A year of dialogue


My reflections on the Work, Stress, and Health Conference, May 2015, Atlanta

Positive social change is and should be measured in much more tangible ways than talk, but meaningful dialogue is often a seed planter for action and a tool for building community. In looking back at the past year, I am grateful for numerous opportunities to connect with extraordinary individuals who are engaged in projects and initiatives to bring dignity, well-being, and social justice into our workplaces, communities, and institutions.

Many of these conversations occurred at conferences, workshops, and meetings (face-to-face and virtual) in the U.S. and abroad. Here are some of the highlights, with links to earlier pieces about the respective events:

Out of these gatherings came an array of collaborations, projects, and partnerships to be shared among the participants. For me they included, among other things, the seeds for a major writing project on workplace bullying, plans for building the therapeutic jurisprudence community, and ideas for legislative advocacy to support the anti-bullying Healthy Workplace Bill. Taken as a whole, they represented a wonderful blend of people, ideas, and commitment.

Group photo, Human Dignity and Humiliation Studies workshop (photo: Anna Strout)

Human Dignity and Humiliation Studies workshop, December 2015, New York City

Positive work cultures create more productive organizations


When will we ever learn? Positive work cultures nurture happier, more productive organizations, and negatives ones do not. Drs. Emma Seppälä (Stanford) and Kim Cameron (U. Michigan) provide a useful reminder of those basic truths in a piece for the Harvard Business Review, summarizing various studies on workplace cultures:

Too many companies bet on having a cut-throat, high-pressure, take-no-prisoners culture to drive their financial success.

But a large and growing body of research on positive organizational psychology demonstrates that not only is a cut-throat environment harmful to productivity over time, but that a positive environment will lead to dramatic benefits for employers, employees, and the bottom line.

High stress organizations often overlook the hidden costs that result from such an environment. These include higher health care costs, greater levels of employee disengagement, and reduced worker loyalty to the organization.

In their piece, Seppälä and Cameron identify “six essential characteristics” of a positive workplace culture, built around qualities such as caring, trust, respect, and support.

Sometimes a short little article like this one speaks volumes. Being a good leader or manager is hard work, but fortunately the basic tenets of quality organizations are readily identifiable and provide a sound starting place.

NPR report: Future doctors depict mentors as monsters


Earlier this month, health journalist Julie Rovner reported for NPR on a class of medical students who were invited to draw comics depicting their training, workplaces, and relationships with mentors/supervisors. It’s not a pretty picture:

How stressful is medical training? So bad that in a class that encouraged medical students to express their feelings by drawing comics, nearly half of them depicted their supervisors as monsters, researchers say.

Students imagined the workplace as dank dungeons, represented supervising physicians as fiendish, foul-mouthed monsters, and themselves as sleep-deprived zombies walking through barren post-apocalyptic landscapes, the study authors, Daniel R. George and Dr. Michael Green, wrote Tuesday in JAMA, the journal of the American Medical Association.

In one particularly harrowing image, a student “depicted his supervising physician screaming at the medical team, causing one intern to urinate herself moments before having her head bitten off for possessing too little information about a patient,” the authors wrote.

Click to the full piece if you’d like to see some of the artwork.

This is yet more evidence that the health care workplace is a troubled one. In fact, last week I shared the story of a nurse who attempted suicide after enduring a prolonged course of bullying and harassment.

Because psychological abuse at work tends to roll downhill, it’s also likely that some of these doctors-in-training will take cues from what they’ve experienced and treat their colleagues and co-workers in a similar manner. In an August 2012 piece, I suggested that professional schools can be incubators for workplace bullying:

It has long been my belief that the seeds of workplace bullying are planted in professional schools that prepare people to enter occupations such as law and medicine.

You start with ambitious young people who (1) are used to being heralded as academic stars; (2) do not have a lot of life experience; and (3) tend to be driven, Type A achievers. You then put them in high-pressured educational environments that emphasize technical knowledge and skills and a lot of “left-brain” logical thinking. These degree programs don’t place a lot of emphasis on interpersonal skills and the development of emotional intelligence.

You then unleash them unto the world of work. Uh oh.

That post includes a summary of a New York Times piece about a resident doctor who terrified the medical students with his explosive behavior.

Wharton prof: When job hunting, organizational culture is key


In an op-ed column for the New York Times, management professor Adam Grant (Wharton School, U. Penn.) urges job seekers to focus on organizational culture as a prime factor in conducting a job search:

When it comes to landing a good job, many people focus on the role. Although finding the right title, position and salary is important, there’s another consideration that matters just as much: culture. The culture of a workplace — an organization’s values, norms and practices — has a huge impact on our happiness and success.

Grant identifies “three fundamental issues” in assessing a workplace:

First is justice: Is this a fair place? Second is security: Is it safe to work here? Third is control: Can I shape my destiny and have influence in this organization?

It may be more important to eliminate the toxic workplaces first, suggests Grant:

It’s always tempting to look for a great culture, but since bad is often stronger than good and toxic behaviors wreak more havoc than positive behaviors breed joy, it’s probably wiser to first rule out the worst cultures.

Hard times, part 1

The worst of the Great Recession may be behind us, but few people can afford to be supremely confident about job security. Accordingly, how an employer deals with possible layoffs is telling. Grant draws a comparison:

Contrast the former Walmart chief executive Michael Duke, who slashed more than 13,000 jobs while raking in $19.2 million, with Charles Schwab executives taking pay cuts to avoid downsizing — and giving employees who lost their jobs a bonus when they were rehired.

That said, one might have to do a lot of homework, or raise some uncomfortable questions to potential future employer, to get an accurate read on an organization’s priorities when layoffs may be in play. Furthermore, because such decisions are usually more discretionary than policy-based, what happened before may not necessarily be predictive of the future.

Hard times, part 2

Grant does overlook one common, harsh reality: Sometimes people don’t have a choice of potential employers. A job offer presents itself, and other options are few. Grant leads his column with an anecdote related to a student at the prestigious Wharton business school, who is likely to have some degree of choice in terms of job opportunities. By contrast, especially if you’ve been underemployed, unemployed, or otherwise out of the labor force, obtaining full-time employment with decent pay and benefits may prove to be a challenging task.

In such cases, the choice may boil down to taking a position at a place that may not have the healthiest workplace culture versus passing on the offer in hopes of something better coming along. If you’re facing destitution or raiding your savings, it may be better to take the job, dig in, and do your best to succeed, while watching your back and keeping an eye trained on the job listings.

Nonetheless, Grant offers sound advice and thoughtful points on what’s important in seeking a new job. It’s a good, quick read.

Sacrificing privilege to advance social change

(Image courtesy of clipartpanda.com)

(Image courtesy of clipartpanda.com)

There are many scenarios in which positive social change can occur in society, including our workplaces. With virtually any of these possibilities, chances of success will be increased when supporters of change are willing to sacrifice some of their privilege in order to advance a cause.

By privilege I refer to some advantage, by virtue of wealth, demographic status, social standing or popularity, organizational rank, legal right, and/or inherited trait. And when I say sacrificing privilege, I mean being counted in a way that could jeopardize some of that advantage. It may mean speaking up in a meeting, intervening as a bystander, endorsing an unpopular yet principled position, or otherwise doing or saying something that potentially puts one at odds with supporters, sponsors, or the in-crowd.

For what it’s worth, I do not recommend sacrificing one’s privileges willy nilly, as if to prove some level of courage or principle to the world. It’s not about that.

Rather, it’s about taking smart risks in support of something bigger than ourselves, of possibly “giving up” some advantage for a greater good.

I’m hesitant to give illustrations because I don’t want the examples to define the map on this one. But I know that some readers here, hopefully many of you, get what I mean.

Especially in times when fear and scarcity drive people to seek security, it may be something of a twist when those who have a lot of advantages are the most cautious about taking risks for reasons of principle. (It’s the opposite of the line made famous by Janis Joplin — “Freedom is just another word for nothin’ left to lose” — in “Me and Bobby McGee“!) In any event, if only the have-nots (however we define them) are willing to stick out their necks, then the path to more humane workplaces, institutions, and organizations will be all the more difficult.

No ho ho: The academic conference season


In addition to grading exams and papers, thousands of academicians across the U.S. devote parts of their semester break to attending and participating in huge yearly academic conferences, hosted by whatever association covers their field of teaching and research. (For example, law professors may be headed for the annual meeting of the Association of American Law Schools.) Slate education columnist Rebecca Schuman humorously captures the emotional heart of the between-semesters academic conference season:

One of the advantages of an academic career is that most universities take a two- or three-week winter break. While students clog the overhead compartments of America with fetid laundry and then gorge on home-cooked meals, their professors presumably get to spend those weeks doing whatever the hell they want. No fair! Bah! Humbug!

Take heart in the anguish of your fellow man, Scrooges of the corporate world: Some of that winter break is ruined, thanks to the big annual conventions that academics must attend in early January. Whether it’s the Modern Language Association (MLA), or the countless others with countless other acronyms (AHA, SCS, APA), conferences loom just after the new year, turning the academics in your family-and-friends circle into shriveled husks of their former selves, darkening every festivity with stress about their upcoming trips. (I guess we should give the conferences a cookie for not clustering in the week between Christmas and New Year’s like they used to.)

Call me a bit of a cynic, but here are some of the qualities that can predominate these mega-conferences, some of which Schuman discusses in her column:

  • Badge-watching — There’s a lot of badge-watching at these conferences. Big names at prominent universities will get the most attention. Junior faculty at institutions of lesser renown, not so much. Most entry-level job hunters must depend on impressing and posterior kissing, described below.
  • Impressing — Whether you’re a big fish or a small fish, if you’re on a conference panel, conventional wisdom says that the immediate objective is to sound learned and serious, with just the right touch of lightness and pizzazz. This supports the broader goals of (1) getting more speaking invitations; (2) being asked to join some prominent executive committee or editorial board; and/or (3) being recruited by a higher-ranked university/department/whatever.
  • Posterior kissing — Making a good substantive and stylistic impression may not be enough to advance one’s goals. Some ego stroking may be advisable and even necessary. Done too transparently, it won’t have the desired effect. But the right puckering up approach may unleash a recipient’s largesse.
  • Job hunting — Some academic associations use their annual conference as an opportunity for schools to conduct screening interviews of promising candidates for faculty positions. For academic job hunters, this adds a humongous layer of importance and anxiety to the whole deal, especially at a time when full-time, tenure-stream positions are in heavy demand.

Like in many other professional settings, it’s all part of the hoop jumping game. And unless someone’s credentials are so absolutely impeccable that a complete lack of social skills doesn’t matter, most people have to play it, at least sometimes.

I plead guilty to having engaged in some of this game myself, but hopefully never to excess. While of course I want to do well if I’m giving a talk or on a panel, my primary goal is that people will learn something from what I have to share. As for badge-watching and posterior kissing, it’s not a natural part of my tool kit. I’m always happy to meet new folks in shared areas of interest, but prominent affiliations don’t necessarily impress me, and I’m simply not that good at kissing up in a superficial sort of way.

Of course, I’m not suggesting that being a curmudgeon or a jerk is the right way to go, either. It’s good to get along with others, to make positive connections, and to express gratitude and thanks when warranted.

The brighter side 

In any event, there is some good news on this front. First, the more senior you get, the less you have to contort yourself. In fact, if you’re sufficiently established in your field and not actively fishing for more invitations to move up the greasy pole, then you can settle back into being a relatively normal, sincere, authentic human being.

Second, not all larger conferences fall into the soulless abyss. For example, over the years I’ve sung the praises of the biennial Work, Stress, and Health conference and the biennial International Congress of Law and Mental Health, because both events attract a cohort of people who want to share, learn, and interact genuinely with colleagues and friends. Both gatherings are a lot more down-to-earth than the typical academic fare.

Third, once you’ve been around these blocks a few times, you can search out your friends and compatriots at even the largest of events, in effect creating your own little community. That may mean skipping the big reception and the stuffy conference banquet, and instead enjoying a nice meal over good conversation.

Finally, you can go small. I’ve become a big fan of smaller workshops, symposia, and seminars that nurture genuine interaction and allow people to get to know each other. Interestingly, some of these small-scale gatherings can lead to more opportunities, conventionally defined, than the larger cattle shows. Such events are also relatively easy to create if you’re willing to do the organizing work.

For what it’s worth, I’ve found that a healthy transition occurs when we go from pursuing ambitions to seeking meaningful connections and activities. Too many of the big conferences are more about the former. We should consider ourselves fortunate when we can get past that stage and seek out the stuff that matters.


I published a short reflection on the benefits of smaller gatherings — “Academic Conferences: When Small is Beautiful,” Suffolk University Law Review Online (2014) — which may be freely accessed here.

WBI: A bullied nurse shares her story after surviving a suicide attempt


We use the term “suicidal ideation” to describe frequent thoughts about suicide, especially for those at risk. But tossing in a clinical word like “ideation” has a way of sanitizing the term and drawing attention away from its core essence: Circumstances in someone’s life can be so challenging, difficult, or dire that they are thinking about suicide.

We know that workplace bullying can be associated with suicidal thoughts. Not every instance, thank goodness, but in some instances, yes. In fact, earlier this week, Dr. Gary Namie of the Workplace Bullying Institute shared this comment, publicly posted to the WBI site, from a nurse who attempted suicide after experiencing a prolonged course of workplace mistreatment.

I’m an RN, I resigned unwillingly Sept.18 from the Veterans Affair. Its difficult for me to determine if I was experiencing bullying, harassment and or discrimination but the end result an attempt to end my life July, 30th, 2015, spending 12 days in the hospital.

I was diagnosed with PTSD and medicated for nightmares while hospitalized. I’m or I was a well functioning Bipolar II. I endured (from a newly arrived nurse manager, moreover the was not my manager) bullying/harassment for 14 months,mid Jan 2014-Mar 2015 and on March 26th 2015 – June 17th she and another official came at me with a vengeance. On June 16th 2015, around 4:30 pm after entering human resources and reading false accusations, a co-worker’s description of me and a sticky on top of the charges “AL, can we ask for fitness of duty, reprimand or suspension” (I had no write-ups prior to these false charges) I started crying, I was devastated, shocked.

. . . I can’t believe or comprehend these unfathomable events, I’m lost. How can this all be happening. I suffered/suffer fear, anxiety, terror, pain, uselessness, worthlessness, impending doom, shame and guilt!!!!!!. My livelihood was taken from me.

There are at least two important points worth drawing from this personal account. First, while suicidal thoughts usually cannot be traced to a single factor, severe bullying and mistreatment at work can be among the causes. Second, we must continue to pay close attention to worklife matters in healthcare workplaces, too many of which are stressful, dysfunctional places to earn a living.

Over the years I’ve written a lot about the healthcare workplace and about suicide. Here are some pieces if you would like to learn more:

World Suicide Prevention Day, 2014: Ties to work, bullying, and the economy (2014)

Suicide and the Great Recession: Will we heed the tragic warnings? (2013)

University of Cincinnati conference examines workplace violence, bullying, and incivility in healthcare (2012)

Cheryl Dellasega’s “When Nurses Hurt Nurses” (2012)

Nursing as a Calling: Aspirations and Realities (2010)

First in a four-part series on workplace bullying in healthcare (2009)

Suicide prevention resource in the U.S.

If you or someone you care about is having suicidal thoughts, the National Suicide Prevention Lifeline can be reached around the clock at 1-800-273-TALK (8255). In addition, you can go to a hospital emergency room and ask for help.

Professional coaching

Targets of workplace bullying may consider confidential coaching by telephone offered by the Workplace Bullying Institute through Jessi Eden Brown, a licensed counselor and WBI’s professional coach. For more information, including availability and rates, go here. You may find helpful this article about her work in Counseling Today.


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Changing the world from a streetcart, one small book at a time


Urbanmonks Thinktank founder Douglas Krisch displays some of his books, with Urbanmonks author John Francis Mcill in the background.

While I was in New York last week, a walk over to Union Square introduced me to the Urbanmonks Thinktank and its founder, Douglas Krisch. Here’s a snippet of the Urbanmonks mission statement from its website:

What we call anxiety and depression have existed for many generations. Though we’ve used different words and applied different forms of treatment, one thing has remained constant: we have primarily diagnosed and treated the individual.

. . . Today, tens of millions of Americans struggle with anxiety and depression. We continue to focus on healing the individual, which is essential and life-saving work. But when anxiety and depression have become common parts to all our families and communities, we must step back and examine the system, the culture.

The Urbanmonks Thinktank proposes that we, in the face of widespread anxiety and depression, must shift our approach from solely diagnosing and treating the individual to concurrently diagnosing and treating the culture.

Douglas introduces himself this way on the website:

I am a life-long learner and life-long teacher. Working with plants and bees grounds me. Producing books and selling them on the streets excites me. Any day I have connected with others feels like a day well-lived.

At Union Square, Douglas further explained his commitment to promoting emotional health in our society. He is doing so in part by writing and publishing short books that educate us about wisdom, reflection, and community, and then selling them via his Manhattan streetcart and online. I ended up buying a bunch of them, including The Weather of the Mind (2015), book 1 of the “Urbanmonks Wisdom Curriculum.” He also is forming a small team of compatriots to work together on various projects.


Douglas explains his publishing philosophy and practice in The Small Street Book Revival (2014) pictured above. Urbanmonks will consider manuscripts from potential contributors and consult with others who want to write short books. (Go here for more info on that.)

It made my day to talk with Douglas and John Francis Mcgill, an Urbanmonks author. You can’t go wrong when you connect with good people who want to create an emotionally healthier world. I look forward to watching how the Urbanmonks Thinktank continues to unfold.

Shame-based organizations: When workplaces resemble dysfunctional families

Please excuse the disembodied hands!

Please excuse the disembodied hands!

What can shame-based family rule systems teach us about less-than-wonderful workplaces?

At the annual Workshop on Transforming Humiliation and Violent Conflict hosted by Human Dignity and Humiliation Studies, Dr. Connie Dawson, author of the forthcoming book, Life Beyond Shame: Rewriting the Rules, facilitated a discussion group on shame-based rules for family systems. Here are the rules drawn from her poster board pictured above:

  • “Do and be right” (“Do it my way”)
  • “Blame shifted elsewhere”
  • “Do not acknowledge feelings”
  • “Keep secrets”
  • “Don’t expect accountability”
  • “Control to get what you need” (“Manipulate to ensure own survival”)
  • “None of this is happening” (“Deny reality”)

If you’ve ever experienced a workplace built on a punitive, negative culture, then these rules may resonate strongly!

Dr. Brené Brown has a lot to say about shame-based organizational cultures in this Fast Company excerpt from her book, Daring Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead  (2012). In fact, she examines shaming behaviors at work in the context of workplace bullying, citing the work of the Workplace Bullying Institute. She doesn’t pull any punches in discussing how shame can be used by management:

When we see shame being used as a management tool (again, that means bullying, criticism in front of colleagues, public reprimands, or reward systems that intentionally belittle people), we need to take direct action because it means that we’ve got an infestation on our hands. And we need to remember that this doesn’t just happen overnight. Equally important to keep in mind is that shame is like the other “sh” word. Like shit, shame rolls downhill. If employees are constantly having to navigate shame, you can bet that they’re passing it on to their customers, students, and families.

While specific acts of bullying, mobbing, and abuse at work can be attributed to individuals, these behaviors are much less likely to flourish without permission — explicit or implicit — from the host organization. It’s why, among other things, that in order to understand workplace mistreatment, we need to keep one eye on the institutions and human systems that enable it.


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Growth-fostering relationships at work


In addition to understanding toxic and abusive work environments, we must comprehend and embrace what good organizations can give to the world. Healthy workplaces nurture, among other things, growth-fostering relationships.

The little card pictured above was distributed at the annual Workshop on Humiliation and Violent Conflict, hosted by Human Dignity and Humiliation Studies (HumanDHS) last week in New York. “The Five Good Things” come from the late Jean Baker Miller, a psychiatrist and pioneer in the field of relational psychology:

Growth-fostering relationships empower all people involved in them.These relationships are characterized by:

1. A sense of zest or well-being that comes from connecting with another person or other persons.

2. The ability and motivation to take action in the relationship as well as other situations.

3. Increased knowledge of oneself and the other person(s).

4. An increased sense of worth.

5. A desire for more connections beyond the particular one.

Let’s apply “The Five Good Things” to the workplace! Quality organizations understand that psychologically healthy work environments not only make our work lives more rewarding, but also fuel productivity and positive results. It’s all good, with no downsides.


Jean Baker Miller’s “Five Good Things” and the work of relational psychologist and HumanDHS director Linda Hartling strongly inspired the New Workplace Institute’s “Eightfold Path to a Psychologically Healthy Workplace.”

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