On Mental Illness: Modifying the Work Ethic

By Jack Bragen
Monday May 23, 2011 - 04:06:00 PM

The work ethic that helps most Americans get their jobs accomplished can be poisonous for a person dealing with a major psychiatric illness. To accomplish overcoming the resistance to work, many non-disabled people create a “turbocharged” motivational system. Such a system doesn’t generally work for someone with mental illness, since there are times when we must slow down and take care. The system that is taught to people under psychiatric and psychological care is often the antithesis of the American work ethic. No wonder that successful people often find it hard to understand, and have empathy for, those who suffer with a mental illness. 

It seems that the axiom of the typical person in business is; “The show must go on.” However, the slogan taught to the mentally ill person may be; “What am I feeling right now?” In business, we are taught to ignore feelings and get the job done, while in the mental health treatment system, people are actually taught to magnify their emotions. The medications that we have to take, and the practices of mental health practitioners both play major roles in the difficulties that mentally ill people face when trying to work. 

The medications tend to block the faculty that ordinary people have of being largely immune to pain. When we see advertisements for that five hour energy stuff, basically they are selling something that raises the energy of the person to an elevated level in which emotional and physical pain are subdued. Many people can naturally achieve this elevation (to an immune state) by finding ways to trigger their adrenal gland. However, for a mentally ill person, both of these options are blocked. That five-hour energy stuff may very well trigger a psychotic episode for someone who already has such a tendency. The same thing applies to the natural triggering of the adrenal gland. The triggering of too much adrenaline can in turn activate the “fight or flight” mechanism, and this plays a major role in a potentially psychotic person becoming ill. 

There was a story of a baseball player who had injured his pitching arm, making it painful to throw a ball. While his arm gave him excruciating pain, he managed to pitch a shut out and win a game. This is a good example of overcoming something difficult and painful, and going on to win a prize. (We are taught to admire such an attitude.) This is one example of the American work ethic in action. The work ethic says to defy the internal sensations and thoughts that introduce difficulty. If there is a day in which one is depressed and would rather not go in to work, do it anyway. If you have a cold, but it is not so bad as to be life threatening, go in to work anyway. If a task is strenuous, and is causing you a lot of physical or mental pain, push through the pain and do the task. If you have neck pain due to whiplash, put on your neck brace and go into work. 

Concerning the role of counselors; they are trained to keep their clientele “in their feelings” which means that the importance level of painful emotions is kept elevated. This practice is sometimes helpful for resolving emotional problems, and it also prevents us from “acting up.” It is hard to break down in tears and at the same time attack your counselor; it doesn’t happen. 

The American work ethic is one of the things that made America a powerful nation. It is the attitude that allowed numerous companies to be profitable. It is something most companies expect out of their employees whether their position is at the bottom, middle or top of the hierarchy. And now I’m saying it shouldn’t apply to mentally ill persons. You could be thinking, “What’s he talking about?” 

The difficulties that mentally ill people experience are often intangible ones, and these difficulties may defy attempts at description. For example, I went years without understanding why work was difficult for me. I believed I was just inferior or that I wasn’t trying hard enough. People who I knew belittled me or made me blame myself for not being successful in many of the jobs I tried. 

People in our culture don’t have much empathy for the difficulties of a mentally ill person because you can’t see, touch, hear or objectively measure those difficulties. Therefore, many people will assume that these problems simply aren’t real. 

I am not asserting that a person with a mental illness ought not be given a chance at working. There is a balance in how a person with mental illness should be treated. You don’t want to presume that the person can do nothing, that he or she is incompetent, or that the person is fragile like expensive china. You should not presume that the individual is constantly on the verge of doing something “crazy” such as driving the company van to Chicago. Yet, some amount of accommodation would be nice, such as shorter hours and possibly reduced expectations of productivity. 

To summarize the above; work is more difficult for persons with mental illness partly because we are denied some of the methods others use to cope with their jobs, because we may be hindered by medication, and also because there are differences in our perceptual filters. 

As to fixing these problems, much of the solution ought to be the responsibility of the individual who has the illness. Once we understand for ourselves what makes work difficult, it becomes plausible to take counter measures. For keeping a job, I recommend self-coaching (during work) as one coping mechanism, meditation in a quiet place prior to going into work, and keeping up on the need for food and sleep. I also suggest that the person with mental illness avoid disclosing the nature of the disability unless circumstances force it. 

As an example of disclosure, I worked at a job in which I had not disclosed my disability, was performing adequately at a driving job, and was at about the two-week point. My employer, the owner of the company, confronted me and said that I appeared as if I was “on drugs.” He said he was prepared to fire me on the spot unless I had a good explanation. It was at that point that I told him I was schizophrenic and needed medication on a continuous basis. This disclosure was the beginning of forging a connection with that employer that helped me succeed at that job.