidayTension, mounts. Dr Mel Borins, author of Go Away, Just for the Health of It (Wholistic Press), says people are less stressed after a holiday, burnout levels reduce, work efficiency improves and there’s less absenteeism. Dr Jason Rutter of Manchester University concurs, "Relaxing at home, or doing something you enjoy, can help recharge batteries, develop new skills and leave you with a better perspective on your working life.” So take time to relax and reflect, after all, even God rested on the Sabbath…

Occupational Hazards

Long hours- Doctor’s long hours are a major stress factor contributing to their high suicide rate as a British Medical Association survey discovered. Long hours also increase fatigue- related workplace accidents.

Deadlines- Swedish Karolinska Institute revealed workers were six times more likely to suffer a heart attack within 24 hours of a work deadline.

Shiftwork- Working the graveyard shift may bring you closer to the grave according Dr Ludovic van Amelsvoort of Maastricht University’s study finding nightshift workers had almost twice the level of irregular heart rates than day workers. Professor Simon Folkard,  studying the effect of nightshifts, revealed problems such as insomnia, fatigue, gastrointestinal disorders and peptic ulcers increase with night work. Studies of shiftwork during the first and second world wars also show a strong link between nightshifts and increased accident rates.

Bad Boss - Bosses can literally make our blood boil as shown in UK research carried out on 28 female healthcare workers with blood pressure readings rising in the group that felt their boss was unfair.

Co-worker Conflict- Ireland’s Small Firms Association 2003 study of 165,000 people who quit their jobs found a large percentage (38,000) did so due to discord with co-workers

Sick Building Syndrome- Poor air quality, toxic building/ decorating materials, strong electro-magnetic fields, fluorescent lighting and chemical cleaning agents create an unhealthy workplace.

Caroline Robertson enjoys her playful work writing, consulting and teaching natural therapies.