We need to change the way we 'work'

The origins of chronic stress at work, and why there is no quick-fix

February 11, 2020

Over the past years, I have looked at stress from different angles. I have experienced chronic stress (resulting in a burn-out), I studied the science behind chronic stress (as an organizational psychologist), and I taught others about chronic stress and how to deal with it (as a yoga teacher and lecturer). This blogpost is a summary of my knowledge about stress, yoga, and organizational culture. I think it is important to note that I greatly value a healthy challenge (which always comes with a little stress), and that this post is by no means a 'relax and chill-your way through life' - story (check out my other blogpost for evidence ). It is, however, a call to action for organizations who value the health of their employees, to have an honest and open look at 'how things are done' in their organizational culture. I do this by explaining the health risks of chronic stress, how stress works in the body, why yoga might help, and why yoga is not a quick-fix tool to stop burn-out. If we want to stop burn-out, we need to do something about organizational culture: we need to change the way we work, as a community.

Chronic stress is rising, and damaging

Chronic stress has been rising steadily for years and at this point, an estimated 17% of the Dutch workforce is experiencing burn-out symptoms. I sometimes hear expats say that burn-out really seems to be a European (or Dutch) thing, because no one in the US has burn-outs. Such statements amaze me. Just because in the US, burn-out is less socially accepted as ‘a thing’, that doesn’t mean it is non-existent. Anonymous questionnaires do show a similar trend in chronic stress increases, and an estimated 63 percent of US employees reports to engage in unhealthy behaviors to deal with stress. For example, opioid and anti-depressant use in the US are both twice as high as in the EU. Each country has their own ‘over-diagnosed’ labels. However, whether burn-out is a culturally accepted label or not, biologically, human stress systems are the same around the world, and data from a large variety of countries shows an ugly picture of the physical and psychological consequences of chronic stress.

A summary of research shows that chronic stress has a long list of physical and mental consequences. As you can see in the figure, chronic stress affects an estimated increased risk of sometimes deadly diseases, and physical and mental disorders over the life span, with a staggering 82% risk increase of anxiety and depression. Performance at work drops by an estimated 30% as a consequence of chronic stress. So even beyond the health consequences for the individual, organizations suffer too. In the Netherlands, total costs are estimated at 2.8 billion euros per year (around 60.000 per employee with a burn-out).

The science of stress

Ok, so stress is bad. Well, not necessarily. Chronic stress is bad. Acute stress is functional. A little stress can temporarily improve performance, which is why we have a stress system to begin with. Stress has evolved as a mechanism that helps us to get away from threat (lions) and pursue opportunity (berries), temporarily increasing physical and mental activation in order to run and think faster. We experience stress when we experience a difference between where we are and where we need to be, and we do not have the ability or the resources to get there. Stress temporarily improves our abilities and our drive to get resources, which makes us more likely to survive. Very simply put, stress is the experience of a gap between what we can do and what we need to do and it helps us improve when necessary. In the time when running and thinking faster happened occasionally (when running away from a predator, towards food, or gaining status in a 50-person community), this was a very effective system.

There are 2 major stress-loops connecting multiple brain and body areas. Two brain areas fire up the stress loops: the Amygdala, and the Hypothalamus. When threat or opportunity is signaled, stress hormones are released into the blood stream, and the body is activated: increased heart rate, breathing. Stress also makes you more alert: the brain areas that are important for attention, thought and emotion regulation, learning and memory: The Pre-Frontal Cortex and Hippocampus, are activated to make sure you are ready to perform cognitively and socially. These same brain areas (PFC and Hippocampus) are also responsible for slowing down the stress response. They put the brakes on the areas that fire up the stress system (Amygdala and Hypothalamus). A great system that regulates itself. You see a lion, the stress loops are fired up, attention and physical activation rise, and then the fire is automatically dimmed once you have run away. Humans, however (unlike other animals), can imagine future lions, think about past lions, get attacked by digital lions (e-mail), lions in the bedroom (taking our phones to bed), lions at the dinner table, berries on social media, well, you get the point.

When we continuously get stress signals, the system starts malfunctioning. The PFC and Hippocampus become overused, and are now unable to slow down the activation of the Amygdala and Hypothalamus. Without the brakes, the fire spirals out of control. Furthermore, because the PFC and Hippocampus are important for attention, thought and emotion regulation, learning, and memory, we lose focus, get emotionally unstable, can’t organize and prioritize, and we snap at our peers. Evidently, this makes the gap between what we can do and what we want to do even bigger, and before we know it, we are in a feedback loop from hell. If the stress system is continuously overused, at a certain point, stress becomes chronic: you will be unable to ‘find the off-button’, unable to relax, sleep, and recover. A burn-out is basically your body pushing the emergency ‘off-button’. Everything shuts down, and you will be literally unable to perform the simplest tasks.

Why Yoga can help

To those who read this and are not familiar with the philosophy of yoga: yoga is primarily a method of reaching ‘unified consciousness’, which means something like: to be able to still, control or relax the ever-ongoing jumping of the mind from future desires to past failures. In other words, to stop mentally running from past lions and towards future berries, and instead to remain in the here and now, learning to observe and accept reality, ‘as is’. Yoga, like Buddhism, it is an 8-step method to reaching this ultimate (liberated) state of mind. Both methods include several practices that are emotional (letting go of attachment to reward and pain, expectations and judgements, ethical (not harming other creatures, being compassionate, being truthful), physical (using the body to regulate the mind with the use of movement and breathing which is what we know as ‘yoga’ in the west), social (using social interaction and group practice to feel belonging and connection), and cognitive (using attention focus and mindful observation to find joyful relaxation and liberation of the mind: meditation). Asana (which is practicing poses), is only one of the 8 steps of yoga, and 'right' mindfulness is only one of the 8 steps of Buddhism. Meditation is a step in both yoga and Buddhism, although in this post, I will sometimes mention it separate from yoga because 'yoga' as a physical practice and meditation as a mental practice are often studied and mentioned separately in research and public.

With time, religion and dogma became part of these 8-step methods, but the basic idea behind Yoga and Buddhism is first and foremost, to be a method of self-help and exploration for the liberation of the mind, not a worshipping of gods or people. Both Yoga and Buddhism presumably originated from the Sramana movement: communities of meditating people who withdrew from Indian society around 800 BCE in order to find mental peace in an age of strict cultural rules, disease, and suffering. Yoga and Buddhism are based on the assumption that essentially, suffering (or, for the purpose of this post, call it stress, although that term doesn’t completely cover the Sanskrit word ‘ Dukkha’) is a state that is created by the mind, and that therefore can be overcome by training the mind.

There is evidence that yoga and meditation can indeed train the mind to be less stressed, by changing brain structures. Particularly those structures that are part of the Stress Loops (Amygdala, PFC, and Hippocampus). For example, meditation is found to decrease size and sensitivity of the Amygdala, and simultaneously decrease depression, anxiety and pain. Furthermore, there is an indication that yogis and meditators do not suffer from the decline in thinking speed that naturally occurs with age, and that Hippocampus and PFC (in particular the areas of attention and intelligence) are bigger in people who meditate than people who don’t. Other research shows that yoga (presumably through breathing) activates the relax and digest system of the body (the parasympathetic nervous system), and thus affects our mood and mental state through use of the body.

More research is necessary to see if yoga and meditation are the prime cause and if the results are specific to yoga, or are the same for other embodied and attention focused practices such as dance, playing a musical instrument, or sports. Other research on stress has shown that physical movement, learning something new, social interaction, and music all activate the PFC and the Hippocampus, and so de-stressing effects are not specific to yoga. The good news is though, that yoga is an integration of all of these anti-stressors, with the specific addition of including the emotional practice and ethics: a non-judgmental, non-competitive, compassionate, inclusive environment. My hypothesis, is that this is the most important reason why yoga is so popular as a stress reduction method, but also, that this ethical part is essential in tackling chronic stress at work. The ethics are necessary to induce connection, calm, and playfulness in a population of individuals that is otherwise constantly competing and achieving.

Why yoga is not a quick-fix for burn-outs

So, we can fix work stress with yoga! Well, yes, maybe, and no. In order to understand why we stress at work and what we need to do about it, we have to understand stress in the broader context of the organizational (and even national or capitalistic) culture. Yoga can help individuals to de-stress and become less sensitive to stress triggers, yet when you put those people back in the same stressful environment, eventually, they are back to square one. For example, a drug addict may fully recover in a rehab clinic, but the real challenge lies in returning to the old environment. The trick is in removing or avoiding triggers in that environment that initiate a stress response, and have been paired with (and automated over time into) drug use in the past. The challenge lies in our automated responses to old triggers. It is not different with people who have experienced chronic stress. If in your company or team, many people are chronically stressed, that means you need to investigate what triggers that stress, and build a more sustainable work environment that goes beyond sending employees to yoga. The biggest problem and challenge to reduce burn-outs, lies in organizational culture.

As you can see in the figure above, research on stress-factors at work shows that stress is not just a matter of lack of autonomy and work hours. It is caused mostly by chaos and uncertainty at work. Ambiguity about what one is supposed to do, conflict between different work-roles and between people, job insecurity, and workload. What stresses people out, is the way work is organized and the way the social work community is structured: organizational culture. The culture affects how psychologically safe people feel, how tasks are divided, how success is measured, and how ‘meaning’ and ‘value’ are defined. Moreover, the culture doesn’t just influence stress, it also influences performance. Google is a nice example. A large study there showed that the most important factors for team success where the degree to which team members feel safe, can depend on one another, have structure and clarity, feel that work means something to them, and feel like what they do matters.

Changing collective habits at work is the only way towards a healthy workforce

Summaries of research on health interventions at work show that the effects of one-side interventions are often very small. It is important that a broad range of interventions (at technical, organizational, and work-time level) is used to sustainably improve employee health. Furthermore, these studies showed that success of interventions is often undermined by uncooperative management. Changing the behavior of a group requires everyone to be on board. People automatically adjust themselves to implicit norms in the organization, and to what they implicitly assume the boss (m/f) expects of them. If the norm is: we eat lunch behind our desks, that is what people do.

A norm is there when the majority of people ‘do it this way’. So, if you sit in an office with 10 people, and 6 people make loud phone calls in the room, that is the norm. If the majority of people work 6 days a week, that is the norm. If the majority responds to e-mail within 10 minutes, the norm will be to have e-mail notifications on. I can visit an organization and explain the importance of switching off e-mail notifications for at least 4 hours a day in order to get any deep work done. However, this only works when everyone is on board. If the majority of employees still walks in unannounced or replies to e-mail within 10 minutes, things will soon be back to ‘normal’. Norms are not what is explicitly written in the company guidelines. Norms are what people do every day, habitually. Often, guidelines and how things are actually done, are not aligned.

This is why I put such emphasis on bringing the yoga and Buddhist philosophy to organizations as a whole (as opposed to just ‘stretching and bending’). I want to discuss and challenge organizational norms, because without having open conversations about values, ethics, emotions, and social connections with everyone (including management), burn-outs will continue to rise. The whole philosophy including practicing the emotional and ethical aspects of yoga is key in getting everyone on board to make a sustainable change in the organization. Repeated yoga classes with everyone can become a safe space where these ethical issues are openly discussed, where psychological safety is created, and more sustainable healthy habits can be implemented and monitored. Changing the organizational culture (changing group habits) requires repeated, physical, mental, and ethical practice with the whole community. There simply isn’t a quick fix.

An important example: the scientific culture

A great (or not so great) example of the power of culture is the scientific community. Science has studied the evident damage of chronic stress, the counterproductive effects of working more than 50 hours a week, and the stifling effects of in-group competition and job insecurity on creativity and performance. Most researchers (at least the ones in my field, psychology) are aware of this. The scientific culture, however, is overpowering. Researchers want to do meaningful, well elaborated and innovative research and be honest about their research failures in order to bring the community as a whole forward. But that is not what is rewarded. Researchers are rewarded (and punished) through the quantity of citations, not the effort and honesty of their research. They are appointed positions based on the grants they win. They have no choice but to subject themselves to working overtime without extra pay, publishing only their successful studies, and putting months of work into grant applications with a 5% win-rate, because this is just ‘the game’. If you don’t play the game, you lose. The results: just last week, a study with input from 4000 researchers showed that more than half of the scientific community needs help for depression and anxiety.

A recent news article in the Netherlands reports that Dutch universities face inspections because employees structurally overwork. The problem, however, is not the overtime. Working overtime is a consequence of working in an environment where the people who are supposed to be your peers and supporters, are the challengers for that one stable job or that one grant that will secure another 3 years of work. They are the result of having to publish only in the best A-listed scientific journals that allow only 5% of submissions to be published. They are the result of an increasing number of students, increasing demands of educational quality, and increased emphasis on lecturer evaluations where students can give lecturers a bad grade without explaining why. While the demands are increasing, the hours in which this must be done stay the same, the contracts are mostly 1- or 2-year flex contracts, and the battle for those contracts needs to be fought with some of the smartest people in the country/world (your fellow academics). You can imagine why some people get stuck in the feedback loop from hell. The demands grow, but the abilities and the resources don’t. The result: a big gap that lasts a lifetime (if that isn’t chronic stress, I don’t know what is).

What worries me about this, and why I think this community is such an important example of why we need leaders everywhere to think carefully about organizational culture, is that the academic community is a group of highly skilled and intelligent people. If a group like that can be forced to extort themselves into mental and physical breakdowns by the power of collective habits (organizational culture), that means that the only solution lies in changing the culture. What inspires me is that a change is coming. Universities, grant allocators, journals, and organizations are slowly seeing the real problems. I hope employees who read this blogpost and work at such organizations or institutions, will shout out to empower their employers to keep at it, and inspire other organizations to do the same: make a lasting change to their culture.

Conclusion

You can teach your staff to deal with stress. Although much more research is needed, there is some pioneering evidence that meditation and yoga are effective tools because they can help to better deal with stress, anxiety, and depression through changing the brain structures and training the physical relaxation responses that are important in the stress system. However, a much broader change in organizational culture is necessary to make sure the work environment will sustain those changes in stress sensitivity in the long run. Using all steps of the yoga method to discuss sustainability, ethics, values, social structure and well-being, could potentially be a tool to change organizational culture, and battle burn-out.

Sources

Not tired of reading yet, want to read more or check the validity of my arguments?

Sources (in order of use)

Chronic stress and burn-out are rising

Data on work stress on the Netherlands

Burn-out trends in the US

Statistics on unhealthy behaviors to deal with stress in the US

Estimated costs of burn-out per year in the Netherlands

The detrimental effects of chronic stress and burn-out

Can work make you sick? Summary of research on the consequences of chronic stress

Summary of research: Physical, psychological and occupational consequences of job burnout

Work stress as a risk factor of cardiovascular disease