Why do people choose to go to work even if they feel so ill they are barely able to do so?

Maarten Vansteenkiste: “Presenteeism is undoubtedly rooted in introjection, a specific type of motivation that has already received a lot of attention in motivation psychology. Together with intrinsic motivation - the content of my job gives me satisfaction and pleasure - and external regulation - I’m bringing home the bacon - some people are strongly driven by an internal sense of duty. Towards their supervisor and colleagues, for example, towards the organisation as a whole, or their customers and projects.”

The dark side of drive

What is the effect of this internal sense of duty?

Maarten Vansteenkiste: “Intertwined with a strong interest in the job, this introjection results in strong drive and dedication. However, there is a dark side to this drive. As people derive a lot of self-esteem from their jobs, it is easier for them to feel shame or guilt when they come up short somewhere. The result is that some people truly exhaust themselves in the workplace and completely derail their work-life balance.”

Do you mean that a burn-out might be lurking around the corner?

Bart Teuwen: “This work ethic driven by a sense of duty can be a dangerous combination if a perfectionist personality is involved too. In any case, certain signs should set off alarm bells for employers: problems concentrating, unexpectedly strong emotional reactions or indifference, appearing gloomy, etc. Intervention is the message, because the employee involved will ignore or minimise the signs. Just blowing off some steam and taking it a little easy? That’s synonymous with failure and feelings of guilt.”

Staying at home? Not an option!

What is the link between presenteeism and tackling absenteeism?

Maarten Vansteenkiste: Most organisations focus on absenteeism in their absence policy. Too often, we still justify it: if someone clocks in, they must be in the right frame of mind to work. But that’s a simplistic view. Some just choose to stay at home far too late.”

Bart Teuwen: “On the one hand, managers need a clear framework of agreements about absenteeism, while on the other hand they are required to be a connecting and supporting force for their employees. The correct mix of both creates a warm-yet-businesslike relationship between the manager and each individual team member. They open up to each other, vulnerability is not taboo and anything can be talked about.”

Maarten Vansteenkiste: “Employees mirror the behaviour of their supervisors. So you can subconsciously set the wrong example. By coming to work when you don’t feel 100%, for example. Or by showing disappointment when an employee calls in sick. At some workplaces, the feelings of guilt are actually fuelled very deliberately: you can’t let your colleagues and customers down, can you?”


“Too often, we still justify it: if someone clocks in, they must be in the right frame of mind to work.”

- Maarten Vansteenkiste

Presence or common sense

So presenteeism is sometimes incorrectly interpreted as the ultimate proof of motivation?

Bart Teuwen: “Indeed. This is how a kind of macho culture emerges, where people are judged by their presence rather than their performance or common sense. Because calling in sick does not mean you’re not motivated. Conversely, people who are at work every day can also lack drive.

The coronavirus did bring about an enormous mind shift in the presenteeism debate. Suddenly, we should stay at home as soon as we feel a little feverish, tired, or even slightly sniffly. After all, if we do go to work, we could endanger our colleagues or possibly even the continuity of the company. In any case, it’s no longer cool to be full of cold and be around your colleagues.

Almost 4 out of 10 respondents want to continue some form of work, even if they are feeling too ill to be at work all day. How can you manage this as an employer?

Maarten Vansteenkiste: “Again, some people should be protected from themselves in these cases. Maybe they could use some support to keep their workload manageable. Or to say no to certain tasks.

However, this is not evident - particularly in performance-focused work environments - because everyone has to prove themselves through results. The role of the manager is to safeguard or restore the balance, but they have to receive training and coaching to do so.”

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“It’s no longer cool to be full of cold and be around your colleagues.”

- Absence expert Bart Teuwen

Wild card for a leave day

Finally, as an employer, how can you communicate that it is okay to let go every once in a while?

Maarten Vansteenkiste: “An unusual example in this context: therapy for eating disorders traditionally strive for a weekly weight gain. But a specialised clinic now works with a wild card system. If you use your wild card, you don’t have to gain weight that week. The wild card can be an occasion for a conversation with the patient: what exactly was the stumbling block? As an employer, you could also incorporate a wild card system like this. For example, you could give your employees the option to take an unscheduled day off now and then.”

Bart Teuwen: “Just the fact this possibility exists offers people peace of mind. It shows that you, their employer, really care about their well-being. That anything can be talked about. That you are willing to look for solutions to issues together. In short, that you are flexible, Because that is also something the coronavirus has taught us: it is possible to be much more flexible than we ever imagined.”