Tag Archives: workplace stress

Living with anxiety

By Bethany Bray May 24, 2017

Anxiety disorders are the most common mental illness in the United States, affecting 18 percent of the adult population, or more than 40 million people, according to the National Institutes of Health. Among adolescents the prevalence is even higher: 25 percent of youth ages 13 to 18 live with some type of anxiety disorder.

Anxiety disorders are often coupled with sleeplessness, depression, panic attacks, racing thoughts, headaches or other physical issues. Anxiety can run in families and be a lifelong challenge that spills over into all facets of life, from relationships and parenting to the workplace.

The good news is that anxiety disorders are manageable, and counselors have a plethora of tools to help clients lessen the impact of anxiety. Caitlyn McKinzie Bennett, a licensed mental health counselor, says she regularly talks this through with her clients at her private practice in Orlando, Florida. She often uses an analogy of ocean waves with clients: Anxiety comes in waves, and managing the disorder means learning coping tools and strategies to help surf those waves rather than expecting the waves to disappear entirely.

“Anxiety can be a long-term thing,” says Bennett, who is also a doctoral student in counselor education at the University of Central Florida. “With clients, I try and explain that [anxiety] is the body’s response that something’s not right — based off of what’s happened to you [such as past trauma] or what’s happening currently. Then we can work to accept it, cope and be happier in your life. Some things you can’t necessarily get rid of in their entirety, and that’s OK. It’s learning to be you and have a fulfilling life with anxiety, where you’re able to feel anxious and [still] be productive and be a mother, a student, a partner. I try and normalize that [anxiety is] going to come and go. It’s OK, and it’s human.”

Anxiety doesn’t happen in isolation

Everyone experiences anxiety from time to time, such as worry over an upcoming work responsibility, school exam or first date. Anxiety disorders, however, are marked by worry and racing thoughts that become debilitating and interfere with everyday functioning.

“It’s a normal part of life to experience occasional anxiety,” writes the Anxiety and Depression Association of America on its website (ADAA.org). “But you may experience anxiety that is persistent, seemingly uncontrollable and overwhelming. If it’s an excessive, irrational dread of everyday situations, it can be disabling. When anxiety interferes with daily activities, you may have an anxiety disorder.”

A number of related issues fall under the heading of anxiety disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), including specific phobia, panic disorder, separation anxiety disorder, social anxiety disorder, generalized anxiety disorder and others. According to the DSM-5, anxiety disorders “include disorders that share features of excessive fear and anxiety and related behavioral disturbances. Fear is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat.”

Racing thoughts, rumination and overthinking possibilities — from social interactions to decision-making — are central to anxiety. In addition, people with anxiety often struggle with insomnia or sleeplessness and physical symptoms such as a racing heart, sweaty palms and headaches, says Bennett, an American Counseling Association member who is currently leading a study for her doctoral dissertation on the effects of neurofeedback training on college students with anxiety. Adolescents sometimes turn to self-harming behaviors such as cutting or hair pulling to cope with anxiety. In adults and adolescents, anxiety can manifest in physiological issues such as stomachaches or irritable bowel syndrome. Although adults may channel their anxiety into physical problems, they’re also generally much more capable than adolescents and children of identifying and articulating the anxious thoughts, ruminations and social struggles that they’re facing, Bennett says.

Bennett worked with a 14-year-old female client whose anxiety had manifested as the behaviors of obsessive-compulsive disorder (OCD), including avoiding the number six, leaving her closet door open a certain way and struggling with crossing thresholds. Bennett worked with the client to identify her triggers and find coping mechanisms, such as connecting with friends and her Christian faith.

“A big part of her improvement was creating the awareness of what was happening,” Bennett says. “Typically there’s a large, irrational fear. With her, she was afraid that her mom was going to die. She would focus on it so much that it would cause her to start the [OCD] behavior. … For her, it felt so real. It was so scary for her that she felt compelled to do these behaviors to keep her mom alive, so to speak.”

Bennett worked with the young client to confront her fears in small doses through exposure therapy, such as listening to a song at volume level six and talking through how she felt afterward. This method allowed Bennett to first address the client’s OCD behaviors and then — once trust was built and the client had progressed — move on to work through the bigger, deeper issue of her fear of her mother’s death.

“It helped her to feel safe enough and have the confidence to work through some smaller things and move on to work on bigger things,” Bennett says. “For her it was talking it out, normalizing that for her and drawing attention to [her anxious behaviors].”

Christopher Pisarik is an associate professor in the Division of Academic Enhancement at the University of Georgia and a licensed professional counselor (LPC) who works with students in need of academic support. He says that stress and irregular sleep and eating patterns — which are often ubiquitous parts of college life — can go hand in hand with anxiety.

“Sleep is a big one — if they’re just not sleeping, or sleeping too much,” says Pisarik, who also treats many college-age clients at his private practice in Athens, Georgia. “This is really, really common — clients who can’t get to bed until 4 a.m., and then they can’t get to class, and it snowballs. Their thoughts just race with worry. … Sleep seems to be a big diagnostic indicator [for anxiety], and not being able to go to bed. [I ask clients,] ‘What are you thinking about, and can you stop thinking about this? Is that what’s keeping you from getting back to sleep?’ They get tired and fatigued, and it’s perpetuated.”

In addition, anxiety is often coupled with — or is an outgrowth of — other mental illnesses, most commonly depression. Counselors will need to treat a client’s anxiety alongside other diagnoses, Bennett says. For example, a client with schizophrenia will have hallucinations that provoke extreme anxiety. If the counselor doesn’t address the client’s anxiety, those symptoms will get worse, explains Bennett.

“Depression and anxiety are like brother and sister,” she adds. “They play off of each other and exacerbate the symptoms. You need to work through both. I don’t think I’ve ever worked with anyone who solely experienced anxiety.”

Stephanie Kuhn, an ACA member and LPC at the Anxiety Treatment Center of Greater Chicago, agrees. She regularly sees client anxiety paired with other issues such as specific phobias, insomnia, chronic pain issues, depression, panic disorders and OCD.

“It’s never really one thing,” Kuhn says. “It’s never just anxiety.”

Pumping the brakes on racing thoughts

The first step for many people who struggle with anxiety is to create awareness of their thoughts and then learn to manage those thoughts with a counselor’s help. Although the strategy of identifying negative self-talk and addressing one’s thoughts is old hat to most counselors, it may be an entirely new concept for some people, especially younger clients, says Pisarik, an ACA member who uses cognitive behavior therapy (CBT) in his private practice. Clients with anxiety often polarize, exaggerate or catastrophize details in their minds as they ruminate over them, he explains.

“Even being able to identify anxious thoughts is big,” Pisarik says. “They just assume it’s normal to walk around [feeling] anxious because of these thoughts. … It gives them a language and a real usable and rudimentary skill they can use in the moment when they’re walking in [to a stressful exam]. They can identify that their inner narrative isn’t healthy.”

For example, a college student might come to a counselor expressing worry about an upcoming exam in a class that he or she needs to pass for a major in pre-med. The student might have allowed negative and catastrophic thoughts to snowball: “If I get a C on this test, I will never get into medical school, which will derail my entire career plan and make my parents angry and disappointed.”

“For … a student who is 20 years old and [still] learning to think critically, it would be easy to blow everything out of proportion and catastrophize everything,” Pisarik says. “I am really big on helping them understand negative thinking and false cognitions, and getting them to self-monitor and renarrate [their unhealthy thoughts].”

Following the CBT approach, Pisarik says he would talk such clients through their thought patterns to identify and restructure their negative thoughts about the exam. He would also suggest that they focus on and remind themselves of prior successes, such as other exams or classes in which they earned A’s and B’s.

“I would try and systematically educate the client [about] what type of thinking that is,” Pisarik continues. “There are many doctors out there who got C’s and got into medical school, and probably [who] got C’s in medical school. I will explain that they are catastrophizing this … [and] try and get them to think about it in a different way, evaluate it carefully and create a different narrative about it. Are there people who have gotten C’s and gotten into medical school? If it stops you from getting into medical school, would that be the worst thing in the world?”

“It takes a consistent effort to practice and challenge one’s thinking,” adds Pisarik, who co-authored the article “A Phenomenological Study of Career Anxiety Among College Students.” The article will be published in the December issue of The Career Development Quarterly, the journal of the National Career Development Association, a division of ACA.

CBT works well for anxiety because “it lets people see that their own thinking and their behaviors are not productive for the way they want to live or the life they’re living right now,” says Kuhn, who uses both CBT and exposure therapy with her clients at the Anxiety Treatment Center of Greater Chicago. “It’s giving people an outside perspective — getting them to look at their own thoughts and behaviors objectively rather than letting those anxious thoughts take over everything, making it harder to function.”

One way Kuhn works with clients on challenging their unhealthy thoughts is by asking them to identify the best, worst and most likely outcomes of situations they are ruminating over. “I ask, ‘Would [the outcome] matter in a week, a month or a year from now?’ Typically the answer is no,” Kuhn says. “After we go through that, we reframe the original thought [and] transform it into something more rational, more realistic.”

Both Pisarik and Kuhn encourage their clients to keep thought logs to track anxious thoughts and the situations that triggered them. This exercise increases self-awareness, helps identify triggers and creates an opportunity to discuss how the client might change the negative narrative.

“Writing helps a lot because it slows people’s minds down, and they can go back and read about it,” Kuhn says. “Creating that awareness is the only way to understand yourself, understand what you’re worried about and be able to accept it and push it away.”

In addition to using thought logs, Pisarik gives his clients a list of automatic negative thoughts, or ANTs, to check themselves against. The collection lists the most common types of unhealthy, anxious thoughts and types of thinking, including catastrophizing and either-or thinking (polarizing).

Kuhn has a particular phrase that she often repeats with clients: “Handle it.” She acknowledges that it’s not the most empathic of mantras, but it does help to focus on the manageability of anxiety. With clients, she works toward a goal of “being able to sit with the uncomfortableness [of anxious thoughts] and tolerate the stress.”

Kuhn says her style when working with clients matches her personality: “Let’s go forward and hit our fears hard instead of tiptoeing around them.”

Exposure therapy, which introduces things in small, controlled increments in session that make a client anxious, is another good way to focus on handling anxiety, Kuhn adds. Whether the scenario is a fear of speaking up in class or a fear of being rejected by a loved one, exposure therapy can help clients learn to live with the issue and the anxious feelings that come with it.

“When I talk to people about ‘handling it,’ it’s creating that awareness and understanding [of] themselves that they’re able to manage or take on more than they think they can,” Kuhn says. “Anxiety a lot of the time makes us believe that we can’t handle the tiniest things. That’s why our body has created or learned how to respond to things in an overactive or hypersensitive way.” This is most commonly experienced in our fight-or-flight response, she says.

Managing worry and taming anxiety

From CBT and mindfulness to a focus on wellness and coping strategies, professional counselors have a wide range of tools to help clients who struggle with anxiety. Here are some ideas and techniques that can be particularly useful.

> Controlling the controllables. Kuhn says it can be helpful for clients to talk through and identify what is out of their control during situations that make them anxious. “A lot of times, anxious clients want control over everything, and that’s just not realistic,” Kuhn says. “It’s important to go over what’s controllable and what’s not. That creates awareness and a pathway to reevaluate [their] own thinking and behavior. I like to call it ‘controlling the controllables.’ I talk with clients about this a lot.”

Kuhn often uses an exercise with clients in which she draws a target with concentric circles. Things that clients can control, such as their own thoughts and behaviors, go in the center circle. Things that they partially control, such as their emotions or what they focus on sometimes, go in the middle ring. Things that are out of their control, such as what other people think or do, go in the outside circle. In a simpler alternative, Kuhn draws a center line down a piece of paper and works with clients to list what is and isn’t in their control in situations that make them anxious.

> Creating common ground. Kuhn says she also talks openly with clients about how common anxiety is, alerting them that they are among literally millions of Americans who are battling the same challenge. “I let them know they are not alone. It creates a universality,” Kuhn says. “To let people know that they’re not the only ones suffering like this can help. … It does create a common ground for people not to feel ashamed of [their anxiety] or feel like they can’t talk to someone about it. Just creating that education typically makes people feel a ton better.”

> Acknowledging and naming worry. Journaling and making lists to document anxious thoughts can help clients address and reframe the everyday rumination that accompanies anxiety. Kuhn offers two variations on this intervention: worry time and the worry tree.

With “worry time,” clients set aside a dedicated amount of time (Kuhn suggests 30 minutes) every day to write down any anxious thoughts that are troubling them. Clients don’t need to engage in long-form writing to complete this exercise, Kuhn says. Making a bulleted list or jotting thoughts down on sticky notes will work just as well. When the designated time is up, clients put all the notes in a box or container that they have set aside for this purpose. This action signifies that they are leaving those thoughts behind and can move on with the day.

“They have to leave those thoughts or sticky notes there and be done with them,” she says. “Obviously more [anxious] thoughts will come, but you have to remind yourself to leave them behind.”

With Kuhn’s “worry tree” intervention, clients create a flowchart of their anxious thoughts. With each item, clients ask themselves whether their worry is productive or unproductive (see image, below). “Is it something that you can actually do something about?” Kuhn asks. “If it’s unproductive, then you need to just let it go. Do something you enjoy or focus on something else to reset [your mind].”

 

> Mind-body focus and exercise. Mindfulness, meditation and other calming interventions can be particularly helpful for clients with anxiety. Kuhn recommends the smartphone app Pacifica, which prompts users with breathing, relaxation and mindfulness exercises, for both practitioners and clients. Kuhn, who has a background in sports counseling, and Pisarik, who is a runner himself, also prescribe exercise to anxious clients. Exercise boosts serotonin, a neurotransmitter connected to feelings of well-being, and comes with a host of other wellness benefits. In addition, exercise allows a person to get outdoors or disengage from work and home activities and other people for a brief period to “have time to hear your thoughts and challenge them,” Pisarik says. “You have to hear your thoughts if you’re going to challenge them.”

> The butterfly hug. Beth Patterson, an ACA member and LPC with a private practice in Denver, teaches deep breathing exercises to anxious clients to help them become grounded, focusing on the flow of energy through the body. She also recommends the “butterfly hug” technique. With this technique, clients cross their arms across their chests, just below the collarbone, with both feet planted firmly on the floor.

Clients tap themselves gently, alternating between their right and left hands. This motion introduces bilateral stimulation, the rhythmic left-right patterns that are used in eye movement desensitization and reprocessing. “It’s phenomenally self-soothing,” Patterson says. “Doing that with deep breathing really helps with anxiety. I love the idea that you’re hugging yourself. Even just doing that helps.”

> Walk it out. Along with deep breathing and grounding, Patterson also recommends walking and movement for clients who are feeling anxious. She instructs clients to focus on the feeling of each foot hitting the ground instead of their anxious thoughts. As with the butterfly hug, this action creates bilateral stimulation, Patterson notes.

Bennett also uses walking as a way to help clients refocus their thoughts. She will take clients out of the office during a session for a “mindful walk” up and down the block. During the walk, they talk about what they’re sensing, from the sunshine to the breeze to the smell of flowers. Bennett says this allows her to work with clients “in the moment,” recognizing and refocusing anxious thoughts as they come. Afterward, they process and talk through the experience back in the office.

“It’s a lesson that [anxious] thoughts are going to come up for you, and you can refocus on your sense of touch or hearing,” Bennett says. “Thoughts will come up, and it’s really easy to attach to those thoughts and become anxious, but we can acknowledge the thought, be accepting of it in the moment and refocus. Change and connection can come that way.”

> This is not that. Clients commonly transfer anxiety-provoking personal issues onto relationships or situations in other facets of life, including the workplace, Patterson says. For example, Patterson worked with a client who had a very domineering, controlling mother, and this client felt triggered by a female boss in her workplace. Patterson introduced the client to the mantra “this is not that,” and they worked on reframing the anxiety the client experienced when she felt her boss was being controlling.

“She had to work through it in a beneficial and compassionate way for herself and really remember ‘this is not that,’” Patterson says. “Our minds are brilliant, but they’re binary computers. When something happens, it will immediately associate it with something else it knows. If a co-worker is being overly competitive, it might trigger feelings about sibling rivalry. This [mantra] offers a great opportunity to work through family-of-origin issues [with clients] when you see them replicated in the workplace.”

> Abstain from negativity. Another empowering tool clients can use is to become conscious of and then avoid unhealthy or toxic situations and people who trigger their anxiety, Pisarik says. He advises clients to “stay away from groups of people or individuals who they know will engage in negative self-talk or negativity. If you’re feeling anxious already, the last thing you want to do is to go and talk to that toxic person.”

Similarly, he commonly advises anxious students to avoid waiting outside the room where they’re about to take a big exam, surrounded by 30 classmates who might be saying that they are going to fail, they didn’t study enough, they don’t feel prepared and so on. Counselors can coach anxious clients to think ahead and prepare ways to remove themselves from these types of situations, regroup and redirect their thinking, Pisarik says.

> Lifestyle choices. Counselors can also educate clients on the connection between anxiety and lifestyle choices such as sleep patterns, exercise and diet, Pisarik says. For young clients especially, this also includes social media use, he notes.

Pisarik says he frequently talks with his college-age clients about their alcohol consumption, drug use, irregular diet and other aspects of the modern university experience. “The lifestyle of a college student is absolutely conducive to generating anxiety,” he says. “While they are college students, I get that — their job is to have fun and sleep whenever [they] want. But building some sort of healthy routine is important, [including] getting enough sleep and making sure they eat well. I tell them to try and maintain the diet they had at home. … If you’re struggling with anxiety to begin with, any one of those [elements] can add to it, and those are really easy fixes.”

For Bennett, conversations with clients about lifestyle also include questions about smoking and caffeine use. Both tobacco and caffeine can make a person shaky or make his or her heart and mind race, which can trigger or exacerbate anxiety, she points out.

In addition to social media use, Pisarik also asks clients about their social engagement, such as participating in sports or other hobbies. Clients who struggle with anxiety often isolate themselves, he notes, so he works with them to identify social outlets, from volunteering to joining a school club. This sense of connection can reduce anxiety, he says.

> Narrative therapy and externalization. Patterson finds narrative therapy helpful when working with clients with anxiety because it allows them to externalize what they’re feeling. When clients uses phrases such as “I am worried” or “I am anxious,” Patterson will gently redirect them by saying, “No, you’re Susan, and you have a problem called worry.”

“Externalize the problem,” Patterson explains to clients. “Externalize it and dis-identify it. See it outside of yourself. … ‘I can deal with that because it’s not who I am.’ … If you’re carrying it around as if it’s you, you can’t do anything about it. The truth of the matter is, it’s not you.”

Counselors can also help clients with anxiety to focus on a time in their lives when they faced a similar challenge and got through it, Patterson says. She asks clients questions to help them probe deeper. For example: How did you handle that challenge? What worked, and what didn’t work?

 

Working with clients on medication

Anti-anxiety medications are commonly prescribed in the United States. Their prevalence means that counselors are likely to encounter clients who are taking medication to control their anxiety symptoms.

Regardless of their feelings about the use of psychotropic medications, practitioners must treat and support clients who are taking such medications the same as they would any other client, Kuhn says. “I never treat someone differently based on their medication. They get the same CBT therapy that anyone else would get,” she says, adding that the most important thing is to ensure that clients don’t feel judged by the counselor.

Kuhn has seen anti-anxiety medications work well for some clients. “It can take that little edge off that they need to get through the day and be able to function,” she says. At the same time, she also has clients who express a desire to be able to stop taking their medication eventually.

Pisarik notes that for anti-anxiety medication to work well, clients must remember to take it faithfully, keep track of how it makes them feel and schedule the repeated appointments needed to monitor and adjust dosage levels. Each of these elements can pose a challenge to college-age clients. “It’s a lot of work, and [college students] often lack the discipline and time to get it right,” Pisarik says.

Bennett agrees, suggesting that even though professional counselors are not the ones prescribing medications, they still need to discuss and explore medication use with their clients. She also stresses that practitioners should be knowledgeable about the different kinds of medications that clients may be taking and their possible side effects.

Bennett sometimes conducts conference calls with her clients and the medical professionals who are prescribing them medications so that she can help clients ask questions and otherwise be a support to them. “We [counselors] don’t prescribe, but at the same time it’s very important to collaborate with whoever is prescribing the [client’s] medication,” she says. “Be supportive and involve the client in conversations: How long have you taken it? Have you noticed any side effects? Has it been helping? Talk about how often they’re supposed to take it and if they’re adhering to that. There can be stigma about taking medications, so it’s important to normalize it. … It’s comforting too for the client to know that you’re on their side, and part of that is collaboration [about medication].”

 

See the person, not the anxiety

Given how common anxiety disorders are, it’s likely that any counselor’s caseload will be filled with clients presenting with symptoms of anxiety. It is important, however, for counselors to treat each client as an individual and to tailor the therapeutic approach to meet that client’s unique needs, Bennett emphasizes.

Building trust and a healthy therapeutic relationship are key in treating anxiety because clients can feel very vulnerable as they talk about what makes them anxious, Bennett points out. That is why it is critical to get to know these clients as individuals rather than through the lens of their anxiety.

“Don’t assume that because they’re anxious, they’re going to think and behave like other people with anxiety,” Bennett says. “Meet them where they are and find out what’s most effective for them based off of their interests. It can be empowering for clients to integrate their own interests and life experiences into the therapeutic process. Not only does this create buy-in for the client, but it can also help in creating a safe space to begin exploring the vulnerabilities that come along with anxiety. … Hear their story, find their strengths and give them a voice in the process. It’s important to honor them as individuals.”

 

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To contact the counselors interviewed for this article, email:

 

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Bethany Bray is a staff writer and social media coordinator for Counseling Today. Contact her at bbray@counseling.org.

Letters to the editor: ct@counseling.org

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Fertile grounds for bullying

By Laurie Meyers April 21, 2016

Bullying isn’t just for kids anymore. In the past 10 to 15 years, recognition has grown that bullying goes beyond taunts in the schoolyard. Adults can encounter it at work, “traditional” bullying is now enhanced and magnified by online or cyberbullying, and those who identify as lesbian, gay, bisexual, Branding-Images_bullytransgender or queer (LGBTQ) can experience it at any age just for being who they are.

“Bullying and interpersonal violence are tragic experiences that far too many people undergo every day,” says American Counseling Association President Thelma Duffey, who has shined a spotlight on anti-bullying/interpersonal violence efforts as one of her main presidential initiatives. “People can be hurt in such devastating ways when they are bullied, and counselors are in prime positions to help.”

But to be effective, counselors need to increase their understanding of bullying in all of its forms.

Trouble in the schoolyard

The first place many people experience bullying is, of course, at school, and school bullying remains a complex problem. Researchers say putting an end to bullying and ultimately preventing it requires the involvement of everyone in the system, including not just teachers, counselors and students, but also staff such as janitors and bus drivers. Even without a comprehensive anti-bullying program in place, however, there are many steps school counselors can take to help those who are being bullied.

Although any student can face bullying, those perceived to be somehow “different” and, critically, viewed as easy targets most often find themselves in the crosshairs, says JoLynn Carney, an associate professor of counselor education at Penn State whose research focuses on bullying.

“Abusers of all ages seem to have an uncanny sense of who can defend themselves and who may be unable to self-defend,” she explains. “Youth who are isolated — meaning few to no friends — are often targeted. They may have poor social skills … or other qualities not valued in the peer social network such as disability, different sexual orientation, different religion/culture or socioeconomic background. Even just being the new kid can be the characteristic that has the person being targeted. Kids who are highly anxious by nature or depressed also often seem to be the students who are bullied.”

Regardless of the reason behind the bullying, being a target is very isolating. A first step for counselors to take is to listen to and to act as advocates for students who are being bullied to reduce their sense of isolation, says Carney, a member of ACA. But she cautions that counselors must not give the impression that students are passive participants in solving the bullying problem. “The worst thing I’ve seen done over the years is to inadvertently teach kids that the adults in the situation have to handle this, which yields a sense of helplessness in the targets,” Carney explains.

Instead, counselors should work with students who are being bullied to help them understand the situation they are facing and what actions they might take to change it, she says. “Actions for targets are meant to change the dynamics of the situation by changing the target’s conceptualization of the situation and the target’s actions before, during or after the situation,” she says.

Carney says counselors should focus on problem-solving, helping bullied students to:

  • Increase connections to others who can provide immediate or follow-up support. Counselors can help bullied students make connections in multiple ways.

“Whether elementary, middle or high school, the counselors know their students; they know the students they can count on who have the social skills and the empathy to be peer mentors [to the student being bullied],” Carney explains. “They also know about the groups of students — like what club could the target student join to form bonds, and so forth. The bridging the school counselor can do often makes a huge difference. Honestly, I’ve had students or parents tell me in clinical settings that having that one friend saved their child’s life.”

The more friends and support from others the student has, the less vulnerable the bullied student will be.

  • Change some aspect of their behavior so that they are less “predictable” for their abusers, thereby reducing the abusers’ confidence that bullying will produce the desired effect. Taking away the desired result can help shift the power imbalance that is inherent in all bullying situations. For example, students who are being bullied can work on reacting in a different manner or even simply changing their body language. Those who are bullied often display a classic posture — slumped shoulders, head down, perhaps crying. Shifting that submissive posture to a posture in which the body is held more upright sends a different message to all concerned — the abuser, the target and any bystanders.
  • Learn appropriate physical, verbal and social assertiveness. Having a sense of assertiveness allows bullying targets to understand their own power and influence in the situation.

Carney says it is also crucial for counselors to show students who are being bullied how, where and when to seek support when necessary. “Working clinically with targets and their families, I’ve helped with the smallest of shifts that [would] seem inconsequential but have yielded good results, such as helping the person being bullied [not to] see themselves as the ‘victim,’ [which is] a disempowering … view of the self,” she explains. “Instead, helping them see themselves as simply the current ‘target’ of an abuser brings a sense of empowerment because anyone can be a target, and it’s not an internalized sense of negative self-worth. Helping the student see themselves differently can make a big difference in the ability to make the changes to end the abuse.”

Those who are being bullied don’t always ask for help or talk in great detail about what they are experiencing, so Carney has identified several red flags that might indicate that a student has become a target. These include:

  • Changes in behavior such as not wanting to go to school or avoiding other social situations such as birthday parties or school trips.
  • Changes in eating habits such as consistently saying they’re not hungry or skipping meals at school (which might be the result of not wanting to face bullying behavior in the cafeteria) or even engaging in binge eating as a source of comfort.
  • Self-destructive behaviors such as running away and serious talk about (or even an attempt at) suicide.
  • Changes in physical symptoms such as frequent headaches or stomachaches, frequently feeling ill, trouble sleeping or an increase in nightmares.
  • Changes in academic performance such as slipping grades or a lack of interest in classes that the student used to enjoy.
  • Changes in emotional state such as feeling helpless, hopeless, depressed, highly anxious or worthless.

Students who are being physically bullied may also have injuries that can’t be explained or damaged personal objects such as clothes and electronic devices.

Carney believes that if bullying is to be fully addressed, a school culture must be developed that doesn’t tolerate bullying behavior. She and her colleague and fellow researcher Richard Hazler, a professor of counselor education at Penn State, are currently part of the research and implementation team for a major anti-bullying initiative called Project TEAM, which former school counselor Lindsey Covert created based on a framework she developed as a graduate student at Penn State. Covert had success implementing the program and then collaborated with another school counselor, Lisa Dibernardo, to expand the program in the Stafford Township School District in New Jersey.

Covert is the director of the program, which is now part of the College of Education at Penn State. Carney says the curriculum, which she and Hazler are currently implementing in several grade schools, teaches students to focus on the importance of teamwork and leadership in their daily lives. It emphasizes helping others, the concept of positive change, problem-solving and conflict resolution, resilience and leadership.

Individual school counselors can help prevent bullying by conducting professional development trainings that educate teachers, school staff and administrators about the behavioral indicators of bullying and victimization, says Rebecca Newgent, a professor of counselor education at Western Illinois University–Quad Cities. “Bullying can take on several forms, such as physical, verbal and relational bullying,” explains Newgent, an ACA member who researches school bullying and children who are at risk. “Signs that school personnel might notice in regard to physical bullying are hitting, pushing and kicking. Signs for verbal bullying typically include calling the other student names, threatening other students or teasing other students. Relational bullying is somewhat harder to recognize, but some typical behaviors include leaving other students out of activities, not talking to other students and telling rumors about other students.”

School counselors should also emphasize the importance of all school personnel teaching children to demonstrate empathy for the bullied classmate by imagining what the student might be feeling, says Newgent, a member of the Association for Counselor Education and Supervision, a division of ACA. Children should also be encouraged to report bullying and helped to understand that this differs from “tattling,” she continues. “Consistent support and encouragement from teachers and school counselors can reinforce this [reporting] behavior,” she says.

Newgent also urges counselors to reach out to parents via newsletters and parent workshops to engage them in anti-bullying efforts. “Counselors can help parents to work with their children on increasing social skills and assertiveness,” she says. “Parents can help ensure that the family environment is one where the child feels safe and understood.”

Workplace bullying

Bullying isn’t confined to childhood or adolescence. Adults can experience bullying too, particularly in the workplace. Bullying in the workplace involves less obvious behavior than does school bullying and can be almost intangible, says Jessi Eden Brown, a licensed professional counselor and licensed mental health counselor with a private practice in Seattle.

“Bullying in the workplace is a form of psychological violence,” says Brown, who also coaches targets of workplace bullying through the Workplace Bullying Institute (WBI), an organization that studies and attempts to prevent abusive conduct at work. “Although popular media theatrically portray the workplace bully as a volatile, verbally abusive jerk, in actuality, the behaviors tend to be more subtle, insidious and persistent.”

Instead of shoving and name-calling, Brown says, workplace bullying includes behavior such as:

  • Stealing credit for others’ work
  • Assigning undue blame
  • Using public and humiliating criticism
  • Threatening job loss or punishment
  • Denying access to critical resources
  • Applying unrealistic workloads or deadlines
  • Engaging in destructive rumors and gossip
  • Endeavoring to turn others against a person
  • Making deliberate attempts to sabotage someone’s work or professional reputation

“It’s the fact that these behaviors are repeated again and again that makes them so damaging for the target,” she explains. “The cumulative effects and prolonged exposure to stress exact a staggering toll on the overall health of the bullied individual.”

What’s more, those bullied in the workplace often stand alone, Brown notes. “While the motivating factors may be similar between workplace bullying and childhood bullying, the consequences for the bully and the target are unmistakably different,” she says. “In childhood bullying, the institution — the school — stands firmly and publicly against the abuse. Teachers, staff, students and administrators are thoroughly trained on how to recognize and address the behavior. Students are given safe avenues for reporting bullying. Identified bullies are confronted by figures of authority and influence — teachers, administrators, groups of peers, parents. When the system works as intended, there are consequences for the bully, as well as resources and support for the target.”

Brown continues, “In the workplace, bullying receives far less attention and focus. Management may fail to appropriately label the bully’s behavior as being abusive, especially if it doesn’t violate the law. Some employers recognize the problem and still choose to turn a blind eye. And even worse, there are some companies that actively encourage ‘weeding out the weak,’ whereby successful bullies are rewarded with promotions, bonuses, extravagant gifts and other incentives. After counseling and coaching more than 3,000 targets of workplace bullying over the years, believe me, I’ve heard it all.”

The consequences can be devastating. “There is a significant body of research linking workplace bullying to physical, mental, social and economic health harm for the bullied target,” Brown notes. “Hundreds of empirical studies have linked repeated exposure to stress, including stress originating from emotional and psychological sources, to severe physical ailments, such as cardiovascular disease, gastrointestinal problems, immunological impairment, diabetes, adverse neurological changes, disorders of the skin, higher levels of cortisol leading to organ damage, musculoskeletal pain and disorders, and more.”

Workplace bullying has also been linked to panic disorder, generalized anxiety disorder, major depression, substance abuse and posttraumatic stress disorder, Brown continues.

Brown began specializing in counseling clients who have experienced workplace bullying after going through the experience herself in two different positions. “Both times were painful and deeply confusing,” she says. “I seriously considered leaving the counseling profession after the second experience.”

However, a friend who was doing web design for WBI introduced her to psychologists Gary and Ruth Namie, the founders and directors of the institute. The Namies were looking for a professional coach and offered Brown the job. As she worked with those who had been bullied, she began to integrate her experiences into her private counseling practice.

“The vast majority of my clients present as capable, accomplished professionals with a documented history of success in the workplace,” she says. “At some point in their careers, they encounter the bully and everything changes. Under constant attack, belittled and sabotaged, the once-competent, assured worker may begin to question her abilities and role at work. She tries everything she can think of to remedy the problem but finds few working solutions. Mounting stress starts to take its toll and spills over into other areas of life. Throughout this process, many targets fall victim to self-blame. Deep confusion, shame, anger and exhaustion are common at this stage. … This seems to be when most clients discover my services.”

Brown says the first step toward helping clients who are being bullied is to identify what they are experiencing — workplace bullying and psychological violence. Naming the behavior helps clients frame and externalize their experiences by realizing that they are not creating or imagining the problem, she explains.

“Encouraging the client to prioritize [his or her] health comes next,” Brown says. “Working closely with other health care providers is essential in situations where the individual’s health has been severely compromised.”

“It is imperative that the counselor promote the client’s self-care and turn attention toward enhancing [his or her] social support network,” she continues. “This may mean helping the client figure out a way to take time off from work, teaching new coping skills and encouraging time spent with loved ones — time that is deliberately not focused on recounting the situation at work.”

“Targeted workers may choose to file formal or informal complaints to unions, the EEOC [Equal Employment Opportunity Commission], the bully’s boss, ethics hotlines or professional boards,” Brown says. “Although there is no legal protection against bullying in the United States, some workers find grounds for harassment, discrimination, constructive discharge, intentional infliction of emotional distress, wrongful termination or other legal claims.”

According to Brown, WBI research indicates that once targeted by workplace bullying, there is a 77.7 percent likelihood that the individual will lose his or her job due to resignation (voluntary or forced) or termination. A 2014 study conducted by WBI found that 60 percent of bullied workers were women and that men were more than twice as likely as women to act as bullies (69 percent versus 31 percent). However, when women exhibited bullying behavior, they were also more likely to bully other women — 68 percent of female bullies’ targets were also female.

Counselors can help clients who experience workplace bullying to consider their options, starting with whether to stay in their current job or leave. “Many targeted workers choose to transfer or quit just to escape the abuse,” Brown says. “The decision to leave on one’s own terms can be empowering and frequently results in better emotional health than being fired or laid off due to the bullying.”

Brown believes that counselors are in a unique position to help those who are bullied at work. “First, and most importantly, we can believe them when they tell us about the mistreatment at work,” she says. The stress and exhaustion that targets of workplace bullying endure are often isolating and paralyzing, Brown points out, adding that it is generally the bully’s goal to disempower the target.

“Even when they do speak up, targets of workplace bullying tell me that their employers, family and friends often do not believe them or understand their level of distress,” she says. “As counselors, we can listen to their story, convey a sense of belief and offer a distinctly different response than the target has received thus far. … Do not blame the client for the abuse [he or she is] experiencing.”

In most cases, Brown says, the target has done nothing to deserve the mistreatment; the bully chooses the target, timing and tactics, and the targeted individual may have very little control or influence over these factors. The responsibility to stop the abusive behavior ultimately rests with the employer. In these instances, just teaching clients to be more assertive or to stand up to the bully is not the answer, Brown emphasizes.

Cyberbullying: Virtual environment, real bullies

Bullying is presumably as old as the human race, but one thing about the dynamics of bullying has changed dramatically during the past 10 to 15 years. Online, anyone can bully anybody anywhere, from next door to halfway across the world. Cyberbullying is often used to enhance the “traditional” bullying tactics that are taking place in a school or workplace, but it can also serve as a standalone method of harassment.

“Cyberbullying can take place via email, text, instant messaging, social media or any other digital form of communication or information dissemination,” Brown explains. “It may manifest as harassment, impersonation, defamation, stalking, manipulation, denigration or other types of abuse.”

Unfortunately, even people who might never consider participating in traditional bullying behaviors are often tempted by the anonymity of cyberbullying. “When people get on [an electronic] device, normal roles of civil interaction somehow become less relevant,” says Sheri Bauman, author of the book Cyberbullying: What Counselors Need to Know, which is published by ACA.

People who previously were afraid of getting caught for bullying or didn’t want to accept responsibility for their actions now feel free to indulge their baser instincts online, she says. “[They think], ‘I can be as nasty as I want to be; no one knows who I am.’ They don’t have to censor themselves and don’t have to follow social rules,” explains Bauman, a professor and director of the counseling degree program at the University of Arizona.

Researchers don’t know exactly why anonymity has this effect, but Bauman, an ACA member, speculates that it may in part be because online interaction doesn’t quite feel real.

Janet Froeschle Hicks, a licensed professional counselor and certified school counselor in Texas, posits a similar explanation. “Not being face to face with a person makes it easier to dissociate and reduce empathy,” she says. “Technology also gives the false impression that the person on the other end is an ‘object’ rather than a person.”

Young people appear particularly adept at cyberbullying, Hicks says. “Youth participate in cyberbullying several ways. They impersonate one another by stealing passwords, create fake social media pages and send cruel messages anonymously. Often they create pages for another person without that person’s knowledge. This is very damaging because several others can be harmed with one posting.”

“For example, Student A creates a page for Student B without Student B’s knowledge. Student A then uses Student B’s fake page to bully Student C. When this happens, Student C is now upset with Student B, and Student B has no idea what has happened. Rumors about others, gossip, humiliating pictures and rude comments can be posted by Student A on this fake page,” explains Hicks, a professor of counselor education at Texas Tech University whose research focuses on cyberbullying, social aggression and school, child and family counseling.

Many students also participate in a practice known as “sub-tweeting” on Twitter. “Anonymous tweeters comment on others’ tweets without identifying themselves,” Hicks says. “This means rude anonymous messages appear in the midst of a conversation.”

Cyberbullies can use a wide array of methods — from texting to social media to digital pictures — to torment their targets online. As a result, Hicks says, those who have been bullied may develop a fear of technology. “Since we live in an age where students need technology to complete homework, apply for college admission and succeed at a future job, it is important to teach that technology can be safe,” she emphasizes. “I teach parents and youth to use privacy controls, not to share confidential information and to avoid negative conversations [online].”

Although adolescents are typically assumed to be both the culprits behind and the targets of cyberbullying, experts say this isn’t always the case. Adults may be targeted as part of a workplace bullying campaign, a neighborhood grudge or simply at random.

Brown urges her clients to think about ways they can minimize the potential of being bullied. “I encourage my clients to be intentional about their online presence and reputation by actively reflecting upon the image they want to portray,” she explains. “What skills, attributes and experiences are important to highlight? Where do you want your information to appear? Who is likely to find and use your information based on how and what you choose to share? What are you most concerned about regarding your online persona? By exploring questions like these, [clients form] a picture and a plan of how they want to manage their online information.”

Brown also advises clients to thoroughly search their own names on the Internet to find out what information — or misinformation — is already out there about them. “I recommend they set up a Google Alert for their own name and any related identifying key terms. Using myself as an example, I’d set an alert for ‘Jessi Eden Brown,’ ‘workplace bullying counselor,’ ‘professional coach workplace bullying,’ etc. This way, I increase my chances of catching any references made to my name or professional identity. The more I know, the better able I will be to respond to online attacks.”

After clients have identified the details of their online presence, Brown talks with them about how to respond to damaging content and minimize future problems. For example, she advises clients to periodically review the privacy settings on their social media and web-based accounts. “For those being actively cyberbullied, it is wise to lock down all privacy settings or, in some cases, to delete or suspend accounts altogether to give the bully fewer points of access to the target,” she says.

Bauman, who is also a member of the American School Counselor Association, a division of ACA, says that given the prevalence of cyberbullying, counselors need to educate themselves about all social media and related online platforms so they can knowledgeably discuss the issue if a client brings it up.

No walking away

It’s certainly not an ideal option, but if all else fails, those who are bullied at school or work might be able to switch schools or change jobs. At the very least, those who are cyberbullied can choose to reduce their online presence or temporarily go offline. Simply being able to leave a bullying situation can provide precious relief.

But for those who are being bullied because of their sexual or gender identification, there is no walking away. “LGBTQ individuals are bullied in all facets of their lives,” says Tonya Hammer, an assistant professor of counseling at Oklahoma State University-Tulsa whose research interests include both bullying and the intersection of gender and sexual orientation. “We are socialized as a society to bully or reject that which is perceived as different. Unfortunately, it permeates so much of our daily lives.”

LGBTQ individuals usually start facing bullying behavior at a young age, regardless of whether the individual is already “out,” says Hammer, who adds that most bullying prevention efforts don’t start until middle or high school. By that time, according to the National School Climate Survey by the Gay, Lesbian and Straight Education Network (GLSEN), a majority of LGBTQ students are routinely hearing anti-LGBTQ language and experiencing victimization and discrimination at school.

The 2013 survey — the latest year for which statistics are available — found that of the 7,898 students between the ages of 13–21 who participated in the study, 55.5 percent felt unsafe at school because of their sexual orientation, while 37.8 percent felt unsafe because of their gender identity. In addition, 71.4 percent of LGBTQ students heard the word “gay” used in a negative way frequently or often at school; 64.5 percent heard homophobic remarks frequently or often; and 56.4 reported hearing negative remarks about gender expression (for example, not acting “masculine” enough) frequently or often.

Distressingly, 51.4 percent of the survey respondents reported hearing homophobic remarks from their teachers or other school staff, and 55.5 percent reported hearing negative remarks about gender expression from teachers or other school staff.

The effects of this widespread bullying are significant, says Hammer, who presented a session on LGBTQ bullying across the life span at the 2016 American Counseling Association Conference & Expo in Montréal. “Bullying results in feelings of shame and humiliation, which can lead to isolation, lack of emotional regulation [and] violence against self or others,” she notes. Hammer adds that it also increases dropout rates and negatively affects academic performance.

Although counselors cannot completely stop school bullying single-handedly, they can provide a refuge for LGBTQ students to feel supported and accepted, says Hammer, president-elect of the Association for Lesbian, Gay, Bisexual and Transgender Issues in Counseling, a division of ACA. “Counselors can create a safe space by a variety of means. It can be as simple as displaying an HRC [Human Rights Campaign] equal sign [the organization’s logo] in their office or a small rainbow flag somewhere. I know that sounds minor,” she says, “but small symbols can signify something to students.”

Hammer says counselors can also reach out to students who may be subject to bullying, but she emphasizes that counselors should not address sexual/affectional or gender identity unless the student brings it up. Instead, counselors could start by letting the student know that they have noticed a change in the student’s behavior that they think might be connected to bullying.

“You can also [just] ask them if everything is OK and if they need someone to talk with,” says Hammer, who during her time as a board member of the Houston GLSEN chapter trained school personnel in Texas using GLSEN’s anti-bullying program. “Sometimes it is also simply providing a space for them. When working with counselors or librarians, we often suggest creating an actual physical space in their office where students can come and just hang out. Make the space feel inclusive in the way you decorate it and in the material that you provide for them to read or occupy their time with.”

“Also understand that the students may still be questioning their sexual/affectional orientation or gender identity or expression and need people who they can confide in while doing this. Furthermore, their parents may not be that safe space,” Hammer says. “Give them time to feel comfortable and to trust you so that they will open up about what is going on with regard to the bullying and also about their sexual/affectional orientation or gender identity and expression.”

Hammer also cautions counselors not to assume that a student is gay simply because he or she is perceived as being gay. “The most important thing is the relationship,” she emphasizes. “Listen to them with respect and treat them with dignity, not as if they are abnormal. Let them know that they matter to you, to their family and to the world.”

Because eliminating bullying requires altering a school’s culture, counselors can also help students by offering schoolwide education on LGBTQ issues or sponsoring formation of gay–straight alliance groups, Hammer says. Additionally there are awareness activities counselors can help organize such as No Name-Calling Week, Ally Week and Day of Silence, in which silence is used to protest the silencing of LGBTQ people due to harassment, bias and abuse.

Workplace bullying based on sexual/affectional orientation or gender identification is also still very common, Hammer says. In fact, according to HRC, of the LGBTQ Americans who have experienced discrimination, 47 percent reported experiencing it in the workplace. To add insult to injury, HRC reports that only 19 states and the District of Columbia explicitly prohibit workplace discrimination based on sexual orientation or gender identity. A 2009 HRC study found that 51 percent of LGBTQ workers hid their identities from most or all of their co-workers. Strikingly, the report found that younger workers were even more likely to hide: Only 5 percent of LGBTQ employees ages 18–24 said they were completely open at work, compared with 20 percent of older workers.

Unfortunately, leaving a hostile working environment and finding another job isn’t always possible — regardless of sexual or gender identity. And given the extent of bullying that LGBTQ workers face, leaving one job for another is far from being a surefire solution to the problem.

“Sometimes it is a matter of helping people to develop support systems outside of work that can help them to address the hardships of their daily life at work,” Hammer says. “If possible, it is our responsibility as counselors to help advocate for our clients. If legal resources are available, we help connect our clients to those resources. Organizations like HRC, the Southern Poverty Law Center and the ACLU [American Civil Liberties Union] can help in some situations, but not all. We can also connect them with career counselors or agencies that can help them see if there are options for them to change jobs or careers.”

Hammer also believes counselors have a responsibility to help lobby to change laws that make it legal for people to be fired because of their sexual orientation or gender identity.

“LGBTQQI clients, like all clients, want to know that they matter and that they are important,” Hammer says. “The therapeutic relationship may be the first and only relationship in which they experience that, and it may be the only place where they can truly be all of who they are. Providing that space and time for them to do that may empower them to be able to do it with other relationships in their life as well. You can help them to understand that they are worth [having] healthy growth-fostering relationships and provide them with the skills and resources to develop those relationships.”

 

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To contact the people interviewed for this article, email:

 

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Additional resources

For those who would like to learn more about the topics addressed in this article, the American Counseling Association offers the following resources:

Books (counseling.org/bookstore)

  • School Counselors Share Their Favorite Classroom Guidance Activities: A Guide to Choosing, Planning, Conducting, and Processing edited by Janice DeLucia-Waack, Meghan Mercurio, Faith Colvin, Sarah Korta, Katherine Maertin, Eric Martin, and Lily Zawadski
  • Youth at Risk: A Prevention Resource for Counselors Teachers and Parents, sixth edition, edited by David Capuzzi and Douglas R. Gross
  • Casebook for Counseling Lesbian, Gay, Bisexual, and Transgender Persons and Their Families edited by Sari H. Dworkin and Mark Pope
  • Cyberbullying: What Counselors Need to Know by Sheri Bauman

DVDs

  • Working With Perpetrators and Targets of Cyberbullying presented by Sheri Bauman
  • Bullying in Schools: Six Methods of Intervention presented by Ken Rigby

Webinars (counseling.org/continuing-education/webinars)

  • “Children and Trauma” with Kimberly N. Frazier (part of the ACA Trauma Webinar Series)
  • “Counseling School and College Students” with Richard Joseph Behun, Julie A. Cerrito and Eric W. Owens (part of the ACA Trauma Webinar Series)

Podcasts (counseling.org/continuing-education/podcasts)

VISTAS Online articles (counseling.org/knowledge-center/vistas)

  • “Anger Management for Adolescents: A Creative Group Counseling Approach,” Carolyn O’Lenic and John F. Arman
  • “BEST Buddiez: A Programmatic Innovation in Early Child Mental Health Treatment for Physically Aggressive Preschool Children,” Rita J. Terrago
  • “Brief Solution-Focused Counseling With Young People and School Problems,” John Murphy
  • “Domestic Violence and Children,” Laurie Vargas, Jason Cataldo, and Shannon Disckson
  • “Making the Change From Elementary to Middle School,” Laura M. Hill and Jerry A. Mobley
  • “Solution-Focused Counseling in Schools,” John J. Murphy
  • “The School Counselor’s Role in Easing Students’ Transition From Elementary to Middle School,” Matthew Mayberry
  • “Empowering LGBT Teens: A School-Based Advocacy Program,” Matthew J. Mims, David D. Hof, Julie A. Dinsmore, and Laura Wielechowski
  • “School Climate Perception: Examining Differences Between School Counselors and Victims of Cyberbullying,” Megan M. Day, Lindsay R. Jarvis, Charmaine D. Caldwell, and Teddi J. Cunningham
  • “School Counseling for Systemic Change: Bullying and Suicide Prevention for LGBTQ Youth,” Jeffry L. Moe, Elsa Sota Leggett and Dilani Perera-Diltz
  • “School Shootings and Student Mental Health: Role of the School Counselor in Mitigating Violence,” Allison Paolini
  • “Sexually Active and Sexually Questioning Students: The Role of School Counselors,” Vaughn Millner and Amy W. Upton
  • “The Bullying Project,” Le’Ann L. Solmonson
  • “The Impact of Attendance at a LGBTQIA Conference on School Counselors’ and Other Educators’ Beliefs and Behaviors,” Aaron Iffland and Trish Hatch
  • “Using the Reflecting As If Intervention to Reduce Bullying Behaviors,” Gerald A. Juhnke, Brenna A. Juhnke, Richard E. Watts, Kenneth M. Coll, and Noreal F. Armstrong

 

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Laurie Meyers is the senior writer for Counseling Today. Contact her at lmeyers@counseling.org.

Letters to the editor: ct@counseling.org

 

Worrying for a living

By Laurie Meyers December 22, 2015

T his past August, The New York Times published an extended and detailed article on the work culture at Amazon.com (“Inside Amazon: Wrestling Big Ideas in a Bruising Workplace.”) The picture it painted was not pretty. The article, written from interviews with 100 former and current Amazon employees, depicts an atmosphere in which employees are pitted against one another and encouraged to report any co-worker’s perceived deficiencies to that worker’s manager. According to the article, workweeks of at least 80 hours are expected, as is the willingness to work on holidays. Branding-WorryThere is also a yearly culling process in which managers at each level must present detailed cases citing the reasons for keeping (rather than firing) each of their subordinates. Multiple former employees also told the Times they were put on “probation” by Amazon after returning from maternity leave or a leave of absence due to serious illness.

The article struck a chord. Loudly. As of Dec. 3, the article had received approximately 6,000 comments, the majority of which reflected reader outrage. Some who commented noted that similar workplace atmospheres exist at businesses in Silicon Valley and on Wall Street.

Other publications debated whether the article provided a complete picture of worker satisfaction at Amazon or merely highlighted the experiences of a few disgruntled employees. Some even questioned why anyone cared about the work culture of one particular company.

Perhaps the article become such a hot topic of conversation because many of those who read it recognized certain of the conditions described therein in their own workplaces, even if Amazon’s work culture as a whole may still be an outlier.

Crushing workloads. Hostile supervisors. The expectation to be available at any time, including during “off” hours. Co-workers competing to see who stays at the office the latest. Work-induced stress and depression. These factors are merely a sampling of the work issues that regularly bring clients to counselors’ offices.

“The corporate world to me sounds horrible,” says Barbara Ungashick, a licensed professional counselor (LPC) with a private practice in Denver. “The CEOs get $100 million, while those on the bottom rung get paid $15 an hour.”

Ungashick, an American Counseling Association member, accepts payment through employee assistance programs (EAPs). Although she says people aren’t necessarily seeking her out exclusively because of work-related stress, she calls it a pernicious force that is frequently entwined with the other problems with which clients present.

Workplace pressure has become so prevalent that both the World Health Organization and the National Institute for Occupational Safety and Health consider job stress to be a significant risk to public health.

Workers in overdrive

When pressed to pick the workplace stressor she hears about most often from clients, Ungashick says it is likely workload. She traces this back to the Great Recession when companies cut back their workforces out of necessity, but never replaced the displaced employees as the economy recovered. Instead, Ungashick has observed, the workers who remain are often performing the work of two or three employees.

Research tends to confirm Ungashick’s observation. Numerous studies have found that although the jobs lost during the recession were more likely to be midlevel and high-level positions, the economic recovery has consisted mostly of adding low-paying jobs. What’s more, the “restructuring” doesn’t necessarily seem to be over.

Robin Redman, a former human resources professional turned licensed professional counselor of mental health, says she continues to see frequent reorganizations that result in higher workloads for clients. “I had one woman yesterday who said she felt like she was on a wheel and couldn’t keep up,” says Redman, who has a private practice in Wilmington, Delaware. “She’s working 12 hours [per day] only to come home and attempt to catch up on emails.”

Brenda Ramlo, an LPC with a private practice in Colorado Springs, is hearing similar stories from her clients. “I think the expectations for workers continue to increase, leading to greater stress, on all levels of employment,” she says. “Because many workplaces are focusing more on increased productivity while using less resources, workers at all levels are feeling squeezed to produce more with less.”

“Additionally,” she continues, “because of the change in methods of communication over the past 10 years, employees are often expected to answer calls, emails and texts at all hours of the day and night, regardless of their pay or position. As a result, their time to regenerate and connect with family and friends is diminished.”

Employees increasingly feel the pressure to be reachable by multiple means, including email, cell phone, voice mail and text, confirms Cristi Thielman, a licensed mental health counselor with a private practice in Seattle. In fact, in some organizations, employees feel the need to use constant connectivity as leverage to ensure job survival, says Thielman, who draws half of her client base from EAP referrals.

“Performance evaluations that rank employees against each other are a source of anxiety for many employees,” she explains. “If an employee knows that their co-worker is working late into the evening or is available at all times of the day, they feel they need to compete with that co-worker and be just as available. So it becomes very difficult to unplug. Clients are often working at home even when they’re off the clock.”

As a result, co-workers often sense they are being pitted against one another, regardless of whether that is management’s intention. In addition, examples of positive management seem hard to come by, according to the counselors whom we interviewed. They say their clients generally report micromanagement, unclear goals, poor communication and other ineffective management practices.

“This increased stress seeps into the way people interact with or support one another at work,” Ramlo says. “When an environment becomes competitive, people are taxed, and negative behaviors are more likely to come out.”

Sometimes, she continues, that negativity and competition become the norm. “If someone is working in a toxic environment or has been dealing with criticism, they may start to lose sight of what is reasonable behavior from both themselves and their co-workers,” she explains.

“Many people feel like they have little choice but to keep working at their current position, despite their discontent, due to high debt, a tight budget and a less-than-ideal job market,” she concludes.

According to a 2015 Work-Life Survey by the American Psychological Association, 37 percent of Americans report regularly experiencing significant stress on the job. With the same study showing that 48 percent of Americans report that they regularly respond to work communications after normal office hours, that job stress is increasingly bleeding into personal time. These stressed-out workers may be worried about losing their salaries, but they are often unaware of the price they’re paying for uncontrolled work stress.

“Many individuals with work stress begin using substances or escalate what use was already present, have trouble sleeping, become irritable or experience depression and anxiety,” Ramlo points out. “These symptoms become noticeable and disruptive in the individual’s personal life and relationships.” Employees suffering from excessive work stress may also develop health problems such as fatigue, headaches, elevated blood pressure, weight changes and gastrointestinal distress, she adds.

“Stress in the workplace and increased workload can lead to poor diet [and] exercise and increased irritability, decreased stress tolerance and increased anxiety and depression,” Thielman says. “Clients in these situations then are less likely to socialize, may rely on drugs or alcohol to relax and have low energy during their free time to pursue hobbies and interests.”

It isn’t uncommon for stressed and overtaxed workers to be unaware of how problematic their behavior has become, Ramlo says. “The person is not always pleasant to be around, has difficulty leaving work [at work] or is not interested in previously pleasurable activities,” she notes. “In many cases, it is a spouse or family member who is the primary motivator for the individual to seek help because they have noticed a change [in the person].”

Something’s got to give

Once clients have realized that work is wreaking havoc in every aspect of their lives, the challenge is figuring out what to do about it.

“I will often do the pros and cons with [clients] to assess if remaining in their current position is the best option or if there are changes that can be made in their current position or if seeking other employment will be the best option in the long run,” Ramlo says. “I’ve worked with individuals who are in work environments or jobs that are more what someone else may have wanted for them or do not match their personality. They often feel there is an expectation to push through and that if they are good enough, they could make it work. Accepting that their personality could be better matched or goals could be realized with much less stress in a different setting is tremendously freeing.”

Thielman says that exploring how clients deal with work stress provides her with clues about whether their current job is a bad fit, whether they need to change their approach to work or both.

“To do this, we look at what they enjoy, what they don’t enjoy and which aspects of the job are causing them the most stress,” she explains. “Another goal is to explore with them how their own actions and beliefs contribute to their work stress. For example, do they believe they must do their job perfectly? Is it difficult for them to say no to more work? Is the amount of effort commensurate with their outcome?”

“I encourage clients to try to understand and become more accepting of their work style and approach,” Thielman continues. “In the process of exploring these issues, we then discuss what changes they could make to their approach to the job while keeping within their own work style and priorities.”

Redman encourages her clients to ask themselves what’s keeping them in their current job. “Is it strictly financial? Is it fear? What’s keeping you there?” she asks. “If you love the field, can you get another position?”

But what happens if a client doesn’t want to or simply can’t leave his or her current job? “Once clients become more aware of the impact of their job stress and become more clear on what helps them decrease work stress, they often become more confident in expressing their needs with their co-workers and supervisors,” Thielman says. “Many clients have had success in communicating these needs more clearly to their co-workers and supervisors and in setting clearer boundaries about the amount of work they can accept.”

Thielman also dedicates time to actively working with clients on communication skills. “I stress [speaking] from a place of what they need versus what they want others to do,” she says. “From our work of understanding and accepting work style and approach, the client is able to communicate with others from the perspective of trying to maximize [his or her] working style [and] emphasizing that [he or she wants] to do good work and be productive, which I generally find is true for most people.”

“I also encourage clients to communicate a willingness to collaborate with the other person,” Thielman says. “For example, I might coach a client to say, ‘I am realizing that with my extra workload, I feel I am having trouble dedicating the amount of time necessary to this project. I want to make sure my work is getting done well, so I am wondering if we could talk about what the possibilities might be for managing my workload.’”

Ramlo also emphasizes communication skills with her clients. “Role-playing can be an effective strategy in helping clients communicate what they want or need,” she says. “Clarifying problems and goals is also instrumental in making sure clients effectively communicate what they want or need. When people get overly emotional, it is often hard to adequately see and articulate what they want to say, thereby increasing the chances they will not get their needs met.”

Communication skills are helpful, of course, but stressed-out workers also need coping mechanisms. Thielman emphasizes the importance of her clients taking simple steps such as eating lunch away from their desks, seeking out co-workers to take brief walks with during break times and engaging in meditation or other mindfulness practices to help with relaxation and focus.

“I work with clients to find little ways all day long to interject some relaxation into their work routine such as taking time out to meditate or do some deep breathing or even go for a walk,” adds Ramlo. “I encourage them to decorate their cubicles with pictures of family or their favorite vacation spot. I encourage them to take breaks, ask for help when needed and go to the nearest park to have lunch and enjoy nature. Above all, I think it’s important to laugh throughout the day to avoid getting too mired down in the details of the job.”

Ramlo also believes it is crucial to help clients identify sources of healthy support in their lives — both at work and outside of work — and reconnect.

“I would help [clients] determine what kind of support they need and who in their life can provide it,” she says. “For instance, instead of commiserating with other disgruntled employees at happy hour, [I might suggest] joining with people who can provide timely feedback if they notice you slipping into negative patterns or help cheerlead you through a tough time. Or, if they need ongoing support that they don’t have or [if they] work from home, maybe joining a local group to help enrich their life outside of work.”

Speaking of which, there is a world outside of work, and these experts emphasize that counselors need to help clients recognize when they aren’t spending enough time there.

Work to live or live to work?

What makes you happy? That’s a question Redman says overworked and stressed employees — and the rest of us for that matter — don’t spend enough time thinking about.

All of the counselors interviewed for this article mentioned the pace of our 24-hour, on-demand society as a complicating factor when it comes to all kinds of stress, including stress connected to work. “People aren’t allowing themselves to have downtime,” Redman asserts. “They’re not taking care of themselves emotionally.”

Redman highly recommends that her clients start taking time to journal, go to the gym, practice yoga or do whatever else they enjoy. Even if it’s “just a couple of hours a weekend — go out,” she says. “Get a babysitter and go to dinner.” She believes these breaks provide people a necessary chance to regroup and review what is important in life and what isn’t.

Ramlo agrees that work-life balance is important. The needed balance is different for each person, she acknowledges, but she often joins with clients to assess whether they’re happy with their current work-life ratio. Ramlo helps clients step back and look at the big picture to prioritize and be realistic about what they can accomplish. For instance, a plan to spend less time at work would involve analyzing what skills the client is currently using, identifying what is and isn’t working, and determining how the client might use his or her time more efficiently.

“Work identity is important for many people, but I encourage them to look at other aspects of their identity that help define them,” Thielman says. “Is family time important? Time with friends? Travel? Spiritual practice? Artistic expression? Whatever it might be, are they satisfied with how much energy and time they are spending in those pursuits?”

“Looking at these issues can help [clients] see how they want to spend their time and balance their life,” she continues. “Recently, a client and I worked on managing her workplace stress and workload issues. The client began to spend more time on self-care and the personal aspects of her life and ultimately decided to leave her current job for a new one. In the new job, which she finds less stressful, she is making a conscious effort to incorporate self-care into her daily routine. Her levels of stress and depression have decreased significantly as a result of finding more balance between work and personal life. And because she has more energy, she is devoting more time to the relationships in her life that matter to her.”

 

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Laurie Meyers is the senior writer for Counseling Today. Contact her at lmeyers@counseling.org.

Letters to the editor: ct@counseling.org