Gender and Workplace Bullying: Men's Experiences of Surviving Bullying at Work.

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research-article2015

QHRXXX10.1177/1049732314566321Qualitative Health ResearchO’Donnell and MacIntosh

Article

Gender and Workplace Bullying: Men’s Experiences of Surviving Bullying at Work

Qualitative Health Research 1–16 © The Author(s) 2015 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1049732314566321 qhr.sagepub.com

Sue M. O’Donnell1 and Judith A. MacIntosh1

Abstract Although men are targets of workplace bullying, there is limited research focused on their experiences. To address this gap, we used a qualitative grounded theory approach and interviewed a community sample of 20 Atlantic Canadian men to explore and explain their experiences of, and responses to, bullying. The main problem identified by men was a lack of workplace support to address and resolve the bullying, a challenge named abandonment. Men addressed this problem by surviving, a process that involved efforts to manage persistent bullying and the associated consequences. Men experienced physical, emotional, and social health consequences and, contrary to prevailing assumptions related to men’s help-seeking behaviors, men want support and many sought help to address the problem and its consequences. Responses to abandonment and the associated consequences varied according to a number of factors including gender and highlight the need for research aimed at understanding the gendered nature of bullying. Keywords gender; grounded theory; health behavior; health seeking; masculinity; men’s health; occupational health; social support; violence; workplace Even though both women and men are targets of workplace bullying (WPB), to date, there has been very little research aimed at understanding men’s experiences (Salin & Hoel, 2013). Furthermore, understanding of men’s experiences has been based primarily on combined samples of men and women; an approach that reinforces the prevailing assumption that all men face similar experiences and challenges when they are bullied. Men might face different challenges when they are bullied for a number of reasons. For example, constructions and expressions of gender could influence vulnerability and exposure to experiences of WPB as well as the nature and severity of those experiences. Health consequences of WPB and subsequent management might also vary according to gender. Even though gender is often assumed to be a fixed trait, many theorists and researchers have argued that it is something individuals do and that changes over time (Connell, 1995; Henson & Krasas-Rogers, 2001; Messner, 2007; Rapala & Manderson, 2005). Based on this view, multiple forms and expressions of gender can and do exist (Connell, 1995). Thus, not all men act in ways that are considered “typically” masculine, rather men can think of and express themselves in ways that range from masculine to feminine and anywhere in between. Despite growing recognition of gender as a social construct, in the context of studies related to WPB,

sex difference research is often mistakenly reported as gender research. For example, even though numerous articles include the word “gender” in the title, much research has involved sex comparisons (e.g., comparisons between women and men) and thus, the ability to account for gender, including variation or difference among men, is limited (see, for example, Salin, 2003). The research discussed here reflects this limitation and the current state of knowledge in the field of WPB.

Literature Review Overall, sex difference and initial gender research has indicated that some men can be targeted for displaying non-masculine behaviors (Berdahl, Magley, & Waldo, 1996; Lee, 2002) or working in non-traditional roles (Eriksen & Einarsen, 2004; Henson & Krasas-Rogers, 2001; Richman et al., 1999). When it comes to recognizing and naming the problem of WPB, Salin (2003) suggested that, in general, men might be more hesitant than women to identify themselves as targets. 1

University of New Brunswick, Fredericton, New Brunswick, Canada

Corresponding Author: Sue M. O’Donnell, Faculty of Nursing, University of New Brunswick, 33 Dineen Drive, Fredericton, New Brunswick, Canada E3B 5A3. Email: [email protected]

Downloaded from qhr.sagepub.com at UNIV OF THE INCARNATE WORD on January 14, 2015

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Qualitative Health Research

This interpretation was based on differences in selfreports of experiencing bullying between women and men when participants used two different approaches to identify whether they had been bullied: One approach was a behavioral inventory measuring exposure to bullying tactics and the second approach involved presenting participants with a definition of WPB and asking them to identify whether or not they had been bullied. Because women were more likely than men to identify themselves as being bullied when presented with a definition, and there were no differences in rates of bullying using the behavioral inventory, Salin concluded that men might be reluctant to openly identify themselves as targets of bullying. Olafsson and Johannsdottir (2004) also used both a behavioral measure and definition to identify prevalence rates of WPB among women and men. They noted that there was no significant difference in rates of WPB between women and men using the behavioral inventory, and prevalence rates were higher among men than women and when using a definition approach. Differences in these findings highlight the obvious limitations of making gender interpretations based on sex difference research. According to existing sex difference research, men and women might respond to and manage WPB and the associated consequences differently. For example, there is evidence to suggest that men are more likely than women to respond to bullying by confronting or retaliating (Lee, 2002; Olafsson & Johannsdottir, 2004; Salin, 2003), responses that could contribute to an escalation of conflict and perpetuate the problem of bullying. When it comes to managing the health consequences of WPB, some researchers have noted that bullied men were less likely than bullied women to seek help for their health (Olafsson & Johannsdottir, 2004; Salin, 2003), including emotional health (Shannon, Rospenda, & Richman, 2007). These results are consistent with findings from studies investigating men’s health behaviors in general, which have indicated that, overall, men are less likely than women to seek help for their health (Addis & Mahalik, 2003; Courtenay, 2000). Because WPB can result in serious health consequences for men, if men do not identify themselves as being bullied, or are reluctant to seek help, health consequences might persist or worsen. Because understanding of men’s experiences of WPB has mainly been limited to comparisons between women and men, variation in men’s experiences has been largely unaccounted for. To understand and address the problem of WPB among men, it is important to examine and focus on those cases, for example, where men do seek help. Furthermore, it is critical to learn about varying conditions, including gender, that influence men’s experiences of WPB. To address these gaps we used a qualitative

grounded theory method to explore and explain men’s experiences of and responses to WPB, and to examine whether gender or other qualities of difference influenced these experiences.

Method “Grounded theory is a paradigm for discovery of what is going on within a particular arena” (Glaser, 2005, p. 145) and is particularly useful for studying social phenomena about which little is known (Beck, 2004; Wuest, 2007). Because the goal of grounded theory is to generate a formal substantive theory that accounts for a main concern and pattern of behavior that is relevant to those involved (Glaser, 1978), it was a logical approach to examining what men find most challenging about responding to experiences of WPB and how they went about addressing these challenges, an area about which little is known. The focus on contextual influences that is characteristic of grounded theory allowed us to explore and understand factors that accounted for variation in how men responded to bullying such as gender. Even though our approach to grounded theory is rooted in the original strategies outlined by Glaser and Strauss (1967) and subsequent writings by Glaser (1978, 1992, 1998), we believe that knowledge gained from research is shaped by both the researcher and participants and thus is socially constructed (Charmaz, 2003).

Sample We recruited 20 men from the Atlantic Canadian provinces of New Brunswick (17), Nova Scotia (2), and Newfoundland (1) using computer, newspaper, and radio advertising. Initial sampling was determined based on the phenomenon of interest (Chenitz & Swanson, 1986) and to be included in the study, men had to be English speaking, above the age of 18 years, and had to have reported experiencing WPB. To determine bullying, we presented interested participants with both a definition and a list of bullying behaviors and asked them whether they would describe themselves as having been bullied. Men in the study ranged in age from 35 to 75 years (average 56 years) and all identified themselves as White. Most participants had some form of post-secondary education including college or university (14) and some had high school education (5) or less (1). At the time of bullying, 15 men were partnered and 5 were single. Men worked in a broad range of workplaces and were employed in various professions, including construction, trade work, education, security and law enforcement, health care, business, and business management. Men were bullied most often by other men (60%) but were also targeted by women (20%) and groups of men and


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O’Donnell and MacIntosh women (20%); a phenomenon known as mobbing (Leymann, 1996). Most men were bullied by superiors (75%). These findings are consistent with other research reports where it has been noted that men were bullied most often by other men (Jones, 2006; Namie, 2003; Zapf, Einarsen, Hoel, & Vartia, 2003) and in 70% to 80% of cases persons who bullied were in positions of power (Namie, 2003; Workplace Bullying Institute, 2007).

Data Collection and Analysis We began collecting data in 2011 after receiving approval from the University Research Ethics Board. Following informed consent, we conducted one-on-one interviews that lasted 1 to 1½ hour and were guided by a semistructured questionnaire. Audio recordings were transcribed by the authors (17) and a paid transcriptionist (3) and were analyzed using constant comparison. Constant comparison is a data analysis strategy that involves moving back and forth between the data and the scene of study comparing incident to incident until categories emerge (Beck, 2004). Using this strategy, we inductively derived ideas and categories from the data and then deductively compared and adapted them through ongoing sampling and data collection (Beck, 2004; Wuest, 2007). We began the analysis with open coding that involved examining interviews line by line to document the discovery of emerging codes and their properties (Beck, 2004; Chenitz & Swanson, 1986). Initially, we identified numerous codes to name what was happening in the data (Wuest, 2007). Using constant comparison, these codes were listed and then grouped into more abstract categories, called substantive categories (Wuest, 2007). To facilitate theoretical coding and identify theoretical relationships, we examined the emerging substantive categories using Glaser’s (1978) Six Cs. This involved examining and documenting the causes, contexts, contingencies, consequences, covariance, and conditions associated with each of the categories. Using this approach, relationships among categories became clearer (Wuest, 2007). As a result of the theoretical coding process, earlier ideas about the main problem and core category that had developed early on were confirmed and we gave each a tentative label (Wuest, 2007). In the end, we named the main problem abandonment. Examining categories while asking the question, “What is it that men find most difficult about managing and addressing experiences of bullying?” helped us identify this problem. The core category was named surviving and emerged as an overriding pattern that described how men worked to address abandonment. Unlike some grounded theories, surviving did not emerge as a basic social process with two or more stages, rather as a single core process with process strategies (Glaser, 1978).

At this point, those categories that did not relate to the core category of surviving were dropped from the analysis. Categories that accounted for variation in surviving (contextual influences) also became clearer after we had identified the core category. We named these contextual influences support, financial considerations, severity of health problems, and gender. Asking the question, “What factors influence men’s ability to survive abandonment?” helped us identify these influences. It is noteworthy that the influences of health and support were identified as being relevant to women’s experience of WPB in our previous research (O’Donnell, MacIntosh, & Wuest, 2010). We tested and refined the emergent theory of surviving through constant comparison to identify gaps among categories (Wuest, 2007). Through second interviews (one telephone, two face-to-face, and four via email conversation) and theoretical sampling of existing literature, we developed and refined the emerging theory (Charmaz, 2003). We used Glaser’s criteria of fit, grab, work, and modifiability to evaluate the theory (Charmaz, 2003; Chenitz & Swanson, 1986). Once categories were saturated and no new information emerged (Artinian, 2009; Charmaz, 2003; Glaser & Strauss, 1967), we used memos that included notes about evolving coding schemes and theoretical ideas as a basis for the final written research report (Charmaz, 2003; Wuest, 2007). As a means of protecting anonymity, participant names or pseudonyms are not included. To situate the theory of surviving within the broader context of WPB, we first describe men’s experiences of WPB. We then provide a theoretical overview of the central problem of abandonment, the process of surviving, and contextual influences (which have emerged from and have been defined in terms of the data). Next, we present the process of surviving that involved processes of addressing health and seeking relief. Contextual influences are woven throughout the description of the theory to explain differences in how men survive.

Results Men’s Experiences of WPB Men in this study were targets of persistent bullying that involved a repeated pattern of harmful behaviors that included things such as manipulation, intimidation, humiliation, teasing, belittling, name-calling, criticism, blame, exclusion, isolation, punishment, oppression, withholding of information and resources, undermining work, credibility, and reputation, removing work roles and responsibilities, altering work expectations, hampering or denying advancement, dismissal and threats of dismissal, yelling, and physical threats. One participant


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noted, “The belittling, insulting, exclusion. The demeaning and downright ignoring. My boss would call a staff meeting, and I would not be invited, would find out later.” Another described, “I was required to post my whereabouts whenever I left the office while the other employees were free to come and go as they saw fit.” These behaviors are consistent with bullying tactics described by other researchers (Namie & Namie, 2003; Salin, 2003), including our previous studies with women who had experienced WPB (MacIntosh, O’Donnell, Wuest, & Merritt-Gray, 2011; O’Donnell et al., 2010). Some men described bullying behavior as subtle and insidious (e.g., occurring in private or behind closed doors), whereas others described it as more overt (threats or humiliating jokes made in front of others).

Health Consequences Emotional consequences were most commonly described and included stress, anxiety, panic attacks, depression, self-doubt and blame, lowered self-confidence and esteem, humiliation, fear, anger, frustration, irritability, powerlessness, hopelessness, decreased concentration, and memory changes. Some men described post-traumatic stress symptoms and disorder, self-harm, and suicidal thoughts. One man expressed, “I developed panic attacks and depression from this, and I still deal with it today. I still take medication.” Another described struggling with thoughts of suicide, “I am not proud to say, but there were four occasions where I had had enough. I didn’t attempt it, but everything was set up. The last time it happened I wrote the note.” Physical consequences, which were sometimes physical manifestations of stress, included headaches, sleep disturbances, decreased energy and fatigue, weight changes, gastrointestinal problems, cardiac problems, and exacerbation of chronic illness. One individual noted, “I was grinding my teeth so much from the stress that I was beating out my teeth, and I was getting these wicked headaches and stuff”; “I started not being able to sleep, and my memory was starting to become a problem”; “My cholesterol went up, stomach problems. I’m on pills for all of that stuff since this happened.” Bullying influenced personal, professional, and financial well-being and resulted in social consequences such as changes in relationships, withdrawal and isolation at work and at home, unemployment, loss of pension or reduced pension, reduced pay (disability, over qualified for jobs), career reputation changes, and health care costs. One man described, “I became testy with people including my loved ones.” Some other men described the financial impact: “Disability was nothing compared to what I was getting and with that comes your credit, trying to survive, you know what I mean.”

Responses to Bullying In response to experiencing WPB, most men took some action (formal or informal) to address and resolve the problem. This involved seeking information and help from workplace professionals, including managers, bosses, human resource personnel, and union representatives. Although men perceived some of these sources as supportive, others were described as adding to the problem. There were no cases where seeking help from these sources resulted in workplace organizations taking appropriate steps to resolve the bullying. The term appropriate is used because, when present, workplace solutions were often indirect and resulted in additional consequences for participants. Some men, for example, were offered opportunities to alter schedules or work from home as a means of dealing with the bullying. Such responses resulted in feelings of frustration and isolation as workplace organizations were seen as avoiding responsibility and perpetuating the problem: “I have a job to do. I don’t just sit in a corner and do it myself. I oversee 14 people. Why don’t you deal with the problem and tell that man to back off, that is the problem.” Among those men who chose not to seek formal help, there was often a perception that seeking help and bringing attention to the bullying would make the problem worse or would not result in positive or lasting change. These opinions were informed by consideration of the risks and benefits of speaking up and how workplace problems had been handled in the past. A number of men, for example, described feeling as if there was no point in speaking up: “After certain conversations with certain individuals you realize that nothing is going to change.” Although choosing not to take action might be seen as a passive or ineffective strategy, in some circumstances it was a useful approach as a number of men described experiencing negative consequences as a result of speaking up to try resolve the bullying. After having confronted the bully one man described, “Well he [bully] realized he was called out. He didn’t say anything. But then after that, it just got worse.” Based on her qualitative study of quitting and other forms of resistance to WPB, LutgenSandvik (2006) reported that speaking up resulted in negative consequences for targets, including having their integrity, reputation, and mental health questioned. The stress and energy required to go through the process of formal reporting (particularly when unsuccessful) was devastating for some targets. After having gone through a lengthy investigation process, one man described how the investigator (who he perceived as having written a clear and fair report) was terminated, the report was deemed biased, and a new investigation was ordered. When administration presented this news the participant described, “I stood up and said, ‘I understand


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O’Donnell and MacIntosh why people jump off the bridge,’ and I walked out the door. I cried and cried and cried. It was just unbelievable, we had put so much into it.”

Overview of Problem, Process, and Contextual Influences Problem of Abandonment Even though in some cases men were not surprised by the lack of support available to address WPB, all described feelings of distress and injustice associated with the desire for support and beliefs that WPB should not be allowed to persist in workplace organizations. In this context of divergent support, the central problem identified in these data is abandonment. Despite the need for support, men described feelings of being abandoned again and again: “I would go to the bosses that were involved and tell them what is being done to me and they wouldn’t do anything”; “I got no support from HR [human resources], they left me, did not contact me. I told EFAP [employee and family assistance program counselor] my story. I still couldn’t get any support from the company, they just abandoned me”; “I’ve got no closure with the whole thing because it was never addressed, it was just dropped.” Another man expressed similar feelings based on the reaction from his employer: “The lack of response from the company, I felt like I was being abandoned.” Disagreement between perceptions or beliefs about how employers ought to handle bullying and how it was actually handled added to the sense of abandonment. Abandoning duties as an employer, through a lack of interest, effort, or will to address and resolve the bullying, resulted in ongoing bullying and, in turn, persistent health consequences. Perceptions of, and commitment to, employers were also negatively affected. Abandonment placed men in a position where they were forced to carry on in a context of daily stress and uncertainty, a process that was named surviving: “I carried on and did my work. But I was carrying on with this extra burden of having to watch my back all the time or keep my head down.”

Process of Surviving Surviving took place in response to abandonment and was a process that involved efforts to function and carry on despite a lack of workplace support to address and resolve WPB. Men survived by addressing health and seeking relief, processes that did not occur as ordered stages rather can occur independently or concurrently depending on the nature and context of the bullying and the contextual influences of support, severity of health problems, financial circumstances, and gender. Addressing health and seeking relief were interdependent processes, for

Table 1. Process of Surviving. Process categories Addressing health Seeking relief

Sub-Processes Caring for self, seeking care Protecting, seeking resolution

example, decision making around seeking relief was often informed by health and necessary actions to address health (Table 1).

Contextual Influences Support. In the context of this study, men described support as the nature and availability of help and resources from a range of sources, including formal help from workplace, business, and community, and health care professionals and informal help from friends, family, and coworkers. The nature and availability of help from these varying sources influenced surviving by limiting or enhancing men’s capacity to manage abandonment and is consistent with Simich, Beiser, Stewart, and Mwakarimba’s (2005) conceptualization of support as enhancing health and influencing stress and coping during life transitions. The mere presence of support and support mechanisms (e.g., human resources, policies to address WPB) was not sufficient for addressing the problem and, thus, the nature and availability of support refer to whether support was available, accessible, appropriate, helpful, and so on. Likewise, support was affected by men’s ability and willingness to reach out and seek help, a factor influenced by perceived benefits and risks and ideas about when and how men ought to seek help. Severity of health problems. Even though all participants experienced health consequences as a result of abandonment and ongoing WPB, health symptoms and problems varied. Less severe health problems were characterized by symptoms of stress and anxiety and continued ability to manage work and day-to-day activities and more severe health problems were characterized by acute depression and lack of motivation, withdrawal and isolation, post-traumatic stress symptoms and disorder, suicidal thoughts, and/or being hospitalized or admitted to treatment facilities. Strategies applied throughout the process were contingent on the severity of health symptoms, for example, when health was very poor some men expressed feeling that they had little choice but to leave the workplace as a means of surviving. Financial circumstances. Financial considerations and resources influenced surviving by constraining or enhancing perceived options for addressing health and seeking relief. Employment benefits including health insurance


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and sick leave and disability benefits, for example, limited or enhanced options for addressing health. As one man described, “Well I quit seeing the psychiatrist because I just can’t afford to keep paying for it.” Consideration of job opportunities and employability, family responsibilities, number of years to retirement, and pension benefits also influenced perceived choices for addressing abandonment. Gender. In the context of this study, we used the term gender to describe how societal, familial, and personal beliefs about how men ought to behave influenced men’s day-to-day lives and interactions with others. Social influences, including upbringing and role socialization, cause different men to act and respond to experiences of WPB and the associated health consequences in different ways. These factors are consistent with social constructionist views of gender as a fluid construct that is shaped in relation to social, cultural, and historical contexts (Connell, 1995; Helgeson, 2009; Johnson, Greaves, & Repta, 2007; Messner, 2007). For example, when seeking help to manage problems was limited by men’s thoughts that they ought to be strong and tough or manage challenges independently, surviving was more difficult. On the contrary, when seeking help was a usual approach to handling problems, surviving was easier.

Theory of Surviving Addressing Health Addressing health was a process of managing the health consequences of abandonment and was aimed at understanding and dealing with health problems. Men addressed health by caring for self and seeking care from others, including health care professionals. Strategies of caring for self and seeking care were used concurrently, or in isolation, and were influenced by a number of factors, including the nature and severity of health problems. For example, some men sought care when caring for self was no longer sufficient for managing symptoms and others relied on both processes to survive. Actions to address health involved more immediate strategies aimed at coping with and minimizing symptoms as well as more measured strategies aimed at understanding and managing underlying health problems. Even though some differences in strategies to address health exist, addressing health also emerged as an important strategy in our grounded theory explaining women’s experiences of sickness absence (requiring a sick leave from work) when they were bullied (O’Donnell et al., 2010). Caring for self. Caring for self was a process of dealing with daily stressors and symptoms associated with

abandonment and ongoing WPB and involved the use of personal coping strategies; strategies that varied according to individual coping styles and skills and contextual influences. Helpful strategies aimed at caring for self include the following: reading, writing, exercising, focusing on hobbies and spirituality, and talking to and spending time with family, friends, and others. Neglectful or potentially harmful ways of caring for self include the following: lashing out, over and undereating, increasing or initiating substance use (including cigarettes, alcohol, and drugs), isolating and keeping to self, and suicidal thoughts and self-harm. Writing about experiences as a way of documenting the bullying and demonstrating evidence of this significant life event was a useful approach to coping. This took many forms, including keeping track of events in ledgers, letters, reflective documents, and poetry. Even though the process of writing and recalling details of experiences sometimes invoked stress, important benefits included sorting through thoughts and feelings, legitimizing and providing proof of the experience, and providing an outlet for reprieve. One man described turning to writing as a form of release: “I do a fair bit of writing and I write a lot of poetry, so I get a chance to get back at people in my poems.” In many cases, these documents were not shared with others, rather kept private. Some men who felt that the problem needed to be addressed or exposed as a matter of principle did submit their writing to employers and others considered it: “I have a letter for [company president], the head guy with the company, and I want him to read it.” Reading provided an opportunity for men to escape and, in some cases, explore and learn about WPB: “I stumbled across it [information about WPB] on one of those early mornings when you can’t sleep, so I researched it a bit more, and the profiles were a perfect match.” Reading and learning about WPB via books or the Internet resulted in a better understanding of the problem and served to validate experiences by confirming that they were real and legitimate. Reading for pleasure provided a useful distraction and short-term relief; however, it was often more difficult when health was poor. When health consequences of WPB include decreased memory and concentration, for example, reading was challenging: “You can’t keep a concentrated thought. I mean I usually like to read, but now, a page or two, maybe.” Hobbies including exercise and recreation activities provided an outlet for distraction, relieving stress, and lifting spirits. As one man described, “I went out biking. I played tennis that was another release.” Another noted, “Tai-chi has really helped me get my physical health in order and relieve mental tension.” The nature and severity of health symptoms influenced health promotion and recreation activities, for example, depressive symptoms


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O’Donnell and MacIntosh left some men feeling less motivated and interested in participating in activities: “I mean I love to golf, at least I did, [I] couldn’t care less [now].” Social support also influenced self-care, including health promotion activities, despite ongoing depression and a lack of interest in activity one man described: “I bike when she [girlfriend] wants to go, that’s the driving force. Once I’m out, I’m fine. But to come up with something fun, [I] just [have] no sense of joy.” Recreation activities sometimes involved a social component and opportunity to connect with others and find relief: “Fishing. Spent a lot of time in a canoe. And [friend], poor guy, he sat in the front and I sat in the back and told him everything.” Another man described how getting out with friends was a useful distraction: “I had a lot of friends. I didn’t talk to them about it but I could always go to the pub and we would forget about all that stuff. Talk about hockey or whatever.” For some men, reaching out and seeking support from others was difficult. Role socialization including beliefs about appropriate coping and help-seeking behaviors influenced ways of caring: “Kept it bottled in, did my job. I had to be tough. I think it started pretty damn young. Dad was an alcoholic. If he wasn’t beating me it was mom. I bottled a lot of it up.” Others found it difficult to admit vulnerabilities and were embarrassed by having been targeted: “Even my closest friends don’t know because that’s the other thing about being a man, it’s embarrassing. It’s hard to admit I’m being harassed at work because, no offense, that’s something that I would anticipate a woman experiencing.” Fear of being a burden or upsetting others also influenced support seeking: “I didn’t want to go too far into it with her [wife] because I didn’t want to worry her too much. I was just thinking I can handle this, it will be alright.” Fear of admitting vulnerabilities and the desire to be self-reliant and manage problems independently are responses to addressing problems among men that have been described by others (Addis & Mahalik, 2003; Connell, 1995; O’Brien, Hunt, & Hart, 2005). As a result of abandonment and the associated consequences, relationships with others including typical sources of support were sometimes interrupted or fractured. One man described his coworkers as being hesitant to provide support because of fear of being bullied: “They [coworkers] all knew what was going on, but nobody would ever watch my back. Because if they [bullies] would do it to me, they would do it to them.” Others described how abandonment and the associated consequences interrupted personal relationships: “I lost a lot of good friends. A lot of people have misconceptions about mental illness. And I mean it’s treatable, a lot of it. And ah, they just stay away.” When support was limited, or reaching out to others was met with reluctance, surviving

was more difficult and feelings of abandonment were magnified. Overall, accessing and relying on relationships with family, friends, and coworkers was a helpful way of caring for self. Supportive individuals took time to listen and validate experiences of bullying and assisted in determining that negative treatment at work was not normal or justified. In the context of abandonment and a lack of support at work, support and validation from others including family and friends was particularly important: “What helps mitigate that is if you have people who empathize, who understand. If I hadn’t had touchstone people, I would have lost it.” Talking with others also provided relief: “Just call on coworkers, talking to them and venting, get it off your chest kind of thing.” Substance use as a way of coping with ongoing stress and caring for self was described by four participants. When asked about strategies to manage daily stressors and persistent WPB one man responded, “Beer, marijuana.” Another described, “I tried to John Wayne my way through it. Just try to cope, endure, you know, drinking and partying. I was doing my best to forget.” Smoking, over- and undereating, and excessive spending were other strategies used to cope with abandonment: “I started buying things to kind of fill that . . . to feel good. I also put on about 45 pounds, I would just eat and eat and eat.” Rather than seeing a physician or a health care provider to seek time off work, one man described self-harm as a way of coping and gaining relief from persistent WPB: “I actually injured myself. I put my thumb down and hit it with a hammer. If I had gone out they would have, ‘Boo-hoo, he can’t do it,’ so I had to hurt myself to get a week off.” Fear of being seen as weak or unable to cope (and viewing self-harm as the only legitimate way to get time off work) reflected a harmful pattern of masculinity that is consistent with reports by other researchers who have suggested that some men engage in harmful or risky practices to demonstrate and preserve manliness (Courtenay, 2000; Messner, 1997; Sabo, 2000). As a result of abandonment and persistent WPB, four participants described experiencing suicidal thoughts. None had a history of mental illness prior to experiencing WPB. One man described feeling so desperate that he found himself standing in front of the mirror one morning with a knife to his throat: “I was crying, the tears were running down my face, I was going to slit my throat because of this. Isn’t that retarded? It just got worse and worse and worse.” Another described, “I almost pulled the plug about 3 times. I had all the plans made. Only thing that stopped me was my daughter.” Social support, including having dependent family members, was described as a protective factor against suicide. Others have reported that risk of suicide is decreased among those with greater social support (Kotler, Iancu, Efroni, &


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Amir, 2001), including married individuals and individuals (married or unmarried) with children (Denney, 2010). Our experience as nurses and in working in the areas of workplace and intimate partner violence made it possible for us to assess and respond to situations of emotional distress and thoughts of suicide. Study protocols included a debriefing tool that was reviewed with all men and a suicide risk assessment tool that was used as needed. On the whole, helpful strategies to care for self assisted men in coping with and reducing daily stressors provided short-term relief. Harmful or destructive coping strategies added to the negative consequences of abandonment and made surviving more difficult. When health consequences were less severe, managing symptoms by caring for self was easier. When abandonment persisted, however, health symptoms progressively worsened and became more invasive making day-to-day functioning more difficult. As a result, the requirement for more focused attention and services directed at addressing underlying health problems was required. Seeking care. Seeking care was a process of accessing and relying on help from health care professionals, including physicians, nurses, counselors, psychiatrists, and psychologists, and was aimed at surviving abandonment and the associated health consequences. Sickness absence, hospitalization, and being admitted to specialized treatment facilities are other forms of seeking care. In comparison with caring for self, which had a more short-term focus aimed at coping with immediate health symptoms, seeking care was directed at understanding and managing underlying health problems and diagnoses. Typical help-seeking practices and perceptions of health, including ideas about if and when it was appropriate to seek help influenced seeking care. Social support, including encouragement or urging from others, and the perceived nature and helpfulness of health care providers influenced actions to seek care. Gender ideals were also influential and seeking care was sometimes avoided as a means of maintaining masculine identity and image. For most men, changes in health occurred gradually over time and symptoms were often poorly understood. As one man described, “It [depression] kind of crept up on me, I didn’t really see it coming. It’s like all of a sudden I said, ‘What the hell is going on?’” Another compared the gradual change in health to hearing loss: “If you subject yourself to loud noises over time, it’s a cumulative effect, and all of a sudden you realize you’re deaf. It’s the same. You have no idea what it’s doing until suddenly everything goes for a poop.” Changes in health altered men’s self-perceptions and sense of stability: “It wasn’t something I was expecting. I always considered myself strong until this happened.”

When health problems were new and unexpected, identifying and managing symptoms was difficult for some men and thus seeking necessary services was sometimes delayed. For example, although more than half of the participants did in fact seek help from health care professionals, it was often when health problems were quite serious and could no longer be avoided: That morning I got up, showered, shaved, and packed a lunch and I just started shaking and couldn’t stop. I called my drive and [I called my] work and told them I wouldn’t be making it. Then I called my doctor.

Another man described, “Finally, I booked an appointment with the doctor and [he/she] thought, being stressed, I should go to counseling. Then, we find out, I [am experiencing] moderate to high depression.” Although some researchers have reported that men might avoid or delay seeking help for fear of seeking services prematurely or without sufficient reason (Mahalik, Burns, & Syzdek, 2007; O’Brien et al., 2005), our previous research (O’Donnell et al., 2010) revealed that uncertainty surrounding experiences of WPB and associated health symptoms also influenced the nature and timing of help seeking among women. Because symptoms were often poorly understood, health care professionals played an important role in diagnosing health problems and determining appropriate treatment. Typically, general practitioners were a first point of care and were involved in making referrals to various health professionals: “I started seeing a doctor and he took me off work. He said, I think you’re suffering from depression.’ He referred me to a psychiatrist.” Finding an appropriate care provider and establishing a diagnosis took time and often required ongoing engagement with the health care system. One man described, “I’ve been treated for depression, anti-depressant drugs, none of them worked because nobody dealt with the problem.” After suffering from post-traumatic stress disorder (PTSD) for some time without a proper diagnosis the same individual described, “I ended up in [hospital] for 3 days and they said you don’t have bipolar. I was into these convulsions and crying and I couldn’t stop. I felt worthless. I felt useless.” Because mental health issues such as stress, anxiety, and depression were among the most commonly reported consequences, when health care providers were not willing or able to talk about and assist in managing these problems, addressing health was more difficult. As one man described, “All they did was pump me full of pills. I went back to see him every month and he wouldn’t even say anything to me, just write a prescription.” Another described trying to talk with his physician about his mental health: “He [physician] really didn’t want to talk about


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O’Donnell and MacIntosh that. He was interested in the physical aspect. The cardiologist was no better. I tried to bring it up and he just didn’t want to discuss it.” Other factors including mandated services (e.g., being required to see health or other professionals selected by the employer or insurance provider), lack of continuity, and limited access to care providers or services made addressing health more difficult. Perceptions of health symptoms including what types of services were appropriate varied and influenced strategies to seek care. In considering sickness absence, for example, one man described, “I couldn’t imagine going on stress leave. I thought about it enough to realize it wasn’t really for me. I don’t think I was ever bad enough. Cause to me, stress leave, you’re on tranquilizers, you know?” Some others recognized the need for sickness absence more readily, particularly when health problems made it difficult to continue working: “That’s why I went off work. I just couldn’t function any more.” Likewise, there were several examples where men were actively involved in seeking services: “[My] first connection with mental health was through the doctor. I asked him to set up an appointment.” When reaching out and seeking care was a usual approach to handling health problems, addressing health was easier. As evident from some examples in this research, being socialized and encouraged to seek help and participate in regular health promotion activities early on influenced health behaviors among men in adulthood. For some men, the desire to remain strong and maintain emotional control also limited seeking care. Despite suffering from anxiety, panic attacks, and suicidal thoughts, one man disclosed that he never discussed these consequences with his doctor or wife: “Well hindsight being the way it is, maybe it would have been better to go and talk to a doctor, but in my way of thinking, what the hell can a doctor do.” Another man described, “Stress was really bad. I was going to go to the doctor, and I hate doctors. I hate to go to doctors. But it was bothering me bad. I’m not sleeping, tired, and just not right.” When asked to reflect on the decision not to seek care the same individual replied, “I think it’s a man thing, I really do. Like, I just didn’t want to be a wimp [laugh]. And that’s not right either. Things bother men as much as they do women I suppose.” Other researchers have reported that some men view not being able to handle problems on their own as a sign of weakness (O’Brien et al., 2005; Royster, Richmond, Eng, & Margolis, 2006). Partners and spouses were important sources of emotional support and facilitated addressing health by encouraging men to seek care: “The wife set it all up [meeting with community support person] because she knew his wife.” Another man, who had difficulty addressing mental health concerns with his physician, described how his

wife encouraged him to seek a new physician: “So my wife said to me, ‘Why don’t you talk to him and see if he’ll take you.’ So I did and he said, ‘Sure.’” Other researchers have identified that prompting by significant others including partners or spouses can facilitate help seeking (Cusack, Deane, Wilson, & Ciarrochi, 2004; Griffith, Ober-Allen, & Gunter, 2011; O’Brien et al., 2005; Seymour-Smith, Wetherell, & Phoenix, 2002). Even though seeking care was a helpful approach to addressing health, unintended consequences sometimes added to problems. One man described how medication side effects influenced his relationship: “With the depression, anti-depressants, comes side effects, sexual side effects. It started to affect my relationship with my girlfriend quite severely because she didn’t feel attractive and she felt unwanted.” Other men described sexual side effects (mostly associated with depression and general lack of interest in sexual activities), demonstrating that some men were willing to talk about health challenges, including more private topics such as sex and sexual function. Overall, seeking care and working with health care professionals to address health was described as helpful and assisted in stabilizing and improving health. Seeking care is most effective when interactions with health care professionals were characterized by empathy and interest and when physical and emotional health consequences were acknowledged and addressed. One man described, “I told her [physician] what had happened and she sat there for 45 minutes saying nothing, just listening.” Given reports that men in general were less likely than women to seek help for their health (Addis & Mahalik, 2003; Shannon et al., 2007), providing opportunities for men to talk and taking the time to listen when men do seek help are important.

Seeking Relief Seeking relief was a process of taking action to limit and/ or address persistent WPB and the associated consequences as a means of dealing with abandonment. Men sought relief by protecting and seeking resolution, processes that were instinctive and reactive or more measured and deliberate, and were influenced by support, severity of health symptoms, financial considerations, and the nature and context of the workplace and experiences of WPB. An important consequence of seeking relief was that targets found reprieve by temporarily or permanently putting a stop to the bullying.

Protecting Protecting was a process of minimizing the bullying and its impact that involved avoiding and limiting contact with persons who were bullying. Protective strategies


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were often reactive and included things such as skipping meetings, monitoring and avoiding correspondence (e.g., phone calls, email), closing the office door, taking more frequent breaks, keeping to oneself, seeking opportunities to work from home or offsite, and avoiding work and work-related functions. Keeping track of WPB by documenting details of bullying incidents and saving correspondence (e.g., email, memos) were other forms of protecting. Limiting contact by setting boundaries and avoiding bullying helped reduce day-to-day stress associated with negative behaviors and interactions. Avoiding bullying often required considerable planning and effort. For example, one man described plans to limit meetings with the persons who were bullying: “I am hoping to discuss if they [supervisors] would take a conscious look at when they’re calling a meeting and whether or not they really need me there.” Another man, who regularly worked offsite, ignored phone calls to avoid persistent bullying from his boss: “Caller ID is a wonderful thing.” Limiting contact was easier when targets and persons who bully do not work in close proximity or do not need to communicate regularly as a function of their work. When regular communication was required, efforts to distance and limit contact were more difficult and could hamper work and productivity. Withdrawing by creating physical distance from the workplace and experiences of bullying also provided relief. As one man described, “I started to take a break each morning and afternoon for 20 minutes. Something really foreign to me.” Another noted, “I used to go to coffee breaks or lunch with these people often I just go myself now ’cause often it turns to some form of picking on me.” Even though withdrawing provided short-term relief, it could also contribute to isolation by limiting support from others, including coworkers. Other researchers have described withdrawing and distancing as responses to WPB (Hallberg & Strandmark, 2006; Lutgen-Sandvik, 2006; O’Donnell et al., 2010). Sickness absence and the use of sporadic sick days was used to establish physical distance and find relief: “Every now and again I wouldn’t even call them, I would just email and say, ‘Yup, not coming in today, don’t feel like it.’” Although sickness absence was aimed at addressing health, it also provided relief from ongoing WPB. In this study, a total of nine participants required sickness absence. In many circumstances, sickness absence was not carefully considered but rather a sudden decision that resulted from physical or mental exhaustion and health crisis: “Finally, I just couldn’t take it any more and I went on stress related leave.” Similarly, our previous research with women demonstrated that sickness absence was not heavily considered, rather a more sudden act based on a sense of urgency to address health (O’Donnell et al., 2010).

Although protecting did provide relief, when faced with continued abandonment and WPB, potential benefits were difficult to sustain. Men who faced persistent WPB approached work with a sense of dread, “I hated to go in every day wondering what on earth is going to happen today,” and found it difficult to go about their day as usual: “The areas that I had to go to day-to-day included his areas. I avoided these as much as possible. I found I could not do my job effectively and was constantly looking over my shoulder.” When protecting was not effective in providing relief, many participants considered and enacted more lasting solutions to address abandonment.

Seeking Resolution Seeking resolution was a process of putting a stop to WPB and occurred in the context of a lack of workplace support to address and resolve bullying. Specific strategies to seek resolution include accessing support from sources such as lawyers, media, and advocacy groups (e.g., workplace health and safety and human rights organizations) that men hoped would be able to exert pressure on workplace organizations and have some effect on the problem. Stopping WPB by leaving the workplace was another strategy for seeking resolution. Seeking legal assistance to explore and enact options for resolving bullying was one approach to seeking resolution. After being threatened with dismissal, one man explained, “I took it to a labor relations lawyer, drafted a letter and had a defense all worked out, but it cost me 1,200 dollars.” Even though legal action resulted in the letter of dismissal being withdrawn, the bullying persisted and the man eventually left for another job. To avoid legal battles, some targets were offered settlements by workplace organizations. When settlements or payouts were not sufficient for covering basic expenses, including medications, they were not an effective or realistic solution for targets: “But right now, there’s not enough money. We make ends meet, but it’s horrible.” Seeking assistance from advocacy organizations such as Human Rights and Occupational Health and Safety was another approach to seeking resolution: “I talked to Human Rights and I talked to Occupational Health and Safety and they couldn’t get any cooperation [from workplace] whatsoever. They just dropped it.” Perhaps because at present, Human Rights and Occupational Health and Safety legislation in the Canadian provinces where the study took place does not specifically address WPB (or psychological harassment as it is often referred to in legal terms), it has not been a helpful approach for dealing with WPB. This is problematic because a number of researchers have reported that WPB is more prevalent than other forms of harassment (sexual or discriminatory) recognized in


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O’Donnell and MacIntosh existing Occupational Health and Safety and Human Rights legislation (Lewis, 1999; Richman et al., 1999; Workplace Bullying Institute, 2007). When employers were not willing to recognize and address WPB, seeking support from police to investigate the problem was another approach to seeking resolution. One man, who was a target of mobbing (targeted by more than one individual) and received harassing and threatening phone calls day and night, sought assistance from the police: “They [police] put a tap on the line. And one person stood out more than the others. They went to his house [police] but with nobody speaking there was no way to prove it.” When asked whether this had any effect toward diminishing or ending the bullying, the participant replied, “Oh, made it worse.” As a last resort, some men considered approaching the media with their stories and one individual did, in fact, publically describe his experience. This was often a final and desperate attempt to highlight experiences of abandonment and the workplace organizations response to WPB. Exploring and accessing options to address WPB required time, effort, and resources, and were challenging when health is poor or when resources and capacity to pursue more formal options were not available. One man described how financial circumstances prevented him from pursuing legal action: “There’s times I fanaticize if won the lottery and had money for lawyers, I’d take them on.” Another man described fear and lack of familiarity with the legal system as barriers to seeking resolution: There is no help. It feels that way and when you’re helpless, and there is no help, that’s worse. So who did I have to turn to? I could turn to a lawyer, but I was afraid because I never had to deal with suing anybody before. I’m not familiar with that stuff and to me, the courts are scary.

Even when formal action was not pursued, because of the lack of workplace accountability and support, there was a strong sense that external oversight and involvement was needed: “It’s overwhelming; there is no help from anybody. The court systems need to get involved, but even before that there should be somebody from Occupational Health, from somewhere, to step in and see what the hell is going on.” On the whole, perhaps because the perceived challenges and risks often outweigh the benefits, few men chose to resolve abandonment by seeking outside help and resources. Leaving was aimed at putting a stop to WPB and involved separating from the bullying environment using strategies of transferring, retiring, and resigning. In some circumstances, transferring to another department or workplace location was considered a suitable option for ending the bullying: “Unless I can find something on a lateral and get out of there, it would be great.” Opportunities

for transfer were sometimes limited, however, and typically depended on whether job postings were available. Because transferring could require moving and would result in additional consequences, including disrupted relationships and social support, it was not preferred: “There may be potential in [location]. Could do that, really don’t want to, my kids are here.” Because of employment and financial considerations, some targets perceived having little choice but to stay and endure bullying. A number of men, for example, described retirement and retirement benefits as influencing the decision to stay: The light at the end of the tunnel is so prominent. If it was any more than five years it might be hard to keep that goal in mind and let it wash away the worries, but it’s that close.

Enduring WPB was not easy, however, and presented ongoing challenges, including health consequences. One man who was close to retirement compared going to work every day and facing ongoing WPB to a prison sentence: “Honestly at this point in time, I really feel like someone who’s doing hard time and it’s like the last end of my sentence.” Enduring abandonment and WPB was easier when daily contact with the person who was bullying was limited and health symptoms were less severe. Another man who was close to retirement noted that his health was so poor and he was feeling so “desperate” that he had little choice but leave: “If I could have finished the 35 years I would have a higher pension. But when he told me how much I would be making if I were to retire now, I said, I can live on that.” Factors including education, employment experience and opportunity, and wages influence decisions and actions around leaving. Even when job opportunities or offers were present, for some men, reduced wages made it difficult to leave: “You have to have schooling to make my kind of money. I’ve been around so long, they paid me just enough.” Financial commitments including providing for family also influenced decision to stay: “I dreaded going to work but I had a wife and two kids and I needed to work.” In comparison, work opportunities that offer improved working conditions and wages made it easier to leave. Greater financial stability and emotional and financial support from a spouse or partner also made leaving easier. At the time of the study, 10 (50%) participants had left their jobs as a means of seeking relief, some others were contemplating it. Even though this was not a preferred choice, most of these men felt that they had little choice but to leave: “If the abuser is in sufficient position of power that they are not likely to be removed, my big solution was leaving.” Men were angry, frustrated, and disappointed by the lack of support to stay and resolve the


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problem and commitment to the employer was negatively affected: “[I was] really disillusioned by the fact that you can go out, do you damndest for your employer, and they don’t even do anything for you.” Overall, feelings of abandonment contributed to leaving: “I got to the point, I couldn’t have cared less, I just wanted to get out.” Other researchers have described lowered commitment and morale (Hoel, Sparks, & Cooper, 2003; Namie & Namie, 2003; O’Donnell et al., 2010; Yildirim, Yildirim, & Timucin, 2007) and leaving or considering leaving as consequences of WPB (Lutgen-Sandvik, 2006; O’Donnell et al., 2010). Leaving was most common when health was poor and prevented men from being able to continue working. After a few short bouts of sickness absence one man described, “When I went to see [doctor] I was a mess. I was shaking, trembling, I could hardly talk. She said, ‘I’m putting you off work for a long, long time.’ And I haven’t worked since.” Even though leaving was an effective strategy for putting a stop to bullying and improving health, improvements were not immediate and moving past the experience and associated consequences was a continued struggle. One man who left by taking early retirement disclosed, “I think for 6 months to a year after I retired, I hated myself.” Another individual who went on long-term disability in his 40s described significant personal and social loss that resulted from being unable to work: “I wasn’t able to earn a livelihood with dignity. Socially I lost, career wise I lost, pension wise I lost, financially I lost.” Unemployment and difficulty finding employment, reduced pay, and career changes were other consequences of leaving: “We had to refinance twice. I am still in the hole and I’m 60 years old.” Similar consequences associated with leaving or being terminated as a result of WPB have been described by other researchers (Hallberg & Strandmark, 2006; Lutgen-Sandvik, 2006; O’Donnell et al., 2010). As a result of abandonment and negative feelings toward work in general, some targets placed less importance on work. After leaving a senior management position, one man described that he was no longer interested in working in a supervisory role, a decision his wife had difficulty accepting: “My wife was ashamed of me when I worked in a junior position. She said, ‘You should be doing consulting for 400 dollars a day,’ I said, ‘That’s the last thing I want to do, it’s too much responsibility.’” Although we often think of men as trying to live up to dominant masculine ideals, other people also position men in relation to these ideals (Connell, 1995; Willott & Griffin, 1997, 2004). Finding new employment and reentering the workforce facilitated healing and reestablished interest in and positive feelings toward work: “I enjoy the people I work with and look forward to going to work every day, which is such a change from 5, 6 years ago.”

On the whole, leaving made it easier to focus on and improve health. When targets chose to stay, conditions that changed or removed the bullying, such as the bully retiring or leaving, made it easier. When targets choose to stay despite persistent abandonment, continued efforts to survive WPB and the associated health consequences were required. This was significant, given that a number of men chose to stay and endure the bullying and possibility of continued declines in health. Although the sustainability of enduring the bullying in the context of abandonment is poorly understood, it is not without challenges. When asked what was most difficult about dealing with ongoing abandonment, one man replied, “Coming in every day until then [retirement] and dealing with the asshole who screwed you.”

Discussion Findings from this research establish WPB as a serious and legitimate problem for men. The theory of surviving extends our understanding of men’s experiences by providing a detailed and contextual understanding of the challenges faced by men who are bullied. Men experienced physical, emotional, and social problems that are consistent with reports by other researchers who have examined the health consequences of WPB among women and men (Bjorkqvist, Osterman, & Hjelt-Back, 1994; Brotheridge & Lee, 2010; Hauge, Skogstad, & Einarsen, 2010; Lutgen-Sandvik, 2006; RodriguezMunzo, Moreno-Jimenez, Vergel, & Hernandez, 2010). Although suicidal thoughts have been described by other researchers (Hallberg & Strandmark, 2006; Namie, 2003), it is noteworthy that 4 of the 20 men in the study described thoughts of suicide. Whether men who are bullied are at a greater risk of suicide deserves attention. Another interesting finding was that two of the participants who described thoughts of suicide had a diagnosis of PTSD related to their experience of WPB and individuals suffering from PTSD have been found to be at an increased risk of suicide (Kotler et al., 2001; Tarrier & Gregg, 2004). Because men described difficulty receiving a diagnosis of PTSD (and thus often suffered for long periods of time), screening for PTSD and suicide risk among men who are bullied might be useful. Links between PTSD and suicide risk in the context of men’s experiences of WPB deserve research attention. Descriptions of abandonment and the absence of workplace support to address and resolve WPB draw attention away from interpersonal relations among the target and person(s) who bully toward the influence of the organization. Whereas organizational approaches to addressing bullying (e.g., mediation, investigation) often focus on the interpersonal context, this research highlights that by abandoning responsibilities to protect the


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O’Donnell and MacIntosh health and well-being of employees, employers enable WPB and directly contribute to the health consequences experienced by targets. In addition, because it is difficult to survive in a workplace where bullying is enabled, employers place targets in a position where they have little choice but to leave. As a result, employers face higher turnover and increased costs for recruitment and training (Namie, 2003) and greater potential for legal challenges. In addition, because work has been described as being central to the lives and identities of men (Pleck, 1981; Springer & Mouzon, 2008) and unemployment can threaten some men’s identity and sense of self (Willott & Griffin, 2004), the costs of leaving in this context deserves research attention. This research establishes a connection between gender and health in the context of WPB and extends existing sex difference research by offering a gender perspective. Findings demonstrate that not all men conform to dominant norms, and there is a considerable range in men’s behaviors when it comes to managing bullying and the associated health consequences. That more than half of the men sought help from workplace and organizational (13) and health care (11) professionals suggests that men can and do seek help. In addition, the fact that the central concern described by men was a lack of workplace support to address and resolve WPB demonstrates a desire for support among men. Demonstrating evidence of variation among men (and the influence of dominant masculine ideals), some men have difficulties seeking help. Fear of being seen as weak, wimpy, or unable to handle work and WPB were described as barriers to seeking help. In many cases, it was only when health was poor and symptoms could no longer be avoided that men sought help. Whether this response is related to men’s desires to be tough and live up to dominant masculine norms by avoiding or delaying help seeking (Mahalik et al., 2007; O’Brien et al., 2005) or the gradual and cumulative nature of health effects associated with bullying is difficult to determine. That women who were bullied also reported delaying treatment because of the gradual emergence of health symptoms (O’Donnell et al., 2010) suggests that delayed help seeking might be a common response among targets of bullying in general. Support persons including health care professionals should be aware of the connection between WPB, gender, and health. Even though some men can be hesitant to seek help to address the health consequences of WPB, many are not. Thus, health care professionals should not assume that men do not want or will not ask for help. General practitioners and nurses who work in primary care facilities are often a first point of contact and thus are well positioned to assist men in recognizing and addressing the health consequences of WPB. Because counseling

was described as a helpful strategy for addressing health, making appropriate referrals is important. Health care professionals who work in occupational health settings can assist in preventing and managing WPB through regular screening of occupational health risks, including assessment of the work environment and conditions. The finding that some men felt that health care professionals were not willing or able to assist them in managing emotional health problems is a cause for concern as emotional health consequences were commonly described by participants. Although relating more to the research process, given reports that some men are hesitant to seek help and discuss problems including emotional health problems, it is significant to note that the men who participated in this study discussed a range of topics, including substance use, sexual function, mental illness, thoughts of suicide, and feelings of hurt and sadness. Some were teary during interviews. Gast and Peak (2011) also noted that men in their qualitative study health beliefs were very willing to talk about health. Although it could be argued that the group of men who responded to advertising and agreed to participate might also be those men who are more willing to talk about problems, some participants had never discussed details of the experience with anyone. Because gender is recognized as an important determinant of health, and WPB is a significant workplace health issue, incorporating gender analysis into studies of WPB is important.

Limitations Diversity in this study was limited. Even though recruiting advertisements were written at a Grade 7 English reading level, overall education levels were higher than expected. All participants in the sample were White. Future research could explore factors such as class, ethnicity, and education and their influence on the process of surviving. Because all men who participated in the study experienced and described a lack of support to address and resolve WPB, it could be argued that variation in experiences of support was not demonstrated. Whether those men who were most affected (and did not receive support) were also most inclined to participate is unknown. This trajectory might be realistic, however, as limited support to address WPB is a problem that has been described by other researchers. Among the 7,740 employees who participated in the Workplace Bullying Institute (2007) survey, for example, of those who reported mistreatment to their employer, 66% reported a lack of support. This includes 44% of targets who reported that “nothing was done” and 18% who reported that the problem “worsened.” Along with this, leaving the organization is a common response to WPB (Lutgen-Sandvik,


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2006; Namie, 2003) and highlights the lack of support to successfully persist at work. Future research could explore how the process of surviving might differ when men do receive workplace support. Research examining the nature and success of approaches to addressing and resolving WPB is also needed. Acknowledgment We gratefully acknowledge the guidance and support of dissertation committee members Dr. Linda Nielson and Dr. Daniel Coleman.

Authors’ Note Portions of this article are presented in the video at http://vimeo. com/100370073

Declaration of Conflicting Interests The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was funded by the Canadian Institutes of Health Research Institute of Gender and Health, the New Brunswick Health Research Foundation, and the University of New Brunswick (200902RFE).

References Addis, M., & Mahalik, J. (2003). Men, masculinity, and the contexts of help seeking. American Psychologist, 58, 5–14. doi:10.1037/0003-066X.58.1.5 Artinian, B. (2009). An overview of Glaserian grounded theory. In B. M. Artinian, T. Giske, & P. H. Cone (Eds.), Glaserian grounded theory in nursing: Trusting emergence (pp. 3– 17). New York: Springer. Beck, C. (2004). Grounded theory research. In J. A. Fain (Ed.), Reading, understanding, and applying nursing research (2nd ed., pp. 265–286). Philadelphia: Davis. Berdahl, J., Magley, V., & Waldo, C. (1996). The sexual harassment of men? Exploring the concept with theory and data. Psychology of Women Quarterly, 20, 527–547. doi:10.1111/j.1471-6402.1996.tb00320.x Bjorkqvist, K., Osterman, K., & Hjelt-Back, M. (1994). Aggression among university employees. Aggressive Behavior, 20, 173–184. doi:10.1002/10982337(1994)20:33.0.CO;2-D Brotheridge, C., & Lee, R. (2010). Restless and confused: Emotional responses to workplace bullying in men and women. Career Development International, 15, 687–707. doi:10.1108/13620431011094087 Charmaz, C. (2003). Grounded theory: Objectivist and constructivist methods. In N. K. Denzin & Y. S. Lincoln (Eds.),

Strategies of qualitative inquiry (2nd ed., pp. 249–291). Thousand Oaks, CA: SAGE. Chenitz, W., & Swanson, J. (1986). Qualitative research using grounded theory. In W. C. Chenitz & J. M. Swanson (Eds.), From practice to grounded theory: Qualitative research in nursing (pp. 3–15). Menlo Park, CA: Addison-Wesley. Connell, R. (1995). Masculinities. Los Angeles: University of California Press. Courtenay, W. (2000). Constructions of masculinity and their influence on men’s well-being: A theory of gender and health. Social Science & Medicine, 50, 1385–1401. doi:10.1016/S0277-9536(99)00390-1 Cusack, J., Deane, F., Wilson, C., & Ciarrochi, J. (2004). Who influence men to go to therapy? Reports from men attending psychological services. International Journal for the Advancement of Counselling, 26, 271–283. doi:10.1023/ B:ADCO.0000035530.44111.a8 Denney, J. (2010). Family and household formations and suicide in the United States. Journal of Marriage and Family, 72, 202–213. doi:10.1111/j.1741-3737.2009.00692.x Eriksen, W., & Einarsen, S. (2004). Gender minority as a risk factor for exposure to bullying at work. European Journal of Work & Organizational Psychology, 13, 473–492. doi:10.1080/13594320444000173 Gast, J., & Peak, T. (2011). “It used to be that if it weren’t broken and bleeding profusely, I would never go to the doctor”: Men, masculinity, and health. American Journal of Men’s Health, 5, 318–331. doi:10.1177/1557988310377926 Glaser, B. (1978). Theoretical sensitivity. Mill Valley, CA: Sociology Press. Glaser, B. (1992). Basics of grounded theory analysis. Mill Valley, CA: Sociology Press. Glaser, B. (1998). Doing grounded theory: Issues and discussions. Mill Valley, CA: Sociology Press. Glaser, B. (2005). The grounded theory perspective III: Theoretical coding. Mill Valley, CA: Sociology Press. Glaser, B., & Strauss, A. (1967). The discovery of grounded theory. Chicago: Aldine. Griffith, D., Ober-Allen, J., & Gunter, K. (2011). Social and cultural factors influence African American men’s help seeking. Research on Social Work Practice, 7, 337–347. doi:10.1177/1049731510388669 Hallberg, L., & Strandmark, K. (2006). Health consequences of workplace bullying: Experiences from the perspective of employees in the public service sector. International Journal of Qualitative Studies on Health and Well Being, 1, 109–119. doi:10.1080/17482620600555664 Hauge, L., Skogstad, A., & Einarsen, S. (2010). The relative impact of workplace bullying as a social stressor at work. Scandinavian Journal of Psychology, 51, 426–433. doi:10.1111/j.1467-9450.2010.00813.x Helgeson, V. (2009). The psychology of gender (3rd ed.). Upper Saddle River, NJ: Prentice Hall. Henson, K., & Krasas-Rogers, J. (2001). “Why Marcia you’ve changed!” Male clerical temporary workers doing masculinity in feminized occupations. Gender & Society, 15, 218–238. doi:10.1177/089124301015002004


15

O’Donnell and MacIntosh Hoel, H., Sparks, K., & Cooper, C. (2003). The cost of violence/ stress at work and the benefits of a violence/stress-free working environment. Geneva, Switzerland: International Labour Organization. Johnson, J., Greaves, L., & Repta, R. (2007). Better science with sex and gender: A primer for health research. Vancouver: Women’s Health Research Network. Retrieved from http:// bccewh.bc.ca/wp-content/uploads/2012/05/2007_Better SciencewithSexandGenderPrimerforHealthResearch.pdf Jones, C. (2006). Drawing boundaries: Exploring the relationship between sexual harassment, gender and bullying. Women’s Studies International Forum, 29, 147–158. doi:10.1016/j.wsif.2006.03.001 Kotler, M., Iancu, I., Efroni, R., & Amir, M. (2001). Anger, impulsivity, social support, and suicide risk in patients with posttraumatic stress disorder. Journal of Nervous and Mental Disease, 189, 162–167. doi:10.1097/00005053200103000-00004 Lee, D. (2002). Gendered workplace bullying in the restructured UK civil service. Personnel Review, 31, 205–227. doi:10.1108/00483480210416874 Lewis, D. (1999). Workplace bullying: Interim findings of a study in further and higher education in Wales. Internati-onal Journal of Manpower, 20, 106–118. doi:10.1108/01437729910268696 Leymann, H. (1996). The content and development of mobbing at work. European Journal of Work and Organizational Psychology, 5, 165–184. doi:10.1080/ 13594329608414853 Lutgen-Sandvik, P. (2006). Take this job and . . . : Quitting and other forms of resistance to workplace bullying. Communication Monographs, 73, 406–433. doi:10.1080/03637750601024156 MacIntosh, J., O’Donnell, S., Wuest, J., & Merritt-Gray, M. (2011). How workplace bullying changes how women promote their health. International Journal of Workplace Health Management, 4, 48–66. doi:10.1108/17538351111118590 Mahalik, J., Burns, S., & Syzdek, M. (2007). Masculinity and perceived normative health behaviors as predictors of men’s health behaviors. Social Science & Medicine, 64, 2201–2209. doi:10.1016/j.socscimed.2007.02.035 Messner, M. (1997). Politics of masculinities: Men in movements. Thousand Oaks, CA: SAGE. Messner, M. (2007). Out of play. Albany: State University of New York Press. Namie, G. (2003). Workplace bullying: Escalated incivility. Ivey Business Journal, 68(2), 1–6. Namie, G., & Namie, R. (2003). The bully at work: What you can do to stop the hurt and reclaim your dignity back. Naperville, IL: Sourcebooks. Olafsson, O., & Johannsdottir, H. (2004). Coping with bullying in the workplace: The effect of gender, age, and type of bullying. British Journal of Guidance & Counselling, 32, 320–332. doi:10.1080/03069880410001723549 O’Brien, R., Hunt, K., & Hart, G. (2005). “It’s caveman stuff, but that is to a certain extent how guys still operate”: Men’s accounts of masculinity and help seeking. Social Science & Medicine, 61, 501–516. doi:10.1016/j.socscimed.2004.12.008

O’Donnell, S., MacIntosh, J., & Wuest, J. (2010). A theoretical understanding of sickness absence among women who have experienced workplace bullying. Qualitative Health Research, 20, 439–452. doi:10.1177/1049732310361242 Pleck, J. (1981). The myth of masculinity. Cambridge, MA: MIT Press. Rapala, S., & Manderson, L. (2005). Recovering in-validated adulthood, masculinity and sexuality. Sexuality and Disability, 23, 161–180. doi:10.1007/s11195-005-6731-3 Richman, J., Rospenda, K., Nawyn, S., Flaherty, J., Fendrich, M., Drum, M., & Johnson, T. (1999). Sexual harassment and generalized workplace abuse among university employees: Prevalence and mental health correlates. American Journal of Public Health, 89, 358–363. doi:10.2105/AJPH.89.3.358 Rodriguez-Munzo, A., Moreno-Jimenez, B., Vergel, A., & Hernandez, E. (2010). Post-traumatic stress symptoms among victims of workplace bullying: Exploring gender differences and shattered assumptions. Journal of Applied Psychology, 40, 2616–2635. doi:10.1111/j.15591816.2010.00673.x Royster, M., Richmond, A., Eng, E., & Margolis, L. (2006). Hey brother how’s your health? A focus group analysis of the health and health related concerns of African American men in a southern city in the United States. Men and Masculinities, 8, 389–404. doi:10.1177/10971 84X04268798 Sabo, D. (2000). Men’s health studies: Origins and trends. Journal of American College Health, 49, 133–142. doi:10.1080/07448480009596295 Salin, D. (2003). The significance of gender in the prevalence, forms and perceptions of workplace bullying. Nordiske Organisasjjonsstudier, 5(3), 30–50. Salin, D., & Hoel, H. (2013). Workplace bullying as a gendered phenomenon. Journal of Managerial Psychology, 28, 235– 251. doi:10.1108/02683941311321187 Seymour-Smith, S., Wetherell, M., & Phoenix, A. (2002). “My wife ordered me to come!”: A discursive analysis of doctors’ and nurses’ accounts of men’s use of general practitioners. Journal of Health Psychology, 7, 253–267. doi:10.1177/1359105302007003220 Shannon, C., Rospenda, K., & Richman, J. (2007). Workplace harassment, patterning, and utilization of professional services: Findings from a US National study. Social Science & Medicine, 64, 1178–1191. doi:10.1016/j.socscimed.2006.10.038 Simich, L., Beiser, M., Stewart, M., & Mwakarimba, M. (2005). Providing social support to immigrants and refugees in Canada: Challenges and directions. Journal of Immigrant Health, 7, 259–268. doi:10.1007/s10903-005-5123-1 Springer, K., & Mouzon, D. (2008). Masculinity and health care seeking among midlife men: Variation by social context. Retrieved from http://www.allacademic.com/meta/ p242283_index.html Tarrier, N., & Gregg, L. (2004). Suicide risk in civilian PTSD patients: Predictors of suicidal ideation, planning and attempts. Social Psychiatry & Psychiatric Epidemiology, 39, 655–661. doi:10.1007/s00127-004-0799-4 Willott, S., & Griffin, C. (1997). “Wham bam, am I a man?” Unemployed men talk about masculinities. Feminism & Psychology, 7, 107–128. doi:10.1177/0959353597071012


16


Willott, S., & Griffin, C. (2004). Redundant men: Constraints on identity change. Journal of Community & Applied Social Psychology, 14, 53–69. doi:10.1002/ casp.762 Workplace Bullying Institute. (2007). U.S. Workplace Bullying Survey. Retrieved from http://www.workplacebullying. org/wbiresearch/wbi-2007/ Wuest, J. (2007). Grounded theory: The method. In P. L. Munhall (Ed.), Nursing research: A qualitative perspective (4th ed., pp. 239–272). Sudbury, MA: Jones & Bartlett. Yildirim, D., Yildirim, A., & Timucin, A. (2007). Mobbing behaviors encountered by nurse teaching staff. Nursing Ethics, 14, 447–463. doi:10.1177/0969733007077879

Zapf, D., Einarsen, S., Hoel, H., & Vartia, M. (2003). Empirical findings of bullying in the workplace. In S. Einarsen, H. Hoel, D. Zapf, & C. Cooper (Eds.), Bullying and emotional abuse in the workplace: International perspectives in research and practice (pp. 102–126). London: Taylor & Francis.

Author Biographies Sue M. O’Donnell, RN, PhD, is an assistant professor at the University of New Brunswick Faculty of Nursing in Fredericton, New Brunswick, Canada. Judith A. MacIntosh, RN, PhD, is an honorary research professor at the University of New Brunswick Faculty of Nursing in Fredericton, New Brunswick, Canada.


Workplace bullying in nursing.

The cure for workplace bullying.

Managerial and Organizational Discourses of Workplace Bullying.

Workplace bullying: a tale of adverse consequences.

The effects of workplace bullying on nurses.

Workplace bullying prevention: a critical discourse analysis.

The standard guide to confronting bullying at work.

Experiences With and Perceptions of Workplace Bullying Among Athletic Trainers in the Secondary School Setting.

Influence of Workplace Bullying on Turkish Nurses' Psychological Distress and Nurses' Reactions to Bullying.

Exposure to workplace bullying and risk of depression.

Workplace bullying among managers: a multifactorial perspective and understanding.

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Asymmetric intergroup bullying: The enactment and maintenance of societal inequality at work.

Bullying in elementary school and psychotic experiences at 18 years: a longitudinal, population-based cohort study.

Gender minority social stress in adolescence: disparities in adolescent bullying and substance use by gender identity.

Workplace bullying as an antecedent of mental health problems: a five-year prospective and representative study.

The association between workplace bullying and depressive symptoms: the role of the perpetrator.

The impact of organisational factors on horizontal bullying and turnover intentions in the nursing workplace.

Workplace Bullying and Mental Health: A Meta-Analysis on Cross-Sectional and Longitudinal Data.

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Childhood bullying and social dilemmas.