Irene is a 30-something businesswoman who has to pass the CPA exam—after flunking it twice. For the past several years, the pursuit has consumed, indeed defined her. She talks about little else when we meet, and frets about it the rest of the time. “I know I sound like a broken record,” she told me, “but I feel like one. Round and round in the same stupid groove.” As I listen, and assure her that she has the energy and grit to pass this exam, I begin to think that she may be her own biggest hurdle, bigger even than the exam that looms larger and more menacing as she keeps up the pace of worry, dismay, and B-movie imagining of total disaster.
Irene is not dumb. In fact, she’s smart. But despite a background in tech-industry start-ups, she’s weak in the math skills that CPAs are expected to possess: statistics, intermediate calculus, mathematical modeling. “I somehow got an accounting degree while blowing off the hard stuff, and now I’m paying for it,” she said. “When I got out, I put together business plans. I focused on raising money, not counting it and making long-term projections.” What I heard in this lament was that she doesn’t like math but, now, wants to make a career in which math is foundational. How could that be? Apparently, as often happens, she switched jobs often enough so that her skills-gap never caught up with her . . . until it did. Her present employer likes her, but expects her to perform with the flexibility and competence of other employees with similar backgrounds. Not long ago, the stress became unbearable. She asked for a reassignment, but management saw this as a ruse on her part not to put in the work and pass the exam, so they refused.
So, Irene is in a tough spot. She hasn’t saved much—mainly because she traded the fun of working at start-ups for a solid income—and her family is in no position to support her. If she had her druthers, she really wants to be on her own but, ironically, feels locked in by an accounting background to a career for which she is not well qualified.
When she last spoke to HR, they said that if she does not pass within the next twelve months, her salary will be frozen and, after a further review, she could lose her job. “Actually,” she said, “they’ve been making allowances for me. But they have to consider the feeling of other people at the firm who think I’m getting a pass.” She told me that in her immediate department, people who used to be friendly now ask snarky little questions like “Hey, you seem stressed—are you studying too hard?” She’s terrified of making even the smallest mistake, and says that while she used to enjoy the camaraderie at work she now tends to stick to her cubicle. “Suffice it to say, I’m not happy. Every day has elements of dread.”
According to Irene, the last time she took the exam, panic and performance anxiety got in the way. I don’t doubt that there is a psychological component to her symptoms. We could talk for weeks about it and maybe make some progress. But to help her with this issue in the meantime, after discussing the risks and benefits with her, I prescribed a small dosage of Propranolol, a beta-blocker, which would short circuit the physiologic anxiety response and hopefully increase her performance.
More to the point, however, we discussed strategies for studying, including setting aside more time, taking a review course, focusing on areas where she was weak. Actually, I thought she needed some courses, maybe at a local community college where she could learn the math that she never did. The suggestion did not make me popular. “This seems like going back to square one,” she said. “I’m too old for cramming.” But, as I indicated, getting to where we need to be is rarely linear. It’s often circuitous—though it’s still better than going round in meaningless circles, as Irene feels like she’s doing already. You make the commitment, and you go where it takes you.
Sometimes in our clinical work, we’ll focus on conflicts that our patients are blind to without dealing with the practical, knowledge-based realities of the situation. These latter, the blank spots, can be addressed through practical measures that do not require deep intrapsychic work. They do, however, require work that takes away from the time we’d like to devote to other pursuits. I urged Irene to consider this type of work as a form of delayed gratification. “If your goal is to get your professional life in gear, then you’ll just have to take time out from the rest of your life.” The problem was that she’d made half-hearted efforts to pass, followed by semi-justifiable excuses. She’s never got hold of herself, put in the effort, and kept her head down until she passed. By now, it had become a pattern, almost a habit that was hard to break and, indeed, hard to see around. To some people, what I was asking that she do might not have seemed out of the ordinary; to Irene, it seemed like I’d asked her to change her life. “If you don’t think of yourself differently, and accept the consequences, you won’t pass. It’s an existential choice.”
But even this challenge, hard as it seemed, was complicated by still more challenges.
That is, Irene has a lot of cognitive dissonance about passing the exam. She saw it as a career path to crunching numbers which, ultimately, she didn’t want to do. So, another part of our work was to separate her passing the exam from the professional box that she thought it would land her in. I thought it was in her best interest to pass because she’d then have more freedom to choose which way it was best for her to proceed. But she wasn’t fully ready to accept this idea. “You just sound so corporate,” she said. “It would give me more freedom to be an accountant, to make more money—but maybe I don’t want to be an accountant.”
She expressed the classic dilemma of someone who doesn’t like what they do for a living; still has to do it to survive; but wants to rebel against what seems like their fate. It is not an enviable position, and I sympathized. But at some point, we have to recognize that life is real, life is earnest, and we have to pay our own way. “Maybe you don’t like accounting, but for now—at least—it’s for you. If you can get through this period and get qualified, maybe you can go back to doing it in a way you like better.” Fate is always open to compromise. I suggested that, perhaps, she might start her own business consulting with scrappy start-ups. It might lead to a position on some boards and, finally, to some real income. To think outside the box, I suggested, required you to be in a box to think yourself out of.
In Irene’s case, pursuing happiness meant neither a total capitulation to professional norms nor a total self-reinvention at the cost of much pain and uncertainty. Actually, she didn’t even know what she’d be if she weren’t an accountant. Instead, arriving at some livable, endurable place—where she had an income but might still be creative—involved following the normal professional steps and then looking around for new opportunities. It meant putting in the work, but then not settling. Maybe she’d never feel entirely settled but, at least, she wouldn’t have cast herself adrift and imperiled her livelihood.
Even when we accept where we are, we can develop travel plans. I advised Irene to adopt that attitude.
But she still had problems. Irene saw passing the exam as bringing her into more direct competition with her father, who was still active as a CPA and ran his own tax consultancy. She imagined that her success might mean losing his love which, however, had never been munificent. I suggested that “Well, since he hasn’t been so loving to begin with, you don’t stand to lose very much.” But what I really wanted to get across was that in making professional decisions, we can’t let our concerns for other people take precedence over our own needs. “If getting this credential feels right to you—if it’s a matter of saving yourself from embarrassment, worry, and maybe losing your job—that’s reason enough to go for it.” If the desire for love comes at a price of harming oneself, then what kind of love is it that we desire? In a way, Irene needed to grow up, and recognize supportive love as distinct from that which isn’t. Moreover, it was entirely possible that Irene’s indifferent father wouldn’t care at all about her professional position, one way or another. He might, in fact, have been horrified at her projecting onto him a kind of mean-spiritedness that was beyond his meager ability to express.
Pursuing happiness is a complex business. Sometimes it requires that we stop being our own biggest obstacles. It requires us to stop finding excuses for lassitude under every (psychological) rock. In the end, it requires self-awareness.
Ahron Friedberg, M.D., is Clinical Professor of Psychiatry at Mount Sinai Icahn School of Medicine, New York, and served twice as President of the American Society of Psychoanalytic Physicians. He is Editor of American Academy of Psychodynamic Psychiatry and Psychoanalysis Forum, Book Editor of Psychodynamic Psychiatry.