Evidence-Based Reviews

Workplace mobbing: Are they really out to get your patient?

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Consider that coworkers’ hostile behavior could be causing paranoid symptoms.



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Mr. G, age 46, works for a large federal government agency in a middle-management position. He presents seeking treatment for insomnia. He says, “I just need a sleeping pill. I haven’t been able to sleep for the last 3 months because everybody at work is talking behind my back and spreading rumors about how I’m crazy. My boss is in on it, too. She is always trying to undermine me and makes a big deal out of every little mistake I make.”

Mr. G is suspicious, asking questions about the confidentiality of medical records. His speech is rapid, and he is anxious but exhibits a full range of affect and no pressured speech or flight of ideas. Mr. G describes early, middle, and late insomnia, decreased energy and interest, and gaining 10 pounds over the past 3 months.

He admits owning a gun and having frequent thoughts of suicide and fantasies of killing his boss, although Mr. G repeatedly affirms he would never act on these thoughts. A week ago, his wife moved in with her parents because, he says, “she just couldn’t stand to be around me any longer.”

I consider involuntary hospitalization for Mr. G. Ultimately I contact his wife, who agrees to pick him up, stay with him overnight, and return with him the next morning. Because the only medication Mr. G is willing to consider is sleeping pills, I prescribe flurazepam, 30 mg qhs.

Mr. G was apparently paranoid, thinking of killing his boss, and had a gun. If his wife had not answered the phone and been willing to stay with him, he might have been involuntarily committed. As it was, further interviews with him revealed that Mr. G had been a target of workplace “mobbing,” and that his insomnia and paranoia developed because of a deliberate campaign by coworkers.

This article discusses how to recognize symptoms of workplace mobbing, using Mr. G’s experience to illustrate the dynamics of this group behavior. An informed mental health professional can be of enormous help to a mobbing victim, but an uninformed professional can unwittingly make the situation much worse.

What is ‘mobbing’?

Initiated most often by a person in a position of power or influence, mobbing has been described as “a desperate urge to crush and eliminate the target…. As the campaign proceeds, a steadily larger range of hostile ploys and communications comes to be seen as legitimate.”1 This behavior pattern has been recognized in Europe since the 1980s but is not well recognized in the United States.

Davenport et al2 brought the phenomenon and its consequences to the U.S. public’s attention in 1999 with the publication of Mobbing: emotional abuse in the American workplace. Otherwise, little professional literature on workplace mobbing has been produced in the United States.

A PubMed search on the term “mobbing” limited to 1982 through October 2008 returned 95 listings, excluding those dealing purely with ethology, but only 1 report from the United States. Studies from outside the United States indicate that mobbing is relatively common (Box).

Mobbing, bullying, and harassment. The term “workplace mobbing” was coined by Leymann,3 an occupational psychologist who investigated the psychology of workers who had suffered severe trauma. He observed that some of the most severe reactions were among workers who had been the target of “an impassioned collective campaign by coworkers to exclude, punish, or humiliate” them.

Many researchers use the term mobbing to describe a negative work environment created by several individuals working together.13 However, some researchers such as Namie et al4 use the term workplace bullying to describe the creation of a hostile work environment by either a single individual—usually a boss—or a number of individuals.


Workplace mobbing: How often does it occur?

In 1990 Leymann3 estimated that 3.5% of the Swedish workforce had been victims of significant mobbing. Studies from various other European countries have estimated prevalence of mobbing at 4% to 15% of the total workforce.10

Studies from Europe have shown that all age groups can be affected, but that posttraumatic stress disorder among mobbing victims is more common in patients age >40. Both genders are equally at risk.6

CASE CONTINUED: Why I first thought ‘paranoia’

During our first interview, Mr. G said that 6 months before he sought treatment he had reported misuse of government property by his supervisor’s boss. The case was investigated and dismissed. Mr. G’s supervisor never confronted him about the complaint, but shortly afterwards Mr. G started to notice disturbing changes in the workplace.


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