The Gun-Toting Shrink, or Sticking Up For The Nervous Worker

As readers of this blog may remember, the Gun-Toting Liberal is only one of several personae of your truly, its creator. You may recall that for a living I am a clinician in a bustling New England psychiatric hospital.

I am called on today to advise an old friend who finds himself in a crisis. We'll call him "Jim" to maintain his privacy.

Jim finds himself, in his early forties, trapped in a cubicle job in a large anonymous company. He does not fit in but has made a go of it for the better part of a decade. His role in the company is to troubleshoot in-house problems - so as we can imagine, most of the time he's trying to help people who are angry, frustrated, and can't get their own work done. Demanding people. Impatient. He gets yelled at a lot.

Jim's chest began hurting a year or two ago, at work mostly, or at home when thinking about work. He began losing sleep, becoming depressed, having difficulty concentrating. He became irritable, his work suffered, he could not shake off his stress at the end of the day and was able to socialize less and less. Anxiety attacks came more frequently, again, mostly at work or when thinking about work. Stomach pain. Weird changes in appetite. The stress and pressure took on the character of a background hum, a drone almost, as the machinery of Jim's daily life and circumstances whittled away the marrow of the bones in his mind.

Vacations became life rafts. Petty workplace treacheries undid him.

Jim finds himself today unable to sleep. His chest hurts more and he thinks he might have to quit his job. He loses and gains weight. He smells the whiff of the long knives out for him at work, supervisors gunning to take him down, to get rid of this cog that hobbles the machine. Even though he does more work than those around him, he can't smile or play nice while doing it, and is frankly too much trouble for his managers. Though his competence is not in question, he is simply too irritable, too moody. He may have to go.

He is asked today to accept a new position, one with a lesser title but the same money, one which everyone around Jim will understand to be an upbraiding, a downdressing, in general a walking of the corporate gauntlet under the unmistakable banner of failure and shame. He calls me in the midst of this, a drowning man. He wonders if he has to take this position, this perp-walk to his new lower perch; he wonders if he would be eligible for unemployment if he turns it down.

Jim wants advice on anxiety cures. He wants to join the GTL at the range for some noise-and-hot-brass therapy, but I hesitate to put a gun in this man's hand.

Do you have disability insurance, I ask him. Yes, he answers. Short and long term? Who pays for it? I ask. I do, he replies, adding that he pays extra for better coverage. He has never made a claim.

Jim, and those of you in similar straits this evening, I say to you the following:

You have been entirely too long-suffering with this anxiety and depression, and entirely too brainwashed by the Machine into accepting a slow death by suffocation. Naturally, you feel trapped, hopeless, helpless, scared and angry - every bad feeling at once is in there, along with a deep lingering suspicion that maybe you ARE a lousy worker, a lousy human being. At times, who knows? Maybe you shouldn't even be alive...

Now your fantasy is to let failure happen, to shed the last vestiges of optimism and hope, and wait humbly by the kitchen door for some scraps of "unemployment compensation." Am I eligible, GTL? you ask.

What you are eligible for, dear reader Jim, is a disability claim. A totally legitimate, medically indicated claim of disability. Chest pain? Panicky thoughts of annihilation? Difficulty sleeping, eating, concentrating? The occasional wish to fly away, like a bird or the soul of a dead man? Only at work? Gradually increasing over a year or more, despite doctor's visits, diet changes, exercise, relaxation techniques?

Not enough, these self-help cures! (Though useful in staving off a breakdown for this long.) No surprise, as what Jim describes are the symptoms of a serious anxiety problem, of depression, of impending collapse.

My informal diagnostic impression: mood disorder, probably depression and/or an anxiety disorder. All with a poor prognosis and further decline if there is no treatment.

Now, of course, Jim feels embarrassed and ashamed when I talk this way. He thinks of a disability claim as some kind of a fraud, and not an important employee benefit he has earned and shared the responsibility of paying for for over half a decade.

Jim, if you're reading this, remember that your guilty feelings and desire to join in your own destruction are part of the syndrome, symptom-thoughts rather than true ones. Your mood disorder is feeding you poisonous negative thoughts right now. It wants you to bend and scrape at the door of the Korporate Kitchen for scraps. Please, sir, let me have some unemployment money, please sir...

Your symptoms want you to join your bosses in beating you down and not asserting your right to dignity, and to help when you need it.

So with both ears hear me: go in to work. If you have chest pains, see the nurse or a doctor. Be explicit in describing your symptoms. Hide nothing and say nothing but what is true and nothing more. Resist the urge to blame yourself or join with your superiors in painting you a bad worker who deserves to be shamed and called out. Ask for all the information there is on sick leave, including your rights to be sick in corporate America without fearing the loss of your livelihood (under the Family & Medical Leave Act), and how to go about accessing short-term disability if a brief sick leave does not help.

Remember that this problem did not develop in one day nor will it go away in a day.

You are no more a cog in a machine than a sunflower is. You are a person, and in trouble. This is your right.

In my clinical role I am asked on a daily basis to help patients with disability claims, short and long term, permanent and brief. Some are legitimate and I am happy to help. Others are spurious, or born of laziness, and I decline.

Jim's case is a no-brainer and one I would defend any time, anywhere. If Jim walked in to my office tomorrow these are the things I would tell him.

I hope he's out there reading - and listening.