Evidence-Based Reviews

Workplace mobbing: Are they really out to get your patient?

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His supervisor avoided Mr. G’s phone calls and e-mails and stopped meeting with him. Instead, she met with Mr. G’s subordinates. The subordinates started to ignore Mr. G’s instructions and would roll their eyes or be inattentive when he spoke. Coworkers stopped talking when Mr. G approached, and he started receiving anonymous e-mails questioning his ability and sanity. He was reprimanded in writing for having made a $9 mathematical error in an expense reimbursement request.

Mr. G said when he approached his superior about the work environment, she stated that he was “just paranoid” and needed to see a psychiatrist.

When Mr. G’s wife accompanies him to the second interview, she confirms his impressions of ostracism and gossip at work. She also relates her experiences with people from Mr. G’s office who previously had been friendly but now were distant or hostile. Mr. G shows me copies of harassing work e-mails and memos. I tell Mr. G I believe his story and diagnose him as suffering from posttraumatic stress disorder (PTSD). He begins supportive/cognitive therapy and continues flurazepam.

Mobbing syndrome

As it turns out, Mr. G was not paranoid; his coworkers really were trying to get him. Leymann5 divided 45 types of mobbing behaviors into 5 categories. These were organized as attacks on:

  • self-expression and ability to communicate (victim is silenced, given no opportunity to communicate, subject to verbal attacks)
  • social relationships (colleagues do not talk to the victim, victim is physically isolated from others)
  • reputation (victim is the target of gossip and ridicule)
  • occupational situation (victim is given meaningless tasks or no work at all)
  • physical health (victim is assigned dangerous tasks, threatened with bodily harm, or physically attacked).
Davenport et al2 distilled this list into 10 key factors of the mobbing syndrome (Table 1); identified 5 phases in the mobbing process (Table 2); and defined 3 “degrees” of mobbing analogous to first-, second-, and third-degree burns (Table 3).

Table 1

Mobbing syndrome: 10 factors

Assaults on dignity, integrity, credibility, and competence
Negative, humiliating, intimidating, abusive, malevolent, and controlling communication
Committed directly or indirectly in subtle or obvious ways
Perpetrated by ≥1 staff members*
Occurring in a continual, multiple, and systematic fashion over time
Portraying the victim as being at fault
Engineered to discredit, confuse, intimidate, isolate, and force the person into submission
Committed with the intent to force the person out
Representing the removal as the victim’s choice
Unrecognized, misinterpreted, ignored, tolerated, encouraged, or even instigated by management
*Some researchers limit their definition of mobbing to acts committed by >1 person
Source: Adapted with permission from Davenport N, Schwartz RD, Elliott GP. Mobbing: emotional abuse in the American workplace. Ames, IA: Civil Society Publishing; 1999:41
Mobbing risk factors. According to Leymann,5 no specific personality factors predispose workers to being mobbed. Westhues1 and others, however, identify a variety of social risk factors. These include any factors that make an individual different from other members of his or her work environment, such as:
  • different ethnicity
  • an “odd” personality
  • high achievement.
Table 2

Phases of mobbing

Conflict, often characterized by a ‘critical incident’
Aggressive acts, such as those in Table 1
Management involvement
Branding as difficult or mentally ill
Expulsion or resignation from the workplace
Source: Adapted with permission from Davenport N, Schwartz RD, Elliott GP. Mobbing: emotional abuse in the American workplace. Ames, IA: Civil Society Publishing; 1999:38
Whistleblowers or union organizers also run a risk of stigmatization and mobbing. Organizations with unclear goals or extensive recent turnover in senior leadership can be conducive to mobbing. Three industries identified as at special risk for mobbing are academia, government, and religious organizations.5

Secondary morbidity. Victims of workplace mobbing frequently suffer from:

  • adjustment disorders
  • somatic symptoms (eg, headaches or irritable bowel syndrome)
  • PTSD6,7
  • major depression.8
In mobbing targets with PTSD, Leymann notes that the “mental effects were fully comparable with PTSD from war or prison camp experiences.”3 Some patients may develop alcoholism or other substance abuse disorders. Family relationships routinely suffer.9 Some targets may even develop brief psychotic episodes, generally with paranoid symptoms.

Leymann3 estimated that 15% of suicides in Sweden could be directly attributed to workplace mobbing. Although no other researcher has reported such a dramatic proportion, others have reported increased risk of suicidal behavior among mobbing victims.10

Table 3

Degrees of mobbing

First degree: Victim manages to resist, escapes at an early stage, or is fully rehabilitated in the original workplace or elsewhere
Second degree: Victim cannot resist or escape immediately and suffers temporary or prolonged mental and/or physical disability and has difficulty reentering the workforce
Third degree: Victim is unable to reenter the workforce and suffers serious, long-lasting mental or physical disability
Source: Adapted with permission from Davenport N, Schwartz RD, Elliott GP. Mobbing: emotional abuse in the American workplace. Ames, IA: Civil Society Publishing; 1999:39

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