Workplace phobia

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Classification according to ICD-10
F40.1 Social phobias
ICD-10 online (WHO version 2019)

Workplace phobia is an anxiety disorder ( phobia ), a pronounced and debilitating fear of the workplace as a place and of situations, objects or people that are related to the workplace or working life .

definition

According to the general definition of phobias ( DSM-IV ; ICD-10 , V, Chapter F), a workplace phobia exists when the real confrontation with or the mere idea of ​​the workplace or certain stimuli at the workplace (such as people, events, Objects, situations) lead to a pronounced fear reaction and avoidance behavior with regard to the job or work-related stimuli.

Symptoms

When approaching the workplace or the fear-inducing workplace-related stimulus, as well as when intensely imagining it, there is typically an increase in fear. This goes hand in hand with an increase in physiological arousal, for example with symptoms such as tremors, sweating, racing heart, lump in the throat, hot flashes or chills, possibly up to the development of a panic attack .

When avoiding or leaving the job, the fear subsides, in the sense of a classic so-called negative reinforcement . Avoidance behaviors are rewarding because they reduce anxiety and are thus reinforced at the same time.

Avoidance

As a consequence, a job phobia usually leads to avoidance of work, which means in the majority of cases to incapacity for work (“sick leave”). There is a risk of generalizing avoidance behavior, such as avoiding the street on which the company is located, avoiding events or places (e.g. local supermarket) where one might encounter colleagues or supervisors, or even anxiety attacks, if only the conversation comes to the workplace.

etiology

Fear reactions related to the workplace can on the one hand be triggered by workplace factors; But they can also be the result of primary mental illnesses (especially anxiety disorders) that manifest themselves in a special way in relation to the workplace. There can also be direct interactions. One often finds workplace phobias following structural changes in the work environment, work content or personnel changes.

Social medical importance

Job phobia is a clinical problem of its own value, with its own developmental factors and therapy requirements. This is due to the special features of the anxiety-inducing stimulus:

  • The workplace is not a simply delimitable stimulus such as a spider or the subway, but usually a complex stimulus in which situational and interactional elements flow together.
  • Avoiding a job generally has negative consequences for one's biographical development (long-term “sick leave”, loss of job, risk of early retirement).
  • Avoiding the job can contribute to the chronification of the underlying disorder, as the patient's own experience of insufficiency and the fantasies about threats solidify the patient's dysfunctional disorder models.
  • In contrast to the street or subway, the workplace cannot be entered anonymously at any time. Therapeutic exposure exercises in the workplace are subject to considerable restrictions.

therapy

The special problem in the treatment of workplace phobia is that the standard exposure exercises to be performed in phobic diseases with the possibility of a gradual approach to the fear-inducing situation are extremely difficult, if not impossible. The external conditions at the workplace cannot be controlled or only insufficiently controlled by the therapist, so that a planned and therapeutically dosed exposure is not easily possible. There is even a risk that the phobia will intensify under these circumstances.

Therapeutic methods that can be used are descriptions and analyzes of situations and behavior, the development of coping skills, the processing of the level of demands, principles of reframing and fear management, conflict clarification or exposure in sensu. A specific therapeutic instrument can also be the “occupational stress test”, which has been introduced in a number of psychotherapeutic specialist and rehabilitation clinics in recent years. Patients are sent under therapeutic supervision to sit in on selected cooperative companies, also to test their performance and / or perseverance in various areas.

Diagnostic classification of workplace phobia

It can be discussed whether workplace phobia should be viewed as an independent disease or as a symptom of other diseases. Due to the peculiarities in the development of workplace phobia, its special clinical and socio-medical consequences and the peculiarities of the therapy, it seems sensible to treat and classify it as an independent disease.

This can be understood as analogous to a heart attack, which is also nothing more than an additional symptom of a metabolic syndrome or a vascular disease, but which nevertheless has an independent disease status due to the peculiarities of the symptoms, its consequences, the prognosis and treatment requirements.

In many cases, those affected experience their workplace-related fear as justified, due to real fear triggers such as a bullying situation . This often perceived appropriateness of fear in workplace phobia contrasts with the perceived inappropriateness or exaggeration of fear in most known specific phobias.

According to the ICD-10 diagnosis code, workplace phobia can be described under F 40.8 (other phobic disorder).

Excursus: bullying

Bullying should also be considered in connection with workplace phobia. Bullying strategies from colleagues or superiors are: openly ridiculing someone, attempting to isolate, assigning degrading work.

literature

  • Janet Haines et al: Workplace Phobia: Psychological and psychophysiological Mechanisms. In: International Journal of Stress Management. 9, 2002, pp. 129-145.
  • Michael Linden , Beate Muschalla: Job-related fears and job phobia. In: The neurologist. 78, 2007, pp. 39-44.
  • Michael Linden, Beate Muschalla: Anxiety disorders and workplace-related anxieties. In: Journal of Anxiety Disorders. 21, 2007, pp. 467-474.
  • Beate Muschalla: Workplace Phobia. In: German Journal of Psychiatry. 2009, pp. 45–53 online (PDF; 176 kB)

Web links

Individual evidence

  1. ↑ Volker Faust : Mental Health 144: Workplace and Mental Disorder. Psychiatric and neurological information offered by the Liebenau Foundation. With the collaboration of Walter Fröscher and Günter Hole. Liebenau Foundation, Mensch - Medizin - Wirtschaft, Meckenbeuren-Liebenau, 2018. (Inability to work, change of job, overtime, mobbing).