Keep the mind on the job

The phrase "I'm in therapy" conjures images of daytime TV, urban America and over-indulged celebrities. But while we may be less inclined than other nations to talk about it, New Zealanders are increasingly turning to psychotherapy to help them deal with problems in their career and personal lives.

"More and more people are seeking professional intervention for career-based difficulties. These often turn out to be a composite of other things, such as having to shift cities to maintain a job," says Maxine Burgham-Page, a psychotherapist on Auckland's North Shore.

Burgham-Page says the pressure to perform, to meet targets and deadlines, and the fear of losing work and income are time-honoured causes of workplace stress. More recent is the increased pace people operate at using technologies such as the laptop computer, digital assistant, email inbox, pager - and the ubiquitous mobile phone.

So are our working environments becoming harder to mentally negotiate? Burgham-Page says it's possible.

"There is a lot of expectation for people to perform and achieve. The performance review process is a good example; it's not necessarily conducted by someone skilled in assessing the performance of a whole person. Do they look at performance in the context of what is happening in the person's life?"

Last October, clinical psychologist Ruth Allen and Leanne Luxford, business manager for Working Well (the workplace and mental health division of the Mental Health Foundation) told the New Zealand Herald employers had a long way to go towards providing workplaces that are consistently mentally healthy. The women said employers are commonly prejudiced against the mentally ill and considered mental illness harder to deal with than other problems.

"I hear again and again that people fear disclosing their mental illness. [Yet] it's the supportive employer who retains staff," said Luxford.

"People are still being told 'don't bring your personal problems to work'," says Burgham-Page.

However, research conducted by Working Well suggests employers may be making more of an effort. A survey last month of the employees of 100 organisations found 64 per cent rated their organisations as doing well or very well at managing stress and fatigue; 23 per cent satisfactorily; 12 per cent poorly; and 1 per cent very poorly. Though almost half the workplaces had introduced one or more mental health initiatives since May 2004 mental health amendments to OSH legislation, Working Well noted this meant almost half had not. Clearly, some employers have a long way to go.

Burgham-Page says she saw one client who, after losing a child, was given three days' compassionate leave by his employer, then pressured to perform as usual.

"What's three days? It's barely enough time to get through a funeral."

She says access to mental health services in rural New Zealand is poor and people will often travel to find help or to avoid stigma - one client regularly made the flight from Gisborne to Auckland.

A lecturer in the importance of colleague supervision for palliative care nurses, Burgham-Page says employers in industries that deal with the personal trauma of others - police, firefighters, medical professionals, family lawyers and funeral directors - probably do not do enough to ensure their employees are coping psychologically.

"The adverse psychological impact of these jobs is much higher than for other careers. In New Zealand there is a 'she'll be right' attitude and there's the debate over who will pay."

Privately funded psychological help doesn't come cheap. Burgham-Page charges $98 for an hour session, a rate commensurate with her qualifications and experience (and well below that of psychiatrists), but still beyond the reach of many unless employers or the Government is willing to pay.

Unfortunately, publicly funded mental health services are stretched. Waiting lists are long and help can be inadequate even for cases in which people show signs of being suicidal. Those struggling with work-related problems are unlikely to qualify for early free assistance.

But does psychotherapy help? How does it work? And do we need it to cope at work or are we just being pathetic?

Burgham-Page says the body and mind are connected - mental problems can make you physically ill. If you feel you need psychological help, then you probably do. And getting help might be simpler than you think. While couches, hypnotherapy and psychiatric hospitals are available if needed, most people simply talk through their problems.

"If they need [other] help, we refer them to the right agencies but most people come because their lives are not working for some reason. Talking to a mental health professional lets them generate options for themselves. They see things more clearly," says Burgham-Page.

Though some work-related problems may seem insignificant at first, Burgham-Page says small incidents can be problematic if they escalate in the mind and emotions of an individual.

"I get lots of people in here feeling miserable and saying 'my boss hates me'. I ask them why they think that. If an individual can isolate the specific behaviours that upset them, they can be supported to make an approach to the other person or to develop strategies that will help them feel more equal."

Far from being an embarrassing indulgence, a little psychotherapy may help you to keep your mind - and heart - on the job.