Do care about and for someone with an illness? Are you the primary care-giver? If you answer yes to any of these questions, it might be worth knowing about caregiver fatigue. WebMD describes this as follows:
http://www.webmd.com/heart-disease/guide/heart-disease-recognizing-caregiver-burnout
It's a reasonably serious fatigue from long-term caregiving, and it is correlated with long-term health consequences for the caregiver. There is some evidence that this fatigue is associated with shortened telomeres, likely indicating a shorter life-span.
http://www.pnas.org/content/101/49/17312.long
Nurses, doctors, and people with relatives or close friends that are ill are at risk.
I've watched my Mom deal with fatigue while caring for my Dad who has bipolar. And, I worry about my partner sometimes, because she can get quite strung out from dealing with life and me at the same time. It is important that we all, caregivers and care receivers, keep in mind the costs of caregiving. Maybe we can find a way to give our caregivers a break.
Friday, 25 January 2013
Monday, 7 January 2013
Mixed States
Mixed states are thought to look different in everyone, and a single person might experience multiple different mixed states. If you think you are experiencing mixed states, the best thing to do is to consult a psychiatrist.
My opinion is slightly non-standard, but I like to think of it this way: mania is an episode centered around feeling good and depression is an episode centered around feeling bad. I believe there are other feelings that can anchor an episode such as anger, or fear. In each case, the trademark of bipolar is that these episodes take an emotion and make an extreme experience. So that anger becomes a rage episode and fear becomes a paranoia episode. These emotional episodes are called mixed, because they are said to have symptoms of both classical mania and depression. For instance a rage episode might be considered energetic and may also involve suicidal thoughts. Or a paranoid episode might be sleepless and may also involve difficulty with concentration.
Recognizing Mixed States
The definition of a mixed state is still being developed. Here is what the DSM IV-TR says:
I believe that mixed states are particularly difficult to diagnose because the subjective experience of the person who experiences them is so much different than the objective experience of an observer. I also believe that this is an instance where language fails to capture the experience and discussion of these things is extremely difficult.
I believe that I experience mixed episodes, both anger-based episodes and fear-based episodes. Detecting the onset of these episodes is critical. Since I have been experience anger episodes, I have long since learned to spot the change in thinking that accompanies it. Fear-based episodes are more challenging, and I have a two-pronged strategy to detect thought changes and cognitive decline. To detect changes in my thinking process, I compare my current thoughts to past thoughts about similar situations. To detect the fear-induced cognitive decline, I use my activity log (discussed in depression). When there is a sudden gap in my productive activities, I try to determine whether the cause is a depressive episode or a fear-based episode, and my overall emotional tenor usually answers this.
Preventing and Treating Mixed States
Similar to mania and depression, drugs are commonly thought to be the best treatment. The appropriate drugs include mood stabilizers and anti-psychotics. There have been a number of studies claiming that mood stabilizers are less effective for people who experience mixed episodes than those who do not. It is not clear why this might be or what to do about it.
Drugs are not the only treatment, it is necessary to employ other coping skills. In this it is best if the person with bipolar takes charge of their illness, as attempts to force the person to comply will likely destroy the very trust needed for success. This can involve contingency planning for future episodes. Discussions with family can cover when family might be requested to aid in decision making. A high level of trust is required to make such discussions useful. (Note, trust will be broken if family involve themselves in decision making without permission.) If family is not available, one can turn to close friends, often termed chosen family. As part of contingency planning, one can decide at which stage of an episode voluntary hospitalization will be sought. Having a plan ahead of time makes implementation easier.
Whereas for depression I mentioned that keeping an activity log could be helpful, I am not sure that is helpful during these episodes. In my experience these episodes get entrenched much faster and much deeper than some depressions. I do, however, find the activity log useful for charting recovery, and it is encouraging to use the log to watch improvements in activity levels and cognitive function.
My opinion is slightly non-standard, but I like to think of it this way: mania is an episode centered around feeling good and depression is an episode centered around feeling bad. I believe there are other feelings that can anchor an episode such as anger, or fear. In each case, the trademark of bipolar is that these episodes take an emotion and make an extreme experience. So that anger becomes a rage episode and fear becomes a paranoia episode. These emotional episodes are called mixed, because they are said to have symptoms of both classical mania and depression. For instance a rage episode might be considered energetic and may also involve suicidal thoughts. Or a paranoid episode might be sleepless and may also involve difficulty with concentration.
Recognizing Mixed States
The definition of a mixed state is still being developed. Here is what the DSM IV-TR says:
A. The criteria are met both for a manic episode and for a major depressive episode (except for duration) nearly every day during at least a 1-week period.There seems to be considerable discussion about how the definition of mixed episodes should be written. Some doctors require a few symptoms from both mania and depression, other doctors require more than a few symptoms. Some doctors will disagree on the classification of a particular symptom, for example, extreme fear and it's cognitive dysfunction, into mania or depression.
B. The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
C. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment), or a general medical condition (e.g., hyperthyroidism)
I believe that mixed states are particularly difficult to diagnose because the subjective experience of the person who experiences them is so much different than the objective experience of an observer. I also believe that this is an instance where language fails to capture the experience and discussion of these things is extremely difficult.
I believe that I experience mixed episodes, both anger-based episodes and fear-based episodes. Detecting the onset of these episodes is critical. Since I have been experience anger episodes, I have long since learned to spot the change in thinking that accompanies it. Fear-based episodes are more challenging, and I have a two-pronged strategy to detect thought changes and cognitive decline. To detect changes in my thinking process, I compare my current thoughts to past thoughts about similar situations. To detect the fear-induced cognitive decline, I use my activity log (discussed in depression). When there is a sudden gap in my productive activities, I try to determine whether the cause is a depressive episode or a fear-based episode, and my overall emotional tenor usually answers this.
Preventing and Treating Mixed States
Similar to mania and depression, drugs are commonly thought to be the best treatment. The appropriate drugs include mood stabilizers and anti-psychotics. There have been a number of studies claiming that mood stabilizers are less effective for people who experience mixed episodes than those who do not. It is not clear why this might be or what to do about it.
Drugs are not the only treatment, it is necessary to employ other coping skills. In this it is best if the person with bipolar takes charge of their illness, as attempts to force the person to comply will likely destroy the very trust needed for success. This can involve contingency planning for future episodes. Discussions with family can cover when family might be requested to aid in decision making. A high level of trust is required to make such discussions useful. (Note, trust will be broken if family involve themselves in decision making without permission.) If family is not available, one can turn to close friends, often termed chosen family. As part of contingency planning, one can decide at which stage of an episode voluntary hospitalization will be sought. Having a plan ahead of time makes implementation easier.
Whereas for depression I mentioned that keeping an activity log could be helpful, I am not sure that is helpful during these episodes. In my experience these episodes get entrenched much faster and much deeper than some depressions. I do, however, find the activity log useful for charting recovery, and it is encouraging to use the log to watch improvements in activity levels and cognitive function.
Friday, 4 January 2013
Depression
Many people have an image of depression as the monster that keeps a person in bed all day, saps their energy, and colors their emotions blue. This post is about another kind of depression that creeps up on a person, saps their energy, but does not put them in bed. In this kind of depression a person is functional but has little motivation and little ability to accomplish things. Neither of these depression types is more sever than the other, they are just different. I choose to focus on this last type of depression, because it is the kind that I can speak about from personal experience.
Recognizing Depression
Here is a list of symptoms of depression as taken from the Major Depression category of the DSM IV-TR.
- Depressed mood most of the day.
- Diminished interest or pleasure in all or most activities.
- Significant unintentional weight loss or gain.
- Insomnia or sleeping too much.
- Agitation or psychomotor retardation noticed by others.
- Fatigue or loss of energy.
- Feelings of worthlessness or excessive guilt.
- Diminished ability to think or concentrate, or indecisiveness.
- Recurrent thoughts of death (thoughts of suicide)
Symptom (4) sleep disturbances is stereotypically taken as the most indicative of depression. It is understandable that changes in sleep patterns are easy to notice and certain to draw attention. On the other hand, for people that do not experience disruptions in sleep, detecting the presence of depression can be more difficult due to the subjective nature of most of the other symptoms. Particularly if one does not feel very 'blue' as in symptom (1) depressed mood, recognizing depression is challenging.
I am in the category of people who do not experience symptom (4) sleep disturbances. In addition, I do not seem to experience (1) depressed mood or (3) weight gain/loss. This leaves me with the following symptoms diminished interest, fatigue or loss of energy, feelings of guilt, diminished ability to think or concentrate. Now, people that know the DSM and that are counting may have noticed that I did not list 5 symptoms of depression which is the threshold for a Depression diagnosis. They would be correct. Recall also that I have had diagnostic issues, perhaps partly for this reason. Despite this issue, I feel that I have indeed experienced depression.
This leaves me with a problem, how do I detect the onset of depression? All the easy indicators like thoughts of suicide and sleep disturbances are not appropriate. While my strategy may evolve further, I am currently using an activity log to track my engagement in work. This is similar to a time-sheet, but it involves extreme honesty about when I am actually working productively. (This is for my eyes only, so I do not have to worry about a negative opinion from my supervisor.) I track the time that I work productively each day and each week. Then I can watch the trend over time. If I start to become fatigued, uninterested in work, or lack the ability to concentrate, my weekly productive time drops.
You might ask if keeping an activity log is difficult. I find that it is not (of course I sometimes lapse), but I have integrated the activity log with my lab notebook which records my research/work activities. So, the log has a dual purpose. Also, I use a computer to compute statistics like average productivity.
This tool is very important to me, because at the beginning of a depression it is easy to rationalize the symptoms. I will end up thinking that I just need a break to recharge when in reality a break might only make the depression worse. This tool allows an objective view of the time I spend being active and helps cut through the subjectivity of the situation.
Preventing and Treating Depression
For me, the primary prevention and treatment of depression is medications. It has been critical to have the right combination of psychotropic medications and to treat physical illnesses that could cause depression. Additionally, I use a motivational tool which turns out to be the activity log described above.
On the topic of medications, being a person with a bipolar family history of sensitivity to SSRIs, I avoid antidepressants. I rely mostly on the antidepressant properties of Lithium. I have experienced an instance where a failure to treat a thyroid problem appeared to result in depression. So, I also keep on top of my general health.
The motivational tool that I use is the activity log mentioned above. In a bad depression, I try to do at least one activity a day. Once each activity is complete, I log it in the activity log making the log into a sort of achievement wall. I get to feel good about each thing that I accomplish. By continuing to track my active hours each day, I can also see whether the depression is improving which also makes me feel more positive.
The activity log could also be viewed negatively, if one were to focus on how little they accomplished each day. To avoid this, I strongly subscribe to a view of life that everyone can improve from where they are at. This view is typically accepting of whatever activity level I find myself at during a depression, and it helps to keep me focused on improvements, no matter how small.
Does anyone else have depression strategies to share? If you do, please post them in the comments.
Wednesday, 2 January 2013
Mania
Mania seems to be one aspect of bipolar that is both the best understood and the most misunderstood generally. It is generally understood that mania is a strong indicator of bipolar, however it is misunderstood that all people with bipolar experience mania. For example, to the best of my knowledge, I have not experienced mania. This makes me less qualified to write a post on this topic. However, since it would be remiss of me to discuss depression and bipolar without mania, here is a post drawn mostly from the literature.
Recognizing Mania
This description from the DSM IV is an objective description of mania which might be different from the subjective experience of it.
A) A distinct period of abnormally and persistently elevated, expansive or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary)
B) During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:
Recognizing Mania
This description from the DSM IV is an objective description of mania which might be different from the subjective experience of it.
A) A distinct period of abnormally and persistently elevated, expansive or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary)
B) During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:
- inflated self-esteem or grandiosity
- decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
- more talkative than usual or pressure to keep talking
- flight of ideas or subjective experience that thoughts are racing
- distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)
- increase in goal-directed activity (at work, at school, or sexually) or psychomotor agitation
- excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
D) The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
E) The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication or other treatment) or a general medical condition (e.g., hyperthyroidism)
It seems to me that mania is difficult to recognize without having repeated experiences with it. Even when I saw mania in a close friend I had difficulty discerning their lack of judgement and impulsiveness.
Preventing and Treating Mania
Mania should be treated together with whatever other bipolar symptoms that one has. This is typically done using drugs such as Lithium that act as a mood stabilizer.
It is not sufficient to treat mania only with drugs, as therapy and support from family and friends also plays a large role. In this it is best if the person with bipolar takes charge, as attempts to force the person to comply will likely destroy the very trust needed for success. One should try to identify triggers as much as possible and make contingency plans for future episodes. Involving family in contingency plans can help with determining when the family can make decisions on the behalf of the person with bipolar and when support is wanted or needed. Or perhaps the person with bipolar might request for a family member to have control over their finances with a mutually agreed upon allowance, and with mutually agreed upon ability to revise the agreement.
These sorts of plans and frank conversations help prevent misunderstandings such as relatives refusing to make a monetary loan to a stable person because they mistakenly believe the request is a symptom of mania. Or an even more harmful misunderstanding, relatives may unilaterally decide when a person with bipolar should be involuntarily hospitalized. Planning helps with decide the conditions under which a person will voluntarily be hospitalized or when they might wish to request decision making help from certain trusted relatives.
It seems to me that mania is difficult to recognize without having repeated experiences with it. Even when I saw mania in a close friend I had difficulty discerning their lack of judgement and impulsiveness.
Preventing and Treating Mania
Mania should be treated together with whatever other bipolar symptoms that one has. This is typically done using drugs such as Lithium that act as a mood stabilizer.
It is not sufficient to treat mania only with drugs, as therapy and support from family and friends also plays a large role. In this it is best if the person with bipolar takes charge, as attempts to force the person to comply will likely destroy the very trust needed for success. One should try to identify triggers as much as possible and make contingency plans for future episodes. Involving family in contingency plans can help with determining when the family can make decisions on the behalf of the person with bipolar and when support is wanted or needed. Or perhaps the person with bipolar might request for a family member to have control over their finances with a mutually agreed upon allowance, and with mutually agreed upon ability to revise the agreement.
These sorts of plans and frank conversations help prevent misunderstandings such as relatives refusing to make a monetary loan to a stable person because they mistakenly believe the request is a symptom of mania. Or an even more harmful misunderstanding, relatives may unilaterally decide when a person with bipolar should be involuntarily hospitalized. Planning helps with decide the conditions under which a person will voluntarily be hospitalized or when they might wish to request decision making help from certain trusted relatives.
Tuesday, 1 January 2013
Bipolar Episodes
The establishment subscribes to 2-3 types of bipolar episodes:
The first two types of episodes are what give bipolar its a name where the 'bi' refers to mania and depression, and the 'polar' refers to the presumed spectrum on which mania and depression sit at opposite ends. It is fairly easy to see that the name bipolar comes from the traditional description of bipolar I and II. The addition of mixed states is an acknowledgement that there is actually not a depression-mania spectrum for some people, and opens a diagnostic category for the people having episodic bi-polar-like symptoms that are not clearly related to schizoaffective disorder.
What are mixed states?
It is thought that they look different in everyone that experiences them. And, one person might experience more than one type of mixed episode. (Keep in mind that this discussion is not very scientific, as the definition of a mixed episode is still being developed.) I like to think of it this way, and notice that my view is different from the traditional definition: mania is an episode centered around feeling good and depression is an episode centered around feeling bad. I believe there are other feelings that can anchor an episode such as anger, or fear. In each case, the trademark of bipolar is that these episodes take an emotion and make an extreme experience. So that anger becomes a rage episode and fear becomes a paranoia episode.
These emotional episodes are called mixed, because they are said to have symptoms of both classical mania or depression. For instance a rage episode might be considered energetic and may also involve suicidal thoughts. Or a paranoid episode might be sleepless and may also involve difficulty with concentration.
Personally, I find the task of identifying both mania and depression symptoms in an episode to be difficult. I would prefer to see descriptions of multiple types of emotion centered episodes. But we will see where scientific discovery takes mixed episodes. Hopefully we will see progress in the near future.
Does anyone else have thoughts about the distinction between mania, depression, and mixed episodes?
- mania - high of euphoria, activity, grandiosity, impulsiveness, etc.
- depression - low of activity, energy, negative thoughts, suicidal thoughts, etc.
- mixed states - properties of both mania and depression, perhaps including psychosis
The first two types of episodes are what give bipolar its a name where the 'bi' refers to mania and depression, and the 'polar' refers to the presumed spectrum on which mania and depression sit at opposite ends. It is fairly easy to see that the name bipolar comes from the traditional description of bipolar I and II. The addition of mixed states is an acknowledgement that there is actually not a depression-mania spectrum for some people, and opens a diagnostic category for the people having episodic bi-polar-like symptoms that are not clearly related to schizoaffective disorder.
What are mixed states?
It is thought that they look different in everyone that experiences them. And, one person might experience more than one type of mixed episode. (Keep in mind that this discussion is not very scientific, as the definition of a mixed episode is still being developed.) I like to think of it this way, and notice that my view is different from the traditional definition: mania is an episode centered around feeling good and depression is an episode centered around feeling bad. I believe there are other feelings that can anchor an episode such as anger, or fear. In each case, the trademark of bipolar is that these episodes take an emotion and make an extreme experience. So that anger becomes a rage episode and fear becomes a paranoia episode.
These emotional episodes are called mixed, because they are said to have symptoms of both classical mania or depression. For instance a rage episode might be considered energetic and may also involve suicidal thoughts. Or a paranoid episode might be sleepless and may also involve difficulty with concentration.
Personally, I find the task of identifying both mania and depression symptoms in an episode to be difficult. I would prefer to see descriptions of multiple types of emotion centered episodes. But we will see where scientific discovery takes mixed episodes. Hopefully we will see progress in the near future.
Does anyone else have thoughts about the distinction between mania, depression, and mixed episodes?
Monday, 31 December 2012
Ways to Prevent Workplace Bullying in the Academy
On the post Workplace Bullying in the Academy I did not discuss what could have been done differently by the people involved in the bullying situation. Here, we will have that discussion and a more general one about what can be done to prevent bullying in the academic workplace.
Before beginning the discussion, I will mention a useful resource:
The International Conference on Workplace Bullying and Harassment
This is the premier academic conference on bullying in the workplace, and serves as a useful source of references to the academic literature.
I like the description of bullying in the conclusion of Prevalence, antecedents, and effects of workplace bullying: A review. I will quote M. Razzaghian and A. Shah here:
There seem to be a few suggestions of how to ameliorate bullying. The good people at The Boss Whispering Institute seem to believe in taking forceful leaders and teaching them how to be considerate of their employees. Other people such as the writer of The Complexity of Academic Bullying in response to Academic Bullies seem not to believe in labeling people as bullies, because of the potential for turning the designated bully into a victim. (See my other posts for further discussion: Workplace Bullying in the Academy and Student Bullying in the Academy.) Other people advocate coping skills such as having boundaries and telling the other involved parties what behaviors are acceptable and which are not (Victim). Yet other people advocate training employees to identify workplace bullying (Beating Workplace Bullying). Presumably there needs to be a component of the training that addresses how to handle bullying once it is identified.
I am an advocate of some of these methods and not of others. I do not believe in labelling people in a bullying situation as bullies and targets, because I believe these roles can be temporary and unintentional. Furthermore, I believe that both bully and target might believe that they are suffering harm from the situation. I agree with one of the authors above who does not believe in labeling bullies due to the potential for turning a bully into a target. I think one of the best methods would be to promote a culture that values fair treatment of everyone while training employees to look for the harm caused by bullying situations and then to look for ways to constructively solve the problems. This perspective allows for all participants to express their views and to hope for resolution in a classic mediation type scenario. I believe that the programs that train bosses to be more empathetic are potentially very useful, though I do not know much about their efficacy.
What can the harmed person do?
One approach is to try a mediation, either a self-mediated or independently mediate discussion with the people with whom their is conflict. While such an approach may de-escalate the situation, it is also possible that the bullying may escalate despite a mediation attempt. In the example given previously (Workplace Bullying in the Academy), my friend attempted a self-mediated discussion which only resulted in ridicule.
Another option is to leave the bullying situation; this is similar to someone leaving a domestic abuse situation. In the example of my friend, this was the solution that they chose, although my friend's low power position in graduate school made the politics slightly tricky. I believe that walking away can be the ultimate expression of free will in a negative situation. Avoiding potential negative health consequences of staying might well out-weigh any career sacrifices that are made by walking away.
Some people believe in teaching coping skills to the harmed person. While coping skills are typically helpful, I do not see how a person can employ such skills when they feel that they have no power to effect any change in the situation. My friend, who has excellent conflict resolution skills was unable to deal with the bullying situation, because people's perspectives regarding the situation were too entrenched.
What do I think academia should do?
I would like to see the academy adopt training programs for professors and staff that are centered around how to recognize and prevent bullying between all members of the academy, between students, between professors and students, between staff, and between staff and professors. Such a training program would necessarily be comprehensive and might take 1-2 days to teach the necessary skills. It seems useful to teach bridge building techniques as taught in workshops by the National Coalition Building Institute. Such methods would teach people how to connect and talk with other people who potentially have different perspectives from themselves. This is a necessary skill for anyone seeking to defuse a bullying situation.
Focusing on short-term situation specific factors will not alter the institutional-level factors that help initiate bullying situations. The institution is responsible for establishing a culture of respect and the leadership of universities must set the example of respectful behavior and treatment of all employees and students. This includes taking seriously complaints about bullying situations, and establishing anonymous surveys to assess under reported bullying situations. The faculty must be involved in this effort as they are in positions to demonstrate a respectful culture to both other staff and to students.
All of these efforts should be evaluated and reassessed to see if they are working. The anonymous surveys can be re-administered to see if there is a decrease in reported bullying situations. The training of faculty and staff can be further adjusted if a large enough reduction is not observed.
Before beginning the discussion, I will mention a useful resource:
The International Conference on Workplace Bullying and Harassment
This is the premier academic conference on bullying in the workplace, and serves as a useful source of references to the academic literature.
I like the description of bullying in the conclusion of Prevalence, antecedents, and effects of workplace bullying: A review. I will quote M. Razzaghian and A. Shah here:
"Bullying is a chronic problem and has a negative
implication for the well-being of employees. Therefore,
individuals subjected to such behaviors are likely to show
increased levels of anxiety, depression and a negative
overall mental health. It can be concluded in light of the
literature reviewed that bullying does not refer to a single
negative behavior, but occurs frequently with increasing
severity over time. The persistence of such negative
behavior builds a constant distress within the individual
leaving that person helpless and unable to cope with it.
Probably, the bully’s intention is to suppress the target to
such an extent that he or she is under constant mental
pressure and ultimately becomes dysfunctional in the
workplace. The negative flashbacks of these events
make it more difficult for the victims to concentrate or
even find suitable words to express their feelings for that
situation. However, it has also been established that the
relationship between the bully and the target is influenced
by personality characteristics an individual carries. The
combined effect of all these facts are a vicious cycle in
which, the more a victim is bullied, the more are his or
her chances of being bullied again and again."
There seem to be a few suggestions of how to ameliorate bullying. The good people at The Boss Whispering Institute seem to believe in taking forceful leaders and teaching them how to be considerate of their employees. Other people such as the writer of The Complexity of Academic Bullying in response to Academic Bullies seem not to believe in labeling people as bullies, because of the potential for turning the designated bully into a victim. (See my other posts for further discussion: Workplace Bullying in the Academy and Student Bullying in the Academy.) Other people advocate coping skills such as having boundaries and telling the other involved parties what behaviors are acceptable and which are not (Victim). Yet other people advocate training employees to identify workplace bullying (Beating Workplace Bullying). Presumably there needs to be a component of the training that addresses how to handle bullying once it is identified.
I am an advocate of some of these methods and not of others. I do not believe in labelling people in a bullying situation as bullies and targets, because I believe these roles can be temporary and unintentional. Furthermore, I believe that both bully and target might believe that they are suffering harm from the situation. I agree with one of the authors above who does not believe in labeling bullies due to the potential for turning a bully into a target. I think one of the best methods would be to promote a culture that values fair treatment of everyone while training employees to look for the harm caused by bullying situations and then to look for ways to constructively solve the problems. This perspective allows for all participants to express their views and to hope for resolution in a classic mediation type scenario. I believe that the programs that train bosses to be more empathetic are potentially very useful, though I do not know much about their efficacy.
What can the harmed person do?
One approach is to try a mediation, either a self-mediated or independently mediate discussion with the people with whom their is conflict. While such an approach may de-escalate the situation, it is also possible that the bullying may escalate despite a mediation attempt. In the example given previously (Workplace Bullying in the Academy), my friend attempted a self-mediated discussion which only resulted in ridicule.
Another option is to leave the bullying situation; this is similar to someone leaving a domestic abuse situation. In the example of my friend, this was the solution that they chose, although my friend's low power position in graduate school made the politics slightly tricky. I believe that walking away can be the ultimate expression of free will in a negative situation. Avoiding potential negative health consequences of staying might well out-weigh any career sacrifices that are made by walking away.
Some people believe in teaching coping skills to the harmed person. While coping skills are typically helpful, I do not see how a person can employ such skills when they feel that they have no power to effect any change in the situation. My friend, who has excellent conflict resolution skills was unable to deal with the bullying situation, because people's perspectives regarding the situation were too entrenched.
What do I think academia should do?
I would like to see the academy adopt training programs for professors and staff that are centered around how to recognize and prevent bullying between all members of the academy, between students, between professors and students, between staff, and between staff and professors. Such a training program would necessarily be comprehensive and might take 1-2 days to teach the necessary skills. It seems useful to teach bridge building techniques as taught in workshops by the National Coalition Building Institute. Such methods would teach people how to connect and talk with other people who potentially have different perspectives from themselves. This is a necessary skill for anyone seeking to defuse a bullying situation.
Focusing on short-term situation specific factors will not alter the institutional-level factors that help initiate bullying situations. The institution is responsible for establishing a culture of respect and the leadership of universities must set the example of respectful behavior and treatment of all employees and students. This includes taking seriously complaints about bullying situations, and establishing anonymous surveys to assess under reported bullying situations. The faculty must be involved in this effort as they are in positions to demonstrate a respectful culture to both other staff and to students.
All of these efforts should be evaluated and reassessed to see if they are working. The anonymous surveys can be re-administered to see if there is a decrease in reported bullying situations. The training of faculty and staff can be further adjusted if a large enough reduction is not observed.
Sunday, 30 December 2012
Workplace Bullying in the Academy
Following on the last post about student-on-student bullying, this post discusses workplace bullying situations of the faculty and graduate student variety. I will say up-front that this is a topic about which I try to be objective, but my experience as student with low power inherently influences my viewpoint. I will tell the story of a friend who experienced psychological harm as result, and this undoubtedly influences my subjectivity. Also, there may be some missing details and some awkward phrasing designed to hide peoples identities.
This bullying situation involves faculty and graduate students, so why do I call it workplace bullying? I call it this, because graduate students in the sciences are typically paid by their faculty advisors to do research. This is an employment situation where the faculty advisor is the boss and the student is the employee. Some faculty advisors are extremely collegial with their students and treat them as almost equal proto-researchers. But other faculty advisors perform the boss role. Like any employment situation this usually works out quite well. However, there are times that bullying situations arise. While it is possible for a faculty advisor to feel harassed and bullied by their students, we tend to hear of situations where the student gets harmed. However please keep in mind that there are infamous examples of students trying to kill their advisors, so the potential for bullying is certainly not unidirectional.
As before in Student Bullying in the Academy, I will try to avoid discussions of bullies and targets. I think it is most productive to discuss the harm that results from bullying situations and to talk constructively about what could have been done differently. This way of discussing bullying opens the conversation to include aggression by individuals who are not always aggressors or who may not have the intent to harm. Since the target can only perceive intent through the actions of another, this means that the target and bully experiences might not agree. This perspective also opens possibility that the target might as an aggressor either in retaliation or ignorance. And the aggressor might be responding to a perceived harm done to them by the target either through action or inaction.
Many, sometimes contradictory, descriptions of bullying exist. I prefer the description given in Prevalence, antecedents, and effects of workplace bullying: A review which says that bullying can be
An Example
In presenting this scenario, I am inherently influenced by having only heard one side. Because of this I will be presenting what happened to the best of my knowledge.
My friend was approaching their final years in graduate school and had two faculty advisors. One of these had just moved to a different school. My friend had gotten along well with both their advisors and had only received one performance-related request of something to change--one advisor had mentioned that my friend did not communicate well enough what was being working on. Another aspect of this situation is that advisor had a collegial style of working while the other advisor had an boss-employee model of working.
The event that triggered the bullying situation was when the collegial advisor told my friend that they were not working hard enough and that they were lazy. My friend asked when the problem started and got no answer. There was no attempt to assess where my friend might be at or what they were doing. They were also told that the advisor might not write a recommendation letter in support of applications for post-doctoral positions.
This was a situation of intense pressure from which my friend did not think they could escape. Not only were career aspirations on the line, but as always my friend had a thesis to write which required their advisor's support. As typical in academia my friend was not told what was expected of them or how to retrieve the situation, but they decided the solution was to sacrifice their holidays to finishing a project that was half finished.
This gambit paid off. My friend finished the project, submitted the paper, and had a successful meeting with their committee. At this point my friend's advisor seemed very happy with their work and was told that it was good. This should be the end of the story, however, it was not since a second bullying situation arose that may or may not have been related to the first situation.
My friend had decided that visiting their other advisor would be a good idea, so they arranged a 2 month visit to that advisor's lab. No sooner had my friend arrived than that advisor took my friend into confidence and started saying how the advisor was doing as little as possible to organize an event. This way, the advisor could get credit for organizing the event without it taking up much time. My friend was horrified, because they knew who would pick up the pieces: the staff. My friend was also encouraged to manage collaborations with other colleagues so that my friend could minimize their contribution. Again, my friend was horrified, because this was the antithesis of what they believe in. Despite my friend's opinion of professed attempts to manipulate other people, they did their best to perform their role in the research project while continuing to work on their thesis projects.
My friend was also told that two of the students had been goofing off. The students were threatened with the advisor taking away their project and giving it to my friend. My friend did not find this amusing neither as a threat nor as a potential work-load increase. My friend was quite disturbed that this comment transformed their social position from being a friendly outsider to being a threatening outsider.
From there things continued to deteriorate. My friend received a threat that if they weren't productive enough, one of their projects would get taken away and given to someone who could do it. They experienced sexual harassment perpetrated by the advisor--a reference on the part of the advisor to the potential for a sexual relationship between my friend and the advisor. They had a rocky relationship with another member of the group who added to the stress by arbitrarily mirroring the gestures of my friend and by seeming to enact a now-I-like-you now-I-do-not relationship. This person repeatedly presented a catch-22 to my friend on the point of whether the advisor was a good person. The stress of not knowing whether this student was a friend coupled with either an ambiguous threat or an ambiguous opportunity to support compounded the stress of the other interactions.
The advisor decided that since the project was not progressing rapidly enough, the students should stay up nights until it was finished. The advisor did seem to have the philosophy that he should be there with them and that if he could handle being awake so could they. Unfortunately, the power difference in the situation played a key role. Over the course of two weeks, my friend watched their two colleagues get warn down and increasingly discouraged. It got the point where my friend begged the advisor to stop making the students work so hard but was told that the students deserved it.
This last was too much for my friend. They had been in this situation a short time, but it followed on the stress that had previously occurred. My friend experience intense sleep-disrupting anxiety for the first time in their life. They were extremely scared, and they had very negative opinions about their colleagues. Indeed, my friend ended up interpreting the second bullying situation as being the result of the first. This made these two incidences, one with each advisor, into one continuous bullying situation for my friend, regardless of the intent of the people involved.
My friend believes that the stress of this situation caused the onset of a sever psychological disorder. While some people might be tempted to claim that such a disorder might be the source of an invented story about bullying, I would remind them that to jump to conclusions when they were not there is discrimination. While hasty conclusions are dangerous, questions are always welcome. My friend's perspective, no matter how it came about, is a valid experience of the world. I would urge people to remember that it is more productive to entertain everyone's perspective and to constructively find ways to change situations. It is also very important that people in positions of power consider carefully how their actions might influence those with less power, particularly since bullying situations and harm can occur without the intent to harm by anyone involved.
For this reason, I will not jump to conclusions about the motives of the people involved. They had their own performance pressures to deal with, and they had other people to keep happy. However, I do think many people could have acted in more constructive ways even to achieve the same performance outcomes. Indeed, if there had been fewer threats, less harassment, and fewer negative social interactions, in the second situation my friend believed they would have been more productive. As things happened, my friend wasted many weeks being too distracted and scared to work productively. Similarly, the students with the second situation who stayed up nights might have also been more productive if they were not hounded into sleepless nights spent working.
This bullying situation involves faculty and graduate students, so why do I call it workplace bullying? I call it this, because graduate students in the sciences are typically paid by their faculty advisors to do research. This is an employment situation where the faculty advisor is the boss and the student is the employee. Some faculty advisors are extremely collegial with their students and treat them as almost equal proto-researchers. But other faculty advisors perform the boss role. Like any employment situation this usually works out quite well. However, there are times that bullying situations arise. While it is possible for a faculty advisor to feel harassed and bullied by their students, we tend to hear of situations where the student gets harmed. However please keep in mind that there are infamous examples of students trying to kill their advisors, so the potential for bullying is certainly not unidirectional.
As before in Student Bullying in the Academy, I will try to avoid discussions of bullies and targets. I think it is most productive to discuss the harm that results from bullying situations and to talk constructively about what could have been done differently. This way of discussing bullying opens the conversation to include aggression by individuals who are not always aggressors or who may not have the intent to harm. Since the target can only perceive intent through the actions of another, this means that the target and bully experiences might not agree. This perspective also opens possibility that the target might as an aggressor either in retaliation or ignorance. And the aggressor might be responding to a perceived harm done to them by the target either through action or inaction.
Many, sometimes contradictory, descriptions of bullying exist. I prefer the description given in Prevalence, antecedents, and effects of workplace bullying: A review which says that bullying can be
"described in terms of: the intentionality of the behavior; the frequency (for example, weekly) and the duration (for example, about six months) of such behaviors; the targets’ reaction(s) to that situation; a perceived imbalance and misuse of power between perpetrator and target; inadequate support; and inability of the target to defend him or herself in that situation, where they have toThere are two aspects of this description on which I will provide my opinion, the first is intent which was covered above and the second is frequency which need not be frequent if the person suffering harm has been severely harmed. Because the threshold for harm is lowered, and an aggressor can provoke harm easily with relatively benign or infrequent stimulus.
face constant negative social interactions, badgering, insulting remarks, and intense pressure. This
strengthens the aspect of power imbalance between the perpetrator and the targets as the perpetrator is believed to be in a position of strength as compared to the victim."
An Example
In presenting this scenario, I am inherently influenced by having only heard one side. Because of this I will be presenting what happened to the best of my knowledge.
My friend was approaching their final years in graduate school and had two faculty advisors. One of these had just moved to a different school. My friend had gotten along well with both their advisors and had only received one performance-related request of something to change--one advisor had mentioned that my friend did not communicate well enough what was being working on. Another aspect of this situation is that advisor had a collegial style of working while the other advisor had an boss-employee model of working.
The event that triggered the bullying situation was when the collegial advisor told my friend that they were not working hard enough and that they were lazy. My friend asked when the problem started and got no answer. There was no attempt to assess where my friend might be at or what they were doing. They were also told that the advisor might not write a recommendation letter in support of applications for post-doctoral positions.
This was a situation of intense pressure from which my friend did not think they could escape. Not only were career aspirations on the line, but as always my friend had a thesis to write which required their advisor's support. As typical in academia my friend was not told what was expected of them or how to retrieve the situation, but they decided the solution was to sacrifice their holidays to finishing a project that was half finished.
This gambit paid off. My friend finished the project, submitted the paper, and had a successful meeting with their committee. At this point my friend's advisor seemed very happy with their work and was told that it was good. This should be the end of the story, however, it was not since a second bullying situation arose that may or may not have been related to the first situation.
My friend had decided that visiting their other advisor would be a good idea, so they arranged a 2 month visit to that advisor's lab. No sooner had my friend arrived than that advisor took my friend into confidence and started saying how the advisor was doing as little as possible to organize an event. This way, the advisor could get credit for organizing the event without it taking up much time. My friend was horrified, because they knew who would pick up the pieces: the staff. My friend was also encouraged to manage collaborations with other colleagues so that my friend could minimize their contribution. Again, my friend was horrified, because this was the antithesis of what they believe in. Despite my friend's opinion of professed attempts to manipulate other people, they did their best to perform their role in the research project while continuing to work on their thesis projects.
My friend was also told that two of the students had been goofing off. The students were threatened with the advisor taking away their project and giving it to my friend. My friend did not find this amusing neither as a threat nor as a potential work-load increase. My friend was quite disturbed that this comment transformed their social position from being a friendly outsider to being a threatening outsider.
From there things continued to deteriorate. My friend received a threat that if they weren't productive enough, one of their projects would get taken away and given to someone who could do it. They experienced sexual harassment perpetrated by the advisor--a reference on the part of the advisor to the potential for a sexual relationship between my friend and the advisor. They had a rocky relationship with another member of the group who added to the stress by arbitrarily mirroring the gestures of my friend and by seeming to enact a now-I-like-you now-I-do-not relationship. This person repeatedly presented a catch-22 to my friend on the point of whether the advisor was a good person. The stress of not knowing whether this student was a friend coupled with either an ambiguous threat or an ambiguous opportunity to support compounded the stress of the other interactions.
The advisor decided that since the project was not progressing rapidly enough, the students should stay up nights until it was finished. The advisor did seem to have the philosophy that he should be there with them and that if he could handle being awake so could they. Unfortunately, the power difference in the situation played a key role. Over the course of two weeks, my friend watched their two colleagues get warn down and increasingly discouraged. It got the point where my friend begged the advisor to stop making the students work so hard but was told that the students deserved it.
This last was too much for my friend. They had been in this situation a short time, but it followed on the stress that had previously occurred. My friend experience intense sleep-disrupting anxiety for the first time in their life. They were extremely scared, and they had very negative opinions about their colleagues. Indeed, my friend ended up interpreting the second bullying situation as being the result of the first. This made these two incidences, one with each advisor, into one continuous bullying situation for my friend, regardless of the intent of the people involved.
My friend believes that the stress of this situation caused the onset of a sever psychological disorder. While some people might be tempted to claim that such a disorder might be the source of an invented story about bullying, I would remind them that to jump to conclusions when they were not there is discrimination. While hasty conclusions are dangerous, questions are always welcome. My friend's perspective, no matter how it came about, is a valid experience of the world. I would urge people to remember that it is more productive to entertain everyone's perspective and to constructively find ways to change situations. It is also very important that people in positions of power consider carefully how their actions might influence those with less power, particularly since bullying situations and harm can occur without the intent to harm by anyone involved.
For this reason, I will not jump to conclusions about the motives of the people involved. They had their own performance pressures to deal with, and they had other people to keep happy. However, I do think many people could have acted in more constructive ways even to achieve the same performance outcomes. Indeed, if there had been fewer threats, less harassment, and fewer negative social interactions, in the second situation my friend believed they would have been more productive. As things happened, my friend wasted many weeks being too distracted and scared to work productively. Similarly, the students with the second situation who stayed up nights might have also been more productive if they were not hounded into sleepless nights spent working.
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