Not All Bullies, Yell and Scream: The Impact of Subtle Bullying in the Health Professions

What comes to mind when you think about bullying? Is it the schoolyard bully type, or perhaps an adult who yells and screams, hurls insults and is violent? Namie and Namie (2009), in their book, The Bully at Work, describe Screaming Mimis. These bullies stamp their authority through blatant and public criticism. Their goal is to strike fear, because scared people are easier to manage. Their actions send a powerful message to others, ‘this could be you’. Screaming Mimis are obvious; victims know they are being bullied. Subtle tactics are more difficult to identify. This is why it took me, like many others, a long time to realise that what was happening to me was workplace bullying. It was time to prepare for retirement for the sake of my physical and mental health. The realisation that I was bullied many times during my career, prompted me to write a book, to share my experiences and those of other health professionals, the idea being to help people recognise more subtle forms of bullying, and understand they are not alone. Sickness in Health: Bullying and Nursing and Other Health Professions (Happell 2024) enabled me to tell my story along with stories of 12 health professionals, whom I refer to as champions. I am in the lab that is the busiest all the time. It's just that grain of sand in your shoe. One grain is nothing, but then you add the next one and the next one and the next one, and then you get a blister. “Okay, so I didn't hear about that,” another grain. “You're going to put me on call before my day off? It doesn't happen to anybody else.” Another grain of sand. How will I say she's making me work harder than everyone else? She's not giving me information. How can I validate this because it's so subtle? If you didn't know, you wouldn't see it Namie and Namie (2009) identified three types of subtle bullying: The Two-Headed Snake, the Constant Critic and the Gatekeeper. While this provided a very helpful framework for me to better understand and interpret the champions stories, the constant critic didn't quite encompass our breadth of experiences. Saboteur better summed up this kind of bullying. Two-Headed Snakes are often only discovered when the harm has been done. They seek to control and destroy their target's reputation under cover of collegiality or even friendship. They backstab, take credit for the victim's work, and play favourites, often excluding people who hold different views. Discovering this kind of bully can be particularly distressing because a fundamental trust has been broken. I often experienced this from peers in the workplace and my broader professional community. I've known colleagues who, behind a veneer of mutual commitment to the broader profession, would destroy my reputation without hesitation, purely for their own benefit. Fewer examples of two-headed snakes were described by the champions. Although I suspect many of the gatekeepers and saboteurs share these tactics. I thought we had a good working relationship. I had no reason to believe she wasn't happy with my work. When I sent her our annual report, she responded: “It looks fantastic. Well done to you and the team but particularly to you.” Four months later, in my performance review, she absolutely shredded me. “Yeah, yeah, fine, you've done this, and you've done that, but you haven't done this, that and the other thing.” I was like, wow, where did this come from? She was totally hostile. Even how she sat, right at the back of the room, almost pushing her chair through the wall. Her arms were folded, and there was only fleeting eye contact. I was blindsided. I was shattered when I left that room Most bullying the champions described was at the hands of the Saboteur. Their tactics focus on ruining the victim's reputation and destroying their credibility. They humiliate, undermine, attack reputation, impose unreasonable work demands, and change the goalposts, to name a few. These bullies strike the person's confidence and, ultimately, their perceived capabilities for their job. Victims are left confused, embarrassed, and with their confidence shattered. Sadly, they often question whether they are to blame for what they are experiencing. The bully would do anything to get rid of me. So, she orchestrated a way to ensure I would leave. She knew what things were important to me, and she systematically took all those things away. She stopped me from doing a group. She took me off the program I was working on that I had set up and loved. She changed my work hours. She stopped me from doing all the tasks I was employed to do. Instead, I would do administrative tasks, photocopying, and saving things to USBs Gatekeepers also seek to control victims and make it difficult for them to do their job effectively. They use tactics such as withholding information and resources, stonewalling and exclusion. Gatekeepers create stressful environments full of obstacles. The champions had many unfortunate experiences with gatekeepers. It's insidious. I'm excluded. There are nursing meetings I'm not invited to. I'm not included in emails, or professional nursing information. It's forwarded to me by the nurses I'm professionally responsible for. They will say, “Do you know about this?” Or they'd tell me they'd received an email saying I would no longer be doing their performance appraisal; it would be done by her Exclusion generally goes hand in hand with favouritism. Bullies often target people they perceive as threatening because of their abilities, successes or achievements. They use exclusion to ensure their friends, frequently less successful and capable than the target, take positions on committees or achieve promotions, allowing bullies more control over the narrative. The victim is left, unable to fulfil what they were employed or appointed to do. The bully ‘wins’ at the expense of the organisation and frequently, the profession, and ultimately the consumers and students we should be serving. I was at a status where everybody else had their own personal admin assistant. I got to share one with the pool. Everybody else at my level got new furniture in their rooms, but I didn't. He tried to stop me having a research career. He didn't give me enough time to do research and stopped me from doing projects. He restricted students that I could have, all these unfair restrictions that others didn't have Through sharing their painful experiences, the champions shed a light on the harm subtle bullying can do. As mental health professionals, we have an obligation to create a positive environment, free of bullying. It is hoped this editorial has shone some light and will facilitate conversations about workplace bullying and the damages it causes. If you are interested in purchasing the book, please send an email to me. Thanks, and stay well. The author declares no conflicts of interest. The data that support the findings of this study is not available due to privacy or ethical restrictions.