Recently, a high-level policy planner for a government agency went to see Washington psychoanalyst Douglas LaBier.
He explained his problem: "The place is so seductive because they tell you what an impact you will have on things if you stick with it, and that your work is so important. The next thing you know, you're working 24 hours a day, sleeping on the couch in your office, playing out being a 'rising star,' enjoying life in the fast lane and all that.
"But when you take a good look at it, you see that the work isn't that important. You're really after power, exciting power. And the glamor of it all. It's all crazy, but also appealing, and nobody talks about it. If you try to explain, people think you're the one who's crazy."
Not long ago, LaBier would have begun his analysis of this patient in the traditional way -- by delving into his past looking for childhood traumas that led him to his emotional problems today. But LaBier has changed his mind.
For many of his patients, he now believes, the problem is not so much in their past traumas as in their work. Increasingly many people are troubled because of what it takes to cope with their jobs.
LaBier buttresses his conclusions with the results of a seven-year study he just completed under the auspices of the Project on Technology, Work and Character, a nonprofit Washington organization where he is a senior fellow.
After interviewing more than 200 people who work in a wide variety of organizations, including people who would not have sought out a psychoanalyst, he is convinced that normal adapta- tion to certain work environments can cause emotional problems.
He also believes that people who have psychological problems, such as sadism or a lust for power, can be the ones who appear normal in some work situations.
These conclusions are controversial. Harold Eist, medical director of the D.C. Institute of Mental Hygiene, for example, thinks they are too simplistic.
"Our history is always alive within us," says Eist. "How we adapt to a career is never fully a function of how we adapt to a career environment but is a function of our experience and how that experience has formed us."
Eist says he does not entirely disagree with LaBier, but he believes there is more to the story than LaBier tells.
On the other hand, Maryland psychiatrist Mauricio Cortina says, "I certainly respect LaBier's work and I think it has merit."
Psychiatrists, Cortina says, are not trained to look to the work situation as a source of aberrant behavior. Yet psychoanalysts do not have closed minds on the subject. "My sense is that psychoanalysts are open. The issue is one of educating. The goal should be one of educating the public and analysts," he says.
LaBier began his study of the effects of work environments on mental health when, in his private practice, he noticed that many patients related their careers to emotional conflicts. He saw "a pattern of trade-offs and anger centered around careers and adapting to success."
In addition, his colleague Michael Maccoby, who founded the Project on Technology, Work and Character, had noted in his study of large organizations that corporations strengthen and support those character attributes that best fit their needs.
LaBier wondered what would happen if an organization supported attitudes and behaviors that lead to emotional problems.
Then LaBier was asked by a large organization to investigate why so many of its employes were psychologically disturbed. "I started interviewing in confidence," he says. "And I found, to my surprise, that many suffered from anxiety or paranoia or had physical symptoms of psychiatric distress.
"Yet a great many were essentially normal characters," he says. "Their symptoms were not due to unconscious attitudes."
The next step for LaBier was to compare these disturbed employes to a group that, he says, were, "always successful, fast-track people who never had any complaints."
He found that a number of these fast-track people were "very sick inside. They were narcissistic or had delusions of grandeur or fantasies of slaying the opposition. Some were more masochistic, needing to submit themselves to humiliation or degradation. Yet all were very adaptive to their work situations."
One man, for example, told LaBier, "I don't get ulcers. I give them."
While they are successful on the job, he says, in private life many of these people have difficulties. They may be unable to form close personal relationships, for example.
As a result of his study of the emotional consequences of adapting to the workplace, LaBier has concluded that conflicts on the job are not necessarily an indicator of whether people are neurotic.
LaBier cites two sources of problems for normal people. The first he calls external trauma, meaning situations that are beyond the person's control. For example, a company may start pruning its middle level managers, creating fear, anxiety and a loss of self-esteem among those workers.
The second is situations that create what he terms the "working wounded." These are people who feel that they must compromise their own values if they want to be successful. "They often feel tremendous self-betrayal," LaBier remarks. "The ways they have to mold their attitudes lead to emotional suffering."
For example, LaBier tells of a working wounded man who was brought into a federal department by the Reagan administration. He told LaBier, "If I play my cards right, this is my ticket to the top. I can feel it. But sometimes I'm bothered by what I'm doing here because I was brought in to help destroy the work of this agency.
"I don't agree that much with what the administration is doing," the patient says. "I want more from life than an important career, but I like having power, too. So there's my conflict." What can normal people do when their career is making them sick? The first step, according to LaBier, is for them to become aware of the source of the problem and to realize that they themselves are ultimately responsible for any change.
Next, people must look at their options. In some cases, the solution is to have more balance in their lives, to look less to the career itself as a source of fulfillment. In others, it is to change the career, doing work that is more emotionally satisfying and that requires fewer moral compromises.
But, says LaBier, "most people don't want to make a major change." And there are some limitations to what can be done. For every unhappy lawyer who finds fulfillment by switching to another aspect of law, there is the civil servant who literally has nowhere else to go without causing a major upheaval in his life.
Some problems can be alleviated only through social change, according to LaBier. "Management and leadership will have to allow more responsibility and more opportunity for involvement, participation and development," he says.
In the meantime, the answers for most of the working wounded must lie within themselves. This does not, however, imply that people should give up and accept their fate. As Eist puts it, "There are very few complex problems for which there is only one solution."