The alarm clock goes off. You are up and about and, in time, you make your way to work. As you enter your worksite, you think: another routine day at work. But what if it were not a routine day? What if today you became a victim of violence in the workplace? It could happen in any number of ways. The bank in which you are a teller could be the site of an armed robbery. Your colleague on the factory floor who has been drinking too much lately might assault you. Your domestically violent and angry spouse might burst onto your medical ward as you, the nurse, are attending to your patients. Rape may occur as a real-estate agent, who is alone, shows a home for sale to a presumed interested buyer. A dismissed ex-employee might return and murder several staff in your office.
What would you do? What would your managers do? How would your company restore order and assist any staff victims? What would you and your company do to reduce the risk of any of these events from ever happening again?
Each of the above examples is a form of violence in the workplace. This two-part essay examines workplace violence and how to reduce the risk of its occurrence. Part 1 explores the general nature of violence that occurs at work, the most frequent types of crimes that take place, the types of assailants, why they are violent, and what is the impact of their violent acts on staff victims. Part 2 examines pre-incident training, organizational stress management, and post-incident counseling for staff victims as basic risk-management strategies for reducing the possible occurrence of violence at work.
The Nature of Violence in the Workplace
As the scientific community works toward an exact definition for violence in the workplace, for the purposes of this essay, workplace violence may generally be considered to be any increased risk of exposure to violence for an employee due to the nature of one’s work or the characteristics associated with the work-setting itself. Many forms of human-perpetrated violence and criminal behaviors occur in work-settings. The most dangerous worksites for homicide include taxi cab drivers, liquor stores, gas stations, jewelry stores, hotel/motels, and twenty-four-hour convenience stores.
Research on violence in the work place has focused primarily on the major felonies of homicide, rape, robbery, and assault (including verbal abuse and racial slurs). The most frequently studied worksites have included corporate/industrial-settings, police/corrections, schools/ colleges, and health-care systems. To date, the findings have corroborated that corporate/industrial and school/college settings are subject to all of the four felonies. Police/corrections are subject to homicides, armed robberies in progress, and assaults. Health-care providers are subject to rape in community residences but most frequently are staff victims of various types of patient assaults. Other at-risk groups that have been examined included judges, lawyers, and emergency-services personnel. Assaults are the most common form of violence encountered in these occupations. Police, emergency-services personnel, and health-care providers also have additional exposure in situations in which they witness violence being perpetrated on others.
All of these direct acts of violence may result in death, permanent disability, interim disability, medical injury, sick leave utilization, and psychological trauma. Witnessing such violence happening to others may itself result in psychological trauma, even though employees such as the police, EMS, and health-care providers are not direct victims themselves. Workplace violence is expensive and includes medical and legal costs, industrial accident claims, lost productivity, and low morale.
Types of Assailants
Although classification systems vary, there are at least six types of assailants that work-settings need to be alert for. The first group of assailants is angry customers. These are individuals who perceive themselves as having been mistreated by the organization and are exacting justice or revenge. Examples might include the mortgage officer who is assaulted by the customer whose loan is not approved, the lawyer who is shot because the litigant is outraged that the case was lost, or the meter maid who is subjected to physical assaults and verbal abuse as she writes a ticket.
The second group of assailants is the medically or psychiatrically ill patients, whose violence may be the result of brain dysfunctions of various types or an irrational anger or fear at being ill. Common medical problems associated with violence include Alzheimer’s disease, delirium, glycemic conditions, lupus, multiple sclerosis, seizures, traumatic brain injury, and thyroid conditions. Common psychiatric problems associated with possible violence include attention deficit/hyperactivity disorder, dementia, mental retardation, some personality disorders (e.g., the paranoid person), serious mental illness, substance abuse, and untreated posttraumatic stress disorder (PTSD). Companies may encounter this second grouping of assailants among both their customers and their employees.
The third class of assailants are the domestic batterers who follow their employee significant others to work and continue the violent abuse in the work-setting itself. Those who abuse in this way are generally narcissistic, fear being abandoned, have been victims of violence themselves in the past, and have substance use disorders. Obviously, they have poor interpersonal coping skills. Perpetrators of domestic violence may again be worksite visitors or employees.
The disgruntled employee is the next type of work place assailant. These are men and women who have been productive employees in their worksites. However, other aspects of their lives are often in disarray. Many are depressed, abusing drugs or alcohol, and facing serious financial difficulties. They also have easy access to weapons. At some point, these individuals face a major life event that includes an important loss: divorce, loss of custody of children, home foreclosure, and the like. These personal life events seriously disrupt their capacity to work productively and they are terminated. Angry, depressed, with brains altered by drugs, they return to the worksite and main. This often occurs a year after the termination when unemployment benefits run out.
The remaining two categories of assailants are juvenile delinquents and career criminals. Common characteristics in these groupings are personal victimization, substance abuse, limited education, social isolation, and poor coping skills that are not adequate for the more prosocial values and work skills of the normal worksite. With society extolling material goods as the key to the good life and with entry into the normal workforce blocked for the reasons noted above, these individuals develop antisocial values and criminal behaviors to obtain through criminal activity what they cannot obtain thorough more socially adaptive coping. These latter two groupings of assailants may again be either employees or worksite visitors or customers.
Why Are They Violent?
Given the maladaptive coping skills and other social ills noted in the various assailant groups above, to understand workplace violence, we need to go one step further and ask why they become violent. The empirical medical and behavioral science literatures have outlined four major theories of why individuals become violent: the cultural, biological, sociological, and psychological theories. At the moment no one can predict violence with one-hundred-percent accuracy and no one theory can explain all types of violence. In fact, in any given act of violence, two or three theories may be involved. However, there is enough scientific data found in these theories to develop sound risk-management strategies to substantially reduce the risk of violence at work. Since these theories have been explained in detail previously (2, 3), the four theories are briefly summarized here. We begin with the cultural theories.
The most cited cultural theory of violence is the theory of anomie, which was developed by Emile Durkheim (4). According to Durkheim, there are five major societal institutions that establish the rules of good conduct in a society. If these rules are adhered to, the citizens of that society know how to behave, feel included and a sense of community cohesion is established. These major societal institutions are the family, business, government, schools, and religious faith traditions. When any society undergoes a radical transformation, Durkheim believes that these major societal institutions are negatively impacted, the common rules for citizens are disrupted and this is followed by sharp increases in suicide, substance abuse, mental health issues, and violence. In Durkheim’s theory, the advent of readily available computer technology in 1965 led to the development of the postindustrial state with its emphasis on knowledge-based growth and global international commerce. Durkheim would have assessed this to be a major and radical societal shift from the industrial-based state that manufactured goods. Thus, it would be a disruptive, major cultural factor in today’s violent age.
The biological theories focus on how violent behavior may ensue as a result of abnormal biology or medical disease. To date, there is no evidence that violence and crime are solely genetic in nature. Violent acts may erupt if the cortex of the brain, the seat of higher reasoning processes, or the brain’s limbic system, the seat of feelings and emotional states, are not working properly. As noted earlier, medical diseases such as delirium, dementia, thyroid conditions, and traumatic brain injuries have been associated with violence in some patients. Similarly, the psychiatric conditions of serious mental illness, mental retardation, and substance abuse may again be associated with violence in some. However, these biological disruptions are relatively infrequent and could in no way account for the extent of the current violence in society.
The sociological theories of violence receive much media attention and are generally well known. They include poverty, inadequate schooling, discrimination, substance abuse, domestic violence, easily available weapons, and violence in the media. Research has documented that each of these sociological factors is associated with violence. Frequently, a violent individual may have been impacted by several sociological factors. For example, a person born into poverty may also have had inadequate schooling, been discriminated against, and begun to abuse substances to self-medicate these various distressing events. Often overlooked among these various sociological factors is that each factor disrupts attachments to others. Social networks, caring attachments, and community resources are often absent for assailants. The weakness or absence of these social ties in the assailant’s life is further aggravated by the loss of social cohesion in society in general. This coupling represents a severe stress on the social fabric and violence may ensue.
The psychological theories form the fourth and last group of the theories of violence. The psychological theories include two domains: reasonable mastery of one’s life and one’s value/motivational stance. Reasonable mastery is defined as the ability to shape one’s environment to meet one’s needs. These coping skills include mastery in self-care, interpersonal relationships, and academics. Individuals who master these skills will likely develop prosocial values and participate in the work force in ways that are constructive for both society and the individual employee. Such persons are less likely to be violent. Persons who do not master these adaptive coping skills are more apt to develop antisocial values and motivations, such as those of jealousy, revenge, and enforcement of one’s own sense of personal justice, combinations that are more likely to result in interpersonal violence.
The Psychological Impact on the Employee Victim
Although violence at work can result in death, disability, medical/legal expense, and lost productivity, violence in the workplace may also result in the severe psychological distress known as psychological trauma and, if left untreated, posttraumatic stress disorder (PTSD).
Psychological trauma may be defined as an individual’s physical and psychological response to experiencing actual or threatened death, serious injury, or the threat to the physical integrity of the individual or others. Individuals have no control over these events no matter how hard they try and these events need to result in a state of fear that would distress any reasonable person (5). One may become a victim of trauma by direct acts, by witnessing these violent outbursts upon others, or by hearing victims recount what has happened to them (e.g., police and paramedics called to a critical incident).
There are three domains of good physical and mental health: reasonable mastery, caring attachments to others, and meaningful purpose in life. In traumatic events any or all of these domains may be disrupted. By definition, mastery is disrupted because the victim has no control over the situation. Attachments are disrupted as the victim withdraws into social isolation, and nonvictims, frightened by the violence, also withdraw and then often blame the victim. (Blaming the victim provides the illusion of safety in that those who blame say to themselves that they would not be so foolish so as to be victimized. This illusion provides no true safety.) Finally, the victim’s meaningful purpose in life is shattered. We all operate each day on assumptions that the world is orderly, safe, predictable, and worthy of our investing energy in it. In the aftermath of violence, these assumptions are crushed. The world does not seen orderly, predictable, and safe, and victims do not want to invest energy in it.
As if this psychological turmoil were not enough, psychological trauma and PTSD, like any medical condition, have symptoms or signs of disrupted normal functioning. Psychological trauma symptoms are of three types: physical, intrusive, and avoidant. The physical symptoms arise from the adrenalin released in the body during the crisis and result in hypervigilance, an aggregated startle response, sleep disturbances, difficulties in concentration and mood irritability. Intrusive symptoms refer to the victim’s recurring memories of the event in thoughts, memories, daydreams, and nightmares. These occur because the brain is trying to heal itself by reviewing what has happened to be better prepared should it ever happen again. However, these intrusive reminders are so distressing that victims often develop strategies to put them out of mind, a strategy that delays recovery.
The last group of symptoms is the avoidant symptoms. Given the physical and intrusive symptoms, it is not surprising that victims withdraw. They withdraw from the scene of the violence and then gradually withdraw from work, community, and family to a state of social isolation and continuing dysphoria.
When a traumatic event occurs, there is a period of acute distress that may last as long as thirty days and involves the victim experiencing disruptions in any of the domains of mastery, attachment, and meaning, and/or any of the physical, intrusive, or avoidant symptoms of trauma. If any of these six types of disruptions are present on the thirty-first day after the event, by medical convention, the victim has developed the medical condition known as PTSD. The disrupted domains and the traumatic symptoms will last until death, if the employee victim has not had satisfactory treatment for the PTSD. Finally, some victims experience understandable distress at the time of the violent incident at work but appear to resume their normal work lives within the first thirty days. However, sometime after six months of normal routine, the employee may experience a significant loss or a symbolic reminder of the crime. This is often followed by a reexperiencing of any of the disrupted domains or symptom clusters and is known as delayed onset PTSD.
The types of workplace violence, the types and characteristics of assailants, the theories for such violence, and the range of impacts of employee victims are complex entities. However, this information can provide the basis for sound risk management strategies to create safe and productive work environments.
We turn now to some of the more important of these efficacious strategies in part 2 of this essay on preventing violence in the workplace.
1. Flannery R. B. Jr. Violence in the Workplace. New York: American Mental Health Foundation, 2012.
2. Flannery, R. B., Jr. Violence in America: Coping with Drugs, Distressed Families, Inadequate Schooling, and Acts of Hate. New York: American Mental Health Foundation, 2012.
3. Flannery, R. B., Jr. Preventing Youth Violence: A Guide for Parents, Teachers, and Counselors. New York: American Mental Health Foundation, 2012.
4. Durkheim, E. Suicide: A Study in Sociology. Trans: Spaulding, J. and Simpson, G. New York, NY: The Free Press, 1997.
5. Flannery R. B. Jr. Posttraumatic Stress Disorder (PTSD): The Victim’s Guide to Healing and Recovery. Second Edition. New York: American Mental Health Foundation, 2012.
Dr. Raymond B. Flannery, Jr., Ph.D. FAPM, is an internationally recognized scholar and lecturer on the topics of violence, victimization, and stress management. Dr. Flannery is available for lectures and workshops for all types of groups and may be reached at the American Mental Health Foundation. Email Evander.