Connection between work conditions and mental health

The connection between mental health and experiences at work is rarely discussed in the UK corporate and mainstream media. Overall understanding and support for mental health difficulties has increased but the media will often focus on the personal stories of celebrities and fail to look to root causes and factors. In the UK, this has given rise, recently, to a debate, initiated by a TV personality, as to whether high profile sports stars that withdraw from events citing mental health lack mental strength and are making excuses for inadequacies.

A wave of peer, media and public support has come in for sports stars who speak openly about mental health difficulties, such as US gymnast Simone Biles, who withdrew from some of her events during the Tokyo Olympics on mental health grounds. Some UK media sources reported the story and the accusation of weakness made by a TV personality against her, without referencing Biles’ history of sexual abuse by a former US Gymnastics physician and the institutional cover-up, nor her diagnosis of ADHD – nor the fact she is considered one of the greatest gymnasts in history. The precise personal concerns that led to Biles’ withdrawing from events this year are not known.

The debate is empty, given that, by definition, an individual who is unwell and takes time off is acknowledging lack of some capacity. Recent data in the UK shows a sharp and growing increase, in the past few years, of older women who challenge employers for discrimination against them due to perimenopausal symptoms. This, too, is an acknowledgement of health difficulties – and an intolerance to discrimination and unfair treatment, which may have gone unspoken in the past. Generalisations about the weakness of their personality and or that of their generation, as a whole, are speculative.

The corporate media, in the UK, rarely ask why it is that not all individuals have the benefit of taking time off work to recuperate their health and to receive treatment, if necessary. Health inequalities exist and ‘debates’ about the character of high profile individuals merely distracts.

After allegations of abuse and bullying in UK gymnastics, a review was initiated, with an interim report published early this year. Around 400 people have submitted information and the review team has referred 39 cases to the police. The review lead, Anne Whyte QC, identified common claims in the submissions of: “bullying, belittling, extreme weight management, regular over-stretching, use of excessive physical force, training on serious injuries, gas-lighting, coercive control and a reluctance to raise complaints/lack of opportunity to do so”. The full review findings are expected this month. 17 former gymnasts are currently suing British Gymnastics for negligence and breach of duty after abusive treatment by coaches.

A leaked report produced by thirteen junior bankers at Goldman Sachs, in the US, earlier this year, called for an 80 hour working week cap. They reported “inhumane” conditions at the investment bank, including 100-hour work weeks and “abuse” from colleagues which has severely affected their mental health. The bank responded, recently, by increasing junior bankers salaries to $110,000, excluding bonuses, going up to $125,000 in their second year.

A former senior banker, who previously worked at Goldman Sachs and headed the London Stock Exchange for eight years, Xavier Rolet, dismissed the workers’ complaints. He wrote on LinkedIn, “How many single working mothers trying to put several kids through school do you think work less than 130 hours a week?” He added elsewhere, “It’s a free world. If you don’t love what you’re doing or think the hours don’t suit your lifestyle, by any means do something else.”

Early this year, workers at Cigna, a US health insurance provider, started a petition demanding improved work conditions. As well as challenging a pay freeze, they demanded an end to harassment by management pressing them to meet production metrics and asked for means to report customer abuse. Workers reported that pressure to meet targets meant that they are monitored and pushed to field as many calls as possible, making provision of a meaningful service to customers challenging. In turn, the poor service rebounded upon them, as one worker stated: “There were times when I was the sixth customer service advocate that they’ve talked to in the last couple of weeks, and nothing is getting resolved. Nothing. This is a customer who has called multiple times and they’re upset.” Another worker, speaking to The Guardian, claimed that pay was deducted by Cigna for any time lost to technical difficulties whilst working from home.

Berlin grocery delivery start-up, Gorillas, which was launched last year and reached a $1bn valuation in nine months, has faced strikes and warehouse blockades by its workers this summer. The company has risen during the pandemic on the back of its model of a 10 minute delivery service for groceries at market rate and reliance on low paid and often, migrant, workers. It presents itself as an alternative to the gig economy model, as it employs its warehouse workers and riders, providing annual leave and sick pay. However, workers challenge this portrayal, claiming harsh and precarious work conditions, including unfair terminations, excessive delivery weights, lack of administrative and technical support, delays to sick pay and inaccurate pay checks. A Gorillas Working Collective was set up in February 2021 by workers and, in June, issued a set of 19 demands, including, provision of two days off in a row in a week for full-time workers. The US’ largest food delivery company DoorDash, has recently been reported to be in talks with Gorillas over investment and, some have speculated, a buy-out, which may affect workers’ efforts to assert their rights.

A recently published study on the health of UK middle-aged adults, born in 1970, as part of the so-called generation X, found that 1 in 3 had at least two chronic physical or mental health conditions. Those raised in poorer families were found to have a 43% greater chance of having multiple long-term health conditions, such as high-risk drinking, diabetes, high blood pressure and poor mental health. David Gondek, of University College London (UCL), who authored the study, said that: “Compared to previous generations, it appears that the health of British adults in midlife is on the decline.” Since 2011, historical improvements in life expectancy, for men and women, has slowed drastically in the UK, most significantly in deprived areas. Public Health England have argued that widening inequality has played a part and noted that health and social care services were underfunded during this period.

Mental health issues often have roots in the structure and culture of society. Those who focus only on individuals deflect attention from the abusive and exploitative hierarchies that are causing or exacerbating hardship and illness for so many – as well as the efforts by workers and unions to assert humane conditions.

My fear of new places

This piece was first published by writer, Kimmie, on her site, Becoming Kimotionally Stable.


A few months ago I joined an extramural soccer league in Baltimore. The team is mostly comprised of people who work in the same building as I do, and even though meeting new people terrifies the shit out of me, I’ve been grateful for the invite. We placed dead last this past season, and I managed to get a red card and get kicked out of a game for punching the soccer ball, but ya know, good times have been had.

However, our current season started up three weeks ago, and as I sit here in my bedroom, I am missing my third consecutive game. The first one was missed because I had mono, so I give myself a pass for that, but the main reason I’m having trouble showing up to the games this season is because they’re at a park I’ve never been to.

Do you remember showing up to a friend’s house for a birthday party in elementary school? You had never been to this friend’s house before, but your mom read the address on the invite while driving over, and she’s dropped you off at this brick house that looks just like every other one in the subdivision, and there’s no obvious signs that you’re in the right place, but here you are walking up the steps to the front door hoping that when you knock, you’ll be greeted with someone confirming that you’re exactly where you need to be. Sound familiar? 

That terrified feeling I used to get when ringing the doorbell of a house with a door I wasn’t sure what was behind is the same feeling I get when I have to meet new (or relatively new) people at a new place. I have diagnosed social anxiety disorder, so committing to the people portion of that scenario already requires a lot of conscious and deliberate energy from me, but add in a location I’ve never been, and I feel helpless to my anxiety. 

I’m sharing these thoughts for accountability. Here I am, acknowledging that I have a problem I want to work on and with a plan to do exactly that: Some time before next week, I am going to drive to the new park for our soccer games, familiarize myself with the parking situation (if you live in a big city, you will understand the anxiety that parking in and of itself can cause), and explore the park. I have no idea what this place looks like, but even if it’s completely barricaded with 10 foot tall fences, I am going to get out of my car and walk around the area. Walk one way, walk another, and maybe even walk in a shop or cafe nearby. I am going to walk around until the knot in my stomach disappears and I feel a degree of peace while being there. 

In some ways, I’m surprised I didn’t put two and two together sooner about what I needed to do in order to feel able to show up again. In all honesty I’ve been trying to will myself to ‘just do it’ for the past two weeks. A day has not passed since the start of this season where I haven’t thought about how I am going to have to bite the bullet and figure it all out in the moment. But that’s not where I’m at emotionally, as much as I wish it were. I can’t just will away my anxieties and force myself into a false feeling of comfort. If I am truly going to make lasting changes to my thought patterns so that one day I don’t feel paralyzed by the new people-new place combination, I have to meet myself where I’m at. I have to give myself the opportunity to face each of those triggers in isolation, even if it means showing up to a new place on my own prior to showing up with others. 

I’ll report back with [hopefully] a success story. 🙂

by Kimmie, Becoming Kimotionally Stable, 2 July 2021

Yellow flag, Iris pseudacorus (Nick Smith, Creative Commons)

Social anxiety news and stories round-up

Blogs

An artist studying art therapy gives an account of her life and experiences of bullying, judgement of her physical appearance and of subsequent social anxiety: “The pain and loneliness I felt from my social isolation was beyond imagining, so I drew to feel less alone. I am no stranger to heartbreak, betrayal and disappointment, and rather then let the pain defeat me I used it to create something beautiful. Heartbreak actually inspired most of my artworks. I use my emotional pain as a major source of inspiration in most of my works. I like to focus on the themes of life and death, nature because it brings life to my heart, and death which represents the suffering.”

A series of clearly written suggestions for using our senses to de-stress, highlighting sound, smell, feel and touch: “Figure out what sounds bring you a sense of peace or help relax you and begin using them to your advantage. The most commonly suggested method for this would be through listening to music, as this can have a positive psychological impact and has been shown to help ease low moods. Whether you are a fan of upbeat pop or more melancholy ballads, music can help us explore our emotions and ease our stress very effectively.”

A succinct post, describing emotions, particularly, feelings of helplessness: “Went for a walk with Sherri yesterday…and came back just full of social anxiety…I just have such a proliferation of thoughts after social encounters, even with people I trust. Why is it so hard to be straight forward? I’m so fed up with myself…”

The writer presents succinct descriptions of childhood friendships, which provide an insightful perspective into character and bonds: “From my infant friend Lincoln, I learnt in humans that I like those who complement my personality, but that’s not to say I atall dislike people similar to me. In fact a certain threshold of shared ethics is necessary. If you ask me when I juxtapose all of these friendships, I see very little in common. Maybe that’s the point. I build myself strong allies of a diverse settings.”

Research

This is a 1990 publication which suggests that social anxiety or phobia has a high incidence amongst the Saudi population and compares it to “the West” where “agoraphobia is the most common phobic disorder and constitutes about 60% of all clinically diagnosed phobic conditions, while social phobia is relatively rare.” The article goes on to suggest some possible reasons for this, including sociocultural.

I have included this article in this list particularly for the following quote: “Social anxiety seems to arise in people who are unduly sensitive to disapproval and criticism and who have inflexible ideas about social conventions which cause them to expect criticism unnecessarily.” This is attributed to a 1974 journal article which I could not find online: Nichols KA. Severe social anxiety. Br J Med Psychol. 1974; 47:301-6.

This quotation suggests an objective judgement of social fear based on an unspecified general standard, without reference to individual history, vulnerabilities or capacities. This objective standard may be helpful for identification of the need for treatment or support, but as a definition of social anxiety, it denies the subjective experience and condition of the person with symptoms and thus denies a holistic treatment approach. The definition also denies the reality of social power differences and social harms, beyond disapproval and criticism. I believe that this narrowly focused understanding of social anxiety disorder is found in modern medical understanding and treatments.

“Social anxiety is a highly prevalent and impairing condition. Understanding prodromal features of social anxiety in infancy can facilitate early intervention and mitigate negative long-term impacts. The present study is the first to examine social anxiety risk markers across multiple indices in infants with fragile X syndrome (FXS), who are at elevated risk for comorbid social anxiety disorder. Evidence suggests that infants with FXS display both behavioral and physiological markers of social anxiety that are detectable as early as 12 months of age. However, these findings were nuanced and not consistent across all measures, highlighting the importance of a multi-method biobehavioral approach.”

Articles

Australian freelance writer, Marnie Vinall, describes the positive experience of joining and integrating into a supportive Aussie rules football team: “I managed to make it a whole three weeks in before needing to sit out a training session because my anxiety got the better of me. It was in a regular drill called “chaos”, which involves a series of balls going in any and every direction. The purpose to practise kicking, marking, calling for the ball and making yourself open and available. “The aim,” the coach said, “is to get your hands on the ball as many times as possible.”

“For some, it will be hard to quiet the ‘threat brain’ and as a result, we may actually see a rise in OCD type symptoms. It’s important to understand that with OCD it is actually anxiety and fear at the root of the problem, it’s just the OCD are the symptoms we see.”

Another article looking at the fears that reopening of countries may bring, with particular attention on those most vulnerable, such as people with anxiety disorders: “Experts say it’s important to acknowledge your stress during this transition. It’s normal to feel nervous. People shouldn’t judge themselves too harshly for their anxieties.”

A deeper look at foods beneficial to emotional and physical health: “Serotonin has a calming effect and also promotes sleep and relaxation, McKittrick explained. In fact, low levels of brain serotonin, research has suggested, can lead to increased vulnerability to psychosocial stress.

Tryptophan is an amino acid that is necessary for the production of serotonin in the brain. Complex carbs including whole grains and vegetables can help boost levels of serotonin because they make tryptophan more available in the brain.”

Very frank and insighful account of a woman fearing social interactions after the lifting of pandemic restrictions in the UK: “Fortunately, I found a career where I could escape those feelings for a couple of hours. As a nanny, social anxiety dissipated as the focus was on the children and I was able to forget about me. I worked long hours and did something so fulfilling, that I realised when it came to caring for others – such as the children I worked with, or taking my husband to hospital – the feeling of being needed, the purpose of doing something for others, overtook the dread and fear.”

Prior to the lockdown in the UK, she had started a new job role: “I don’t currently know if I will be able to go back to it – the most I can achieve is going to a chemist to collect my husband’s medication once a month and that is a mammoth task that takes a lot of psychological build-up.”

Rugby vs. Football

On the Saturday evening train, two middle-aged men in rugby shirts got talking to some young men. One of the younger men had been a promising rugby player but had given it up after injuring both shoulders. He and his friend quizzed one of the older men about the game, local teams and names. Here’s the gist of what that older man, to the agreement of the others, had to say.

Rugby’s a man’s game,
tough but fair,
no harassing the referee,
or segregating fans.
We drink together,
we sing together,
no trouble in the stands.

Footballers are pussies,
one of the young men said,
its crazy how much they get –
way too much.

Our players chose to stay amateur, the older man said,
they’ve all got jobs in the City
why give up that sort of money
for a £25,000 a year?

We’re second in the league now, you know, –
without playing a game,
Chichester have been suspended –
a player took out the touch judge
and is being done for bodily harm.

GBH, the young man exclaimed.
They were going to go the RFU route, the older man said,
but it’s gone the way of a civil proceeding.

There was a game at Chichester, he continued,
when the touch judge resigned at half-time,
he handed his flag to the referee
and said he’d had abuse enough.

Too right, the young man said,
who needs that?
who needs that on a Sunday morning?

At the next stop, the young men got off.
“Cheers, boys” the older men said,
the train rolled on through Surrey