Work addiction or workaholism is an addiction in the same way that cocaine and alcoholism are addictions. Progressive in nature, these addictive behaviors are unconscious attempts to resolve unmet psychological needs that have roots in the family of origin and can lead to an unmanageable everyday life, family disintegration, serious health problems, and even death. Similar to alcoholics, workaholics have rigid thinking or “stinkin’ thinkin’” patterns that feed their addiction. Because of their self-absorbed preoccupation with work, workaholics often do not notice signals, such as physical aches and pains or reduced ability to function, that can be warnings of serious health problems. Work addiction damages the mental and physical health of the workaholic. It is physiological and chemical in nature and can lead to anxiety and depression and even to suicidal ideation.

Work highs, reminiscent of the alcoholic euphoria, run a cycle of adrenaline-charged binge working, followed by a downward swing. Euphoria eventually gives way to work hangovers characterized by withdrawal, depression, irritability, and anxiety. Members of Alcoholics Anonymous often speak of the moment they “hit bottom.” The glamour peels off like old varnish, alcohol stops working for them, and they can no longer think of themselves as simply “bon vivants” or “men-about-town.” Workaholics, too, hit bottom: a spouse may threaten divorce; a long ignored back problem or stress-related illness like psoriasis may become painfully disabling; or valued employees may quit, tired of trying to meet impossible deadlines. Some hit bottom before they can admit they have a problem and get the help they need. Some workaholics become so depressed that they cannot get out of bed. They find themselves alone, unable to feel, and cut off from everyone they care about. Marriages crumble, and health problems hit crisis proportions. Breaking through the denial shakes workaholics into facing the truth and getting the help they need.

Many of the workaholics I see in private practice are dragged there kicking and screaming by their partners; others finally burn out or get tired of being perceived as the impossible boss at work and the distant parent at home. “It finally reached a point that I hit a wall!” exclaimed Ed, smacking his right fist into his left palm. “And I couldn’t escape it anymore. I was either going to deal with it or I was going to die.”

Workaholism and Work Addiction

The term workaholic was coined by Wayne Oates in the first book on the subject, Confessions of a Workaholic, in which he described workaholics as behaving compulsively with work in the same ways alcoholics do with alcohol.9 More than thirty years later, no consensus exists among clinicians on how to define or categorize workaholism. Neither workaholism nor work addiction is defined in many dictionaries, and the latter term wasn’t included in the spell-check on my brand-new Dell computer, on which I wrote the second edition of this book. Clearly, we still haven’t developed a language that would enable us to properly refer to the problem of workaholism or to distinguish among its various nuances. And although it has become a household word, workaholism has not been accepted into the official psychiatric and psychological nomenclature.

The American Psychiatric Association considers it a symptom of obsessive-compulsive personality disorder. Jeffrey Kahn, consultant for the American Psychiatric Association committee on psychiatry in the workplace insists that “other professionals who think workaholism is an addiction or a diagnosis in and of itself are ‘missing the boat.’ ” It is shocking that in 2006 the Priory, Great Britain’s high-profile clinic for addiction, charged that “workaholism is just something journalists like to write about.”

Sadly, in the twenty-first century work addiction has become so pervasive that many of us don’t see the condition or realize how serious it really is. Many clinicians—vast numbers of whom are also workaholics—still do not recognize workaholism as a problem. They see nothing wrong with eighteen-hour, pressure-cooker days. They deny that workaholism is a factor in their patients’ problems or in troubled relationships among couples who see them for psychotherapy. Although it surrounds us daily, they look on it much as we do caffeine or prescription drugs—as harmless, even beneficial.

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