Ask the Stress Doc -- Q & A

1) Managing an Employee Who Is Deteriorating Psychiatrically
2) Further Reflections on Whining or Grieving

Q. I manage an office of 69 people. I have an employee with a bipolar disorder who has been with the company for five years. The employee has been off his medicine for two years and is now showing many signs of an increasing manic state. I have spoken to him and he states he is "not sick like he used to be." I fear for the welfare of my employees. What should I do?

A. Alas, yours is a common yet difficult managerial challenge: handling effectively, an employee who, at one time, was hardworking and effective but whose performance and/or interpersonal behavior has deteriorated. And invariably this person has so many others walking on egg shells, adding to office tension and dissension, etc. A stressful event or series of stresses can provoke disorganization or defiance regarding his medication. And much like the alcoholic, denial is great: "I'm not sick like before, etc." Unfortunately, this individual often equates taking meds with being crazy. (Sometimes medication reduces the exhilarating and seductive highs.) The reality is that he has a biochemical imbalance such that without medication and, often counseling or a support group his behavioral, emotional and mental states will regress. And without proper intervention his condition will worsen. So what can you do? Try the following:

1. Document the individual's unsatisfactory job performance and problematic behavior and schedule a meeting with your Human Resource Specialist and, if possible, with an Employee Assistance Program (EAP) counselor. Relay in the clearest terms your concern regarding verbal abuse and physical violence for yourself and/or your staff. 2. Schedule a meeting with the troubled employee and the above professionals. If the HR person is not comfortable intervening with a volatile employee and there is no EAP counselor, bring in a consultant trained in violence prevention or critical incident intervention. (Also, if there's a union steward, and the employee would want the steward present, invite the latter.) 3. At the meeting, supportively yet firmly outline the employee's problematic behavior. Ask the employee how he sees the problem. Compassionately confront his denials and distortions. Strongly suggest he get a psychiatric evaluation. You might want to place him on a leave of absence till he complies. He will also need to sign a release so you can get general feedback regarding his involvement in therapy. The psychiatrist should have input regarding the employee's readiness to return to work ('fitness for duty"). To do anything less than these steps will enable this person's dysfunction and self-destruction, erode the morale and, even, productivity of other employees and undermine your leadership position and moral authority.

Q: I work in small law firm (what else in Washington), and we have a small staff. One staff member came on board 1.5 years ago and had taken a secretarial position after being an administrative manager for years. All we have heard from her is that how she has come too far in life to do the work of a secretary and how she hates secretarial duties. I am a secretary and accept my duties as part of the job and feel if they are so bad, maybe she should get another position. Anyway, what should my response be to her whining and complaining. I would like to tell her to take a hike. It really has screwed-up the morale at the firm. Her supervisor is the managing partner and well as the office administrator. So of course its difficult to go to him as an administrator because usually that person is a totally neutral party. Would like to hear your take on this.

A. I recently responded to this question and belatedly realized I had overlooked a key element -- the loss of a former position that was, in her mind, one with likely greater power, pay and status. I wonder why she departed the position? Was she burnt out? Was she asked to leave? Did she leave to have more time with family? I suspect the former scenarios. So, her constant whining about her secretarial work sounds like unresolved grieving and unhealed narcissistic injury regarding her traumatic career change. Perhaps by realizing her complaining has as much to do with her recent past losses -- ego-related, identity-related, psychological and tangible -- as it does with the present work situation, you'll be able to put her groaning in perspective. Nonetheless, my suggestion to have you and other aggrieved colleagues encourage management to examine barriers to positive team morale (and to have a meeting with your group and her senior partner) still stands. In fact, it would be great if her supervisor would suggest she get some counseling to help her with her unfinished grief. Just remember...Practice Safe Stress!

Mark Gorkin, LICSW, the Stress Doc, a psychotherapist and nationally recognized speaker, trainer, consultant and author, is also known as AOL's and the internet's "Online Psychohumorist" ™. Check out his USA Today Online "Hot Site" website - www.stressdoc.com  and his page on AOL/Online Psych, Keyword: Stress Doc

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