These are awful findings – a third of our doctors are suffering from depression and burnout.  And sadly 20% of those who completed the survey said they’d had thoughts of suicide. The distress and suffering this causes is best illustrated by the doctors’ own words:

“I feel like a trapped animal sometimes”

“I’m no longer the person I used to be”

“I sleep a lot, and it doesn’t take much to make me cry. I snap at everyone”

It doesn’t need stating that the Covid-19 pandemic has put enormous physical and psychological strain on all health professionals. Survey respondents reported that amongst the issues contributing to burnout were too much bureaucracy, too many hours at work, a lack of control and feeling like just a cog in a wheel.

But the factor identified as contributing most to burnout may surprise you: a lack of respect from colleagues (including co-workers, managers and administrators).

My response to this was initially one of sadness and anger. Doctors endure the gruelling and relentless demands of their jobs – that currently place them at considerable personal risk – and yet also have to survive rudeness, bullying and unkindness from those who are supposed to be on the same team.  It’s tempting to conclude that this is a result of bad apples – a few nasty people victimising others. Certainly there are those working in the NHS who routinely mistreat people, and who rely on bullying behaviours to meet their own needs for power and control.  I think it’s also true that the NHS doesn’t do enough to tackle this.  However, as I continued to explore the survey data, a more nuanced picture emerged.

Doctors who described themselves as being depressed reported that this had a significant impact on their workplaces and colleagues.  They described being less engaged, less friendly, and more exasperated and frustrated.  For colleagues on the receiving end this is likely to be experienced as a lack of respect.

Thus a vicious cycle emerges: a lack of professional respect contributes to depression and burnout which in turn leads to disengagement or hostility towards colleagues.

What can we do about this?

Here are 3 suggestions:

• Many of the factors that contribute to burnout and depression amongst doctors are massive systemic issues. Individual health professionals have very little, if any, influence over these problems. But we can manage our own behaviour and responses to colleagues.  If we were all able to prioritise kindness and respect towards each other, even in the midst of overwhelming demands, we might be able to ease at least some of the burden.

• Respect is demonstrated in lots of ways. It’s not just about not being rude. It’s also about honouring agreements, enabling people to meet their basic needs (food, water & rest), and recognising workers as people first – names on a shift rota second. If you have responsibility for managing operational systems and logistics, you have frequent opportunities for demonstrating that your colleagues are valued and respected. Take these opportunities – they mean a lot.

• If you notice that you are disengaging from colleagues or responding in ways that don’t feel right this might be a sign that you are struggling with depression or burnout. Reach out for support – to colleagues, friends, family or a professional.

Sources of professional support include your GP, Practitioner Health, Project5, Frontline19, or a private therapist or counsellor. If you would like to talk to me about whether I might be able to help, you can book a free 20-minute call.

The post How lack of professional respect contributes to burnout in doctors appeared first on Dr Paula Redmond, Clinical Psychologist.

What is the role of the National Guardian’s Office and Freedom to Speak Up Guardians in tackling bullying?

The Freedom to Speak Up Guardian role was created in response to recommendations made in Sir Robert Francis’ report on the Freedom to Speak Up review, which found that the culture in NHS organisations did not always encourage or support workers to speak up, and that patients and workers suffered as a result.

The National Guardian’s Office (NGO) aims to effect cultural change in the NHS and make speaking up business as usual.

The NGO supports a growing network of nearly 600 Freedom to Speak Up Guardians throughout the health sector who have collectively dealt with over 35,000 issues brought to them by workers.

FTSU Guardians ensure workers can speak up about anything that has an impact on their ability to provide quality patient care, and feel safe and supported when doing so. That includes behavioural issues like bullying.

Workers voices’ form a pillar of the People Plan. Guardians are key in ensuring workers are heard, particularly those groups of workers who are less often heard and who may face barriers to speaking up.  Fear of being bullied for speaking up is one of those barriers.

In the Freedom to Speak Up Review, Sir Robert Francis recognised that bullying is often “in the eye of the beholder” and that the term can be misapplied but also that “to an extent, whether people’s experiences meet an objective standard definition of bullying or not is beside the point. If someone believes they have been bullied or harassed and the perception of others around them is that they have suffered or will also suffer in a similar way as a result of speaking up, then they will be less likely to raise a concern in future …. The perception of bullying can have the same detrimental effect as deliberate bullying conduct.”

The NGO collects data from Guardians about the type of cases being brought to them, and one of the questions we ask is whether there is an element of bullying or harassment. Of the 16,199 cases brought to Guardians last year, 36% had an element of bullying or harassment.

How can FTSU Guardians help people who are being bullied at work?

FTSU Guardians provide an alternative channel for people to speak up to, if they feel for whatever reason they can’t speak to a line manager or a supervisor. They listen, and can offer support to help the person escalate the matter. Importantly they will also feedback to the person about how the matter is handled and used for learning.

At the NGO, we’ve been collating stories of people who have spoken to guardians, and you can read some examples of how guardians help, not just the individual, but the organisation to learn from that person’s experience and begin to improve their culture.

I have come across people using accusations of bullying as a form of bullying – how do you manage this in your work?

One of the Freedom to Speak Up Guardian values is impartiality. Guardians listen without judgement. They are there for those who speak up and for those who are being spoken up about.

The challenge when talking about bullying is, as Sir Robert said, it is about perception. Could how I’m behaving be perceived as bullying? Is what I’m asking someone to do aligned with my own and my organisation’s values? Or is there an opportunity to have a conversation, and for mutual learning to take place? It’s worth checking in with yourself as a manager, using a tool like the Vanderbilt model.

What work are you doing (or what changes would you like to see happening) within organisations and senior leadership to tackle bullying?  In my experience bullying is rarely dealt with effectively or directly, often leaving the victims no choice but to leave their jobs. If it is dealt with it is usually through a “bad apple” approach meaning that the organisation does not accept accountability for the systemic issues that enable bullying. Do you take a systemic approach in your work?

I would agree that bullying is perceived differently by different people, that the underlying causes can be systemic and that it can impact on delivering high quality care. I’ve heard this described as rotten apples, rotten barrels or rotten orchards.

We know, for example, that incivility in the workplace is a patient safety issue – that 38% of those who experience it say the quality of their work is reduced. And the impact is on the whole team – witnesses to workplace rudeness have a 20% decrease in performance. So, bullying is both a behavioural and a patient safety matter –  and there needs to be an organisational response to it.

The Freedom to Speak Guardian role is both reactive and proactive. As well as supporting workers, they work in partnership with other parts of their organisation to identify hotspots of cultural issues and to tackle barriers to speaking up. They present  learning and themes to senior leaders, so that the information brought is used for learning and improvement.  Alongside data and intelligence, staff stories to Board can be used to engage the senior leadership.

We are helping to develop that holistic approach across the healthcare sector by sharing the FTSU Guardian data with the Model Hospital team, so that speaking up data can be viewed alongside other data points, such as staff absence.

Silence can also be a signifier of a bullying culture. Take a look at where there are pockets of silence within your organisation (for example, who you are not hearing from; who isn’t filling in the staff survey). Guardians work proactively to encourage those whose voices may not be heard, for example by working with their local Workforce Race Equality Standards (WRES) experts and Equality, Diversity and Inclusion leads.

The NGO is a founding member of the AntiBullying Alliance and I commend the resources developed by Royal College of Surgeons of Edinburgh and their #LetsRemoveIt campaign.

Next steps:

If you would like to contact your Freedom to Speak Up Guardian to discuss bullying at work, you can find their details on the NGO website.

The post How the National Guardian’s Office is helping to tackle bullying in the NHS appeared first on Dr Paula Redmond, Clinical Psychologist.

In previous posts, I have written about how to identify bullying in the workplace and how to cope with it when you are at the receiving end. However, I also want to emphasise that the responsibility for dealing with bullying does not lie with the victims of this harmful and corrosive behaviour. Responsibility for action lies with the organisations accountable for employee welfare, and in the context of healthcare professionals in the UK, the NHS. Three things NHS organisations can do to tackle bullying are listen up, follow up, and wise up.

Listen up

It is not enough to encourage employees to “speak up”. Organisations and leaders need to be willing and able to listen up.  This requires acknowledgement of the impact of power on the ability to speak up.  Research has shown that healthcare leaders in the UK lack awareness of how their power silences others and how unskilled they are at listening. They are also overly optimistic about how often junior staff do speak up.  Tackling bullying in the NHS requires its leaders to have the self-awareness to understand the barriers that power dynamics create, and the willingness to overcome these in the service of staff wellbeing. Reitz and Higgins (2020) recommend that leaders need to assume they are scarier than they think; question their ‘little list’ of whose opinion counts; and check the nonverbal “shut-up” signals they send. 

Senior managers often appear defended behind management speak, processes and policies when all they need to do is take time to speak with and listen to junior staff about issues they raise – and take them seriously without minimisation and deflection. One health professional, Sam*, described a positive experience of being listened to, by people who wanted to hear:

“When I was on the receiving end of control, coercion and intimidating behaviours I sat several times with a blank word document just thinking ‘where on earth do I start?’. I was in the fortunate position of having a very supportive manager and an occupational psychologist within our trust. What helped was being able to tell the full story, with all the different strands, and my ‘formulation’ of the behaviours and the different agendas driving them. I was listened to with empathy and was asked questions like, “Have you got an example of that?”. This was helpful for me.”

Freedom to Speak Up Guardians can be an important asset and ally in helping organisations to listen up. Supported by the National Guardians’ Office, Freedom to Speak Up Guardians were established following the Francis report to enable health workers to speak up about issues affecting patient and staff safety, including bullying.  Their role is to support workers to speak up, but also to proactively identify and tackle barriers to speaking up. 

Dr Henrietta Hughes, OBE, National Guardian for the NHS offers this advice: “Silence can also be a signifier of a bullying culture. Take a look at where there are pockets of silence within your organisation (for example, who you are not hearing from, who isn’t filling in the staff survey). Guardians work proactively to encourage those whose voices may not be heard”.

Follow up

Sam continued…

“But despite the support and evidence I had, my concerns weren’t taken seriously.  No one from senior management spoke to me other than to ask me if I would consider mediation and to ask if I would consider keeping on some of my duties when I had requested redeployment (I also had support from an employment lawyer, so they ‘had’ to move me on). So, an empathic and open conversation with senior management would have been helpful, rather than sweeping everything under the carpet because it was too much to deal with.”

Listening to people who have experienced bullying is not enough.  Meaningful action needs to be taken, not only to support victims and hold those doing the bullying to account, but also to examine the organisational cultures and systems that enable and maintain this behaviour. 

Reitz and Higgins (2020) surveyed thousands of UK healthcare workers about speaking up. When junior staff were asked what they thought would happen if they spoke up about a problem at work, only 13% expected a positive outcome. Nearly half (48%) expected to be ignored, and 33% thought they’d be actively suppressed and prevented from speaking up.  Given these statistics, it is no surprise that people are suffering in silence.

Following up means taking meaningful action so that people who are guilty of emotionally abusing their colleagues are held accountable (as opposed to simply “moved on” or even promoted).  Those who are accused of bullying need to have access to fair, open and transparent processes so that they and the organisation can learn and implement meaningful change. 

But most importantly, those who have been victim to bullying need better options than having to choose between going through a gruelling disciplinary process that can re-enact the abuse they have suffered, or leaving their jobs.  Too often, the best option for victims of bullying is to leave because the follow-up is non-existent or makes things worse. 

Wise up

Prevention is always better than cure.  Leadership and management appointments need to be considered with greater wisdom if real culture change is going to happen. Recruitment processes for leadership positions in the NHS need to actively seek out those with personal qualities that promote psychologically safe working cultures, including high levels of self-awareness, compassion and courage.  This requires more than the standard interview process.

Dr John Marshall, Consultant Clinical Forensic Psychologist,  with management and senior management experience, writes about how this needs to start at board/executive levels: “Some people who thrive in this arena often have Machiavellian narcissistic traits: they can be a self-selecting group who then set the tone in organisations. We need organisational psychologists who actively advise on screening out managers who have dark triad traits which can lend themselves to bullying and incivility. Selecting compassionate leaders, who enable their staff to take decisions, ensure staff have genuine autonomy (people mostly come to work to do good!) or even take risky decisions (within safe parameters), in a culture of acceptance and support, will generate innovation.”

Incivility in the workplace is a fertile breeding ground for bullying and a serious patient safety concern.  Incivility should be addressed as a conduct issue, and politeness and kindness modelled in all parts of an organisation.  This is not rocket science, but can make a world of difference:

Next Steps:

If you want to get in touch with your Freedom to Speak Up Guardian you can find their details on the NGO website.

Further reading: Reitz M, Higgins J. Speaking truth to power: why leaders cannot hear what they need to hear. BMJ Leader Published Online First: 29 October 2020. doi: 10.1136/leader-2020-000394

*Names and details changed to preserve anonymity

The post 3 things the NHS needs to do to tackle bullying – Listen up, follow up and wise up appeared first on Dr Paula Redmond, Clinical Psychologist.

Paula has kindly asked me to contribute to her blog series on bullying in the workplace.  As we discussed it, the question that arose in my mind was: if you are being subjected to emotional abuse at home, are you more likely to suffer bullying at work?  The answer is a resounding yes, but perhaps not for obvious reasons.

I am a psychotherapist who specialises in helping people who are dealing with emotional abuse and am contacted every week by people seeking help with this distressing problem.  Since emotional abuse isn’t much talked about, it may come as a surprise to learn that it is a widespread problem that can affect people from all walks of life. 

By its nature, it is hard to quantify how many people in the UK are trapped in emotionally abusive relationships.  The problem primarily occurs behind closed doors and is rarely disclosed, except to the very closest confidants. When details are disclosed, the problem is often not understood in terms of abuse; because the behaviours are covert and subtle they can appear negligible to an outsider.

What is Emotional Abuse?

Emotional Abuse is an insidious pattern of behaviour designed to undermine, isolate, control, and coerce another person.  It is common for the behaviour to seem innocent at first, especially if individual acts are taken in isolation.  For this reason it is not unusual for the person in receipt of the behaviour to be unaware that they are experiencing abuse. 

However, these apparently trivial acts are repetitive and continuous, and the cumulative effect over time can be very considerable.  Here are some examples:

• Trivialising or ridiculing our opinions.
• “Pet names” that are derogatory, dressed in the guise of an affectionate joke.
• Passing slighting comments about how much we eat or what we wear
• Being dismissive or critical of family, meaningful friendships or cherished hobbies
• Telling us that we are silly, oversensitive or crazy when we challenge behaviour
• Ignoring us when we are speaking
• Gradually taking over control of aspects of our lives, including finances
• Complaining about how much time we spend speaking on the phone or walking to the local shop.

The Impact of Emotional Abuse

If we are continuously subjected to ridicule, subtle put-downs, covert threats, or gaslighting, we will begin to lose our self-confidence and over time may begin to doubt our own mind.  Because the behaviour is subtle, we may begin to locate the problems within ourselves, questioning why we never seem to be able to get anything right, or why we can never please our partner. We start to wonder if there is something wrong with us, particularly as we may find it very difficult to believe that partner, who we love, could wish us harm. We may well start to think that we are too sensitive, too demanding, or imagining things. We begin to walk on eggshells, becoming hypervigilant about the atmosphere in the home for fear of displeasing our partner.

Abusers generally seek to isolate their partners from friends and family gradually.  Consequently, the opportunity to “reality check” what is going on with trusted allies outside the relationship is slowly eroded.   

Finally, if our partner has made us feel small, insignificant, stupid and wrong, we feel shame.  This renders it almost impossible to speak up about what is going on.  It becomes a painful secret.  And so it is that the problem of emotional abuse becomes invisible.

Abuse in the Workplace

So what happens when a person in this position is at work? 

This is Emma’s story*:

“I realised over time that I was becoming more and more reluctant to go into work each day, I’d wake up feeling cheerful but the closer I got, the more I felt tired, downcast, and unmotivated. I mean, I was really dragging my feet. And I kept finding excuses to visit the bathroom, just to sit on my own in the quiet.  The dread I was feeling was just too overwhelming sometimes.  I started to think that I hated my job, but the truth is that it wasn’t the job that was the problem.

The work I was doing was just as interesting as it had always been.  My ambitions for progression hadn’t changed either.  It was just that those dreams seemed less realisable since my new manager started.  I couldn’t understand why everything felt so wrong. I brought it up with a group of friends one evening and everyone chipped in with encouraging suggestions: have a chat with your manager about your hopes for promotion and ask for feedback on how you are doing.  Ask if there is any training available, or if there’s an extra project you could take on?  As they were speaking, I realised that I felt sick at the thought of having any of those conversations.  In fact, I felt a bit the way I did when I told my husband about my career ambitions”.

Emma was in a relationship where her husband habitually underplayed her achievements and the importance of her salary to the family budget.  He talked about it as “pin money’, as though her contribution was inferior to his.  He made jokes about her how earnest her teammates were, though no-one should take such work seriously. When they were out socialising, he teased her publicly about NHS salaries in a way which felt humiliating.  If she protested he’d laugh, telling her that she was getting upset about nothing, why couldn’t she take a joke? In fact, he regularly commented that she had no sense of humour.  Within the family home, Emma felt on-edge, always treading carefully, anticipating any possible situation that might cause discord. It was exhausting.  Originally, work had felt like a welcome respite from this, a place where she could be her own self, separate from her identity as a wife and mother.  That had inexplicably changed.

Vulnerability to Bullying at Work

Emma’s new manager seemed to be distracted a lot of the time.  Sometimes when she was speaking to him, he’d just carry on, rifling through notes as though she wasn’t speaking.  Pausing to gain his attention, he’d often look at her for a long minute before raising a completely unrelated issue. Emma felt very confused.  Initially she wondered whether he really hadn’t heard her, but when she reiterated her point, he’d either gesture dismissively, or say he’d get back to her.  Which he never did.

Having never doubted her position in the service, Emma now began to feel anxious. She found herself watching her manager, trying to judge when would be a good moment to catch him. Often he’d sigh before she started speaking, and she would feel a hot, creeping embarrassment. She’d never felt so small.

In team meetings there was no really obvious difference in the way her manager spoke to her than to her colleagues. He was popular because he liked to make jokes, but Emma felt uncomfortable and on edge. “Come on Emma! Lighten up!” he’d said once or twice. She would cringe; he seemed to like putting her in the spotlight.  After a while she stopped saying very much in meetings, and she began to feel invisible.  He’d stare at her sometimes; it felt as though he was wondering why she was there. Indeed she began to wonder why she was there herself, it was true that she didn’t seem to have much to contribute these days.  The dreams of career progression began to fade, to be replaced with anxieties about the security of her role.

The Legacy of Emotional Abuse

Emma was unable to recognise that her boss’ behaviour was inappropriate because in certain crucial aspects it mirrored her husband’s longstanding treatment of her.

It felt familiar, and so it served to compound the doubts she was already carrying about herself. In fact she feared her boss’s belittling stance towards her was further evidence that’s she wasn’t up to much, just as her husband had said. Emma thought that she was the problem.

So the question arises, is someone in Emma’s position more likely to be picked on by a bullying boss or co-worker?  On the face of it, it appears not, as we can’t reliably claim that there is a particular type of person who is more likely to singled out by a bully. 

However, it is true that someone who lives in an environment where emotional abuse has been normalised will have more difficulty recognising, and dealing with, bullying behaviour at work.

If bullying behaviour isn’t recognised as such, but rather it feels like shameful evidence of inadequacy, it is likely to be held as a painful secret. In other words, it’s less likely to be reality checked with colleagues or friends.   

Lacking the support of a caring partner, and isolated from family and friends, someone in this position is in a very lonely place. It’s clear to see how difficult it is to muster the resources needed to confront bullying behaviour with such limited support. 

In earlier posts Paula has written eloquently about the steps we can take if we are being bullied in the workplace. I’d like to acknowledge that if we are being bullied at home, it will be much more challenging to confront bullying behaviour at work. If the abuse is long-standing, we may even be suffering from complex PTSD, and experience flashbacks in situations that feel potentially confrontational. It is important to seek support.

If anything in this post resonates with you, however terrifying it seems, try to find a trustworthy person who can become your ally.  The route to recovery begins when we are able to speak out about what is happening in private, so that we can begin to rebuild our sense of self.

Sources of Support

Controlling and coercive behaviour within a romantic or family relationship became a criminal offence in the UK in 2015 under Section 76 of the Serious Crimes Act 2015. 

If you are affected by the issues described in this post there are places to go for support.

*Client material is always held in confidence, and the example here is a composite picture with all identifying details changed.

Jo Mercer is a Psychodynamic Psychotherapist working in private practice online via Zoom.

The post Are we more likely to be bullied at work if we are being bullied at home? appeared first on Dr Paula Redmond, Clinical Psychologist.

We recently introduced our children to the original 1980s Karate Kid movie – a classic tale of the new boy in town who gets bullied and beaten up by the cool kids with motorbikes and black belts in karate.  Under the gentle and wise guidance of Mr Miyagi, Daniel-san learns self-discipline, a variety of DIY skills, and some excellent karate moves.  In the closing scene Daniel faces his bully in the final round of the karate championship. Hobbling on an injured ankle he seems doomed to defeat, until the final moments when he pulls off the awesome crane kick and wins the day. And the girl, of course.

If only our own stories of being bullied at work could end this way.  But the reality is that many people feel they go to work each day to be beaten up again and again, limping home to tend to their wounds. 

In our professional lives bullying is more likely to be subtle and insidious. There is less physical violence, but just as much emotional harm. In previous posts I have discussed how to recognise insidious bullying and how to respond to it.  Here I will offer ideas for managing the emotional impact of bullying at work.

It is important to say, however, that this is not about being more “resilient”. The priority should be to get out of harm’s way. You should not be subjected to bullying behaviour. It hurts because it is harmful, not because you are not “resilient” enough.  However, if you are not yet able to escape, or you are still dealing with the emotional fall-out of past bullying, the following ideas might be helpful.

How bullying affects us

Bullying is essentially threatening behaviour.  Although we may not be physically threatened, bullying works by creating social threats such as humiliation, rejection and isolation.  This activates our innate threat response resulting in anxiety. When anxiety becomes chronic and we feel unable to escape or manage the threat this can damage self-esteem and lead to depression.  Therefore, bullying can have both short and long-term emotional consequences.

3 ways to deal with the emotional impact of bullying at work

1. Complete the stress cycle

Our bodies don’t recognise the difference between physical and social danger. They respond the same way to someone undermining our professional competence as they would to a lurking predator in the bush. Imagine that you are being stalked by a lion. You respond by fighting or fleeing. Once you have either vanquished the lion or reached safety, what do you do? 

This reminds me of a close encounter with an angry bull elephant in Tanzania.  Once our guide had skilfully sent it on its way I felt all shaky, wanting to collapse, start breathing properly again, and then celebrate our survival – hug my partner, run or dance off the nervous energy, tell anyone who would listen, and I have no doubt there was a G&T involved at some point.  This was my way of completing the stress cycle and allowing my body to process the anxiety of that encounter.

However, when we face social threats such as bullying at work we rarely allow ourselves the opportunity to complete the stress cycle. This means that we can be left with the physiological, cognitive and emotional impact of the threat, long after it has passed. We can start to feel unsafe, worried and tense even when we’re not at work.  To combat this we need to find ways of telling our bodies that the threat has passed.

In their excellent book “Burnout”, Emily and Amelia Nagoski describe 7 ways to complete the stress cycle:

• Physical activity – this is the most effective way of letting your body know you are okay.  As a wise woman once said, “shake it off”. It’s boring but true that if you can spend 20 minutes or more each day walking, running, dancing or stretching your body and your soul will thank you.
• Breathing – slow deep breathing will calm your nervous system and help you gently connect with your body. Try the simple square breathing technique: inhale for 4 counts, hold for 4, exhale for 4, hold for 4 and repeat.  It might help to find something square or rectangular in your surroundings to focus on while you do it – following the sides of the shape as you complete each step.
• Positive social interaction – have a casual friendly chat with someone to remind you that the world is not all bad, and that you are likable, no matter what the bullying has led you to think about yourself. Try not to withdraw into your inner world.
• Laughter – watch or listen to a show that gives you deep belly; call a friend to reminisce about a funny memory.
• Affection – reach out to those who make you feel safe. Hugs with a loving person, cuddles with a pet, or a spiritual connection with a higher power all offer sources of affection that can let your body know you are safe.
• Crying – having a “good cry” releases the body’s natural painkillers and enables self-soothing.
• Creative expression – engaging in absorbing tactile and multi-sensory activities such as making art or music, crafting and creative writing enables emotional processing and can be very calming.

2. Curate your corner

In Karate Kid both Daniel and his opponent – the bully – had people in their respective ring-side corners cheering them on, giving them advice, commiserating with their failures and celebrating their successes.  They were able to draw on this support to keep going when things got rough. If you are facing or recovering from bullying, you need to take note of who is in the bullying corner, and pick your ring-side team.

In the bullying corner you may recognise other people from your past who have bullied you, and your own inner-critic. These are the memories, thoughts, and feelings that are activated when you are undermined or humiliated at work. They add strength to the bullying attacks because they give weight to their harmful narrative. You are not only battling a cruel colleague, but also wounds from the past.  This can make the bullying person seem incredibly powerful, as they are somehow able to hook right into your vulnerabilities. However, if you can recognise that this power is not theirs alone, but enhanced by the shadows of your past, you may feel more able to hold your own against emotional assault.

In Daniel’s corner were his mum, the girl he fancied and Mr Miyagi.  Draw strength from the people in your life who embody these characters:

• The mum: someone who is passionate about your wellbeing, and for whom your safety is more important than anything else; someone who would fight your battles for you if they could;
• The girl: someone who cares about you because you’re cute/funny/clever/interesting and doesn’t care about the battleground; maybe someone who has no idea what your job is or how good you are at it, and loves you anyway;
• Mr Miyagi: someone who embodies wisdom and containment and who understands your pain; a person who can help you think through your experiences, gain a broader perspective and offer advice and guidance.

Reach out to the people in your life who embody these traits and tell them what you’re going through.  If you don’t have people who can take on these roles seek them out – perhaps through professional support networks, mentorship schemes, or therapy. 

Activate the parts of yourself that can offer you this support. Carry the encouragement and care of Daniel’s mum, Elisabeth Shue and Mr Miyagi into work with you. Call on them in the immediate aftermath of bullying or when reminders of past bullying experiences are activated – what would they say to you now?

You may have people in your life who seem to be, or want to be, in your corner, but who offer support that isn’t actually helpful. Those people who dismiss your worries in an effort to cheer you up, or who can’t grasp how badly you have been affected. Relegate them to the side-lines, for now at least.

3. Take your recovery seriously

Being bullied at work can be a significant trauma.  It can lead to ongoing anxiety and depression. Take your self-care seriously.  I am sure that unless Daniel took proper time to recover from his injuries, his competing days would have been over and there wouldn’t have been a Karate Kid 2.  Tend to your emotional wounds by:

• nurturing your non-work identities,
• spending time with people and hobbies that make you feel good,
• and connecting with your body and with nature.

You may need to make a job change or take a career break.  You may need to invest in counselling or therapy. Whatever you need, give it to yourself.

Next steps:

If you need support in dealing with the impact of being bullied at work consider accessing your employer’s counselling service where available. Alternatively make contact with Project5 or Frontline19 – free services available to NHS staff.

If you would like to explore whether working with me in therapy might be helpful book a free 20-minute consultation.

The post How do I cope with being bullied at work? appeared first on Dr Paula Redmond, Clinical Psychologist.

When I was 13 years old I was cornered in a classroom by a teacher who accused me of something I didn’t do. Shouting at me, she hurled insults at my parents and said she would make it her personal mission to ensure I never achieved anything in that school.  I just stood there gaping like a goldfish.  My head was reeling with the injustice of it all, and my body was shaking with fear.  Later I felt full of shame that I hadn’t been able to stand up for myself.  I rehearsed all the things I could have said, kicking myself for having frozen to the spot.  I swore that when I grew up I’d do better.

Looking back now I know I was a defenceless child who had no chance against an aggressive adult.  But there have been many times when, as a grown up, I’ve felt the same way. Frozen to the spot when someone has been cruel to me – even when there’s no shouting involved.  Or worse, smiling and nodding as they slyly undermine me.  And then berating myself afterwards for being so pathetic and letting them get away with it.  

So how do you empower your inner grown-up when you’re made to feel like a child?

7 strategies for responding to bullying at work:

1. Be clear about responsibility

If you are a victim of bullying at work the responsibility for addressing this does not lie with you.  Your employer has a legal duty to protect you from bullying and create a safe working environment.  Accountability for threatening behaviour lies with the person choosing to act this way.  While it is not your responsibility to tackle this behaviour, you can choose how you respond to it.  You may decide to take formal action or to do nothing. You may decide to address the issue directly with the person, or you may choose to work through the channels within your organisation.

Any of these actions, including doing nothing, may create further consequences. The person might back off or they may escalate their behaviour. You can’t predict what they will do, but remain clear that their behaviour is not your responsibility. Your primary responsibility needs to be to yourself.  Never feel bad if you choose to protect yourself rather than tackle the bullying.  You may decide that you need to leave your job. It isn’t right or fair that you should be faced with this decision, but sadly if your employer can not, or will not, protect you this may be the best way to protect yourself.  Don’t be trapped by a sense of loyalty to an organisation if this means remaining in harms way.

2. Naming is taming

Something as simple as naming a behaviour can have powerful impact.  If you can call out what the other person is doing this immediately creates a sense of accountability. Stick to observable facts about the person’s behaviour – not their intention.  Reflect back their own words, rather than your interpretation. For example, if I had been able to say to my teacher “You’re shouting at me”, or “You’re saying my parents raised me badly”, this might have stopped her in her tracks. Of course she may have denied this, but naming the behaviour shifts the power dynamic in that moment. It lets the other person know that you are consciously observing them, rather than being stunned into silence.

There are times when naming a behaviour out loud may feel too dangerous or you may not be able to get the words out.  When this happens, naming it to yourself can be just as powerful. This enables you to create some emotional distance from the experience so that it is less threatening.  When you feel less threatened the other person has less power over you. When you start to recognise patterns in the bullying behaviour you could even try playing “bullying bingo” – noticing each predictable attempt to control you as it occurs. Bringing humour into this situation can be an empowering move.

3. Develop a catch-phrase

Find a way to communicate that you are not buying into their bullying narrative by having a stock phrase or two that you can use whenever you get that threatened feeling. That way your brain won’t have to do the work when it is in a state of anxiety. For example, you could just say “I’m not sure about that”, or curiously ask “Why do you say that?”, or just say “okay…” in a tone that implies that you really don’t agree. It might not feel like the most eloquent response, but it will register that you’re not buying their story, and create a subtle shift in the dynamic.

4. Change your stance

We communicate more through our bodies than through our words. It can be very difficult to engage a “power pose” when we are feeling threatened, but small changes in our posture or gestures can be equally effective.  Notice how your body responds in these situations and think about some small changes you could make to communicate a shift. This could be a different tilt of your head, or where you place your hands. Practice in front of a mirror and notice how these small changes can make you feel different too. Like a catch-phrase, have a practiced stance or gesture that you can use without thinking to communicate that you’re not powerless in the face of bullying behaviour.

5. Harness your anger for others

Sometimes we can be stunned into silence when faced with undermining or humiliating behaviour from others. However, witnessing this happening to other people can activate us. We might find it easier to stand up for other people, than we do for ourselves. If you are being bullied at work, chances are you’re not alone. You may feel able to react more directly when you witness this happening to others.  This will not only be hugely appreciated by your colleagues, but will also enable you to communicate a different way of being to those doing the bullying.  This is another way of creating a shift in the power dynamic, and breaking the silence that often accompanies bullying cultures.

6. Keep a log

As I explored in the previous blog in this series (Am I over-reacting or am I being bullied in my healthcare job?) keeping a log of the bullying behaviour can be really useful.  This can help you to name what is going on, give you some emotional distance, and is a valuable way of collecting evidence should you want to take further action. 

7. Be kind to yourself

Don’t become your own bully. It is easy to criticise ourselves for the way we respond in threatening situations, but we need to be kind to ourselves.  I will be looking at this in more detail in the next blog of this series – how to cope with the impact of being bullied at work.

Next Steps:

If you think you are being bullied at work and want to speak to someone in confidence about your experiences call the National Bullying Helpline on 0845 2255787.  Alternatively, speak to your organisation’s Freedom to Speak Up Guardian. Information on how to contact them should be available via your employer.

If you are struggling with the emotional impact of being bullied at work and want to address this in therapy book a free 20-minute consultation to discuss how I can help.

The post How to respond to bullying at work appeared first on Dr Paula Redmond, Clinical Psychologist.

*Names have been changed

The latest NHS Staff survey from 2019 reported that 12% of staff experienced harassment, bullying or abuse from their managers, and 19% from their colleagues – in the last 12 months alone.

While harassment and physical or sexual assault clearly have terrible impact and can be difficult and painful to address, they are at least fairly easy to identify. 

The sort of insidious bullying described by Max is much harder to name and, therefore, to tackle.  It can go unchecked for years, leaving a trail of anxiety, helplessness, and damaged self-esteem.  Insidious bullying can create stifling workplace cultures that are damaging for staff and ultimately for patients. Knowing how to identify it is the first step in taking action.

3 steps to identify insidious bullying:

1. Recognise different types of bullying

When we think of bullying, we generally think of overtly nasty behaviour. It can be more difficult to recognise those bullying behaviours that are covertly nasty, such as giving back-handed compliments; undermining you in public or behind your back; isolating you from colleagues; or creating a sense of dependency. These may be framed or delivered in very subtle ways that can be explained away by suggesting you are confused, mis-interpreting the situation, or even imagining things.  This is akin to gaslighting – the deliberate attempt to make you question your own sanity – and is another form of bullying.  Being professionally undermined, humiliated, isolated or gaslit are all forms of insidious bullying.

If someone is rude to you at work there could be a whole host of reasons for their behaviour – maybe they’re having a bad day, or not feeling well, or under a lot of pressure. Understanding this can help you to take things less personally, and lessen the impact of isolated events.  But if this behaviour is persistent, and not addressed, being too empathic can collude with a culture that accepts uncivil behaviour.

If you are feeling threatened, isolated or humiliated due to someone’s behaviour at work, it’s important to acknowledge this, no matter what the reasons behind the behaviour might be. It’s possible that this behaviour is entirely unintentional, and that the person would be horrified to learn how you feel. It’s also possible that there is conscious intent to exert power over you – but it’s unlikely that anyone would admit to that.

So don’t get caught up in trying to understand why someone would behave this way, and second-guessing yourself.  The impact of the behaviour is key, whatever the reasons behind it.

2. Keep a log

Keep a log of all the encounters you have with this person or group of people that make you feel bad.   You may decide never to show this to anyone else, but it is useful in several ways.

Firstly, it can help you gain some perspective. Often writing things down can help us get emotional distance from a situation and develop new insights. It may help you figure out ways of responding next time it happens. 

Secondly, keeping a log can help to identify patterns. Insidious bullying often takes the form of very minor incidents that in themselves are not significant but when seen in the context of ongoing behaviours a pattern of chronic bullying can emerge.

Thirdly, a log can help you to build up valuable evidence should you wish to take formal action.

Record the date, time, place, what was said or done and whether there were any witnesses.  Also record the impact this had on you (how you felt, what you were thinking, what you did), both immediately and in the aftermath.  It could also be helpful to record what you think the longer term impact of this behaviour could be (e.g. affecting how safe you feel discussing work dilemmas with colleagues etc.).

3. Talk about it (officially or unofficially)

Talk about these incidents with your friends, family and trusted colleagues. You may want to share the log you have kept.  This will help you to reality-check your experiences and reactions. It is always helpful to reach out to those who love and respect you, especially when your confidence is being undermined. But talking to others will also help you to name more clearly what is going on so that you can take action. 

You could also talk to your organisation’s Freedom to Speak Up Guardian (or equivalent). They will be able to have a confidential conversation with you to help you clarify whether the behaviour constitutes bullying in the eyes of the organisation, and what your options are.

Next steps:

If you think you are being bullied at work and want to speak to someone in confidence about your experiences call the National Bullying Helpline on 0845 2255787.

If you are struggling with the emotional impact of being bullied at work and want to address this in therapy book a free 20-minute consultation to discuss how I can help.

The post Am I over-reacting or am I being bullied in my healthcare job? appeared first on Dr Paula Redmond, Clinical Psychologist.