The Impact of Bad Bosses: A Major Health IssueRobert Brooks, Ph.D.


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The following account is based on a true story, as they say in Hollywood. In consideration of issues of confidentiality some details have been changed, including the names of the participants. However, the facts most pertinent to the theme of this article reflect the situation that actually occurred.

Years ago a CEO of a corporation asked me to provide a consultation. He was concerned about one department in which the absentee and resignation rates among employees were higher than those for other departments. In exit interviews conducted by Human Resources, employees gave as their primary reason for leaving the angry, abrasive behavior of the department head, John Westwood. When asked why they had not reported Westwood’s behavior to Human Resources before making their decision to resign, a majority voiced the belief that little, if any, action would be taken to remedy the situation and that they would be vulnerable to retribution.

The head of Human Resources, Sarah Lincoln, spoke with Westwood about the feedback she was receiving about him. In response, he offered several explanations, all of which directed blame back to his staff. He described most of them as basically lazy, requiring him to raise his voice and be very firm in order that they listen to him. “What they see as yelling, I see as being emphatic. It’s the only thing that gets their attention. I have the best interests of the company in mind, but they don’t.” Westwood added that he hoped motivated employees could be hired to replace those who had resigned so that his department would be more productive.

Lincoln, who had joined the corporation a year earlier, told me that Westwood’s file described him as a hard-working, devoted employee who had been with the corporation for more than 15 years. She said it was her understanding that he eventually attained an administrative position as a reward for his diligence. Given what she learned about him during her exit interviews with his departing staff as well as his seeming lack of insight into his own behavior, she had serious reservations about his leadership capabilities.

Westwood was informed that they were enlisting an outside consultant to speak with him and members of his department. Although my involvement was cast in a positive frame of obtaining information that could help to strengthen Westwood’s relationship with his staff and their productivity, not surprisingly he interpreted the action as “gathering material to be used against him.”

Lincoln informed me that several of the staff were initially hesitant to speak with me, once again voicing concern that their comments would not eventuate in positive changes and might harden Westwood’s stance towards them. Lincoln assured them that whatever reservations they held from past experiences would be remedied in the current consultation. The willingness of a few employees to meet with me was the impetus for others to step forward and do the same.

Several common themes emerged from the discussions. His staff uniformly described Westwood as an intimidating man who often yelled at them. When I asked if he ever provided positive feedback, they could not recall any instances in which he offered praise or encouragement. A number of the staff reported that they experienced intense anxiety as a consequence of Westwood’s behavior, anxiety that they believed contributed to physical symptoms including heart palpitations, rashes, stomachaches, and headaches.

One member of Westwood’s department observed, “When I wake up each morning and think about seeing him at work, I get anxious, my heart starts to race, and I wonder who will be the brunt of his anger that day. On the few occasions when he is out of the office the entire atmosphere of the department is so much more relaxed. I’ve decided that getting physically ill and emotionally drained are not worth the price of continuing to work here.”

I was impressed by the profound impact an intimidating, negative superior had on his staff. As more information came to light, senior administrators realized that action should have been taken earlier to address Westwood’s leadership and interpersonal style. Interestingly, Westwood resigned his position before I had an opportunity to interview him. He told the CEO that he knew his staff didn’t like him because he had high expectations while they were content to be mediocre. He felt meeting with me would not accomplish anything, that the cards were already stacked against him. Although he offered a veiled threat at litigation, he never took any legal action. After he departed the company, the atmosphere and productivity in his department improved significantly.

Research about Bullying Bosses

In the past 15-20 years there has been a noticeable surge in research examining the lifelong impact that bullying has on children. We now recognize that the adage “sticks and stones may break my bones, but names will never hurt me” does not capture the actual hurt that all forms of bullying, including cyber-bullying, create. This recognition has resulted in the development and implementation of innovative programs in schools to lessen bullying.

More recently, increased attention has been directed to the impact of a bullying boss. This has been especially evident in the area of sexual harassment, which typically represents a devastating form of bullying within a power relationship. I know of one situation that occurred years ago in which the sexual innuendos and harassment displayed by an executive at work led to little more than a slap on the wrist. I would guess that the same behaviors today would place him on probation or prompt his dismissal, especially since more of the women whom he sexually harassed would be less frightened to report his transgressions. In this particular case, several women came forth but only after he had left his position. Even after he was no longer employed at the company, they worried that when they reported his behavior he still might find ways of derailing their careers. Fear is a powerful force in promoting acquiescence and silence.

A recently cited study prompted me to think about my consultations involving Westwood and similar situations. The study has major implications for our training and on-going supervision of employees at all levels of a company, but especially those in leadership/managerial positions. The study, which was described in an article authored by Stephen Smith in The Boston Globe, contained the provocative title and subtitle, “Heart attack, eh? Boss may be cause. Mr. Burnses (from the Simpsons) of the world can raise workers’ risk of cardiac woes, study says.”

The article highlights the findings of Swedish researchers who examined the influence of bosses on one’s health. The researchers followed 3,100 Swedish men between the ages of 17 and 90. The medical history of each participant was obtained and cardiovascular tests such as blood pressure and cholesterol readings were performed. The workers were also requested to evaluate their bosses’ behavior by answering such questions as “My boss is good at pushing though and carrying out changes,” “I have a clear picture of what my boss expects of me,” and “I have sufficient power in relation to my responsibilities.”

The results were startling. Smith writes, “The longer workers toiled for feckless bosses, the more likely they were to be felled by heart disease. That was a greater negative effect than if the employee smoked, didn’t get enough exercise, was overweight, or had high cholesterol. . . . Workers saddled with managers who were inconsiderate, opaque, uncommunicative, and poor advocates were about 60 percent more likely to suffer a heart attack or other life-threatening cardiac condition. By contrast, employees whose managers exhibited robust leadership skills were roughly 40 percent less likely to suffer heart emergencies.”

Anna Nyberg, a psychologist at the Karolinska Institute in Stockholm and lead author of the research observes, “For all of those who work under managers who they perceive behave strangely, or in any way they don’t understand, and they feel stressed, the study confirms this might actually be a health risk and they should take it seriously.”

Dr. Christopher Cannon, a cardiologist at Brigham and Women’s Hospital in Boston, found Nyberg’s study so compelling the he plans to obtain a more extensive picture of each patient’s work experiences. Cannon says, “Now we’ll ask what is your job like. Are you happy in your job? Is your boss difficult to work with? I guess Dilbert would fit in here. Dilbert’s looking at an early heart attack, given that he has very little control over his life and doesn’t seem to have a very nice boss.”

In a BBC News report, Cathy Ross, a cardiac nurse for the British Heart Foundation, commenting on Nyberg’s study, notes, “This limited, male-only study suggests that a good, clear working relationship with your manager may help to protect against heart disease. Feeling undervalued and unsupported can cause stress, which often leads to unhealthy behaviours.”

While the study conducted in Sweden involved only men, other research has included women and similar outcomes were found with both sexes. In a website article “Good Boss, Bad Boss” posted on Psychology Today in 2005, author Willow Lawson emphasizes, “Surveys show that up to half of all workers have a shaky, if not downright miserable, relationship with their supervisors. According to a Gallup poll, a bad relationship with the boss is the number one reason for quitting a job. Supervisor problems outpace all other areas of worker dissatisfaction, including salary, work hours or day-to-day duties.”

Lawson describes research undertaken by Nadia Wager, a psychologist at Buckinghamshire Children’s University College in England. In a study of hospital workers, Wager discovered that “nurses toiling for hospital supervisors with poor management styles- lacking in respect, fairness or sensitivity- had dramatically higher blood pressure throughout the day than nurses working for bosses who were judged as considerate and empathic. As a result, the nurses with bad bosses had a roughly 20 percent higher risk of heart disease.”

Bullyproofing the Work Environment

As the studies cited in this article indicate, there is a growing body of research indicating that bullying by one’s boss can serve as a profound assault on one’s physical and emotional well-being to the point of contributing to heart attacks. In essence, bullying in the workplace represents a major health issue that must be actively addressed.

As noted earlier, there has been increased attention directed towards eradicating sexual harassment in the work environment. I remember as a faculty member at Harvard Medical School being asked to complete a questionnaire that contained different scenarios involving situations between bosses and those who report to them. We were asked to judge whether these scenarios portrayed examples of sexual harassment. While there was overwhelming agreement about some situations, others were less clear. The questionnaire contributed to a more open discussion and greater sensitivity about the boundaries of harassment. I believe it also prompted some staff who felt they had been exposed to sexual harassment to step forth and report the incidents. In the past few years the media has reported instances of people resigning their positions, including the head of a hospital in the Boston area, as a result of sexual harassment charges. Progress is being made in combating sexual harassment, although more must be done.

Equal effort must be directed to eliminating all bullying in the workplace. No individual should ever have to go to work more concerned about interacting with an emotionally abusive boss such as John Westwood than fulfilling his or her job responsibilities. A few years ago while speaking at a conference I engaged in a conversation with another psychologist. I advocated that more must be done to target abuse at work. He agreed, but voiced some skepticism at the reality of reining in abusive bosses, citing the hesitation of employees to confront those to whom they report, especially if they believe that they would receive little, if any, support from others in the organization.

I responded that the task of ending abuse in one’s place of employment might be very challenging but it was critical to do so. I cited Daniel Goleman’s writings, including his books Emotional Intelligence, Working with Emotional Intelligence, and Primal Leadership, all of which capture the benefits of having an emotionally intelligent leader, a leader who practices empathy, compassion, thoughtfulness, and effective interpersonal skills. In our book The Power of Resilience: Achieving Balance, Confidence, and Personal Strength in Your Life my colleague Sam Goldstein and I highlight the characteristics of leaders who live a resilient lifestyle and nurture resilience in others. Such leaders and managers create a climate at work that enriches rather than weakens its inhabitants.

I added that the heads of organizations should incorporate regularly scheduled, ongoing training for those in supervisory positions in order that they become guardians of an environment in which all staff feel safe, secure, and welcome. While some might argue that this kind of training is expensive, I would counter that the monies spent on the training would be more than offset by the savings accrued from having employees who are more comfortable, motivated, and productive and less likely to use sick days as a way of escaping from a noxious workplace. In addition, since retention rates would increase, expenses for training new staff would be greatly reduced.

Such leadership training is gaining greater acceptance. Smith, in his Boston Globe article, quotes Dawn Hatterer, principal of the Consulting Authority in Frederick, Maryland, who contends, “A manager needs to be sincere and care about his or her employees from an individual standpoint and know what motivates them, and understand what their skills and competencies are.”

Smith continues, “At Winchester Hospital, rated as the best place to work in Massachusetts in a Globe survey released recently, managers undergo two or three days of training together each year and must spend an additional 24 hours engaged in leadership development, said Kathy Schuler, vice president for patient care. The hospital has even hired executive coaches to work with subpar managers.”

Schuler offers this astute observation, “People join an organization for a variety of reasons- salary, job position- but people leave because of their relationship with their direct supervisor.”

The required training activities at Winchester Hospital are worthy of duplication in every organization and business. We will all be the beneficiaries when bullying is replaced by acts of caring, kindness, and compassion in the workplace.

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