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Praise for IS WORK KILLING YOU? A Doctor’s Prescription For Treating Workplace Stress.

“Dr. Posen’s work could not be more timely…We won’t make our world safer until we learn to manage our work and ourselves better.” – Margaret Heffernan, author of Willful Blindness: Why We Ignore the Obvious at Our Peril

“Posen makes a sound, compelling case for active stress reduction at work.” – Publishers Weekly

“Solid Advice for anyone who wants to transform their current workplace, or is looking for new employment.” – Winnipeg Free Press

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Dr. David Posen, a leading expert on stress mastery, gives us the definitive guide to treating — and eliminating — excessive stress in the workplace. Here he identifies the three biggest problems that contribute to burnout and low productivity: Volume, Velocity, and Abuse. Using revealing anecdotes and real- life case studies, he describes the physiological effects of stress, and illustrates how economic uncertainty, technology, and corporate culture have made the workplace more toxic than ever. Most importantly, he offers practical solutions and easy techniques to cope with workplace stress, and outlines what we can do collectively to maintain a healthy, productive atmosphere.

Witty, engaging, and accessible, Is Work Killing You? touches on everything from meetings to tweeting, fake work to face time, the overworked to the underemployed, and more. With this book, Dr. Posen gives us the tools to stop harming our most valuable resource — ourselves.


PREFACE: Why I Wrote This Book 1
Introduction Workplace stress — Setting the Context
Defining the Problem 9
What Is Stress and How Do You Know When You Have It? 13
Why Should You Care? Why Is This Important? 17
The Futility of It All: When Good Stress Becomes Bad Stress 23
Six Degrees of Stress: Everyone’s a Victim 28
Sources of Stress: The Big Three 34


Chapter 1 What Tips Us Over: The Causes of Overload 45
Chapter 2 Too Few Hands to Share the Load 55
Chapter 3 The Elephant in the Room: The Conspiracy of Silence 62
Chapter 4 Belief Systems and Changing the Corporate Zeitgeist 74
Chapter 5 The Fallacy of Face Time: Performance Measurement Has to Change 82
Chapter 6 The Lunacy of Long Hours and the Need to “Work Fresh” 87
Chapter 7 The Slippery Slope to Burnout 102
Chapter 8 Where’s Your Sweet Spot? The Zone for Optimal Performance 114
Chapter 9 Fake Work and Spinning Wheels: Prioritizing and Letting Stuff Go 121
Chapter 10 Slicing Up the Corporate Pie; Restoring the Basic Bargain 130


Chapter 11 Unrealistic Expectations: The Mind Trap That Fuels the Treadmill 143
Chapter 12 Realistic Expectations: Training Your Clients and Customers 155
Chapter 13 The Myth of Multi-tasking: Single-tasking and Focus 160
Chapter 14 Timeouts: The Pause That Refreshes 166
Chapter 15 Overuse and Misuse of Technology and How to Tame It 174
Chapter 16 Meetings: The Need for a New Meetings Manifesto 191
Chapter 17 Bureaucracy and Red Tape: Bumps on the Road to Productivity 199
Chapter 18 The Work-Life Interface: Balance or Blending? 204
Chapter 19 Health Habits and the Staggering Cost of Self-Neglect 216


Chapter 20 Identifying and Dealing with Problem People 225
Chapter 21 People Don’t Leave Jobs, They Leave Bosses 241
Chapter 22 The Games People Play: Office Politics 256
Chapter 23 The Keys to Employee Engagement and Stress Reduction 261
Chapter 24 The Obsession with Numbers 274
Chapter 25 Does It All Have to Be About Money? Must the Rich be Filthy Rich? 279


Pay Now or Pay Later: Prevention Is the Best (and Cheapest) Cure 289
What Companies Can Do to Decrease Workplace Stress 295
What Managers and Leaders Can Do 303
Throttling Back to Move Ahead: It’s Time to Recalibrate 308
Who Will Lead the Charge for Change? Who Will Bell the Cat? 312
Wrapping Up and Moving Forward 321



It happened again today. A patient sat down for his first appointment and told me a story of workplace stress that made me want to jump out of my chair, call his employer, and yell, “Stop killing this man!”

Joe was a smart, no-nonsense, down-to-earth guy with a warm smile and an easy laugh, but when he began to talk about his job, he became animated and upset. His knee started bouncing, his brow was furrowed, and the words poured out of him. As a physician who has done stress counselling for thirty years, it was a scene I’ve watched for many decades: agitated or depressed patients who finally get to tell their story at their own pace to a therapist who is eager to listen and help. At times Joe’s voice would rise with indignation and amazement at some of the ridiculous things going on in his company. More than once he said, “They just don’t get it!”

He was a supervisor working thirteen hours a day, six days a week, with only a half hour for lunch and no other breaks. He had no assis- tant, was required to attend eight to ten meetings a day (most of which were “wasteful”), had to field fifty to eighty emails a day—even on weekends and vacation — and he said, “The volume of work is incredi- ble.” He’d had three managers in eighteen months, and each had tried to restructure the department. He had a host of stress symptoms and health problems, among them low energy, insomnia, palpitations, high blood pressure, muscle tension, trouble with concentration and memory, and he was taking four different medications. He also had a spouse, a house, and a mortgage, so quitting his job wasn’t an option.

He applied for a transfer, but was told there was nothing available. He felt totally stuck, caught in a vise that was doing him in.
It’s a story I’ve been hearing from patients for most of my career. The people are different, the details vary, but the theme is always the same: Workplaces are making people sick.

In another instance, a woman came to see me about a work situation that involved frank psychological harassment by her boss. Over time, four other patients appeared in my office, all with similar stories. No wonder—they all worked for the same boss! (There’s nothing like word of mouth to keep a stress doctor busy.) Here were five decent, hard-working people who became stressed enough to seek professional help, all because of one abusive manager.

Organizations, and the people who run them, keep ramping up the stress levels of their employees. Some workers wear their stress as a badge of honour, a sign of macho toughness and strength, or they believe that stress is an indication of their level of dedication, commitment, and loyalty. For them, the more stress the better. For others it’s a nightmare. They think they have to suck it up and suffer in silence. They feel they have no choice and are resigned to “the new normal.” They accept that “that’s the way it is” as the pace of the work world speeds up, the economy sputters, and jobs are in short supply.

These notions have become a sacred cow that no one is willing to challenge. There’s a chill in the air about even addressing work- place stress. It’s the elephant in the room that people are reluctant to acknowledge, much less talk about—except in hushed tones—lest they

This book is based on four premises—observations I have made that compelled me to speak out:
1. Workplaces are making people sick.
2. Not enough people are talking about it, and when they do, nobody’s listening.
3. Much of the time and effort put in by stressed-out workers is unproductive.
4. Many of the solutions aren’t complicated.
I want to shine a light on the situation, offer some constructive strategies and solutions, and stimulate a conversation about how to fix these problems.


“Everyone can relate to this book! Dr. Posen teaches us, through practical and entertaining stories, how to make our lives better in every way – and inspires us to take action!” Jack Canfield, co-author of Chicken Soup for the Soul

“This book makes change seem fun rather than a chore. Dr. Posen shows you how to turn dreams into reality. Begin reading any page – you’ll not want to put this wonderful book down. Christine A. Padesky, PhD, co-author of Mind Over Mood, Director, Center for Cognitive Therapy, Newport Beach,CA

“For a Change: a practical book full of the clinical wisdom of an experienced physician” Dr. Stanley E. Greben, Professor Emeritus of Psychiatry University of Toronto

“This book is perceptive, instructive, productive and written in an entertaining fashion. It is a valuable addition to any growing person’s library.” Dr. Ron Taylor, Toronto Blue Jays Physician, Former Major League Baseball Pitcher

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Now updated and expanded, the bestselling Always Change a Losing Game explains how to make changes in your life. Whether you’re dealing with compulsive eating, addiction, struggling with kids, or stuck in an unhappy relationship or a deadā€end job, Dr. Posen provides practical guidelines that will help you make positive changes in your life. He does this by showing you how to take control of your life and transform the way you think, the way you behave and the lifestyle choices you make.

If what you’re doing and how you’re living are not producing the results you want, then you are playing a losing game. If you want things to get better, then you’ve got to change that losing game. This book is your key to success.


“The Little Book of Stress Relief” is filled with great tips and insights. And it’s fun to read!” Peter G. Hanson, M.D. author of The Joy of Stress and Stress for Success

“It’s amazing that such a little book can deliver such an impact! Superb!” Rita Emmett, author of “The Procrastinator’s Handbook”

“I love this guy!” The Edmonton Sun

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In the Little Book of Stress Relief, stress expert Dr. David Posen teaches us how to take back control of our lives and regain a satisfying work-life balance. Dr. Posen proposes that we change our fundamental thinking and lifestyle choices by becoming aware of our behaviour, making informed choices and giving ourselves permission to make necessary changes in our day-to-day lives. In 52 short sessions, one for each week of the year, Dr. Posen isolates specific causes of stress and provides detailed “prescriptions” for overcoming them, as well as easy-to-follow activities and exercises that will help with everything from getting enough sleep to overcoming procrastination to perfecting the art of prioritizing. You’ll also learn how to avoid letting other people’s stress rub off on you.

The Little Book of Stress Relief guides us through making small changes every day, changes that once implemented can have a profound positive effect on the quality of our lives.



Welcome 13
Is Stress a Friend or Foe? 16
Do You Know Your Signs of Stress? 19
Where Does Stress Come From? 22
Internal Sources of Stress 25
The Mind/Body Connection 28
Factors Influencing Our Stressful Interpretations 32
The Fascinating History of Stress Theory 35
Unrealistic Expectations 37
Use Your Stress Reactions Wisely 40

The Work–Life Balancing Act 42
The Power of Permission 45
Where’s the Pressure Coming From? 48
Peer Pressure and Corporate Culture 51
Setting Boundaries and Limits 55
Saying No 59
Sleep 62
Caffeine 65
Putting Your Work in Perspective 68
How to Leave Work at Work 71
Reclaiming Ownership of Your Time 74
Making Time for Leisure 77
Beliefs That Oppose Balance and Leisure 80
Pacing and Time-Outs 84
It’s Time to Plan Your Next Vacation 87
Burnout 90
Dealing with Deadlines 94
Prioritizing Tasks 97
Delegating 100
Communication Skills 103
Communication Aggravation 106
Dealing with Information Overload and Technostress 109
Handling Home Chores 113
Procrastination 116
Dealing with Clutter 119
Paper Clutter 122
Money and Stress 125
Trouble Making Decisions 129
Long-Distance Worrying 133
Closing “Open Circuits” 136
The Art of Reframing 139
Conversations with Yourself 142
Thought Stopping 145
Reframing Other People’s Behavior 148
Dealing with Difficult People 151
Stop Giving Power to Other People 154
Good Health—It’s Your Choice 157
How I Learned to Meditate 160
Relaxation Techniques 162
Outlets for Frustration 165
Dealing with Anger 168
Dealing with the Blues 172
The Importance of Social Support 175
How to Enjoy Holiday Stress 178
Feelings That Surface During the Holiday Season 182
New Year’s Resolutions 185
Wrap-Up 188
Appendix 1: How Stress Happens 192
Appendix 2: What Is Stress? 193
Appendix 3: What Are the Symptoms of Stress? 194
Appendix 4: External and Internal Sources of Stress 196
Resources 199
Index 203


What is the one condition every doctor shares with every patient? The answer is stress. It’s everywhere. Whenever people find out I’m a stress consultant (from librarians in Toronto to limo drivers in New Jersey to techies in California), they invariably say, “Boy, could I use your services!” We all know about stress from experiencing it—even suffering from it at times. What we don’t all know is what to do about it. That’s what this book is about. I became interested in stress in 1981. Actually, “hooked” would be more accurate. I was a family doctor, and had just received a flyer advertising a seminar in Montreal on heart disease. The topics included nutrition, exercise, stress management and sexuality (that was probably the teaser—I guess someone figured that, even at a medical meeting, sex sells!). The conference looked intriguing, and a few days off appealed to me, so I signed up. Little did I realize, when I got off the train on that sunny June afternoon, that my work life was about to change forever.

The program featured three lectures on stress management. I was riveted. The presenter was a young, funny, self-admittedly nervous psychologist—and she was fabulous! Not only was the information fascinating, but I could see how helpful it would be for my patients. Even more compelling was the fact that I could see huge potential benefits for myself. I was not the most laid-back guy in the world. And working in a high-pressure job only added to my stress. Those first presentations explained things I had been experiencing all my life, but had never previously understood. I have pursued the subjects of stress theory and stress management with a passion that has not abated in more than 30 years.

Over time, I began to appreciate the widespread impact of stress on my patients— not only on their health and emotional well-being, but also on their energy, productivity, relationships, self-esteem and overall quality of life. I also made big progress in handling my own stress.

Evidence of stress surrounds us, from cover stories in magazines to newspaper tales of road rage; from people around us looking harried and hurried to the face looking back at us in the mirror.

Statistics bear this out. According to a 2010 Globe and Mail series on stress, Canadians experience an average of fourteen stressful episodes a week. Twenty percent of workers reported high levels of “crunch time when they feel over- whelmed by overcrowded inboxes and jammed weekly schedules.” In 2008, close to two million Canadians were working more than fifty hours a week, up 23% from a decade earlier. Absentee rates for full-time employees increased by 21% in the past ten years. In the United States, the National Institute of Mental Health reports that more than 18% of adults suffer from an anxiety disorder each year. In his 2011 book Nerve, author Taylor Clark notes that “stress-related ailments cost the United States an estimated $300 billion per year in medical bills and lost productivity”—yes, billion with a “B.” He states that, in the past ten years, anxiety has surpassed depression as the number one mental health issue in the United States. An online 2011 survey conducted by Harris Interactive on behalf of the American Psychological Association revealed that “more than one third (36%) of employees report they are typically stressed out during the workday” and “20% report that their average daily level of stress from work is an 8, 9 or 10 on a 10 point scale.” Sort of catches your attention, doesn’t it?

As if the news of current stress levels isn’t bad enough, an earlier research study for the Heart and Stroke Foundation in 2000 showed that only 26% of Canadians felt that they knew how to handle their stress well. Dr. Rob Nolan, a Foundation spokesman, said that people often cope with stress by engaging in harmful lifestyle habits. “About 75% of the respondents say their coping mechanisms include eating fatty comfort foods, watching TV, smoking cigarettes or drinking alcohol.”

It seems safe to say that stress is a huge problem in our society and that most of us are not handling it very well.

We’re living in stressful times: economic upheaval: debt crises in Europe; stock market gyrations and volatility; job shortages since the 2008 market meltdown; climate change; natural and weather-related disasters such as earthquakes and hurricanes; political instability and unrest; ongoing fear of international terrorism and overall uncertainty. It’s easy to feel overwhelmed and powerless. In the face of these enormous problems, one might ask how relevant it is to deal with the smaller issues of day-to-day life. Ironically, it may be more important in difficult times. I believe that the less control you have over your external environment, the more important it is to take control of your internal environment.

Aim to take control of the things you can control. These include the way you think, the way you behave and the lifestyle choices you make. If you manage these issues better, you’ll have much more energy and resilience to deal with the larger, external forces that affect us all. And the good news is, you have more control than you think.

In the pages that follow, I will show you how to take more control of your life and handle stress with skill and confidence. I hope you find the journey both beneficial and enjoyable.

Each chapter begins with a story or analogy, followed by relevant information and suggestions. The chapters end with prescriptions: specific, simple, concrete things you can do over the next week to put the ideas into action. My goal is to have the book serve as a guide for making gradual changes that will reduce your stress and improve your health.

The book can be read in three possible ways. You can read it straight through as with any other book. Or you can go directly to specific chapters that interest you. Or you can use it as an action-oriented manual, reading one chapter per week and implementing the prescription over the ensuing seven days. If you want to read about any subject in greater detail, there is a reading list at the end, organized by topic. Whichever approach you take, I hope you find the book engaging, interesting, fun and of practical benefit as you deal with the stress of your life.