Work is of pivotal importance in our society as well as in our personal experience. It provides livelihood on the one hand, and on the other the base for individual self-esteem and recognition by others. In addition, work facilitates social contacts and structures the day.
Nevertheless, there is still no clear definition of the word “work”. The term is very broad in meaning and covers an extremely wide variety of activities. People’s capacity of “coping” with work cannot be objectively defined either: What is perceived as much (or “too much”) work by one person, may be easily handled by another.
Assuming thus that neither “work” nor the amount of a reasonable workload can be universally defined, it becomes clear why there is no clear definition for “workaholism” either.
However, as to all addictions, the following applies: Addiction is not a disease of “wimps”. Only those who tolerate a lot from the very beginning are at risk of workaholism.
Delineation of the term and attempt at definition: What is workaholism?
The psychologist Wayne Edward Oates describes “workaholism” as a “compulsion or uncontrollable need to work incessantly that entails impairments in the areas of physical health, interpersonal relationships, personal well-being and fulfillment of social roles.”
Reflecting the implications of the word “alcoholism”, here thus the excessiveness is brought into focus. But what does “excessive work” mean? What is a “normal” amount of work, and where does it start to become “excessive”, “problematic”, or even “pathological”?
Musalek and Zeidler argue for a delineation based on qualitative rather than quantitative criteria: So-called “dedicated work” can also become excessive in terms of quantity, but it is perceived as positive and invigorating by the person concerned and the environment.
To the definition of workaholism therefore the following applies: “The crucial factor is not how much a person works (…), but whether it is his or her own choice to work a lot (because he/she takes pleasure in the work or the associated success), or rather because he/she is emotionally compelled to work or works constantly to avoid unrest and stress states that set in immediately whenever he/she is not working.” (Musalek, Zeidler)
A term that is often heard in connection with workaholism is “burnout”. Here, however, it should be noted that massive workloads or overloads are only partial aspects of a burnout. Other factors include bullying, unfair treatment at work, value conflicts or partner conflicts.
Who is affected by workaholism?
The days when workaholism was a marginal social phenomenon are long gone. Although there are not enough data yet, the massive increase in the number of burnout cases – which are, as mentioned, closely related to workaholism – indicates that this is increasingly a mass phenomenon.
The condition affects both sexes to the same extent. Currently there are reliable data only for people of working age. Since the development of an addiction is a protracted process, however, it can be assumed that such problems are not exclusive to adults. Adolescents and children, who often try to compensate for depressive symptoms by hours of learning, can likewise develop symptoms of workaholism.
Symptoms of workaholism
“High commitment to work” must be distinguished from “compulsive addiction to work”. The former is related to well-being (also in the sense of “flow” or “zone”) and professional or occupational advancement, while the latter means illness and suffering for those affected.
Symptoms of obsessive-addicted or problematic work habits are:
- Inner urge and compulsion: Workaholics work not because of external incentives, but due to inner agitation.
- “Craving”: As in substance addictions, there is an inner urge for more and more.
- Development of tolerance: It takes more and more work to satisfy the “craving”.
- Increasing of the dosage or temporal extension of the work to all areas of life, respectively
- Loss of control: Work abstinence is becoming increasingly impossible.
- Restlessness during leisure times: What characterizes the workaholic is not the sheer amount of work, but rather the fact that he/she is unable to spend any time without work.
- Vegetative over-excitation (hyperarousal)
- Exhaustion and feeling of being wasted
- No satisfaction from the work, lack of self-esteem
- Abstinence symptoms in advanced workaholism: These include increased blood pressure, sweating, insomnia, etc.
- Physical and mental disorders, social disturbances (depression, anxiety syndromes, social isolation…)
- Work as the sole focus of life: All other interests and activities are pushed into the background. It is no longer about working to live, but about living to work. Recreation from work becomes impossible.
The term “comorbidities” is used to refer to concurrent diseases or disorders that set in simultaneously with the (primary) addiction. The most common comorbidity of workaholism is burnout. Both burnout and workaholism are multi-stage processes. The two processes can be closely interwoven. Accordingly, the treatment of the primary disease must also take into account the stages of the respective comorbidity.
Other frequent comorbidities of workaholism:
- Anxiety disorders
- Personality disorders
- Addictions: Here nicotine addiction is to be named first, but alcohol and stimulating drugs (cocaine, amphetamines) can also serve as catalysts.
Development and risk factors
In the development of workaholism, predisposing or disease-causing factors are distinguished from addiction-maintaining or -enhancing disease factors.
The precondition is – as for any addiction – the attractiveness and easy availability of the addictive substance.
No genetic predispositions are known. However, there are conditions that are closely linked to workaholism (see comorbidity) and in turn exhibit strong genetic components (e.g. bipolar disorders, depression.)
The following circumstances promote workaholism:
- Intrinsic factors: Compulsive behavior, anxiety syndromes, lack of self-esteem, depressive disorders
- Extrinsic factors: social interaction problems, dependency on recognition by others, partnership disturbances
- Interaction with mood or personality disorders can significantly reinforce the process of workaholism.
Diagnosis of workaholism
Currently there is no separate ICD-10 classification of workaholism. The phenomenon is classified under “Disorders of personality and behavior" in the category “Abnormal habits and impulse control disorders" (F6.3).
This definition falls short because workaholism is a highly complex addiction process, not just a simple impulse control disorder. Workaholics usually meet all the criteria that are internationally recognized as criteria of “addictions”. Therefore Musalek proposes extending the criteria of dependency accordingly: What applies to “psychotropic substances” (viz. substances that affect the human psyche), can be observed in “psychotropically effective practices” mutatis mutandis. (Gambling addiction, work addiction …)
In addition, the diagnostics of workaholism (like burnout) is burdened by another problem: It is not a “thing” that has come into the world all of a sudden, but a dynamic process. A diagnosis that provides only a snapshot of this process will always fall short. Rather, the goal must be to capture the entire process.
Furthermore, the symptoms are experienced in a very variegated manner. Hence a comprehensive diagnosis of workaholism must not only list the symptoms, but also understand their significance for the individual and his or her environment.
The main problem in the treatment of workaholism is the lack of awareness of and insight into the pathological nature of the condition (in German referred to as “Krankheitsbewusstsein”) on the part of those affected. They usually seek treatment only late, or do not consider their behaviors as problematic.
However, early detection and early treatment favor successful treatment significantly.
Like all addictions, workaholism is a chronic disease that develops slowly and imperceptibly, so its beginning is not clearly determinable, but – also in regard of its co-morbidities and complications – it can even be fatal.
Approaches to treatment and rehabilitation:
- Focus on the revaluation of the previous priorities
- Treatment should not be based solely on the individual symptoms, but also take into account other disorders interwoven with them.
- A critical success factor is a clear treatment objective agreed by the therapist and patient.
- The treatment objective must be attractive and accessible for the patient. For in addictive disorders the success of treatment depends less on the treatment method than on whether someone partakes in treatment consistently over a longer time. The more attractive the target, the lower the “drop-out rate”.
- The treatment objective is not merely a change in behaviors. It is a transformation of the lives (and experiences) of those affected.
- “Quality-of-life concepts”: It is not just about reintegration into society and the work process, but also about quality of life for those affected.
- “Recovery concepts”: The recovery process has no fixed end point, but is seen as a development, as a gradual improvement in general health.
- “Orpheus Program”: Developed at the Anton Proksch Institute, this program serves for activation of the resources of those affected. The joy of a “beautiful life” is to be rediscovered.
- The comorbidities determine the duration of treatment. Each treatment plan must therefore include the comorbidities, especially burnout.
About the Anton Proksch Institute:
The Anton Proksch Institute is one of Europe’s leading addiction clinics. Our range of services covers on the one hand inpatient treatments for alcohol, medicine, drug, nicotine, gambling, computer, internet, working and shopping addiction. On the other hand, we offer outpatient therapies as well.
Continuous scientific development, professional quality standards, but also humanity and respect in the treatment of addicts – these are the hallmarks of the Anton Proksch Institute (API) in Vienna-Liesing, which celebrated the 60th anniversary of its foundation in January 2017. The Institute currently serves about 2,000 patients and inpatients and 4,700 outpatients per year. In the house in Vienna-Liesing, in the recent past also the “Orpheus” program was developed that represents a new paradigm in dealing with addicts. As Orpheus from Greek mythology defeated the sirens by singing a more beautiful song himself, the innovative treatment concept is about making the lives of addicts beautiful, pleasurable and meaningful again – and thus to minimize the seductive power of addictive agents.
The Anton Proksch Institute is a healthcare institution of the VAMED group.
These articles might also interest you:
+ "The Orpheus Program" - from Prim. Univ. Prof. Dr. Michael Musalek
+ "Burnout as a process" - from Prim. Univ. Prof. Dr. Michael Musalek
+ "Alcohol Addiction" - from Prim. Univ. Prof. Dr. Michael Musalek
+ "Alcohol at the workplace" - from Prim. Univ. Prof. Dr. Michael Musalek