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The Stress Doc Letter
Cybernotes from the Online Psychohumorist ™

March 1999, No. 1

Special Announcement: Sorry for the interruption in the weekly mailing of this newsletter. Groups in the Midwest and out west have been calling me on my motto -- "Have Stress? Will Travel: A Smart Mouth for Hire!" Sometimes the Stress Doc must walk the talk and be a good stress management role model. Consider the latest aphorism: "Discretion is the better part of exhaustion." (At this point, forget the valor thing!) In fact, with multitasks, tight deadlines, performance pressure and email eruptions, we'll go with some classic "could this be me?" material on stress and burnout. Hey, I just survived the Stress Doc in the lions den: led a stress/conflict work team focus group for 22 attorney/supervisors and managers.

Actually, this reminds me of the invention of a favorite slogan back in the mid '80s, just as AIDS was penetrating the mass consciousness. I received a call from an administrator of a law firm. She wanted to know if I could lead an overnight stress retreat for thirty litigators. Before I could answer, she anxiously explained that the previous year they had a "let it all hang out"consultant. Not surprisingly, with this crowd, the retreat turned into a rout. And she also made clear, her butt was on the line if it happened again. We went back and forth, when I suddenly blurted out, "You want to make sure these adversarial Type A's don't kill each other off. You want a workshop on 'Safe Stress!'"

Well she burst out laughing and promised to get back to me. When I didn't hear from her after two months, I called. Her resigned sigh made it all to clear. The executive managers of the firm not only decided to play it safe, they opted for abstinence...They were having a training retreat on computers!

Oh yes...you can obtain the burnout recovery strategies on my website -- www.stressdoc.com <A HREF="www.stressdoc.com">STRESSDOC HOMEPAGE</A> . Just click Humor Essays index on left, then click Stress/Burnout Category. Also, you can retrieve old Stress Doc Newsletters on the website. Click on the newspaper icon.

So the newsletter will be weekly or bimonthly depending on the number of waking and working neurons. Also, I haven't forgotten the unfinished "Codependency" series. This is just a test of my commitment ;-)

Dear Readers. By popular demand, here is your gumbo of the sublime, the spicy and the ridiculous: a tasty mix of my writings along with humor jokes, lists and other sparkling entities that have descended from cyberspace.

News Flash: Alas, only for AOL members, stop by my online "Shrink Rap and Group Chat," Tuesdays, 9-10:30pm EST: <A HREF="aol://4344:2993.chat.31195386.586807274">Washington LIVE CHAT</A> . It's a dynamic, lively, at times witty and always warm, thoughtful and supportive problem-solving group. We raise questions and share our ideas, hopes and experiences with each other.

However, for all cyberspace travelers, there's the new Stress Doc Work Stress Q & A -- <A HREF="http://digitalcity.aol.com/washington/stressdoc/">AOL.COM: Washington, DC - Ask the Stress Doc</A> is now featured on a variety of Portals to the Web, including <A HREF="http://compuserve.digitalcity.com/washington//main.dci">Compuserve </A>, <A HREF="http://home.digitalcity.com/washington//main.dci">Digital City </A>, <A HREF="http://mci.digitalcity.com/washington//main.dci">MCI</A>, <A HREF="http://netscape.digitalcity.com/washington//main.dci">Netscape</A> and <A HREF="http://digitalcity.aol.com/washington/main.dci">AOL.COM: Washington, DC - Home</A> (Main Screen, look under "People").

If you know others who would like to receive "The Stress Doc Newsletter," please pass their names along. (AOL subscription link <A HREF="aol://1391:43-61027">form driven mail</A> .) And, if you wish not to receive the newsletter, just email me with, "unsubscribe."

Stress Smoke Signals

Standing in a crowd at a party, years ago, I was crowing about my new workshop: "Rebuilding the Fire: Burnout Prevention to Positive Stress." A passer-by, called out, "Forget the fancy title. Just call it 'Getting Up in the Morning.'" She saw through my smoke. But are you aware of your stress smoke signals? Can anyone relate to my "Three 'B' Stress Barometer: How does your Brain-Body-Behavior tell you when you're under more stress?

1. Exhaustion. Does this after work ritual sound familiar? As soon as you get home, you turn on the TV, hit the fridge, get out the Haagen-Dazs or Ben & Jerry's, collapse on the sofa, and you're comatose for the rest of the evening? And this is on a good day!

2. Sleep Patterns. Now some people do crawl further and further under the covers or keep piling on blankets to block out the slightest hint of morning light. Perhaps, you're an obsessive-compulsive type who, in the middle of the night, wakes up screaming, "Dust, dust, where is there dust?" Do you sonambulate nightly with the computer, checking and composing email in your sleep? Or do you know all the best buys at 3 am on the QVC Cable TV home shopping channel?

3. Eating Patterns. When doing a workshop, I sample the audience: how many people tend to eat when feeling anxious or depressed? Just about the whole group raises their hands. Then I ask, "Are there any folks who lose their appetite when stressed? A few hands flutter. My immediate reply: "Of course, we hate these people!"

4. Sighing. Do you find yourself increasingly engaged in labored breathing or deep, heartfelt sighs? When do you often hear people engaged in deep and heavy sighing and breathing? (Other than when you call those 900 numbers.) Basically, when they are overwhelmed by demands and are increasingly losing that sense of control. Email me for information on how to join my on-line stress support group - "The Frequent Sighers Club." Believe me, with so many folks seething in their breathing, this group will take off.

5. Boredom. Has your long-standing niche of success now have you stuck in the ditch of excess? The routine is making you mean and green...less with hard- earned money and more with hardened envy. You may be experiencing what overcame the tennis great, Bjorn Borg. The Swedish star, after winning a slew of tournaments, suddenly burned out on the circuit. It's The Bjorn Bored Syndrome: "When Mastery times Monotony provides an index of Misery!" The key: Fireproof Your Life with Variety. (Reader beware: This is not an endorsement for cultivating a cyberharem of virtual lovers.)

Stress Smoke Signals: Part II

Is your good nature eroding from too many demands or from juggling responsibility for too many people or projects? Is facing an everexpanding base of data, policies and procedures causing a personality transformation -- going from Dr. Jekyl into Hiding? Perhaps you're a slave to deadlines, or tied up by thieves of time? Beware! You may be caught in the "Multiple & Simultaneous Demand Situation." If you're not careful, this Multiple & Simultaneous (or M & S) Demand Situation can turn around and become an "S & M" experience. You end up a "Servant to too many Masters!"

Are you servant or master with these stressors?:

1. Telephone Tremors. Do you start shaking when the phone rings? Or, can't set limits on yourself and others? Are you ready to rewrite the old AT&T television commercial. One more abrasive caller or intrusive telemarketer and you will "reach out and CRUSH someone!" Take control of the telephone. Don't allow others to keep interrupting you. If you think Alexander Graham Bell was "the father of stress," you probably have not cut the cord with your mother. Enough already!

2. Clutter. How cluttered is your life? Does the state of chaos or stacks of paper in your office or apartment have you almost envious of the unemployed or homeless? What about the inside of your car? Be honest...Do you feel like you're driving around in a pocketbook on wheels?

3. Type A Trap. Are you reluctant to delegate work because no one can do it as efficiently or perfectly as you? Be careful. You may be setting up a self-fulfilling prophecy. People may start agreeing: "You're right. No one can do it quite like you. Please, go do it yourself!" (You know, of course, who's the real Type A...The person who won't settle for anything less than being a Type A+.)

4. Cover-up. I once encountered a law firm where we finally exposed the big stress secret: half the attorneys - male as well as female - kept Grecian Formula 44 in their top draw. Makes me think of a T-shirt I once bought for an anxious woman friend with a good sense of humor. There's a picture of a woman having a "bad hair day" with the caption: "How can I control my life when I can't control my hair!"

But now for a real cover-up. After discussing a list of stress warning signs in a workshop, a somewhat pompous State Department manager arrogantly asked, "What do you call it if you don't have any stress?" I looked Mr. Bluster in the eye and calmly gave a word reply: "Denial!"

So laugh or lampoon, just don't tune out, those stressors and smoke signals. Email me and for those in AOL join "The Stress Doc's" on-line support/chat group -- "Shrink Rap and Group Chat" <A HREF="aol://4344:363.gorkin.5732839.568857121">Dig City Promo - Stress Doc </A> . Come learn the art and practice of "Safe Stress!"

The Four Stages of Burnout

Years ago, a magicaI moment whirled me in a mystical web. I was consumed by the path of "academic flashdancing." I succumbed to the "burnout tango." Now let me not just walk the talk, but deromance the dance: "Burnout is the gradual process by which a person, in response to prolonged stress and physical, mental and emotional strain, detaches from work and other meaningful relationships. The result is lowered productivity, cynicism, confusion...a feeling of being drained, having nothing more to give." Whether at work or school (or even in a marriage), to prevent it you must get it. To provide a framework both for understanding and, hopefully, inoculating against future burnout, let's begin with "The Stress Doc's Vital Lesson of the Four 'R's":

If no matter what you say or what you do, Results, Rewards, Recognition and Relief are not forthcoming, and you can't mean "no" or won't let go...trouble awaits. The groundwork is being laid for apathy, callousness and despair.

Have I captured your attention? Let's examine some of the progressive signs of being caught up in this erosive spiral. Here are "The Four Stages of Burnout":

1. Physical, Mental and Emotional Exhaustion. Maybe you are still holding it together at work (or school). Still, can you relate to this sequence? As soon as you get home, you head for the fridge, get out the Haagen-Dazs or Ben and Jerry's, turn on the tube, collapse on the sofa and you're comatose for the rest of the evening? Doing more with less, having plenty of responsibility but not enough authority, or juggling an unmanageable schedule is taking a toll. (For those grappling with all three stressors...automatically proceed to stage two, if not three.)

Normally, you pride yourself on doing a thorough job, a high quality performance. Now you are looking for shortcuts, if not cutting corners. And this gnaws at your self-esteem. There may even be pangs of guilt. A case of the "brain strain" is developing, accompanied by an energy shortage and feelings of exhaustion. If stress levels continue unabated, you may be ripe for the second stage.

2. Shame and Doubt. Perhaps this scenario is familiar. A supervisor (or professor) asks you to take on a new assignment. You want to...but this voice inside silently screams, "Who are you kidding!" So what's happening? You're not feeling confident about the future; and you're feeling pretty lousy in the present. Not surprisingly, you may even start discounting your past accomplishments. Beware...This is not a logical process; it's a psychological one. Now you wonder if colleagues, friends or family members will detect that something is wrong. While projecting a competent image has been the norm, now this voice inside is relentlessly shouting, "Impostor!" "Impostor."

And then you catch yourself emitting heavy, labored sighs. (When do people often engage in deep, labored breathing or sighing? Other than when calling those 1-900 numbers. When experiencing a deep sense of loss and change perceived as uncontrollable.) Is chronically grappling with a profound sense of vulnerability or uncertainty anyone's favorite state? Certainly not mine. No surprise then that some folks will "progress" to the third phase: "Cynicism and Callousness."

Are you starting to feel I've been looking in your window? Or, as a reader recently emailed: "Have you been a fly on the wall in my house?" Let's not be premature. We still have two more stages to go. And next, we'll check out your "tude."

3. Cynicism and Callousness. In response to that prolonged feeling of insecurity or vulnerability, some folks feel there's only one thing left to do: put on the heavy armor. They develop an ATTITUDE: "Look out for # 1." "Cover your derriere." "No one's getting to me." And, in the short run, the strategy often works. You become sufficiently abrasive or obnoxious, people start avoiding you. But this hard exterior can eventually become a burdensome, self-defeating strategy.

Here's an example. Years ago, I was leading a workshop at a construction industry conference. There was a guy, I'll call him Joe, who was head of a large plumber's union. Now Joe was basically a down to earth, nice guy...who found himself becoming increasingly bitter, with that hard attitude. And it was scaring him! Now granted, Joe was in a position that pulled him in all directions - compelling demands, favors, complaints, bribes! Still, what do you think was Joe's biggest stress trap? That's right, this "good Joe" was such a "nice guy." What can't nice guys and nice gals do? They can't say "no!." Nor are they confident establishing their boundaries. They have difficulty with authority - being one or interacting with one. These nice folks tend to avoid conflict; they don't want to hurt others' feelings. They are not comfortable with anger, or don't know how to express their frustration or displeasure in a focused manner. Their personal mantras are being "fair" and "accommodation" (while feeling deep rejection when other's aren't fair or accommodating).

These accommodators, despite having a full workload plate, when asked to take on new work will just smush their peas and bread into the mashed potatoes and allow others to pile on more stuff. Hey, being a team player doesn't mean you have to sacrifice your integrity or health. There's an option: "Sure I'll help you with this new demand and deadline. But for me to give the assignment the attention it deserves, we'll have to renegotiate my priority list and timelines." (I'm not saying there aren't extra-ordinary and emergency situations. But there is a difference between urgent and important. When everything is urgent, nothing is important!) Setting realistic limits is not a negative reflection on your work ethic or your ability to to go the extra mile. Without boundaries, that mile often morphs into a marathon. Remember, someone once said: "Burnout is less a sign of failure and more that you gave yourself away."

Joe was really worried. He thought he was going through a split personality process - going from Dr. Jekyl into Hiding. I had to reassure him that there wasn't any genetic transformation occurring. Without realizing it, he had been sucked up by the progressive burnout whirlpool.

And there's another reason for paying attention to this process. Burnout doesn't just facilitate a hardening of the psyche. When your stress starts to smolder into frustration and anger; then turns to suspicion and mistrust as you enclose yourself in embattled armor or a crusty shell...This is not just how you harden an attitude, but it's a formula for hardening the arteries, as well. Cardiovascular complications, high blood pressure, even premature heart attacks can ensue. Which is why, usually, I'd rather people hit the fourth stage of burnout, than linger in the third. Of course, "Failure, Helplessness and Crisis" sounds terrible. But consider this: "hitting bottom means there's no more downward spiral." And, if you can reach out, there's no where to go but up. Hold on. One more lap to go.

4. Failure, Helplessness and Crisis. Being caught in a familiar "Catch-22" often signals the final phase: "Damned if you do, damned if you don't." "Damned if you stay, damned if you leave." Your coping structure seems to be coming unglued. Next stop...the psychiatric ward! Probably not, however, the crisis smoke signals are billowing big time. Why is that? Burnout is like trying to race a marathon - full speed, nonstop. Can anyone race 26 miles full speed, nonstop? Of course not. Even Olympic marathon runners must pace themselves. If not, the body parts will break down. And with burnout, over time, the mental apparatus also wears out.

In fact, one reason the fourth stage is so disorienting is that a person's psychological defenses have worn down. Cracks start appearing in the defensive armor. Painful memories and old hurts normally contained by your emotional defenses are leaking through the cracks. A slight or an emotional bump can set off an overly sensitive and personal reaction. Now a mate's occasional, somewhat annoying behavior really irritates as it reminds you of a mannerism of your father. Or, jealousy towards a colleague reeks of sibling rivalry.


Hey, before throwing up your hands, remember...burnout is not for wimps. A lot of other folks would have jumped ship much earlier. Many of you reach the farther stages of burnout because of your tenacity and dedication. You have a strong sense of responsibility and don't like being deterred from reaching your goals. All noble qualities...unless compelled by rigid perfectionism and "there's only one right way" thinking. Then, pursuing your goals takes a back seat to proving others wrong and overcoming humiliation. You are chasing (maybe, also, being chased by) ego-driven egoals. Especially in times of overload, uncertainty and major change, "driven and rigid responsibility" can quickly transform a performance benefit into a personal and professional liability.

Also, these folks are usually not just responsible, they often are quite responsive to others. People lean on them for support. Are you a pillar of strength for those around you? If so, will those dependent upon you be quick to notice when you are feeling shaky? That you may need a shoulder? Often not, as their sense of security is contingent on your always being strong and available. Are you buying into this "superperson" role or hiding behind a heroic mask? Maybe you always had to help mom with (sometimes raise) the other kids. Or you're the emotional sponge in the office, frequently absorbing your colleagues' complaints. Can you hear that screeching, scratching sound? That's the stress knot twisting and turning tighter and tighter about your neck.

On the Edge

No wonder people start jumping out of jobs or school, out of relationships, sometimes just jumping. And for those not into jumping, you may be into swinging by the fourth stage. Mood swinging, that is, between short highs and/or prolonged depressive lows. Okay, the existential question: Is it Miller Time or Prozac Time? From my perspective, it's way too late for the former (though, clearly, many people disagree with me) and a decision on the latter requires expert opinion. But that's exactly the key for transforming a danger into an opportunity. Fourth stage burnout is the crisis point, it's crunch time. Are you ready to step up to the plate and reach out for the help and resources you need? A person recovers and expands his or her strengths and possibilities through a crisis when: 1) getting proper and sufficient support; someone trained in crisis intervention and loss, 2) confronting denial, false hopes, cynicism or helplessness, 3) grieving past and present losses while turning guilt, hurt, anxiety and aggression into focused energy and 4) acquiring and applying skills and technology for turning new problem- solving options into productive attitudes and actions.

My poetic anthem to burnout and beyond:

For the phoenix to rise from the ashes One must know the pain To transform the fire to burning desire.

Four Stages of Burnout. Four Steps For Recovery and Rejuvenation. Any readers care to share how you turned a burnout situation into a transformational experience? Can you say, "Creative Burnout"?

And will you Practice Safe Stress?

Mark Gorkin, the "Stress Doc," Licensed Clinical Social Worker, is a national speaker and trainer on stress, communications, team building, creativity and HUMOR. He is the "Online Psychohumorist" for the major AOL mental health resource, Online Psych and for Financial Services Journal Online. Mark is also a Contributing Writier for the national publications Treatment Today and Paradigm Magazine. And, the "Doc" is a critical incident specialist for a variety of EAPs. Check his website - recently featured as a USA Today Online "Hot Site" - at: http://www.stressdoc.com or email Stress Doc@aol.com.

The Stress Doc Ezine The Higher Power of Humor Section...

The second section will consist primarily of humor material that filters down from cyberspace. And fitting in perfectly with our theme of stress and excess, a little internet inventory of your addictive potential. Enjoy!

Net Addicts: We Know Who You ARE! From: SWells1835


Yes, you. You, looking at this screen for hours on end, online. You, bleary- eyed. You, an addict. Have you looked in the mirror lately? Been outside? Know what day of the week it is?

Your name was given to us by a spouse or family member who is concerned about your internet addiction. At Internetaholics Anonymous, we can help. We're a non-profit society of recovering addicts that provides support and counseling through weekly meetings designed to help WWWs - World Wide Wimps - like yourself you cope with your problem.

We feature a twelve-step recovery program and in extreme cases, interventions. Although it is our firm belief that you are never "cured," you most certainly can recover.

We have designed a brief checklist to determine if you are an addict. Do you: 1) Have twitches of the hand when you walk by your terminal? 2) Check e-mail more than five times a day? 3) Spend more time chatting than eating or sleeping? 4) Surf aimlessly with no direction, if only to be online? 5) Leave your name and information at countless sites if only to hope you'll receive a reply one day from a company you'll never do business with anyway? 6) Log on before important personal habits, such as meal preparation, hygiene or bodily functions? 7) Have red, swollen eyes that hang halfway out of your head? 8) Spend hours online on a holiday from work, where you'd usually be griping about your carpal tunnel syndrome? 9) See smoke arising from your computer or WebTV box? 10) All of the above?

If you answered yes to four or more questions (or chose #10), you have a problem. Please call us at Internetaholics Anonymous at: 1-800-LOGOFFNOWFORSWEETJESUSSAKES.

We're here, we're free, and we're confidential. The first step to recovery is admission that you have a problem. Call us today. If you can power off to free up your phone line, that is.

Seek the higher power of humor...May the Farce Be with You!

And, of course...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

** Join the Doc's "Shrink Rap and Group Chat" on AOL/Digital City, Tuesdays, 9-10:30pm EDT (AOL Members Only) -- Dig City Promo - Stress Doc.

** The Stress Doc's Work Stress Q&A  -- Ask the Stress Doc  is now featured on five Portals to the Web, including

  1. Netscape Netcenter  
  2. Compuserve
  3. Digital City
  4. MCI
  5. AOL.COM Washington, DC - Home

All five portal links can be shared with and are operational for both users of AOL and the Internet.

** For his free newsletter, Notes from the Online Psychohumorist ™ or for info on the Stress Doc's Online Coaching program, email Stress Doc@aol.com