Freud famously said that the mental health was the capacity to love and to work, but my impression is that most people imagine we Marriage and Family Therapists talk primarily with our clients about the “love” part of that equation—getting together, breaking up, happiness and unhappiness in one’s relationships, sexuality. However, in a month that begins with the Labor Day holiday, as most of us come back from summer vacation to get busy again at work or school or around the home, it seems right to talk some about how large people’s work lives looms in the therapy that I do with them.

I would say that no less than half of the people that come to see me have significant issues with regard to their work lives, and really, in my experience, that has always been the case. During my internship at an agency affiliated with the University of California, graduate and undergraduate students often needed help to find a way to transition from the safe structure of school to the real, true autonomy of adulthood while negotiating the long process of finding that first job. In recent years, with an economic downturn and even less help from parents and institutions, that process has only gotten more difficult and more drawn out and has created what looks to be a generation where underemployment, insufficient income, and living at home with their parents is becoming the “new normal.” The stress of not being able to find one’s place in the work world, not having the security and satisfaction of knowing one can support oneself, and the more chronic, psychological disappointment of feeling unfulfilled creatively and vocationally makes up a huge part of what I talk about with my clients under the age of forty these days: How do I adjust my expectations? How do I support myself outwardly and inwardly as I continue to look for work? How can I open my creativity, imagination and my personal courage to think outside of the box and put together for myself, not just a job, but an actual vocation and career?

Another large portion of my therapy work with clients is also related to the difficult economic situation of the past decade, as even stable employment situations turn into essentially hostile work environments, psychologically speaking: repeated layoffs, cutbacks forcing individuals to do two or three jobs with no increase in pay or acknowledgment, insufficient or poorly trained management creating dysfunctional organizations where problematic situations or people are not effectively handled, financial pressures on the company forcing a change in mission, focus or goals that leave employees feeling alienated from the reasons they originally loved working there. I have been surprised to find an even increasing post-traumatic stress disorder (PTSD) quality to my work with some fully employed individuals who have found themselves in this situation, suffering from anxiety and depression along with various physical stress-related illnesses as well. When one’s livelihood and capacity to support oneself and one’s family is threatened by these workplace dynamics, it is no exaggeration to call what is happening “traumatic” and to get some professional help in coping with the ongoing uncertainties and fears.

But beyond these more recent, recession-related issues, therapy has always been a place, in my experience, where people can come to consider other options for their work lives. Most often this happens in midlife, when previous choices in career seem not as satisfying or fitting or when family obligations finally lessen to make some time and space for new possibilities of training, education or work in another field. Midlife is also a time, I’ve discovered, when someone may finally feel secure enough in their own abilities and resources to launch off from the sometimes confining security of working for someone else and start their own business to pursue their own personal dreams and visions, which can be a simultaneously thrilling and scary process.

In all these cases, psychotherapy can be the place where a consistent and objective perspective on these dynamics can be provided and where one’s own growing edges can be explored and pushed. Fulfilling work and a “right livelihood” is definitely a significant part of our lives and our happiness.