A client of mine, an engineer with a PhD from a top school, had an easy time getting interviews. But during every meeting he became nervous and hesitant, stuttering and sweating as he was asked to respond to the most basic interview questions.
Another client, highly intelligent, articulate and charming with many interests and good work experience for her age, didn’t feel worthy of the jobs she interviewed for. Each time she met with a hiring manager she spent most of the time nervously apologizing for the 20% of the job’s requirements she lacked instead of focusing on the directly related experience she did have.
Trying to figure out your career is hard enough without being sidelined by anxiety. Many otherwise high-functioning people experience anxiety attacks before and during interviews, which can include difficult to mask signs like a pounding heart, lightheadedness and noticeable sweating.
Interesting fact: Anxiety disorders affect 40 million adults in the United States and are highly treatable, yet only about one-third of sufferers receive treatment. (Anxiety Disorders Association of America) When therapy is so widely available, and is covered by most health insurance plans, why do so few Americans take advantage of it?
There are many types of therapy available to treat anxiety, both with and without medication, and practitioners trained in a number of different techniques. To help readers understand more about the effects of anxiety disorder on a job search and the kinds of treatment available, I spoke with Sarah Paul, MD, a psychoanalytically trained psychiatrist, and Anna Edwards, PhD, a Cognitive Behavior Therapist. Here are excerpts from those conversations:
Can you give me a sense of the kinds of anxiety your patients are grappling with?
Sarah Paul, MD:
Anxiety can be viewed as a mechanism for signaling danger—as a message that there’s a need for either special attention and vigilance, or for obsessive review and rumination. In working with patients, I seek to uncover if the danger is real or fantasized, rational or imaginary. Is it present in the current-day actual life circumstances of the patient? Or is it instead a remnant of some much earlier, powerful experience or set of experiences from childhood? And what was the nature of those early experiences—what was the threat, how severe or real, how avoided, and what were the consequences of risk?
Anna Edwards, PhD:
Individuals who suffer from anxiety may expect that they will fall short relative to other applicants, no matter what their qualifications actually are. Some may tell themselves that they don’t have something to offer an employer. Others may worry that the job will not be the right fit or will not be fulfilling, and thus will not go through the steps of gathering information to actually identify the characteristics and fit of the job. Many tell themselves that only “perfect” cover letters and resumes would enable them to move ahead in their search, thus they may spend an inordinate amount of time crafting these materials, most frequently resulting in procrastination (due to the gravity of the assessed task) and abandonment of the process.
What’s your approach to working with patients suffering from anxiety in their job search?
Sarah Paul, MD:
My approach to the anxious patient usually involves exploratory talk therapy with the aim of understanding the unconscious roots of the patient’s symptoms. This generally involves detailed discussion of the many aspects of the patient’s anxiety (the way it feels, its verbal content, typical triggers, etc.), and his or her methods of coping (also known as defenses). While a person may know that certain stressful situations (public speaking, job interviews) make them anxious, they may be unaware of how subtler stimuli in the environment, even simple thoughts, can bring it on.
Throughout this kind of exploratory work, the patient and I return repeatedly to the present manifestations of his or her anxiety, learning about how it has affected all aspects of their life and how they have either consciously or unconsciously compensated. Perhaps in order to avoid competition with an angry or narcissistic parent, they have developed a chronic insecure sense of themselves, an avoidance of challenges, an inhibition even of ideas or life goals—a chronic apathy, negativity, or indecisiveness? Perhaps they fear success, and have inhibited their ambitions?
Anna Edwards, PhD:
The cognitive behavioral model posits that the narrative we tell ourselves about who we are, other people, and the future largely contributes to our emotional and physiological responses and our actions (as well as inaction). Our expectations about the job search, even our expectations of contemplating a job search, impact our ability to engage with the process and ultimately reach the goal of career plan and employment.
Cognitive behavioral therapy and acceptance based behavioral treatments encourage patients to identify the narratives they are telling themselves, specifically to identify what is going through their minds when they experience anxiety and choose procrastination. A variety of interventions are aimed to distinguish a thought from a fact and create some space and freedom from the thought. Many patients protest that their thoughts may represent a reality (i.e. I was actually let go from my last job). My answer is that there are many truths at any given moment and the choice to focus on any particular one is inherent in one’s expectations. I spend a lot of time talking about goals and values with my patients and the utility of focusing on the critical thoughts in their effort to achieve a full and fulfilling life. In addition to targeting one’s narrative of the world, we also focus on changing behaviors; oftentimes, this means experiencing some anxiety in order to move forward with their goals. Paradoxically, the more individuals move toward anxiety-provoking situations, the less anxiety provoking these situations become as they build a new association with these previously avoided activities.
If you suspect that you or someone you know is suffering from anxiety that’s impacting your ability to stay employed or look for a new job, check out the Anxiety and Depression Association of America or the American Psychological Association for more information.