How Workplace Stress Becomes Trauma

There's no shortage of misconceptions about post-traumatic stress disorder (PTSD), but one of the most prominent is that PTSD is only caused by combat or abuse-related trauma. However, post-traumatic stress disorder can also be caused by various other stressful and traumatic events in your life, such as those caused in the workplace.

All specific causes of PTSD can be impacted by the triggers of symptoms and you should know how to recognize and treat them.

Work-related trauma

We've all had a boss who keeps us on our toes, second-guesses our decisions and makes our daily existence a nightmare. Sometimes it's an everyday inconvenience, but in more extreme situations, such a workplace dynamic can foster trauma.

I was formerly a manager in a corporate healthcare setting. I was salaried, which meant I frequently worked 80 hours but only got paid for 40. I loved my staff and found the job rewarding. However, there was a near-constant threat: A citation from the Department of Health, a poor review from an admin or even a high employee turnover rate could all jeopardize my employment.

The looming, unending fear of termination meant all employees, including managers, were afraid to admit failure, which discouraged us from asking for help. Instead, we took on more of the work ourselves, which increased our own levels of stress and fatigue. My insecurities became cyclical.

Though short-term episodes of stress can evoke motivation, long-term stress can cause anxiety. And those frequent traumatic events can lead to work-related post-traumatic stress disorder.

'Trauma as a general phenomenon, different from a formal diagnosis of PTSD, is now more commonly understood as something that happens inside us versus something that happens to us.'

Gina Schwarz, OTD, OTR/L and a clinical assistant occupational therapy professor at the University of Kansas Medical Center, explained some of the nuances of this situation. Her work as the advocacy and policy coordinator for the Mental Health Special Interest section of the American Occupational Therapy Association has given her insight into how trauma manifests.

"Trauma as a general phenomenon, different from a formal diagnosis of PTSD, is now more commonly understood as something that happens inside us versus something that happens to us," Schwarz said. "By not having an outward outlet, human beings often internalize events, and more importantly, the feelings that come with events."

I didn't realize until after I left my position that I'd been traumatized by the situation. Even after changing careers out of the corporate world, my brain was still on high alert, waiting for the next psychological attack. Every email was a passive-aggressive threat and every offer to help me with my transition was an implication that I was somehow incapable.

Identifying your triggers

Research on PTSD has indicated the disorder can arise from one traumatic incident or multiple incidents. While it's true many people diagnosed with post-traumatic stress disorder experienced physical trauma, mental and emotional abuse is just as likely to be a culprit.

And, yes, such abuse can take place at your place of work.

It's important to note that surviving a traumatic work situation does not mean you will meet the clinical criteria for post-traumatic stress disorder. The label of "workplace PTSD," while buzzy and popular, is not one accepted by the psychiatric community. But, as evidenced by anecdotal cases of employees suffering flashbacks and other PTSD-like symptoms, the suffering caused by workers' trauma isn't to be dismissed.

I've been out of the corporate world for six years, and while many of my triggers have subsided, I still find myself second-guessing everything, including my abilities. Whether actual PTSD or not, in my experience, any interaction with an authority figure is now a cause for increased stress. An email inviting me to a meeting might as well be a pink slip. The years of back-biting and sabotaging mean every coworker may be a spy and any missteps might be a sign that my termination is imminent.

Overcoming trauma

In an ideal world, the horrible boss would be discovered, fired and everyone would live happily ever after. Unfortunately, this doesn't always work out. One problem is many abusive bosses have found their position of authority because the company allows it. Ever heard, "The fish stinks from the head down"? It's often true.

Bosses who succeed in toxic environments make that environment the norm: A place where mental tactics, such as manipulation and abuse, are accepted. If workplace culture is this way, no matter how many people you complain to, it's unlikely to change. In these instances, you may need to find a new position.

Once you've gotten distance from the source of your trauma, or even before, it's important to get professional help to better process your experience. The American Psychological Association has specific recommendations for treating PTSD. While, as mentioned, your experiences may not fit an official diagnosis, the same steps are helpful for trauma in general.

'Practice self-nurturing and self-soothing activities, limit commitments, practice body scans and listening to the needs of the body, and practice assertive communication skills to meet your needs.'

First, cognitive therapy (CT) can help reroute your thoughts about traumatic experiences. Another approach is eye movement desensitization and reprocessing therapy (EMDR), in which a person is asked to recall distressing images while being directed to one type of bilateral stimulation. For a more head-on approach, prolonged exposure therapy (PE) will have you re-experience the event in a safe, controlled manner, to ensure you face the problem at its root.

Kim Pisarcik, LCSW, emphasized a support system for these therapies to be most effective, whether that's family or other loved ones. She also recommends several self-care techniques.

"Practice self-nurturing and self-soothing activities, limit commitments, practice body scans and listening to the needs of the body, and practice assertive communication skills to meet your needs," Pisarcik said. "Request help when necessary."

As you work through trauma, you will find your workplace relationships become easier as your brain learns it no longer needs to be on guard constantly. It will take time, but work can and should be something you look forward to, rather than dread.