“I'm suffering from work related stress, doctor”

BMJ 2000; 321 doi: (Published 19 August 2000) Cite this as: BMJ 2000;321:519
  1. Kevin Barraclough, general practitioner
  1. Painswick, Gloucestershire

    My first girlfriend would sometimes ask me, as we wandered along the deep lanes by our Cotswold school, whether I was happy. The question would uniformly plunge me into a state of self questioning doubt. The truth was that, when I paused to examine the question, I was not happy. At least not to the degree that the films shown in the assembly hall on a Saturday night had led me to expect that I should be. But equally I was not unhappy. At least not until she asked me the question.

    I read an article recently by a sociologist from Kent University called Dr Furedi. The man is a prophet and I hereby burn incense at his shrine. Writing about the phenomenon of workplace stress, he notes that a huge proportion of the workforce perceive themselves as highly stressed by work. (I suspect that anyone working in the NHS also comes into that category.) But this is not a new phenomenon, he points out, nor one confined to those in work. Those who are unemployed experience similar stresses. And even children are not immune. At a recent national teachers' conference, examinations were denounced as being “sadistic” and little more than “child abuse.”

    And yet, as Dr Furedi points out, there are many therapists, lawyers, and others who have a vested interest in creating a climate in which people are encouraged to interpret their daily problems through the metaphor of psychological illness. By medicalising stress we “inflate the sense of emotional injury and invite people to perceive themselves as ill.”

    I still dream sometimes about a young woman with diabetes whom I was unsuccessful in resuscitating. She asked me to “save her” as she disappeared under the waves of ventricular fibrillation. Should I sue the NHS for the Post Traumatic Stress Disorder (note the capitals) as some police officers have done in the case of the Hillsborough disaster?

    The problem seems to be that we expect to be happy. We perceive it as a right, and we feel guilty, inadequate, and resentful if we are not. Perhaps we should accept, like the generation who came through the second world war, that life is not always easy and that a sense of aggrieved injustice often only makes it worse. As someone once said, “the natural state of the intelligent human being is one of modified unhappiness.”

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