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The best way to build yourself is to build
There’s a phenomenon most therapists have been confronted with, but few explicitly identify or discuss (partly because it’s hard to know what to say about it): the patient who is financially disincentivized from working. Often it’s because the patient receives some form of disability benefits contingent on demonstrating their continued incapacity to work; other times it is the patient’s parents or other family members who, with the best of intentions, fall into playing the role of the “disability office.” Regardless, the observed effect is the same: an arrested development that makes it impossible to achieve any but the most superficial and transient gains in therapy—until and unless the anti-work incentive gets explicitly addressed and challenged.
To be clear, my experience of working with such patients was not that they were “lazy” or that they lacked motivation for treatment. Many were combat veterans injured in the line of duty, having risked their lives to protect their brothers and sisters in arms. Whatever the reason for their prolonged non-working status, they were often highly motivated to “do the work” of therapy, and they put significant time and effort into that work. They diligently tracked their thoughts and feelings, they courageously faced and re-processed traumatic memories that had haunted them for years, they put into practice the distress tolerance strategies I had taught them, and so on.
Yet none of it felt, to them or me, like it was adding up to much. Rather it felt like a senseless game of “whack-a-mole.” The modal patient—let’s call him John—would achieve a decrease in his trauma symptoms, which meant he was no longer having the recurrent nightmares that kept him up until 5am every night playing video games; so now he was going to bed at 2am and waking up at 11am instead of mid-afternoon, which left him with 3 extra hours to… play video games, which he now felt ashamed of doing “in broad daylight,” which sent his depression skyrocketing. So then we came up with more purposeful, values-based activities with which he could fill those hours instead—going for a run? volunteering at a shelter? cooking a nice meal?—and John made a plan to engage in one or more of these activities before the next session. Only none of the activities felt particularly urgent or important to John, and they all required more activation energy than the video games. So John didn’t end up following through on them, which then exacerbated his feelings of guilt and shame, which re-aggravated his trauma symptoms and led to a fresh bout of insomnia—with which he then coped by losing himself in video games.
So then I would ask, what legitimate needs might the video games be serving for you? Well, he’d say, at least they give me a sense of accomplishing something; of expressing myself through my custom avatar and the gaming environment I’ve set up; of pursuing and achieving meaningful goals by my own effort; of… well, of doing work.
So what’s the problem then, I ask?
Well… none of it’s real, says John. It’s just a meaningless game.
Empirical research has quietly but inexorably borne out my observations: those engaged in some form of productive work—be it via school, employment, training, or caregiving—consistently demonstrate better therapy outcomes than those who aren’t. This finding remains even after controlling for confounds like socioeconomic status, chronic physical illness, severity of mental health problems at the onset of therapy, and so on. Even individuals with serious mental illnesses like schizophrenia show remarkable gains in functioning and quality of life when they are supported in finding gainful employment—far more so than when they are supported in obtaining disability insurance to obviate the need to work.
You might think there’s something counterintuitive in these findings: shouldn’t patients be able to make more progress toward their mental health goals when they don’t need to worry about showing up to work each day? But what this intuition misses is that doing productive work—bringing something valuable into the world by one’s own focused efforts—forms the essential basis of a person’s mental health.
I’d even go so far as to say it forms the essential basis of a person.
Work, as I’m using it here, refers to any effortful activity purposefully directed toward the achievement of some valued outcome in the world.
Our choice of the particular work we do depends on the whole context of our life and society and current needs, of course; but there is also just a general orientation that emerges out of almost any set of accumulated experiences of doing something useful, particularly as part of a coordinated exchange with others. And there is profound, life-giving value in even the seemingly mundane ways we apply our minds and direct our focused efforts toward purposeful ends that matter to us. This could be as complex as building an entire company, or it could be as simple as flipping burgers at a restaurant. It could also be volunteering at a shelter, if we make a serious and sustained project of it.
All this assumes, of course, that we do our work, not under a drill sergeant’s whip or with a Zen master’s detachment, but with a builder’s loving care. Simply “having a job” is not enough; if we approach our work as soulless drudgery or as somehow “beneath us”, it will not serve this soul-building function for us. To forge our better selves through the work we do, we need to consciously respect that work and ourselves for doing it, enough to do it thoughtfully and well.
The resulting orientation amounts to a felt understanding that our capacity to make things happen in the world through the application of our rational thought is our most precious and irreplaceable resource, and our key to getting whatever we want out of life. Not our innate genius, or our compliance with some moral authority (cf the drill sergeant), or any particular talents or strengths on which we might stake our self-esteem—but this, our capacity to do purposeful work. If we’ve got that, we can develop whatever particular talents we need, or figure out ways to compensate for the lack of them.
Doing purposeful work is also how we pressure-test our mental models against reality and build our knowledge and self-trust over time, making us that much better and braver at getting what we want. And it is how we even figure out what we want: by putting ourselves in direct contact with the varieties of work to be done and value to be created in the world. As Paul Graham wrote in his recent essay on “How to Do Great Work”:
The way to figure out what to work on is by working. If you're not sure what to work on, guess. But pick something and get going. You'll probably guess wrong some of the time, but that's fine. It's good to know about multiple things; some of the biggest discoveries come from noticing connections between different fields.
Doing work is also how we learn what putting in sustained effort toward worthwhile outcomes actually feels like, and how we learn to love—rather than dread or resent—that feeling.
It’s no accident that so many legendary founders and innovators worked “menial,” unglamorous jobs before advancing to the endeavors for which we know them today. Jeff Bezos credits his job flipping burgers at McDonald’s as a teenager with crucial lessons about automation and customer service, which he later brought to bear on building and growing Amazon. Andrew Carnegie “worked from dawn until dark as a bobbin boy in a cotton mill” from age 13, then as a messenger for a telegraph company, where he “taught himself how to use the equipment and was promoted to telegraph operator,” which in turn “landed him a job with the Pennsylvania Railroad, where he was promoted to superintendent at age 24.” Nike founder Phil Knight worked as a door-to-door salesman of encyclopedias and later financial securities, which got him over the worst of his extreme shyness. Such examples abound.
As to the unemployed veterans and others like “John” in my earlier example, many have gone on to flourish after traveling their own circuitous paths to the work they love. Some went on to found their own business ventures, channeling the healthy risk appetite and entrepreneurial spirit borne of their personal “rock bottom.” In many cases their work leverages and gives meaning to the very struggles that previously kept them stuck, as exemplified by such high-profile cases as J.R. Martinez and the veterans who share their stories for the Wounded Warrior Project.
This idea about the centrality of work in human character development features heavily in Maria Montessori’s work, as Montessori scholar Matt Bateman explains here. Privately, Matt (who happens to be my spouse) often half-jokes that people suffering from depression or anxiety should just “go build a cabin,” and that that would be the cure for all their problems. The kernel of truth here is that sometimes the experience of solving a tangible human problem by the application of our reasoned efforts is, in fact, what we need above all. And if we can give ourselves a critical mass of such experiences, and imbue them with the profound meaning and personal import they deserve, then they can form the most solid kind of foundation on which to (re)build ourselves.
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