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Beyond bullying.

Bullying is a sensitive topic today. Although bullying has always been a social problem, society can no longer ignore its consequences. According to the Universal Declaration of Human Rights adopted by the UN General Assembly as long ago as 1948, no one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment. (1)

With the rise of suicides because of bullying, a movement began to develop policies of zero tolerance around acts of bullying. (2,3) Awareness, discussion and education are paramount in battling the destructive behavior, and legislation is evolving to protect the victims. To date, 32 state and territory legislators have introduced a Healthy Workplace Bill. The legislations function is to set boundaries on what is and is not healthy behavior in the workplace. (3)

Dental offices are not immune to the destructive effects of bullying, and bullies can be found throughout the hierarchy of the dental office: dental assistants, receptionists, dental hygienists, office managers, associates and dentists. There have been documented cases where a dental assistant bullied a hygienist (4) and where multiple workers inflicted their bullying behavior as a "clique." (5,6)

The author of this article experienced working in an office during an instance of bullying that showcases the fallout of such behavior. An associate dentist who had a short-term (four-month) contract in the office felt bullied by a group of workers in the office. Upon finishing her contract, she sought legal counsel and had a lawyer draw up letters of slander against five dental staff. The result was a crisis and a disruption to the entire office. Morale and trust were eroded and a strategy had to be created to address the highly sensitive issue. The strategy proved to be an investment for the office, with the dentist-employer absorbing the following costs: four individual counseling appointments for each staff member with a qualified counselor; four full days of the entire staff working with this counselor to rebuild the team, including the cost of lost production on those days and full salaries for all employees on the team-building days. There may also have been the cost of a payout to the disgruntled dentist, as no further legal action was taken. Clearly, bullying has costs.

National statistics from 2014 showed that 27 percent of employees are targets of workplace bullying, with 72 percent of employers not addressing the toxic environment or even acknowledging it. (7) Employers were sometimes themselves the bullies, and when not, they sometimes diminished the bullying actions by discounting or rationalizing the behavior. Lack of acknowledgement and support results in loss of engagement. A job that was once meaningful to employees becomes traumatic for them. In 2014, 13 percent of employees eventually decided to leave. Other employers released employees without just cause (24 percent) and 40 percent of targets quit their jobs due to declining mental and physical health. (7)

It should be noted that not all aggressive and inappropriate behavior constitutes bullying. Workplace bullying is when one person or group of people in a workplace singles out another person for unreasonable, embarrassing, or intimidating treatment. (5) The workplace perpetrator intentionally campaigns to jeopardize another person's livelihood. (8) Bullies feel threatened by the target and are insecure, immature and driven to seek recognition within the organization at any cost. They seek increased social status by dominating those they see as rivals. (8,9)

Recognizing workplace bullying is imperative to addressing it. Examples include: (6,8,10,12)

* Malicious criticism of the target

* Repeated lies about the target

* Blaming the target for something without proof

* Intentional isolation of the target

* Harsh, inappropriate language directed at the target

* Humiliation of the target in front of others

* Micro-managing the target

* Minimalizing concerns from the target or observers

* Causing the target to feel shame or guilt

* Withholding pertinent information from the target

* Setting unrealistic deadlines for the target

* Undermining the target's work

* Accepting credit for work the bully didn't do

* Rationalizing inappropriate behavior.

Profile of the Target

Both superiors and coworkers bully their target because the target is a threat to the bully. A common target is the employee who is independent in nature and refuses to be subjugated in any demeaning way. (9,13) This inflames the bully, who often escalates the attacks, using abusive language or undermining the credibility of the target. Bullies want to make their targets look bad (and therefore less valuable) and themselves look better within the organization. (9) For bullies, competence is competition. (14)

Underlying this behavior is jealousy of the targets. Targets are often talented workers with solid social skills who are liked by others. (9,13) They demonstrate warmth and empathy (even for the bully) and are nonconfrontational. (9) The bully, on the other hand, may feign friendliness in order to gain information that can be used against the target. The "two-headed snake" tactic is a way of sabotaging the target, wherein the bully enlists others within the organization to undermine this capable worker. (15) This seems to support the saying that, "Those who can, do ... those who can't, bully." (16)

A second type of person targeted is the staff member who is non-confrontational and kind. This person has no interest in inflaming others and often will neither confront the bully nor report him or her. This staff member doesn't intimidate others and wants to be a team player. The bully feeds on this target's collaborative nature, knowing that the target is predisposed to give the bully the benefit of the doubt. (9)

This target's character attributes are healthy, team-building traits, whereas consensus building, coorperation and collaboration are not a part of the bully's arsenal of communication. Bullies see others who exercise these traits as threats to their own power. (9) According to the Workplace Bullying Institute, "The most easily exploited targets are people with personalities founded on a pro-social orientation--a desire to help, heal, teach, develop and nurture others." (9)

The team player is not equipped to deal with the vicious attacks that can come at any time. Unless this negative behavior is halted, over time, there can be an eroding of the target's effectiveness, quality of life and happiness. (17)

Profile of the Bully

The bullies' manipulation is meant to demean coworkers while elevating the bullies' self-importance. Behind the facade of false confidence, they are actually insecure, with low self-esteem. (18) They will backstab their targets, telling them one thing while saying something entirely different to others. They aim to please those in superior positions while secretly attacking a colleague. (18) Fuelled by anger and aggression, bullies are skilled at controlling their outward appearance much of the time--especially in front of the people they want to impress. (18) In the dental office, this would usually be the dentist or office manager. Bullies vent their anger on those who do not matter to them, or on people they are actively trying to undermine. Consequently, the team member being oppressed is the first to see behind the faccade. Bullies use unethical tactics to get what they want and will resort to lies for their own benefit. (18)

Some bullies are unaware of how others perceive them, but others are fully aware of their intimidating behavior. It is highly possible that they inflate their own value by diminishing others' value and do not expect to be challenged. (18) It is not unusual for dental team members to recognize one of their teammates as a bully, but decide not to address the issue because they don't want to become the focus of the bully's wrath.

Bullies have underlying psychological issues that perpetuate antisocial behavior. (19) They have not developed persuasive communication skills and instead push their agenda through aggression. Although their self-esteem may appear inflated, they actually have poor self-esteem, resorting to aggressive behavior that in reality diminishes them, despite giving them a false sense of power. (19) Bullies lack collaboration skills and may have learned bullying from having been bullied themselves. At some point in their lives, they have been hurt, and they reflect their own pain onto others. (20)

Profile of the Bystander

In a sense, the bystanders are victims of bullying as well. Although they are not direct targets, they are subjected to uncomfortable, traumatic situations where they are put in a position of having to choose whether to do nothing or exercise the ability to respond to injustice. We all have the responsibility to intervene. (21) Healthy bystander behavior is the act of responding to inappropriate behavior in a way that expresses disapproval.

Before taking action, the responsible bystander needs to assess if he or she is safe from danger. If the bystander feels safe, it is appropriate to verbalize disapproval of the bully's behavior--or at the very least, leave the scene, thus robbing the bully of an audience and thus diminishing the bully's power. (22)

Martin Luther King said, "He who passively accepts evil is as much involved in it as he who helps perpetrate it." (23) Although in the past, people have remained silent in the witnessing or the knowledge of abuse and bullying, the trend, reflected in recent legislation, is to hold us all responsible for inappropriate behavior.

Costs of Bullying to the Office

Research conducted by the Bureau of National Affairs claims that $5 to $6 million is spent per year because of workplace bullying. (24) The stress placed on the targets has implications not only for their health, but it also has financial implications for the workplace. (25) Absenteeism is high in offices where bullying behavior is not checked, so productivity declines. (26) Targets, who are often talented and contributing members of the staff, may take sick days for stress-related illness. Absenteeism also has costs to offices in hiring replacement staff as well as increased costs for retraining because of high turnover. (27) This can result in higher health care premiums for the owner of the practice. (28) In addition, there is the cost of hiring and training new employees because the most talented and productive employees leave the bullying environment. Employer liability can be substantial. (15,29)

With such prohibitive expenses, it would be wise for employers to take reports on bullying seriously. However, statistics show that employers consistently fail to respond appropriately to bullying complaints. According to the 2014 U.S. Workplace Bullying Survey, 25 percent of employers denied a problem, 16 percent discounted it, 15 percent rationalized it, 11 percent defended it and 5 percent encouraged it. On the positive side, 12 percent of employers worked to eliminate the bullying, 10 percent acknowledged it and six percent condemned it. (7) The denial or discounting of incidents, along with a lack of anti-bullying policies in the workplace, leaves targeted employees vulnerable.

What Everyone Can Do

Everyone has a responsibility to prevent bullying in the dental office ... the bully, the bystander and the victim. Although it can be tempting to sweep it under the carpet, bullying behavior should not be ignored. Once it has a foothold in an office, it becomes habitual and can escalate into a toxic environment, spreading an infection throughout the workplace. Developing a healthy work environment through healthy relationship training is proactive and, in the long-term, cost-effective. (21)

Educate all team members on what bullying behavior looks like and how it can be prevented. If, in spite of education, it occurs, get help and support from professional experts. Not only may targets need professional help to defend themselves against the bully, but perhaps even more importantly, the bully needs help developing skills for healthy relationships. Like a dental infection, until the root cause is addressed, there will be no healing. Nelson Mandela said, "The oppressor must be liberated just as surely as the oppressed." (30)

As difficult as it is to talk about bullying, it is good that today it is in the public eye. We need to make a concerted effort to understand the bully, the target and the bystander. When we teach a code of conduct to bullies, give assertiveness skills to the targets and create a compassionate culture where bystanders intervene, a shift will occur. This shift will be reflected in a healthier tomorrow for both the dental office and society.


1. Become aware of the bullying policies in your workplace. Know if you have an anti-bullying policy in place and who the go-to person is if you need to report incidents.

2. Keep a journal of all of the incidents. Record the date, time and details of the events along with the outcomes. If witnesses were present, add this to your log.

3. Keep copies of all hard copy correspondence; i.e., letters, notes, emails, etc.

4. Speak to people whom you trust about the incidents. These people can be friends, family members or coworkers.

5. Seek support through counseling or workplace assistance programs.

6. Do not retaliate. Although it is tempting to retaliate, you may end up looking as if you are the instigator, since bullies will have made sure to keep their own behavior unnoticed by superiors.

7. Keep copies of the documentation of your performance history (performance evaluations, patient testimonials, etc.).

8. Continue doing your best in your job.

9. Confront the bully. Tell the bully that his or her behavior is inappropriate, and you wish it to stop.

10. Focus on the problem. Keep your language non-accusatory while letting the bully know how they made you feel.

11. Remain professional. In the words of yogi and guru Paramahansa Yogananda, "be calmly active and actively calm."

12. Report the incident. If no resolutions are forthcoming, report the incidents with all of the documentation to the human resource manager.


(1.) United Nations. The universal declaration of human rights. Available at: human-rights/.

(2.) Coloroso B. The bully, the bullied and the bystander. Toronto: HarperCollins Publishers Ltd. 2006, p. 40.

(3.) The Healthy Workplace Campaign. Healthy Workplace bill. Available at:

(4.) Watterson DG. Workplace bullying. Available at: www. workplace-bullying.html.

(5.) Drew CP. Surviving bullying in the workplace. Available at: issue-3/features/surviving-bullying-in-the-workplace.html.

(6.) Kane S. Workplace bullying: bullying facts and figures what is workplace bullying? Available at: http://

(7.) Workplace Bullying Institute. 2014 WBI U.S. workplace bullying survey. Available at:

(8.) Workplace Bullying Institute. Employer Resource Council: 20 subtle signs of workplace bullying. Available at:

(9.) Workplace Bullying Institute. Who gets targeted, why me? Available at: problem/who-gets-targeted/.

(10.) Lipinski J, Crothers L (eds). Bullying in the workplace: causes, symptoms and remedies. New York: Routledge; 2014, p. 179.

(11.) Work life wellness: stop workplace bullying--dealing with workplace bullies. Oh! Canada. 2015; l4(Summer).

(12.) Canadian Centre for Occupational Health and Safety. OSH answers fact sheets, workplace bullying. Available at:

(13.) Namie G, Namie R. The bully at work--what you can do to stop the hurt and reclaim your dignity on the job. Naperville, Ill.: Sourcebooks; 2000, p. 23.

(14.) Oliker DM. Is it competition or bullying? winning at the other's expense. Available at: www.psychologytoday. com/blog/the-long-reach-childhood/201203/is-it-competition-or-bullying.

(15.) Namie G. Workplace bullying: escalated incivility. Available at: workplace-bullying-escalated-incivility/.

(16.) Field T. Bullying in medicine, those who can, do; those who can't, bully. BMJ. 2002;324(7340):786.

(17.) Workplace Bullying Institute. Being bullied? start here. Available at: individuals/problem/being-bullied/.

(18.) Bullyonline. Serial bully. Available at: http://

(19.) Donnellan MB, Trzesniewski KH, Robins RW, et al. Low self-esteem is related to aggression, antisocial behavior, and delinquency. Psychol Sci. 2005;16(4):328-35.

(20.) Harwood W. Win Harwood's blog. Bus driver bullies mother and children. Available at: https://winharwood.

(21.) Namie G, Namie R. The bully free workplace--stop jerks, weasels and snakes from killing your organization. Holden, N.J.: John Wiley & Sons, Inc., 2011.

(22.) Dilbeck M. The power of a parent. Available at: www.

(23.) Martin Luther King, Jr. quote. Available at: http://

(24.) Mattice CM. White paper. 7 steps to a healthy workplace. Available at: assets/docs/White_Paper_Seven_Steps.3122517.

(25.) Workplace Bullying Institute. Impact of workplace bullying on individuals. Available at: www. individuals/impact.

(26.) Bullying Statistics. Anti-bullying help, facts, and more, do you have workplace bullies at your job. Available at:

(27.) Merhar C. Employee retention--the real cost of losing an employee. Zane Benefits. Small business employee benefits and HR blog. Available at: http://www.

(28.) Workplace Bullying Institute. Estimating the costs of bullying. Available at: individuals/solutions/costs/

(29.) Workplace Bullying Institute. Economic harm. Available at: impact/economic-harm/

(30.) Ward B. Learning from Mandela: on going beyond the obvious goal. Available at: uncategorized/87823/learning-from-mandela-on-going-beyond-the-obvious-goal/.

By Dorothy Garlough, RDH, MPA

Dorothy Garlough, RDH, MPA, YES, is an innovation architect facilitating strategy sessions and forums to orchestrate change in the dental office. As an international speaker and writer, she trains others to broaden their skill-set to include creativity, collaborative innovation and forward thinking. She recognizes that engagement is the outcome when the mechanisms are put in place to drive new innovations. For more information, visit her websites and
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Title Annotation:SPECIAL FEATURE; bullying in dental offices
Author:Garlough, Dorothy
Date:Apr 1, 2016
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