Get Back in the Box: Nurse Ratched is Alive and Well

In the famous book and movie, One Flew Over the Cuckoo’s Nest, Nurse Ratched thoroughly runs the roost. From a Jungian archetype perspective Nurse Ratched represents the dominating and emasculating mother. Her main modus operandi is to manipulate the male patients into believing that their welfare is her primary concern and that everything she does is for their benefit. With this backdrop of apparently caring intention, she holds tightly onto control in the guise of benefactor and protector from the evils of the world. The most mischievous component of her behaviour, however, is to build up expectations for rewards in the form of activities, treats or even positive attention from her as a projection of their mother, and then shatter them at the last moment. It is consummate controlling and deeply obsessive behaviour. When McMurphy (Jack Nicholson in the movie) challenges Nurse Ratched by emancipating the patients and shows signs of winning the battle for control, he is lobotomised.

Ken Kesey’s Nurse Ratched character is based in reality. I actually saw this archetype in the real world when working in a psychiatric hospital in Western Australia in the early 1970s. In my case Nurse Ratched was a male. So, what follows is equally applicable to both sexes but I refer to Nurse Ratched as female throughout to be consistent with the fictional character and, hopefully, not for any other unconscious desire.

Some recent research I have conducted with colleagues suggests that the Nurse Ratched archetype is alive and well in organisations other than psychiatric institutions. It appears in various configurations and degrees but has the same end game, which is to control the inmates: to keep them in their box. This reinforces Nurse Ratched’s sense of power, strengthens the mask that hides a deep-seated insecurity, a poorly developed sense of self and a sense that all is not well with herself, and, hence by projection, the world. Nurse Ratched has developed a set of behaviours that serve to protect her from seeing her true self and the maintain the illusion that others can’t see it either.

Nurse Ratched is a micromanager. Nothing is left to the deliberations of others. Of course there are committees, although one might find precious few of them and they are functionally impotent. This impotence is openly reinforced by Nurse Ratched who frequently overwrites their decisions using an unwritten but thoroughly understood power of veto. All decisions no matter how minute and trivial such as office allocation and travel claims are made by this manager: nothing is left to chance.

The archetype is surrounded by supplicants who have been handpicked to ensure that they do not challenge in any real way. Most importantly they all toe the party line. Dissidents are seen as not being loyal and either micromanaged or managed out. Members of the management group are found on most committees in the organisation. Committee membership has less to do with expertise and more to do with ensuring control. Loyalty is much more important than ability to be appointed as an acolyte. Even the most appalling manager and bully will be supported as long as they are loyal, get the job done and make Nurse Ratched look good.

Nurse Ratched makes sure that appointments are carefully managed. Selection panels are small and consist of herself, a couple of acolytes and a rep from HR. It is important not to have someone on the committee with expertise in the area of the appointment. Lower levels of staff are never involved in the selection process. It is not unusual for Nurse Ratched to veto an appointment and tap someone on the shoulder either within or from outside the organisation. Nepotism is so commonplace that it is taken to be normal. It is one of the rare instances where the manager does not employ a clone of self. There is room for only one Nurse Ratched in an organisation.

Information flow is carefully managed by our archetype. Most critical information is held by the management group and does not filter down: there is a hard communication barrier between senior management and the inmates. The acolytes realise that their survival depends on making sure that only selected information is sent upwards. Meanwhile Nurse Ratched is fed a diet of misinformation from employees dotted around the organisation that are the result of the nepotistic and political appointment processes. There is nothing like pillow talk to sink an upstart’s reputation.

Nurse Ratched likes to make sure the inmates are busy: extremely busy. Staff levels are kept to a minimum, performance expectations are high and there is little room for diversion from the key tasks of the business. This archetype depends on looking good in front of the board or shareholders and this is achieved by ensuring positive business outcomes no matter what the cost to people or organisational climate. There is a Calvinesque austerity and lack of celebrations of success are rare and token. Nurse Ratched depends on an efficient and well-run ward. In the movie McMurphy’s joie de vive is a major irritant and is finally silenced by reducing him to a vegetable. With such a threat people become malleable.

The result of this archetype’s behaviour is an adversarial, ‘us and them’ culture. The ‘management team’ interpret any discontent as being due to the implicit failing of the inmates and not the result of dysfunctional leadership and a toxic culture. The inmates should be grateful: let them eat cake.

Widespread cynicism pervades the organisation underpinned by powerlessness. Some inmates, like the Chief in One Flew Over the Cuckoo’s Nest, find a way to escape-he throws a water cooler through the window and runs away. In less potent expressions of their disappointment, the more imaginative and stronger personalities soon see the organisation for what it is and fly the coop. There are others who don’t quite understand the culture and innocently push back. But they are soon put in their box one way or another by being micromanaged to death, assigned meaningless tasks, and/or subtly bullied. Many are trapped due to circumstances and suffer the same pathology as Seligman’s dogs, learned helplessness that manifests itself as depressive behaviour. Denial and rationalisation of their situation help maintain a tolerable level of mental health in many.

People being people, they will in even the most adversarial environment find a way to let their creative juices flow and mostly find satisfaction in doing well what they often love doing. This is tolerated as long as the widgets continue to be churned out and there is not too much dysfunction. In fact Nurse Ratched rewards this behaviour with acknowledgement, which is gratefully received from inmates starved of recognition and positive reinforcement. But beware if the light shines too bright or the irrelevance of the activity to Nurse Ratched’s agenda is brought to her attention, the tit-bits are quickly withdrawn. After all, it is for the inmates’ own good.

This is the most toxic aspect of the culture that Nurse Ratched presides over and is the hallmark of the ultimate bully: the manipulation of the human need for recognition. The bully keeps the other in a state of constant desire for acknowledgement by maintaining a high level of disappointment, an air of disapproval. The victim’s diminishing self-esteem cries out for recognition and is occasionally, momentarily rewarded. The rush of pleasure increases desire for more and the person works even harder even as the tsunami of disappointment washes them away yet again.

Such is the dark side of organisations.

Workplace Bullying: Blowing the Whistle on Conspiracies of Silence

There is a conspiracy of silence when it comes to workplace bullying. In the many thousands of words recently written about bullying at work in the local press the conspiracy has been maintained.

A conspiracy of silence occurs when everyone knows that bad behaviour is occurring but there is a tacit decision not to talk about it and certainly not to do anything. It was first used to describe incest in families and, more recently, other forms of abuse. People don’t do anything because they don’t want to rock the boat, to avoid conflict, and because it is just too hard. Sadly, by not speaking up or doing anything the observers validate the perpetrator and invalidate the victim.

As I have often seen in clinical practice, the effect of these conspiracies on the victims is monstrous. The victim feels as if he or she is somehow at fault, they are confused, and feel alone and unsupported. Most importantly they come to feel powerless and it is this that results in anxiety and depression, the most common effects of being bullied.

In all that is written about bullying at work there are two major conspiracies of silence that result in enormous pain and suffering for victims. It also seems that workmates who see the bullying can also be badly affected resulting in significant symptoms on their part too.

The first gaping silence is that senior managers in organisations prefer not to do anything about bullies. This conspiracy of silence occurs despite the fact that bullying is against the law and CEOs and boards of directors are in fact culpable by not acting. It is interesting to watch an organisation move a victim of bullying to another branch or even another job, and leave the bully in place: even after admitting openly that the bullying has occurred. Sometimes, it is easier to call a case of bullying a personality conflict and call in a mediator. The damage these behaviours do to the victim is enormous.

It’s also common to blame the victim. This is easy because the bullied worker has repeatedly made complaints, as instructed by the legislation and the bullying literature that is laying on the coffee table in the CEO’s waiting area. The victim, who has become increasingly distressed over time, can be simplistically labelled as unstable or over-sensitive: a trouble maker. Let’s not forget too that bullies often pick on already vulnerable people who might have a reputation already for being oversensitive.

There have been some notorious bullies in organisations in and around Lismore that have been allowed to get away with bullying behaviour time and time again: I have seen many of their victims at the clinic. Many of these bullies get promoted. There are also large numbers of senior managers that know that their staff are being bullied but do nothing. Under the legislation they are just as culpable as the bully and their organisation can be fined many thousands of dollars. But they still engage in the conspiracy and more often than not put the fox in charge of the chook shed.

The preferred personality profile of a successful manager (or one on the way up) appears to be someone who is aggressive, dominant, single minded, achievement-oriented, and task focused. Throw in a little pinch of narcissism, low empathy for others and an unsatisfied need for power and this is a nasty recipe for bullying behaviour. These are not easy people to deal with which makes it so much easier to turn the blind eye. Bullies often appear so good at their job and they create the right relationships with the right people to protect themselves.

And it happens every day in organisations in which we all work. In a recent case a colleague of mine was told by the human resource manager of her organisation that it would be better to let a case of bullying drop because it was against a very senior manager. The reason being that the consequences would not be worth it in the end.
The other conspiracy involves an unholy alliance between the organisation and the insurance company. Despite the pretty advertisements insurance companies want to avoid liability. To do this they will find any excuse to blame the victim rather than make the workplace deal with the problem. Everyone’s a winner: the insurance company doesn’t have to pay out and the organisation’s premiums are protected.

The main way this is done is to find a pre-existing condition in the victim such as a history of previous abuse, anxiety, depression, previous bullying or any other negative behaviour. This is then used as a means of blaming the victim. This is easy to do by running a unbalanced investigation and being highly selective with ‘the evidence’. For someone who has genuinely been bullied at work this outcome is extremely damaging.

It is time for the conspiracies of silence to be broken. Those with the power to act need to make the hard decision and deal with the perpetrator rather than leaving it up to the victim who is already disempowered.

Positive Management in Times of Crisis

Change has taken on a new and disturbing hue. It is now so rapid that the rate of change is no longer linear but exponential. There is often no time for preparation and it may in fact be over before we notice its effects. This can be very disconcerting.

Most humans seek safety and security; we are creatures of habit and generally eschew change unless, paradoxically, we are in danger. We adapt slowly and do not react well to high levels of uncertainty. In fact it is high doses of these traits that have contributed in no small part to the current fiasco. In fact we can turn into quite difficult creatures when under threat. And organisations, by virtue of the people who work therein, are poorly equipped to deal with human distress and more often than not cause or exacerbate it.

First though, I need to explain the biases that drive my thinking. I am a psychologist and psychotherapist with over 30 years experience in working with people who have been psychologically damaged by what has been done to them at work. I have a vast portfolio of stories demonstrating the damage that can be done to people at work by what I call ‘careless conversations’, on the one hand, and ‘intentionally destructive conversations’ on the other. These conversations also include actions because they say something to and about people. I have also worked extensively with organisations in various contexts and have come to the conclusion that at a deeply fundamental level most organisations are dysfunctional.

What I mean by dysfunctional (and there is a good deal of literature to support my view) is that while organisations might work in terms of what they produce, they mostly fail to create a healthy environment in which people can be content and happy. Organisations are mostly hotbeds of harmony that often pose significant and myriad social and psychological problems for people that have to work within them. Of course this presumes that CEOs/Directors/Managers believe that work should make people feel is satisfaction, fulfilment and other aspects of psychological health.

For the employee it is more conclusive. Research on motivation and work satisfaction does indeed show that we need to think of workplaces as communities in which people are seeking far more than a wage and paying the fees of superannuation fund managers. While most CEOs and senior managers would say that this is obvious, there is in fact more rhetoric than reality surrounding crating workplaces as communities where people can be satisfied and happy. A big reason for this is that characteristics such as empathy (being concerned about people and being able to respond to people’s needs) are more personality-based than organisationally driven and managers do not necessarily have these attributes. Where they do we see a much more functional workforce. There is ample research evidence in the employee engagement literature that shows that workers look for attributes such as empathy, listening skills, interpersonal skill, inclusiveness and openness in managers. Technical skills in managers are much less valued by workers.

So let’s get back to the present crisis. Recent studies about workplace stress undertaken in Australia show that the two most important workplace stressors are job insecurity and conflict with one’s manager. Clearly the first of these stressors is a grim reality given the shedding of the emperor’s clothes and people are quite right to feel insecure. Unemployment rates continue to rise in most industrialised countries in the world. The second, the behaviour of managers, is perhaps where we can make a difference.

Fear and uncertainty have a habit of expressing themselves, for many people, as anger and as withdrawal for others. When we feel anger towards things that we cannot confront (like the financial crisis or senior people in our organisation) we feel impotent and we are likely to displace or project that anger onto those around us. As a result we see behaviours such as:

* A lack of eye contact, warmth, even scowls and ignoring others
* facial expressions of boredom or irritability that suggest ‘just get on with it will you? I’m busy and you’re not important’;
* a failure to give positive feedback and even being negative;
* an irritable tone to the voice; and
* just not being interested with what others are doing.

Incidentally, email can become a tool used by the angry and the insecure to shout at others publicly in extremely destructive and manipulative ways. It enables people to make public things that should be (and were in the past) dealt with over the phone or face-to-face. Sometimes email is a way of expressing narcissistic rage. Eric Berne called this ‘The now I’ve got you, you son of a bitch’ game because the victim is screwed if she/he responds or does not respond. All of these behaviours have a greater impact if the perpetrator has influence or is a manager. The effect this type of behaviour can have is:

* lowered self-esteem which makes people less effective;
* high levels of anxiety and all its myriad symptoms including sleep disturbance, fatigue, hypervigilence, tearfulness, diminished concentration;
* feelings of anger, powerlessness and indecision;
* lack of motivation and volition;
* and low job satisfaction.

All of this is capable of creating very debilitating levels of anxiety and depression and dysfunctional workplaces. To overcome these challenges some help can be found in the relatively new area of ‘positive psychology’. This approach offers the following lessons for managers seeking to develop a positive working environment and a more functional workforce.

A concentrated effort to be extremely positive and warm in behaviour and speech.

Conversations should involve smiles, eye contact, a high level of listening, a recognition of the importance of the other, and concentrating and engaging fully with those around you. Manage by walking around

Awareness of one’s feelings and behaviour and the capacity to change them from negative to positive.

Learning to be optimistic.

The Petruchio Trap

I published the following little article in a local newspaper, The Northern Rivers Echo. It was stimulated by a number of stories about how our workplaces are unhealthy places and a result of applying the 'business model' blindly.

Organisations at Their Worst

The Petruchio Trap

You might, as do a lot of workers, sometimes wonder about the long hours you’re working, the way in which your bosses keep increasing your targets, loading you with extra tasks. What is worse is that you feel powerless to stop it. You can’t complain because that will really work against you. And with a poor job market and your other responsibilities, you feel trapped. You may be someone low in the food change, a manager under pressure to get your team to perform or even a CEO who has to meet the expectations of the board or shareholders.

Well there’s a name for this situation and I’ve called it the Petruchio Trap. The term is taken from The Taming of the Shrew in which Petruchio systematically tames Katherina through prolonged, non-violent abuse until she becomes a totally subservient wife. The tragedy, of course, (I’ll avoid the debate about how tragedy can be found in what is essentially a comedy) is how Katharina became trapped and allowed him to do this to her at all.

In the frenzy of the industrial revolution it was standard practice to exploit workers in myriad ways that included poor wages, unsafe and poor working conditions, long hours, and low prospects. Most people, even employers, would agree that sending young children up chimneys is undesirable, although the export of manufacturing to exploit the low cost workforces of SE Asian and Pacific countries might belie that hope. Nonetheless, most Western countries have enjoyed largely civilised industrial conditions post revolution. But capitalism, or at least its ideals, has come up with some new ways of exploiting workers in the new globalised age. One of these is the Petruchio Trap, a tactic based on abuse and exploitation.

The inability experienced by some people to leave an abusive, controlling or just plain negative relationship is a well-known psychological phenomenon. The victim unwittingly, reinforces the behaviour of the perpetrator by not taking positive action to stop it. For example, the victim, usually a female, is subject to physical and/or verbal abuse but on each occasion either stays in the relationship or returns after a having left during the incident. The implicit message in the simple act of not taking a stand and leaving the relationship if the behaviour continues is permission to continue the abuse. It is important to point out that it is not the victim’s intent to be abused and that the perpetrator is solely responsible.

This phenomenon is quite complex and controversial regarding the underlying pathology. The victim often believes that one day the negative behaviour will eventually cease and life will get better. This is usually underpinned by emotional dependency by the victim on the perpetrator so that the consequences of leaving far outweigh those of staying. Fear of retribution, powerlessness, worthlessness and decreasing self-esteem may also play a role in the victim not being able to see a way out of the situation. The perpetrator, however, continues to have his or (more rarely) her needs met in a strange, unconscious and pathological way.

The Petruchio Trap is an organisational variant of this phenomenon. It is particularly invidious because it is consciously employed by CEOs with an astonishing lack of concern about the damage that it does to people. Psychologists and medical practitioners commonly see the damage in their consulting rooms and organisational psychologists are often called in to fix organisations fractured by the inevitable human resource disaster.

The relationship between victim and organisation starts innocently enough and may appear very positive at the outset. Then slowly, once the honeymoon is over, management keep upping expectations for deliverables until the employee is completely overwhelmed. It is often done gradually, just like the boiling frog syndrome, and the employee often doesn’t realise what is happening until it is too late. By then the employee is working at weekends and evenings just to keep up. Often there is a decrease in staff rather than an increase and this strategy has a subtle intent of creating uncertainty. It also starts a cycle of a sense of increasing worthlessness, that no-one cares. As I’ve often said to suffering patients in this trap that it takes a long time for an organisation learn to love you!

The fear for the employee is that if they say ‘no’ to additional work, complain, or fall behind they will be ‘performance managed out of their job’. The victim may mention their situation with their line supervisor who is just as powerless to do anything because they are in the same situation. At some stage up the food chain, the ‘complainant’ is met with a sage smile and a shrug. I have even heard more than one senior manager in organisations for which we have consulted say that, ‘if they don’t like it then they can apply for another job’ when confronted with staff dissatisfaction and without understanding the true cause of the problem. Humans attack when they are criticised and this response is understandable but it is not the best response, which is to think hard about why people are unhappy.

The employee who is most conscientious, agreeable, and who enjoys their profession is most likely to hang on and keep trying to attain the targets drifting ever further out of reach. Other factors that contribute to Petruchio Trap are financial insecurity, a mortgage, a single parent family, and a poor job market.

The effect on the victim is enormous. Responses include anger, anxiety, sleep disturbance and ensuing fatigue, substance abuse, relationship problems and physical illness related to stress. A drop in actual work performance and accuracy results from these symptoms. The victim loses confidence in the organisation but, in a spiral of increased powerlessness, cannot find a way out of the trap. The link between helplessness and depression is well known and the spiral downward is not uncommon when the trap is sprung.

The negative effect on the organisations is just as deleterious and it is strange that CEOs and boards would encourage an activity that, despite being intuitively logical, will be more likely to reduce effectiveness and efficiency. There is a mountain of research that demonstrates that reduced job satisfaction is directly related to reduced performance and quality. There is also vast occupational stress research, which shows that mental health problems (stress, anxiety, depression) are also related to performance, sick leave and staff turnover. Of course high staff turnover is a huge cost to organisations resulting in lost service ability, advertising, recruiting, and training. Of course, there is strong self-destructive element on the part of the perpetrator in abusive relationships, so at least organisations are remaining consistent with the syndrome.

The phenomenon is not confined, as one might think, to the big business end of town. In an age when all organisational activity is based on a business model the public sector is as culpable as the private. In fact, those organisations, such as health, which you would somehow expect to be more sensitive to the wellbeing of their employees, are often worse than others who might not know better. One only has to look at the plight of nurses to see the effect although they are leaving the profession in droves thereby, wisely, avoiding the Petruchio Trap.

The answer to this problem is not simple because, like the exploitation of the industrial revolution, the core of the issue is corporate greed. A solution will involve CEOs and boards of directors being held accountable for creating these damaging co-dependant traps. It will take governments to do what they did with bullying and harassment, which was to expose the behaviour and make it illegal. Or will we see the rise of unionism again to protect these new victims of the industrial age?