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Institutional Betrayal and Gaslighting: Why Whistle-Blowers Are So Traumatized
Abstract
Despite whistle-blower protection legislation and healthcare codes of conduct, retaliation against nurses who report misconduct is common, as are outcomes of sadness, anxiety, and a pervasive loss of sense of worth in the whistle-blower. Literature in the field of institutional betrayal and intimate partner violence describes processes of abuse strikingly similar to those experienced by whistle-blowers. The literature supports the argument that although whistle-blowers suffer reprisals, they are traumatized by the emotional manipulation many employers routinely use to discredit and punish employees who report misconduct. "Whistle-blower gaslighting" creates a situation where the whistle-blower doubts her perceptions, competence, and mental state. These outcomes are accomplished when the institution enables reprisals, explains them away, and then pronounces that the whistle-blower is irrationally overreacting to normal everyday interactions. Over time, these strategies trap the whistle-blower in a maze of enforced helplessness. Ways to avoid being a victim of whistle-blower gaslighting, and possible sources of support for victims of whistle-blower gaslighting are provided.
... Whistleblowers in various organisations often experience similar dismissals and discrediting, alongside false accusations of overreacting and lying in their testimonies (Wozolek, 2018). Complaints frequently trigger organisational/corporate gaslighting, where whistleblowers are superficially praised but ultimately portrayed as incompetent or mentally unstable by senior managers (Ahern, 2018). This is also mirrored in acts of organisational social power (Graves and Spencer, 2022), where companies encourage workers to voice systemic issues as a discursive exercise, providing performative attention and care to these complaints without any genuine intention of rooting out the problems. ...
... Rather than acknowledging the underlying automation and process-related problem, platform representatives often minimised their support by offering basic guidance to users on how they can do better to avoid triggering the algorithm, resembling a practice akin to gaslighters' attempting to shift responsibility onto victims (Johnson et al., 2021;Spear, 2019). Similarly to institutional gaslighting and whistleblowing cases, here, the hate cleansers experienced cognitive dissonance: they are commended for identifying harm, yet simultaneously face denial about the extent of the issues they bring to light (Ahern, 2018). This trend was also observed by activist and sex positive communities on Instagram: ...
... This approach includes denying any favouritism on their part, with reactions that reflect the 'discursive performances' (Gillespie, 2010) embedded in their community guidelines. It also reflects previous research on corporate strategies to simultaneously praise and minimise whistleblowers' reports (Ahern, 2018;Graves and Spencer, 2022), suggesting that TikTok's interruption of the creator might be perceived as an attempt to dismiss Palestinian concerns by implying their allegations lack foundation. This redirection from users' valid, nonaccusatory concerns to other, unrelated accusations, which TikTok aims to disassociate from, appears to be a subtle act of manipulation that is felt as a form of gaslighting, seeking to distort the user's perception of the situation (Omran and Yousafzai, 2023). ...
This paper delves into communications dynamics between social media platforms and their users as they navigate the opacity of governance policies. Using Meta and TikTok as case studies, we reveal that gaslighting – traditionally linked with relationship abuse where one partner undermines the validity of the other's experience – has become a pervasive communication strategy for platforms, manifesting in numerous instances where automated and human platform communications have directly contradicted users’ experiences, evidence and research. We analyse 36 diverse interview datasets and six public platform responses to content moderation issues, highlighting the systemic nature of this phenomenon within digital spaces. By moving beyond shadowbanning and isolated platform-to-user dialogue, we expand the scholarly understanding of platform gaslighting to encompass a broader spectrum of governance-related communications. Our dataset draws from seemingly disparate groups who share moderation experiences: Jewish creators engaged in combating antisemitism, Palestinian creators advocating for human rights and sex-positive creators, whose expertise and stories are dismissed and belittled by platforms. Our participants' experiences demonstrate that conceptualising platform communications as gaslighting can help expose corporate power imbalances in platform-user interactions, particularly in cases where platforms govern through undisclosed practices such as shadowbanning and de-platforming triggered by malicious flagging, along with ambiguous communication from their representatives. We demonstrate how the dismissal or minimisation of participants’ traumatic experiences by platforms’ automated processes and human teams is weaponised to inflict epistemic injustice, consolidate power, safeguard public image and evade accountability.
... The tactics of lying, denying, dismissing, and minimizing are frequently described as used in the service of avoiding accountability or shifting the responsibility of the perpetrator's actions onto the victim, i.e., 'there is nothing wrong with my behaviour, your reaction is out of proportion' (Klein et al., 2023;Williams, 2021). The arguments of responsibility, combined with the repetition of lying and denying behaviours, contribute to a sense of confusion and uncertainty (Ahern, 2018). Hayes and Jeffries (2015) reflected upon their experiences of psychological abuse and noted that gaslighting exists on a spectrum from outrageous lies and obvious manipulation therefore provides no basis of which to build self-trust and self-esteem. ...
... As gaslighting may target a wide range of domains (i.e., emotions, memories, thoughts, perceptions;Hailes, 2022;Klein et al., 2023), it may become increasingly difficult to check in with oneself for validation (Sodoma, 2022). The cognitive dissonance that exists between the victim's experiences and what they are told, in combination with coercion and the victim's desire to resolve this dissonance, has been argued to lead to confusion and self-doubt (Hailes, 2022;Ahern, 2018). Stern (2007) noted that the experience of self-doubt can vary across victims, with some only experiencing self-doubt in one domain and others in multiple. ...
... Burnett (2020), in a review of women's experiences of covert abusive tactics, argued that the ability to leave an abusive relationship often relies upon being able to label the abuse. Further, as gaslighting has been argued to often centers around shifting blame onto victims (Ahern, 2018), labelling abuse can have an important role in clarifying and reducing the self-blame that victim-survivors often experience (Hayes & Jeffries, 2013). It is apparent that the term 'gaslighting' has helped many people find meaning and understanding in their experiences, as it has had a large grassroots movement in domestic violence support groups (e.g., Kippert 2021). ...
Purpose
With the rise of coercive control legislation in Australia and the UK, it has become increasingly important to clarify the discourse surrounding common psychological abuse tactics, such as gaslighting. This literature review seeks to aid future research in conceptualising gaslighting by exploring its complex nature and tracing its evolution across different fields. The primary aim is to compile and synthesize research from various disciplines, enhancing cross-field communication and providing a clearer understanding of the term’s origins and potential future applications.
Method
This literature review synthesizes existing research on gaslighting by examining its evolution and operationalization across multiple fields, including medicine, psychiatry, psychodynamics, psychology and individual differences, sociology, and philosophy.
Results
The review reveals significant inconsistencies in the operationalization of gaslighting across various fields, such framing gaslighting as a type of family abuse used for personal or material gain, a form of interpersonal communication between couples, and an expression of structural power. It underscores the need for a stronger theoretical basis in empirical research on gaslighting and recommends moving away from the current focus on individual differences prevalent in empirical studies.
Conclusion
By providing a comprehensive synthesis of existing research, this review shines a light on the shifting conceptualization of gaslighting. It emphasizes the importance of interdisciplinary communication and the need for a more robust theoretical framework to improve empirical studies. This unified understanding is crucial for developing more effective legal and psychological interventions to address gaslighting and other forms of psychological abuse.
... The term "Gaslighting" was first mentioned in a play named Gas Light by Patrick Hamilton in 1938, and was later adapted into a movie named Gaslight in 1944 (Ahern, 2018;Aisha et al., 2022). The movie resulted in the widespread concept of gaslighting. ...
... Most researchers see gaslighting as a psychological phenomenon (Ahern, 2018;Klein & Wood, 2022), whereas a few researchers (Sweet, 2019) see it as a sociological phenomenon. The former researchers see gaslighting as a psychological phenomenon, as they focus on the result of gaslighting, that is, to psychologically manipulate and control the victim, whereas the latter sees gaslighting as a sociological phenomenon, as they focus on the causes such as gender, financial, and social inequality that contribute to it. ...
... Several researchers have investigated gaslighting in various contexts, such as the workplace (Ahern, 2018;Irigaray et al., 2023;Lesaca, 2023), politics (Carpenter, 2018), and intimate, romantic relationships (Abramson, 2014;Aisha et al., 2022;Graves & Samp, 2021;Klein & Wood, 2022;Stern, 2008). However, to the best of my knowledge, no research has investigated gaslighting in the classroom; gaslighting in a teacher-student relationship. ...
Gaslighting is a form of psychological manipulation and emotional abuse that is subtly manifested in a perpetrator’s speech to control someone by leading them to doubt their reality and discernment; their own beliefs, thoughts, behaviors, emotions, memory, and sanity. Gaslighting has been investigated in the context of many relationship dynamics such as intimate relationships, the workplace; an employer-employee relationship, and politics. However, to the best of my knowledge, a few, if any research papers addressed gaslighting in the classroom; a teacher-student relationship. This paper aims to succinctly address [some] teachers' gaslighting of their students in the classroom and how it negatively impacts students' credibility, self-confidence, memory, and sanity, as well as provide suggestions on how educational institutions and students should and can deal with incidents of gaslighting and perpetrators of gaslighting. Besides, a [general] framework for gaslighting that can help identify cases of gaslighting is proposed.
... First, researchers emphasize that gaslighting occurs in the context of power-imbalanced relationships where the dyadic relationship is situated within naturally existing, power-differentiated structures (Abramson, 2014;Riggs & Bartholomaeus, 2018;Sweet, 2019), such as the hierarchical organization of most workplaces. Second, the act of engaging in gaslighting abuse is typically described as patterns of psychological or emotional abuse (Ahern, 2018;Graves & Samp, 2021;Sweet, 2019) that are covert and difficult to detect (Hightower, 2017;Miano et al., 2021). In a thought experiment, Abramson (2014) outlines how the covert tactics of gaslighting facilitate the gaslightee's own denial and lack of awareness. ...
... However, Rietdijk (2018) aptly notes that expanding gaslighter intent to understand why they want to disorient their target is a complicated endeavor due to the "diverse and often unconscious" nature of gaslighting motivations. Fourth, gaslighting is largely defined by the effect of the mistreatment on the target, such that the gaslightee doubts their perceptions, feelings, identity, and self-worth (Abramson, 2014;Ahern, 2018;Christensen & Evans-Murray, 2021;Graves & Samp, 2021;Rietdijk, 2018;Sweet, 2019). This is a critical component that makes gaslighting a unique and insidious form of interpersonal mistreatment. ...
... Although gaslighting has primarily been explored in the context of romantic relationships, researchers regularly emphasize that gaslighting can occur in many types of power-differential relationship including the supervisor-subordinate relationship (Abramson, 2014;Ahern, 2018;Christensen & Evans-Murray, 2021;Hightower, 2017;Rietdijk, 2018;Sweet, 2019). However, integration of gaslighting into the existing destructive leadership literature requires a systematic comparison of leader gaslighting tactics against other forms of destructive leadership. ...
... Older case studies (1960s-1980s) focused on perpetrators who gaslight their romantic partners to attain some tangible goal, such as acquiring their partner's assets. Contemporary case studies of non-romantic gaslighting relationships similarly tend to involve perpetrators with specific tangible goals (Ahern, 2018;Christensen & Evans-Murray, 2021;Dumitraşcu et al., 2015). In recent discussions, it is unclear how intentional and aware perpetrators are that they are gaslighting their survivors. ...
... Unlike what is suggested in older psychiatric publications and contemporary work on gaslighting in the workplace (e.g., Ahern, 2018;Calef & Weinshel, 1981), our findings suggest that perpetrators rarely attempt to achieve some specific type of explicit or material goal. Our findings are in line with more recent discussions of gaslighting in a romantic context (e.g., Sarkis, 2018;Stern, 2008). ...
... Such inquiries may help reveal strategies for how survivors can prevent bad actors from undermining their self-representation and modeling of the world, even in situations in which they are unable to cut off contact with the abuser. Notably, these studies would be applicable outside the domain of romantic relationships, such as in the workplaces (Ahern, 2018). ...
Gaslighting is an understudied form of abuse wherein a sane and rational survivor is convinced of their own epistemic incompetence on false pretenses by a perpetrator. The current study aimed to characterize the features of gaslighting as well as test and verify common claims about gaslighting. We recruited participants ( N = 65) who self‐identified as having experienced gaslighting in romantic relationships to fill out a qualitative survey wherein they described instances of gaslighting, features of their relationships, and the consequences of gaslighting on their mental health. The age of participants in this study ranged from 18 to 69 (M = 29), most participants identified as female (48), and heterosexual (43). Gaslighting occurs within relationships that are typified by a combination of affectionate and abusive behaviors extended over the course of a relationship. Gaslighting victimization was associated with a diminished sense of self, mistrust of others, and on occasion, post‐traumatic growth. Those who recovered from gaslighting often emphasized the importance of separation from the perpetrator, prioritization of healthier relationships, and engaging in meaningful and re‐embodying activities. This study provides a basis for further research into gaslighting and recovery from gaslighting, which will contribute to the prevention and treatment for this type of abuse.
... This was supported by Riggs & Bartholomaeus (2018), who identify gaslighting as a manipulative tool used in identity abuse, as a means of controlling or belittling them. In addition, Ahern's (2018) exploration of gaslighting describes it as being a tool of institutional betrayal, which can occur when one party trusts another party and is therefore dependent on them for safety, money, or housing. The institutional betrayal occurs when the harmed party raises a concern but is exploited for their (Ahern, 2018). ...
... In addition, Ahern's (2018) exploration of gaslighting describes it as being a tool of institutional betrayal, which can occur when one party trusts another party and is therefore dependent on them for safety, money, or housing. The institutional betrayal occurs when the harmed party raises a concern but is exploited for their (Ahern, 2018). In addition, Thomas (2017) and Wozolek (2018) both provide personal accounts of how their respective institutions gaslighted them, with themes of dismissed concerns, false allegations, ostracising, and changing rules and regulations to fit with their aims. ...
... Connected to this, there was evidence that those involved in the perpetration of gaslighting showed proclivity for perpetrating other emotional abuse (Abramson, 2014;Simon, 2011). This, in itself, supports the use of gaslighting as a tool for abuse, as captured by one of the themes from the REA (Abramson, 2014; Ahern, 2018;Riggs & Bartholomaeus, 2018;Thomas, 2017;Wozolek, 2018). Interestingly, a role for a raised tendency for trait aggression was not clearly indicated, suggesting that gaslighting is more closely aligned to emotional aggression (Wozolek, 2018) than aggression more broadly. ...
Purpose
The study aims to examine the nature of gaslighting and how it relates to interpersonal aggression.
Design/methodology/approach
It does so first through application of a Rapid Evidence Assessment (REA) to understand how gaslighting is understood academically. This RAE captured 50 articles, with 12 retained for thematic review. Results were then used to develop a gaslighting behaviour measure, which was then applied in an online study of adults ( n = 386; 77.2% women).
Findings
Five themes were identified from the REA: components of gaslighting; gaslighting as a tool for abuse; perpetrators as damaged manipulators; experiences and characteristics of victims; and institutional and racial gaslighting. In the ensuing study, results demonstrated that emotional abuse was broadly related both to the perpetration and experiencing of gaslighting, indicating that it may represent an extension of emotional abuse. The relationship to trait aggression was limited and primarily isolated to victims presenting with higher levels of trait aggression capturing more emotional components (e.g. anger/hostility).
Research limitations/implications
The importance of context in understanding the relationship between gaslighting, emotional abuse and aggression was indicated, with some complexity found. Suggestions for future research are made.
Practical implications
Accounting for context in understanding gaslighting is key. Developing and validating measures for gaslighting would assist with the evaluation of this behaviour. When working with those who have a history of emotional abuse, considering gaslighting as a further element is potentially important. It should not be assumed that gaslighting has an association with non-emotional aggression; the type of relationship where it is occurring is important.
Originality/value
This study is the first to consider the development of a gaslighting measure, which is informed by a methodological review of the literature.
... In these moments of conflict, extrinsic pressures due to fears about litigation and reputation of the unit or individuals may push leaders toward inaction, silence, and attempts to control or suppress the conflict by applying top-down authority. However, as the costs and visibility of conflict mount, frustrated and polarized faculty (Ahern, 2018) protected by academic freedom turn to social media to express frustrations or confusion, and avoidance becomes untenable (Ahmed, 2021). Rather than framing discussions in these contexts as mere compromises, leaders could seize the opportunity to resolve these issues in a way that builds intergroup engagement skills and creates systemic change (Fisher & Ury, 1981). ...
... However, it is critical to act. In addition to reputational risks and reduced institutional legitimacy, not acting, especially for people with marginalized identities in conservation and in academia, can lead to gas lighting, despair, hopelessness, increasing polarization, reduced well-being, and reduced commitment and engagement in conservation or JEDII in universities (Ahern, 2018;Trejo, 2020). ...
Despite widespread plans to embed justice, equity, decolonization, indigenization, and inclusion (JEDII) into universities, progress toward deeper, systemic change is slow. Given that many community‐based conservation (CBC) scholars have experience creating enduring social change in diverse communities, they have transferable skills that could help embed JEDII in universities. We synthesized the literature from CBC and examined it through the lens of self‐determination theory to help identify generalizable approaches to create resilient sociocultural change toward JEDII in universities. Fostering autonomous motivation (i.e., behaving because one truly values and identifies with the behavior or finds behavior inherently satisfying) is critical to inspiring enduring change in both CBC and JEDII. Based on theory and our examination of CBC, we provide 5 broad recommendations that helped motivate behavioral change in a way that was self‐sustained (i.e., even without external rewards or pressure). Guiding principles support autonomy by creating meaningful choice and different entry points for JEDII; prioritising relationships; designing payment programs that enhance autonomous motivation; developing meaningful educational opportunities that are relevant, timely, relational, and authentic; and creating institutional change by focusing efforts on critical moments.
... We propose that this also applies to the actions of dominant group members, particularly when thinking about resistance to social change, or system-supporting collective action, as others have also suggested (Jost et al., 2017;. Further, one effect of hidden power exertion is that members of the powerless group become isolated, a consequence of normative violence such as gaslighting and creating fear cultures (Ahern, 2018). Undermining powerless group members' understanding of belonging to a collective can prevent their transition into visible resistance for long periods of time. ...
... Finally, we encourage more interdisciplinary efforts into the substantial detrimental effects that unequal systems, as well as the actions of those benefiting from them, have on the disadvantaged. Trauma research, for instance, shows that resistance tactics such as normative violence, gaslighting and silencing contribute to complex trauma, increased distrust and cynicism (Ahern, 2018;Harsey & Freyd, 2020). ...
Recent protest movements such as #MeToo exposed that institutional change initiatives targeting harassment and discrimination have so far failed to achieve equity. We propose that this is because such policy initiatives fail to account for the motivation of those privileged by inequality regimes to maintain and perpetuate these systems. Addressing gaps in collective action scholarship, we introduce a normative framework conceptualising the inaction of dominant groups as system‐supporting behaviour to preserve the status quo. System‐supporting inaction is a central and highly effective technique used by dominant group members to hinder processes of change and preserve their power, and it often preludes escalation to violent backlash over time. Building on sociological models of inequality and power, we develop a conceptual model that accounts for the group dynamics associated with collective system‐supporting (in)action. We propose an agenda for future research that focuses on resistance to change as a means of maintaining privilege.
... Unlike what is suggested in older psychiatric publications and contemporary work on gaslighting in the workplace (e.g., Ahern, 2018;Calef & Weinshel, 1981), our findings suggest that perpetrators rarely attempt to achieve some specific type of explicit or material goal. Our findings are in line with more recent discussions of gaslighting in a romantic context (e.g., Sarkis, 2018;Stern, 2008).Specifically, we found that perpetrators' motivations for gaslighting were rarely singularly focused. ...
... Such inquiries may help reveal strategies for how victims can prevent bad actors from undermining their self-representation and modelling of the world, even in situations in which they are unable to cut off contact with the abuser. Notably, these studies would be applicable outside the domain of romantic relationships, such as in the workplaces (Ahern, 2018). ...
Gaslighting is an understudied form of abuse wherein a sane and rational victim is convinced of their own epistemic incompetence on false pretenses by a perpetrator. We recruited participants (N = 65) who self-identified as having experienced gaslighting in romantic relationships to fill out a qualitative survey wherein they described instances of gaslighting, features of their relationships, and the consequences of gaslighting on their mental health. We found that gaslighting consists of a dynamic combination of affectionate and abusive behaviors extended over the course of a relationship. Gaslighting victimization was associated with a diminished sense of self, mistrust of others, and on occasion, post-traumatic growth. Those who recoveredfrom gaslighting often emphasized the importance of separation from the perpetrator, prioritization of healthier relationships, and engaging in meaningful and re-embodying activities. The present study represents a first step towards characterizing the gaslighting phenomenon, as well as understanding the recovery process.
... Our participants viewed organizations responsible for players' welfare and education, such as the PFA, as complicit in the bullying process. As such this reflects what Ahern (2018) articulates as an institutional betrayal of victims. In addition, at the individual level the image of victims being laughed at reinforced a highly degrading feeling for them. ...
... Albeit potentially indirectly, these organizations such as the PFA appear to maintain the culture of victim silencing (Nite & Nauright, 2020), rather than leaving individuals with a strong sense that they will be protected. This potential failure represents institutional betrayal whereby footballers' expectations for safety and at work are violated (Ahern, 2018), which may explain why some individuals are driven to the point of considering suicide (BBC, 2021b). ...
Only recently has research begun to focus on workplace bullying within organizations outside of traditional white-collar industries, such as professional football. While this is an important development, there remains a lack of understanding around the reporting of bullying in professional sport. In this paper, the authors explore how the professional football workplace shapes perceptions of whistleblowing and unearths individual perceptions around reporting bullying behavior. We used a phenomenological approach to gain rich experiential data from eighteen male professional football players in the UK. Interview data were analyzed in accordance with the principles of Interpretative Phenomenological Analysis. Two superordinate themes were identified from the analysis, (a) professional football’s influence on whistleblowing, and (b) the challenges of reporting bullying. These themes highlighted that the unique, institutionalized nature of professional football interacts with participants’ ability to report bullying behavior. The participants’ accounts revealed divergent perceptions around how professional football shapes the degree to which players feel they can report bullying behavior. It was apparent that the authoritarian, often abusive and intimidatory nature of professional football significantly impacts whistleblowing. Our findings demonstrate the importance of workplace context when exploring the reporting of bullying behavior. They also demonstrate the need to address organizational culture and differentiate bullying education programs to alternative workplaces.
... Stark developed the notion of manipulative gaslighting, which denies, minimizes or challenges testimony about harms done to the target [65], by sidestepping evidence that supports the target's testimony, or attributing cognitive or characterological defects to the target, e.g., "Can't you take a joke? " or "Why are you obsessing on this?" Ahern referred to whistleblowing gaslighting, which involves trauma resulting from the emotional manipulation used by employers to discredit and punish employees who report misconduct [66]. ...
... The cross-cultural portability of organizational silencing dynamics, such as victim-blaming, retaliation, minimizing, deflection, gaslighting and institutional betrayal, is borne out in the study results [16,61,62,64,66]. Some of the theories of sexual harassment mentioned earlier also appear portable to UMOH workplaces. ...
Introduction
Sexual harassment is a ubiquitous problem that prevents women’s integration and retention in the workforce. Its prevalence had been documented in previous health sector studies in Uganda, indicating that it affected staffing shortages and absenteeism but was largely unreported. To respond, the Ministry of Health needed in-depth information on its employees’ experiences of sexual harassment and non-reporting.
Methods
Original descriptive research was conducted in 2017 to identify the nature, contributors, dynamics and consequences of sexual harassment in public health sector workplaces and assess these in relation to available theories. Multiple qualitative techniques were employed to describe experiences of workplace sexual harassment in health employees’ own voices. Initial data collection involved document reviews to understand the policy environment, same-sex focus group discussions, key informant interviews and baseline documentation. A second phase included mixed-sex focus group discussions, in-depth interviews and follow up key informant interviews to deepen and confirm understandings.
Results
A pattern emerged of men in higher-status positions abusing power to coerce sex from female employees throughout the employment cycle. Rewards and sanctions were levied through informal management/ supervision practices requiring compliance with sexual demands or work-related reprisals for refusal. Abuse of organizational power reinforced vertical segregation, impeded women’s productive work and abridged their professional opportunities. Unwanted sexual attention including non-consensual touching, bullying and objectification added to distress. Gender harassment which included verbal abuse, insults and intimidation, with real or threatened retaliation, victim-blaming and gaslighting in the absence of organizational regulatory mechanisms all suppressed reporting. Sexual harassment and abuse of patients by employees emerged inadvertently.
Discussion/conclusions
Sex-based harassment was pervasive in Ugandan public health workplaces, corrupted management practices, silenced reporting and undermined the achievement of human resources goals, possibilities overlooked in technical discussions of support supervision and performance management. Harassment of both health system patients and employees appeared normative and similar to “sextortion.” The mutually reinforcing intersections of sex-based harassment and vertical occupational segregation are related obstacles experienced by women seeking leadership positions. Health systems leaders should seek organizational and sectoral solutions to end sex-based harassment and make gender equality a human resource for health policy priority.
... Of the articles reviewed, only one used the term institutional betrayal to describe experiences among nurses. 10 Five articles suggested betrayal within the experiences of nurses and two articles discussed betrayal as a factor of moral injury and moral distress; these seven articles were used to define the concept. The remaining articles did give clear indications of the conceptual definition or manifestations of betrayal and thus were not used. ...
... individuals or collective systems) to which an individual belongs. 2 One article was identified in which institutional betrayal was specifically named as a possible issue in nursing. 10 The article uses the term institutional betrayal to describe gaslighting, where nurses who report issues in the workplace (i.e. whistleblowers) were made to feel that their complaints were insignificant or that issues in the workplace were not really happening. ...
Background
Ethical relationships are important among many participants in healthcare, including the ethical relationship between nurse and employer. One aspect of organizational behavior that can impact ethical culture and moral well-being is institutional betrayal.
Research aim
The purpose of this concept analysis is to develop a conceptual understanding of institutional betrayal in nursing by defining the concept and differentiating it from other forms of betrayal.
Design
This analysis uses the method developed by Walker and Avant.
Research context
Studies were reviewed using health literature databases with no date restrictions.
Ethical considerations
Analysis was conducted using established guidelines for ethical research.
Findings
Although institutional betrayal is a concept applied in the literature, there was a paucity of studies exploring the concept within nursing. Examples of the concept in the literature include violation of trust between organization (i.e. employer) and nurse, such as provision of inadequate workplace protections, ineffective or hostile management, and gaslighting of those who experience negative events. Examples of institutional betrayal have become more visible during the COVID-19 pandemic.
Discussion
A conceptual definition of institutional betrayal is a deep violation of trust or confidence or violation of moral standards committed by an institution toward a nurse. This definition incorporates experiences and issues suggested by the literature. Outcomes are likely negative, including impacts on nurse psychological and workplace well-being. This concept likely fits within a framework of ethical workplaces and has conceptual relationships with moral distress and moral resilience. Further studies can help qualitatively explore and empirically measure this concept.
Conclusion
In the pursuit of improving the ethical culture of healthcare workplaces, this concept can provide meaningful insight into organizational behavior and its consequences. Naming and describing the concept can promote conceptual clarity and equip researchers, nurses, and leaders to identify and mitigate the issue.
... This resulted in the daughter suffering symptoms of complex posttraumatic stress disorder and being unable to work for 18 months. Although numerous regula-tory investigators later substantiated many of the problems the family had reported, and the professional complaint against the family member was dropped, the family's grief was needlessly complicated by institutional betrayal triggered by their whistleblowing (Ahern, 2018). ...
... An additional layer of betrayal that recent news stories make clear is the reality that these are not isolated incidents; research across American and Canadian health care systems estimates that two thirds (Smith, 2017;Tamaian, 2019) of patients experience institutional betrayal related to medical experiences. Hearing that other families have been trying to sound the alarm about the same problems is an additional form of institutional betrayal: making it seem to each individual patient or family that their situation is unusual or denying or minimizing the problem, when in fact it is now obvious that the problem is systemic (Ahern, 2018). This is one example among many. ...
In this commentary, researchers, health care consumers, and medical providers reflect on institutional betrayal during the COVID-19 pandemic in American and Canadian health care systems. Examples of institutional betrayal experienced by patients and their family members, as well as medical providers, are described. Although such examples may be more evident to the general public during the current pandemic, they do not represent new problems.
... However, many quickly learn there is a price to pay when exposing organizational corruption. Whistleblowers frequently endure retaliation from organizations, managers, and even co-workers for exposing wrongdoing (Ahern, 2018;Richardson & McGlynn, 2011). Forms of retaliation include job loss, blacklisting, ostracism, physical intimidation, surveillance, and even death threats (Garrick & Buck, 2022). ...
Whistleblowers frequently endure retaliation from organizations for exposing wrongdoing, but struggle to effectively communicate their experiences of ostracism, exile, and physical intimidation. This qualitative study used a metaphor framework to examine whistleblower experiences of retaliation. Semi-structured interviews were conducted with whistleblowers (N = 21), each of whom had experienced organizational retaliation. Guided by sensemaking theory and reflexive thematic analysis, themes were generated to categorize the metaphors that whistleblowers used to make sense of their experiences, and to portray participant experiences of organizational retaliation through the metaphors identified. Whistleblowers described two primary types of metaphors to describe their experiences of organizational retaliation, including metaphors of violence and metaphors of isolation. Metaphors of violence included metaphors comparing whistleblower experiences to forms of physical harm and mental harm. Metaphors of isolation described whistleblower experiences of professional isolation and relational solitude. The findings of this study inform whistleblowing research by increasing understanding of whistleblower experiences of organizational retaliation, extending knowledge of the types of support needed throughout the whistleblowing process, and providing empirically grounded recommendations to assist past, present, and future whistleblowers in their efforts to fight organizational corruption.
... Victims often exhibit a significant drop in mood and somatic anxiety due to mental manipulation (e.g., Hightower 2017). In addition, the feeling of uncertainty, due to the deconstruction of an individual's beliefs and perceptions caused by the gaslighter's behavior, can contribute to increased anxiety in the victims of this type of manipulation (Abramson, 2014;Ahern, 2018). ...
Gaslighting is an understudied form of psychological violence aimed to reduce victims’ autonomy, decision-making ability, security, and belief in their own perceptions. Although it leads to negative psychological, relational, and health consequences, few studies have examined the protective variables of this form of violence. The present study aims to analyze the role of self-compassion and social support (from family, friends, and significant others) in predicting gaslighting experiences, psychological health, and eudaimonic well-being among young Italian women. The mediational role of the gaslighting experience was examined. Participants (251 women, mean age = 38.72) completed an online survey assessing the variables of interest. Path analysis showed that participants’ self-compassion and perceived social support from family and significant others (but not one from friends) were negatively and significantly associated with gaslighting experience. Gaslighting experience emerged as a significant and negative predictor of both psychological health and eudaimonic well-being. Gaslighting experience partially mediated the relationship among self-compassion and both psychological health and eudaimonic well-being, and totally mediated the association among perceived social support (from family and from significant others) and both psychological health and eudaimonic well-being. This is one of the few studies that allowed to identify the important role of some interpersonal (i.e., social support) and intrapersonal (i.e., self-compassion) factors in predicting gaslighting experience. Our findings could be useful in designing preventive programs aimed to increase women’s abilities to cope with the potential manipulative intentions of their partner with positive consequences on their health and well-being.
... Institutional betrayal manifests when the victim voices his concerns but is subjected to gaslighting by the other party (Dickson, Ireland, & Birch, 2023). This form of gaslighting entails disavowing any wrongdoing in the face of evidence, asserting that the victim is overreacting, resorting to falsehoods, downplaying the matter, or challenging the victim's credibility (Ahern, 2018). ...
Until now the research has mainly examined visible abusive supervision, like aggression and violence, but it’s unclear how subtle forms, such as gaslighting, impact victims. Gaslighting, an emotionally and psychologically manipulative form of abuse, is an increasingly prevalent phenomenon in contemporary times. Based on the conservation of resources theory, we examined how supervisory gaslighting affects job embeddedness directly and indirectly through work motivation. We also explored how coworker support moderates the gaslighting-work motivation link. Structural equation modeling was used to assess the two-wave time-lagged data from 337 Chinese hotel employees. The results show the negative direct and indirect effects of gaslighting, and coworker support moderates the negative link between gaslighting and work motivation. Hotel organizations should exercise caution when hiring supervisors to prevent gaslighting, which can undermine employee motivation and job embeddedness. This study also recommends raising awareness among employees to speak out against supervisors’ gaslighting behavior.
... This corporatization of medical services contributes to a focus on institutional identity and opportunity for institutional betrayal (45). Unfortunately, administrators within healthcare institutions may leverage gaslighting behaviors, including explaining away concerns and labeling anyone who continues to push back on policies as irrationally overreacting to normal, everyday operations (46). This is especially true for women, or racial and ethnic minority professionals (47). ...
Background and Objective
Gaslighting is defined as behaviors inflicted on an individual which invalidate or call into question their ability to judge their own lived experience. Research into gaslighting in other contexts, such as domestic violence, underscore its potentially damaging effects. Medical gaslighting is an increasingly used, but poorly defined issue in a progressively more complex healthcare system in the United States. Limited studies constructively evaluate this breakdown in the provider-patient relationship and no studies exist evaluating gaslighting in the care of patients with digestive diseases. This narrative review aims to add clarity to the definition of medical gaslighting, evaluate the mechanisms that perpetuate gaslighting in gastroenterology practice and offer pragmatic solutions to begin to reduce its prevalence.
Methods
Narrative overview of the literature retrieved from searches of computerized databases.
Key Content and Findings
The potential root causes of gaslighting in gastroenterology practices are multifaceted and complex, and encompass patient, provider, and systemic factors.
Conclusions
An important distinction for medical gaslighting from other forms of gaslighting is the role of intent. As such, we propose the term “medical invalidation” be added to this construct and conceptualize medical gaslighting as occurring on a continuum. Within each facet of the relationship between system, provider and patient there are opportunities to prevent and recover from the occurrence of medical invalidation/medical gaslighting.
... Greenhouse gaslighting is perpetrated by both individuals and institutions (Ahern, 2018); as an example of both, here I articulate the practice of greenhouse gaslighting through a brief examination of the discourse of former Prime Minister of Australia, Scott Morrison, throughout his time in government. The three examples I focus on must be seen as representative of a long running consistent rhetoric and almost a decade of policy that actively sought to heat the climate, through promoting fossil fuels and preventing climate action, both at home and abroad. ...
This paper explores the process of feeling climate injustice. It aims to situate climate distress as an issue of justice, in order to generate more politically accountable and empowering responses. It firstly situates climate anxiety, solastalgia and climate disaster trauma as symptoms of affective climate violence, where harm that could have been prevented was instead consciously and systematically exacerbated by fossil fuelled political regimes. It articulates witnessing as a practice of affective climate justice, an approach that would recognise climate distress as violence, and offer support, apology and redress for this violence, including through seeking to prevent future climate change. However, the second section outlines how, in perverse efforts to maintain fossil fuel interests, climate distress is often further amplified through practices of greenhouse gaslighting – denying, deriding and dismissing people's experiences of harm. Greenhouse gaslighting is outlined as a patriarchal practice of emotional abuse that is enabled by and seeks to perpetuate white-colonial-extractivism. Thirdly, the paper argues that even within progressive circles, current efforts to witness climate distress potentially fail to enact affective climate justice due to discourses that centre whiteness and privilege, rather than recognising and responding to the different and unequal forms of affective climate violence experienced by diverse peoples.
... 이러한 보복은 공익제보자들에게 최대 스트레스원이 된다(Lennane, 1993; McDonald & Ahern, 2000; 신광식, 박흥식, 2009). Ahern은 공 익제보자가 조직 내에서 경험하는 어려움을 조직배반과 가스라이팅 개념을 통해 설명하였 다(Ahern, 2018).이 외에도 사법체계(Smith, Gomez, & Freyd, 2014)나 의료기관(Smith, 2017)에서, 그리고 해 외 유학 중(Wright, Smith, & Freyd, 2017)에 경 험하게 되는 조직배반의 영향에 대한 연구가 진행되었으며, 정부나 미국심리학회에 조직배 반에 가담한 책임을 묻는 연구도 진행되었다(Gómez, Smith, Gobin, Tang, & Freyd, 2016). ...
본 연구에서는 조직 내에서 외상경험이 발생했을 때 조직이 피해자를 적절하게 보호하지 않거나 오히려 가해에 가담하는 현상인 조직배반 이론을 국내에 소개하고, 기존에 조직 내 성범죄를 설명할 때 많이 사용되어 온 개념인 그루밍(Grooming)과 가스라이팅(Gaslighting) 개념과 어떠한 차이가 있는지 설명하고자 하였다. 조직배반 이론은 최근 국내를 포함하여 국제 사회 전반에 걸쳐 발생하고 있는 위계를 이용한 성폭력 또는 권력형 성범죄 및 조직 내 성폭력에서, 피해자가 몸담고 있으며 신뢰했던 조직에게서 구조적이고 제도적으로 입는 2차 피해의 양상을 확인하고 심각성을 인지할 수 있도록 돕는다. 이로써 성폭력 피해자에 대한 심리적 개입의 방향을 설정하고 적절한 보호 조치를 취할 필요성을 제시하며, 전반적인 사회문화가 어떠한 방식으로 변화해야 하는지 제안한다. 본 연구에서는 조직배반 이론에 대한 소개와 더불어, 조직배반 현상을 측정하고 적절한 개입을 고려할 수 있도록 Smith와 Freyd(2014)가 개발한 조직배반질문지(Institutional Betrayal Questionnaire-2: IBQ-2)를 한국판으로 타당화하고자 하였다. 이를 위해 원척도를 번안하여 한국판 조직배반 척도를 제작하여 요인구조를 확인하고, 신뢰도 및 타당도를 검증하였다.
Institutional Betrayal Theory is introduced, a phenomenon in which an institution does not adequately protect or rather participate in perpetration when trauma experiences occur, and explained how it differs from the concepts of grooming and gaslighting, which have previously been used to describe sex crimes. Institutional betrayal theory explains what difficulties victims face in recent hierarchical and intra-institutional sexual violence. It suggests that the need to set the direction of psychological intervention in victims of sexual violence, seek appropriate protective measures, and suggest how the overall social culture should change. It is examined the validity and the reliability of a Korean version of the Institutional Betrayal Questionnaire (K-IBQ). To validate IBQ in Korea, item translation and back-translation, item analysis, and confirmatory factor analysis (CFA) were conducted in a 462 females who have experienced sexual violence. Confirmatory factor analysis supported the 2 factors structure of the K-IBQ and both factors were correlated one another. The K-IBQ factors were adequately related to the social reactions to trauma experience, posttraumatic cognition and psychological symptoms, supporting good discriminant and criterion validity. The implications and limitations of this study, and directions for future study were discussed
... By relying on their heightened sensory perceptions, akin to Medusa's decapitated head, they confront the cognitive dissonance arising from their unique insights (McArdle et al., 2023). When gaslighting is the main response they receive from institutions ignoring their persistent demands to redress sociopolitical problems (Ahern, 2018), the resulting dissonance provokes moral injuries (Brewer, 2021). To combat the subversion of care by economic imperatives, postprofessionals must remain vigilant, resisting norms that threaten their practice and patients' well-being (Ceci, 2008). ...
Within the context of neoliberal healthcare, nurses and other health professionals face working conditions that leave them perpetually feeling inadequate, as though they are not enough. They are consistently expected to achieve more with less resources. In such an environment, mere professionalism proves wholly insufficient, enforcing norms of altruism and kindness. Professionals must transcend this disciplinary tool and embody a ‘more‐than‐professional’ approach. This study, informed by critical posthumanism, employs three mythical archetypes—the Medusa, the Witch and the Siren—to illuminate potential avenues for resistance against prevailing trends in healthcare. Drawing on the perspectives of Hélène Cixous, Silvia Federici and Jacques Rancière, we introduce a process of resistance for healthcare professionals pushing back against the challenges of crumbling healthcare systems. Cixous' feminist reimagining of Medusa symbolizes intensified embodied sensory experiences, emphasizing the power of irony, laughter and writing in highlighting the daily struggles faced by healthcare workers. Federici's depiction of the Witch exposes clandestine alliances among healthcare workers and patients, akin to a pact with the devil, countering the individualistic, alienating approach to care provision and resisting neoliberal pressures. The Witch archetype embodies resistance grounded in creativity against the commodification of public healthcare. Finally, Rancière's ‘politics of the Siren' offers a strategy for disrupting entrenched hierarchies from the underworld. Like Sirens, healthcare workers and patients can subversively transform their silence into songs of resistance, simultaneously operating from beneath the surface of accountability measures. Our intention is to showcase the emergence of posthuman ‘professionals’ who adapt by forging new modes of social relations in response to neoliberal constraints, straying from conventional, apolitical notions of ‘professionalism’. Drawing lessons from mythical figures of resistance offers a fresh understanding of subversion as a catalyst for social and political transformation within the healthcare sector.
... Кроме того, институты также обладают уникальной способностью применять газлайтинг благодаря политике, а в случае государства -с помощью законов (Nyden, 2023). Жертвы институционального газлайтинга в результате оказываются травмированы эмоциональными манипуляциями, связанными с изменением восприятия окружающей действительности (Ahern, 2018). Следуя определению газлайтинга как дисфункциональной коммуникативной динамики, при которой одна сторона пытается дестабилизировать чувство реальности другой стороны (Graves and Spencer, 2022), можно утверждать, что дисфункциональность и манипуляции с реальностью возможны и в социальноэкономических отношениях, одной из сторон которых выступают институты-газлайтеры. ...
Prince Charles' allegations of institutional gaslighting against Buckingham Palace in 2022 sparked an extensive discussion around a phenomenon that, until this event, was considered predominantly psychological in academia. The authors of this article, relying mostly on socio-cultural and institutional approaches, also abandon the strictly psychological interpretation of gaslighting as a form of violence in favor of an interdisciplinary approach. This made it possible to identify the foundations and features of institutional gaslighting, studied by scientists in economics and management, healthcare, science and education, politics, etc. The article also reveals the tools for implementing institutional gaslighting in various spheres of social life. As a result, the authors conclude that the key feature of institutional gaslighting is the ability of the institutions themselves to change the mental environment and influence the perception of reality. This was actually ruled out, for example, by D. North, who denied institutions independent existence. In addition, the authors consider gaslighting not just as an institutional betrayal, but as a dysfunction of any institution, one of the most important functions of which is to limit and control violence in society.
... When the next ACBS was planned, however, the Black trainer was not invited to host a workshop but instead told that they were considered inadequately qualified by the conference organizers, despite national prominence and having written a CBS book on this topic. This kind of retaliatory action is often observed when whistleblowers shine light on organization misdeeds (Ahern, 2018). While the Black trainer missed out on this opportunity, from a systemic level, it is important to note that the White trainer continued as a CBS trainer and retained his title as an ACBS Fellow and Certified FAP Trainer, despite a subsequent complaint from another co-trainer of color who was also worried about him causing harm to people of color. ...
Anti-racism approaches require an honest examination of cause, impact, and committed action to change, despite discomfort and without experiential avoidance. While contextual behavioral science (CBS) and third wave cognitive-behavioral modalities demonstrate efficacy among samples composed of primarily White individuals, data regarding their efficacy with people of color, and Black Americans in particular, is lacking. It is important to consider the possible effects of racial stress and trauma on Black clients, and to tailor approaches and techniques grounded in CBS accordingly. We describe how CBS has not done enough to address the needs of Black American communities, using Acceptance and Commitment Therapy (ACT) and Functional Analytic Psychotherapy (FAP) as examples. We also provide examples at the level of research representation, organizational practices, and personal experiences to illuminate covert racist policy tools that maintain inequities. Towards eradicating existing racism in the field, we conclude with suggestions for researchers and leadership in professional psychological organizations.
... Institutional betrayal is a concept used by scholars to describe the process(es) wherein institutional leaders erode trust with community members by enabling and/or overlooking harm that the community members experience (Linder et al., 2018). Institutional betrayal often occurs at the hands of decision-makers who prioritize the reputation of the organization over the wellbeing of its members (Ahern, 2018), enabling institutional responses that normalize abuse, support cover-ups, and [punish] victims and whistleblowers (Smith & Freyd, 2014). The institutional responses in the previous cases discussed involving BWCS athletes are indicative of how betrayal manifests as institutional-sanctioned violence. ...
No existing literature centers Black women college students (BWCS) who are targeted yet absent the discourse on anti‐black incidents at the intersection of gender. Using a 42‐case database, we highlight how BWCS are targeted with hate, discuss gender‐based racial trauma fueled by these incidents, and share recommendations for higher education.
... While gaslighting is often used to refer to intimate partner relationships, a growing body of literature recognizes how institutions, too, can engage in similar behavior particularly in the context of whistle-blowers (Ahern, 2018). When the perpetrator is an institution, the behavior is typically referred to as institutional betrayal (Smith & Freyd, 2014), a framework which includes a more extensive set of behaviors in which powerful institutions act in ways that harm those dependent upon the institution for safety and well-being. ...
Becoming pregnant as an academic is risky. Many who want to become or find themselves pregnant structure their lives and careers to try to mitigate the potential negative effects of pregnancy on their future careers. Yet research continues to suggest that having been pregnant or being a mother significantly reduces the likelihood of career success compared to either being child‐free or a father. While in some cases success is defined as research productivity, in many cases, it is defined as simply remaining in academia. Governments, societies, and institutions bemoan the resulting “leaky pipelines” and speculate as to the causes of seemingly reinforced glass ceilings. Yet, underlying so many of the formal and informal conversations, norms, and policies surrounding pregnancy and academia is an implicit assumption that pregnancy and pregnant people are the problem to be solved and solutions thus require repairing some deficit created in the individual by pregnancy. In this article, I argue that pregnancy discrimination in academia is in large part a problem resulting from power and how it is wielded against pregnant people, both by institutions and by individuals. Using both a personal narrative account of the process, experience, and outcomes of pregnancy in the academy resulting in filing a formal Title IX complaint and a review of contemporary research on power, discrimination, and pregnancy, I explore how academic structures and systems nominally tasked with supporting equity can instead serve to exaggerate power differences and foster discrimination.
... The concept of institutional betrayal arises from betrayal trauma theory (Bach 2018;Smith and Freyd 2014;Ahern 2018), that traumas perpetrated within a previously trusted and dependent relationship are remembered and processed differently to other traumas. Empirical evidence of the impact of institutional betrayal includes psychological distress, anxiety, dissociation, and suicide attempts (Gomez et al. 2016). ...
Psychoanalysis can advance our understanding of responses from the hierarchy of mainstream religious denominations to disclosures of abuse by clergy. This paper takes analytic insights to discuss how and why the Anglican institutional church has responded so callously to disclosures of child sexual abuse within the church. Inhumane responses have led to feelings of institutional betrayal in survivor groups. The subject is explored firstly in the context of organizational and group dynamics, and, secondly, by analysing defences that underly the interaction between the person who has been abused and the member of the church hierarchy who is hearing the disclosure. Defences and deceptions have been consciously and unconsciously used within the organization that have obstructed contact with reality, and so hindered it both in fulfilling its task in responding appropriately to what has taken place, and in adapting to changing circumstances. Churches have been active agents in re-traumatising individuals. Examples to illustrate are taken from hearings on the Anglican Church by the Independent Inquiry into Child Sexual Abuse in England, UK. The idea of organizational redemption is presented.
... Il est important de comprendre que le détournement cognitif dans les organisations ne relève pas d'une seule personne narcissique en position de pouvoir organisationnel. Une étude de 2018 mettant en évidence les expériences d'infirmières dénonciatrices a décrit comment la trahison institutionnelle et le détournement cognitif peuvent se manifester dans une organisation de soins de santé au niveau de l'établissement lui-même, et a postulé qu'ils reposent fondamentalement sur le fait que la personne requérante fait confiance à l'organisation pour traiter la plainte avec intégrité 13 . L'auteure souligne que les personnes qui dénoncent sont souvent des « membres performants, respectés, exceptionnels et engagés » dans leur milieu de travail, et qu'elles n'ont aucune raison de se méfier des engagements déclarés de l'organisation en matière de responsabilité sociale, d'équité et d'inclusion. ...
... A 2018 review highlighting the experiences of nurse whistleblowers described how institutional betrayal and gaslighting may manifest in a health care organization at the level of the institution itself, and posited that the fundamental prerequisite for gaslighting is that the claimant trusts the organization to treat the claim with integrity. 13 The author pointed to whistleblowers as often being "highachieving, respected, exceptional, committed members" of their workplace who have no reason to distrust the organization's stated com mitments to social accountability, equity and inclusivity. It is possible to imagine similar circumstances for those reporting antiBlack racism. ...
... First, the historical perception of speaking up as a risky, morally dubious and taboo act and the need, therefore, for a space within which speaking-up activities can be cloistered without fear of exposure and retribution. [97][98][99][100] Second, some FTSUGs were reluctant to be situated on the 'executive corridor' for fear that this symbolised too close an association or exposure to senior leaders that could taint Guardians' independence and workers' perception of a safe space. ...
Background
The introduction of ‘Freedom to Speak Up Guardians’ into every NHS trust in England was intended to support workers and trusts to better raise, respond to and learn from speaking-up concerns. However, only broad guidance was provided on how to implement the role. As a result, there is the potential for important local differences to emerge as the role is implemented across England.
Objectives
The overall aim of this study was to better understand the implementation of Guardians in acute trusts and mental health trusts.
Design
The Freedom to Speak Up Guardian role was conceptualised as a complex intervention consisting of several interacting and interlocking components spanning the macro level (national organisations), the meso level (individual trusts) and the micro level (employees, teams and wards/units). A mixed-methods study was designed, which consisted of three work packages: (1) a systematic narrative review of the international literature regarding interventions promoting ‘speaking up’ by health-care employees; (2) semistructured telephone interviews with Guardians working in acute hospital trusts and mental health trusts; and (3) qualitative case studies of Freedom to Speak Up Guardian implementation, consisting of observations and interviews undertaken in four acute trusts and two mental health trusts. Interviews were also undertaken with national stakeholders.
Setting
Acute trusts and mental health NHS trusts in England.
Participants
Work package 2: Freedom to Speak Up Guardians ( n = 87) were interviewed. Work package 3: 116 interviews with key stakeholders involved in pre-implementation and early implementation decision-making, workers who had spoken up to the Guardian, and national stakeholders.
Results
Wide variability was identified in how the Guardian role had been implemented, resourced and deployed by NHS trusts. ‘Freedom to Speak Up Guardian’ is best considered an umbrella term, and multiple versions of the role exist simultaneously across England. Any comparisons of Guardians’ effectiveness are likely to be possible or meaningful only when this variability is properly accounted for. Many Freedom to Speak Up Guardians identified how a lack of available resources, especially time scarcity, negatively and significantly affected their ability to effectively respond to concerns; their opportunities to collect, analyse and learn from speaking-up data; and, more generally, the extent to which they developed their role and speak-up culture.
Limitations
It is possible that those whom we interviewed were more receptive of Freedom to Speak Up Guardians or may have been biased by ‘socially desirability’, and their answers may not always have represented respondents’ true perceptions.
Conclusions
Optimal implementation of the Guardian role has five components: (1) establishing an early, collaborative and coherent strategy congruent with the values of Freedom to Speak Up fosters the implementation of (2) policies and robust, yet supportive, practices (3) informed by frequent and reflexive monitoring of Freedom to Speak Up implementation that is (4) underpinned by sufficient time and resource allocation that leads to (5) a positive implementation climate that is congruent with Freedom to Speak Up values and is well placed to engender positive and sustainable Freedom to Speak Up culture and the well-being of a Guardian.
Future work
The following recommendations for future research are considered to be of equal priority. Studies of the speaking-up experiences of minority communities and ‘seldom-heard’ workforce groups are a priority requirement. There is also value in undertaking a similar study in non-hospital settings and where peripatetic working is commonplace, such as in ambulance services and in primary care settings. The role of human resources and ‘middle managers’ in the management of concerns is an area requiring further research, especially regarding concerns relating to unprofessional and transgressive behaviours. Devolved administrations in Scotland and Wales have adopted different approaches to speaking up; research undertaken in these contexts would offer valuable comparative insights. Researching the Guardian role ≥ 5 years post implementation is recommended to understand the medium-term impact and the longer-term sustainability of the role and well-being of Guardians.
Study registration
This study is registered as ISRCTN38163690 and has the study registration CRD42018106311.
Funding
This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme and will be published in full in Health and Social Care Delivery Research ; Vol. 10, No. 23. See the NIHR Journals Library website for further project information.
Victims of domestic violence who bring their experiences to the attention of their spiritual communities and faith leaders have experienced both betrayal and courage from their religious institutions. There is much hurt in the betrayal and much to celebrate in the courage. Institutional betrayal can be embedded in systemic and organizational cultures that repeat themselves even with new leadership and across generations. When leadership hesitate to take actions to protect members, or values the institution above the individuals that depend on it, betrayal ensues. Alternatively, institutional courage can be implemented through improved practices and updated organizational policies. This is true in all communities, including those of faith. When clergy take supportive actions to ensure the safety and wellbeing of those within an institution, healing is more likely to follow. Faith leaders must seek to engage proactively, protect the vulnerable against injustice, and create cultures that benefit those who depend upon the institution. It takes courage to practice institutional courage!
This article provides a conceptual framework of the dimensions of a toxic culture in higher education and the impact it has on the meaning of work. Seven dimensions of a toxic culture in higher education are presented as follows: toxic leadership; bullying and mobbing; colleagues as enablers; reinforced toxic social norms; purposeful, chaotic change; manipulation of systems, structures and processes; and weaponization of the work itself. The article then discusses how the harmful individual outcomes of working in a toxic culture change the meaning of work from meaningful to meaningless, and the corresponding organizational outcomes. These include high turnover; decreased performance and productivity; lack of effective problem solving; increased expenses for legal, healthcare, unemployment, recruitment and the inability to recruit new talent. Recommendations are provided for systemic culture change.
Women are increasingly moving into leadership roles, but minimal research addresses how adverse leadership experiences can lead to distress. Employing participant observation in workshops for senior women psychologists, the article describes experiences women leaders face in the workplace and strategies they use to work through these distressing experiences. Findings from participant observation qualitative research (N = 8) indicate leaders experienced a plethora of poor management behaviors, including gaslighting, belittling, and undermining. Women attempted to defend themselves politically but ultimately succumbed to leaving their positions, experiencing low self-confidence and self-blame. For these women leaders, we propose that the context of women’s visibility in leadership roles, combined with exposure to negative workplace experience, led to perceptions of both public humiliation and threats to their livelihood, reputation, and character, which amplified their experience of traumatization. We provide recommendations for clinicians, policy makers, and researchers to further understand these challenges, address these issues, and facilitate women leaders’ success.
p style="text-align: justify;">Gaslighting is typically viewed as a form of psychological manipulation that makes the victim doubt his or her sense of reality and leads to a loss of agency and mental stability. It was spotted over 60 years ago and has long been the subject of study by psychiatrists. Recently, interest in the phenomenon of gaslighting has grown significantly, becoming the subject of research by scientists of various scientific disciplines, which inevitably leads to the expansion of the meaning of this phenomenon and endowing it with additional properties. Psychology is thought to have contributed to this process through the study of symbolic interactionism, attachment theory, self-verification theory, and shared reality. This article presents the dynamics of the development of this term, defines the main features of this phenomenon, and analyzes the basis on which new approaches to the study of gaslighting in modern international psychology are built. The most common assumption in the latest studies is that gaslighting is possible when standard social-cognitive mechanisms are involved in atypical social situations. Relationships with significant others largely determine people's epistemic needs: close people shape and reflect an individual's self-image and perception of the surrounding reality. It is this special position of loved ones that gives gaslighters leverage over the victim.</p
This paper proposes that, in many cases, conversational norms permit gaslighting when socially subordinate speakers report systemic injustice. Section 1 introduces gaslighting and the kinds of cases on which I focus—namely, cases in which multiple people gaslight. I give examples and statistics to suggest that these cases are common in response to reports of race- or gender-based injustice; and I appeal to scholarship on epistemologies of ignorance to suggest that this kind of gaslighting is common because it is systematically produced by dominant epistemic systems. Section 2 draws on Lynne Tirrell’s account of language games that’ve been influenced by oppression to make the case that conversational norms make gaslighting “appropriate” when socially subordinate speakers report systemic injustice. Together, these points make the case that the kind of gaslighting discussed in this paper (i) occurs systematically and (ii) is mutually reinforcing with systems of ignorance. The discussion is meant to help us understand and address the conditions that make gaslighting commonplace. If it’s true that gaslighting occurs systematically in part thanks to our warped conversational norms, then we may be able to mitigate the prevalence of gaslighting by attending to these norms.
One factor potentially driving healthcare and hospital worker (HHW)’s declining mental health during the COVID-19 pandemic is feeling betrayed by institutional leaders, co-workers, and/or others’ pandemic-related responses and behaviors. We investigated whether HHWs’ betrayal-based moral injury was associated with greater mental distress and post-traumatic stress disorder (PTSD) symptoms related to COVID-19. We also examined if these associations varied between clinical and non-clinical staff. From July 2020 to January 2021, cross-sectional online survey data were collected from 1,066 HHWs serving COVID-19 patients in a large urban US healthcare system. We measured betrayal-based moral injury in three groups: institutional leaders, co-workers/colleagues, and people outside of healthcare. Multivariate logistical regression analyses were performed to investigate whether betrayal-based moral injury was associated with mental distress and PTSD symptoms. Approximately one-third of HHWs reported feeling betrayed by institutional leaders, and/or people outside healthcare. Clinical staff were more likely to report feelings of betrayal than non-clinical staff. For all respondents, 49.5% reported mental distress and 38.2% reported PTSD symptoms. Having any feelings of betrayal increased the odds of mental distress and PTSD symptoms by 2.9 and 3.3 times, respectively. These associations were not significantly different between clinical and non-clinical staff. As health systems seek to enhance support of HHWs, they need to carefully examine institutional structures, accountability, communication, and decision-making patterns that can result in staff feelings of betrayal. Building trust and repairing ruptures with HHWs could prevent potential mental health problems, increase retention, and reduce burnout, while likely improving patient care.
How could we better use public inquiries to stem the recurrence of healthcare failures? The question seems ever relevant, prompted this time by the inquiry into how former nurse Letby was able to murder newborns under National Health Service care. While criminality, like Letby’s, can be readily condemned, other factors like poor leadership and culture seem more often regretted than reformed. I would argue this is where inquiries struggle, in the space between ethics and law—with what is awful but lawful. In response, we should learn from progress with informed consent. Inquiries and civil litigation have seen uninformed ‘consent’ shift from being undesirable to unlawful. If better leadership and culture were sole drivers here, we would likely be doing far better in many other areas of healthcare too. Instead, one could argue that progress on consent has been made by reducing epistemic injustice —by naming and addressing epistemic issues in ways that enhance social power for patients. If this is an ingredient that transforms clinician–patient working, might it also shift conduct within other key relationships, by showing up what else should become unlawful and why? Naming medical paternalism may have helped with consent reform, so I continue this approach, first naming two areas of epistemic injustice: management feudalism and legal chokeholds . Remedies are then considered, including the democratisation of management and reforms to legal ethics, legislation and litigation. In brief, public inquiries may improve if they also target epistemic injustices that should become unlawful. Focus on informed consent and epistemic relationships has improved the medical profession. Likewise, it could help healthcare leaders shift from fiat towards consent, and their lawyers from a stifling professional secrecy towards the kind of candour a prudent public expects.
The COVID-19 pandemic has exacted a physical and mental health toll on health care and hospital workers (HHWs). To provide COVID-19 care, HHWs expected health care institutions to support equipment and resources, ensure safety for patients and providers, and advocate for employees' needs. Failure to do these acts has been defined as institutional betrayal. Using a mixed-methods approach, this study aimed to explore the experience of institutional betrayal in HHWs serving COVID-19 patients and the associations between self-reported institutional betrayal and both burnout and career choice regret. Between July 2020 and January 2021, HHWs working in an urban U.S. health care system participated in an online survey (n = 1,189) and semistructured interview (n = 67). Among 1,075 quantitative participants, 57.8% endorsed institutional betrayal. Qualitative participants described frustration when the institution did not prioritize their safety while reporting they perceived receiving inadequate compensation from the system and felt that leadership did not sufficiently respond to their needs. Participants who endorsed prolonged breaches of trust reported more burnout and stronger intent to quit their job. Quantitatively, institutional betrayal endorsement was associated with 3-fold higher odds of burnout, aOR = 2.94, 95% CI [2.22, 3.89], and 4-fold higher odds of career choice regret, aOR = 4.31, 95% CI [3.15, 5.89], compared to no endorsement. Developing strategies to prevent, address, and repair institutional betrayal in HHWs may be critical to prevent and reduce burnout and increase motivation to work during and after public health emergencies.
Toxic leaders tend to isolate, ostracize, and punish employee voice behaviors, resulting in numerous negative outcomes; however, most organizations allow toxic issues to get out of control. Past suggestions for handling toxic leadership have mostly proposed top-down changes. In contrast, this paper examines what can be done from the bottom up by briefly reviewing methods that can help employee voicing in toxic situations and then considering how team spiritual power serves to extend those methods. Team spiritual power includes characteristics such as calmness, flexibility, and compassion primarily developed from spiritual practice. The paper concludes that teams with shared mental models based on spiritual power are able to persist in voicing under a toxic leader more than most groups, even those with high emotional intelligence, because the team can better support members emotionally during and after toxic interactions while also providing compassion and psychological safety for the toxic leader.
The term gaslighting has become commonly used when describing the manipulation and intimidation used by bullies, sociopaths, narcissists, and verbal or emotional abusers to degrade and diminish the discursive power of their victims. Gaslighters elevate their own social status and authority in the workplace by removing the autonomous moral authority of their victims and take away their ability to own their own narrative. The goal of gaslighting is to get the victim to doubt their own reactions and judgments about a situation and to make them more submissive and compliant while ruining their reputation. It creates a cognitive dissonance in the employee who must reconcile their moral judgment and their organizational loyalty. It feeds the feeling of imposter syndrome and leads to ruminations, intrusive thoughts, flashbacks, and nightmares. The gaslit victim is forced to obsessively think about the facts and the evidence needed to prove their disclosure and can easily suffer from PTSD.
Sosyal medya uygulamalarının gelişmesi, kullanımının yaygınlaşması ve çocukların da bu platformlarda denetimsiz ve aktif olarak yer almaya başlamaları ile çocuk istismarı yeni bir boyut kazanmış ve sosyal medyanın çocuklara yönelik etkileri, incelenmesi gereken önemli bir alan olarak ortaya çıkmıştır. Bu çalışmada erken çocukluk dönemindeki Youtube içerik üreticilerinin yayınladıkları videolarda, anne-babaları tarafından duygusal istismara maruz kalma durumları, duygusal istismar türleri ve sıklığı araştırılmıştır. Çalışmada durum ve olaylar olduğu gibi müdahale edilmeksizin ele alındığından nitel desende tasarlanmış ve metin, renk ve imajlar gibi çoklu iletişim tarzlarına bakma fırsatı veren “Çok Modlu Eleştirel Söylem Analizi” yöntemi kullanılmıştır. Çalışmada videolar amaçlı örneklemle, Youtube’da içerik üreten ve en yüksek takipçiye sahip 4 çocuk içerik üreticisi olarak seçilmiştir. Her kanala ait son 6 yılda yayınlanmış, içeriğinde anne veya babası bulunan, en çok izlenme sayısına sahip 10 video olmak üzere toplam 40 video, duygusal istismar ve alt boyutları kapsamında incelenmiştir. Video içerikleri duygusal istismarın alt boyutları baz alınarak oluşturulan kodlara göre “Dedoose” programı ile analiz edilmiştir. Çalışma sonucunda incelenen 40 video içerisinden 13 videoda duygusal istismar bulgusuna rastlanmıştır. Çalışma kapsamında analiz edilen videolarda çocukların anne veya babaları tarafından duygusal istismara uğrama sıklığı %33 olarak belirlenmiştir. Çocukların bu videolarda daha çok anneleri tarafından duygusal istismara uğradığı, en çok uygulanan duygusal istismar davranışlarının ise azarlama ve aşağılama olduğu görülmüştür. Reddetme, aşırı koruma, izole etme, ayrım, karşılaştırma, suça yöneltme ve lakap takma alt boyutlarına rastlanmamıştır.
The theme for this issue, 'It’s Time: The re-form of Australian public universities’, is timely for the forthcoming federal elections in Australia, particularly as the higher education system is crucial to Australia’s path forward at any time. While the university sector has gone through constant changes historically, the themed articles in this issue express
significant concern about recent reforms where: managers, administrators, academic staff and students now function under a commercial, transactional system of hierarchical
power relations informed by ‘managerialism’ and ‘new public management’ principles (Hil et al 2022: 3). While the articles go beyond critique and propose alternatives to the
‘corporate university’, this cover design specifically aimed to visually capture their quite complex concerns.
Gaslighting is a type of abuse aimed at making victims question their sanity as well as the veracity and legitimacy of their own perspectives and feelings. In this article, we show how gaslighting can operate as a key, yet underexamined, strategy of obstetric violence, or the institutional and interpersonal violation of women's rights during pregnancy, childbirth, and postpartum. We draw on forty-six in-depth, semi-structured interviews with mothers who experienced a traumatic childbirth to examine how obstetric providers gaslight mothers before, during and after childbirth when they deny – and thereby destabilize – mothers' realities. We identify and examine four core types of denials: denials of 1) mothers' humanity, 2) mothers' knowledge as valid, 3) mothers' judgements as rational and 4) mothers' feelings as legitimate. All four denials work to render mothers noncredible and their claims illegible within clinical encounters. In explicitly naming, theorizing, and examining obstetric gaslighting, our aims are threefold: 1) to uncover and theorize an underexamined mechanism of obstetric violence through a sociological lens, 2) to offer a typology of obstetric gaslighting's manifestations to aid scholars and practitioners in recognizing when obstetric gaslighting is occurring and 3) to advance a growing research program on gaslighting in medicine.
Con questo contributo si intende analizzare e fornire strumenti per rilevare tempestivamente relazioni caratterizzate da dipendenza affettiva, con condotte di abuso emotivo. Si propone una concettualizzazione che tiene conto dei sistemi mo-tivazionali interpersonali e del funzionamento metacognitivo del paziente. Si pre-sentano spunti per rilevare, alla base, disequilibri dell'abilità sociale di empatia, analizzando il "profilo codipendente" e si evidenziano le modalità disfunzionali di formazione e mantenimento tipiche di alcuni stili affettivi. Per sostenere tali rifles-sioni si è fatto riferimento al modello dei sistemi motivazionali interpersonali elaborati da Liotti e collaboratori.
This article is based on interviews with U Ashin Wirathu and an analysis of Buddhist nationalist discourses of violence against religious and ethnic minorities in Myanmar. I explore a fundamental issue that continues to plague the Rohingya—the emphasis on the Rohingya as victims of nationalist systemic Buddhist violence. This chapter sets out to bring Rohingya agency to the forefront. Rohingyas are characterized as immutably foreign and Muslim—that is, they are labeled with an identity convenient to state-sangha oppression. Through interviews with relocated Rohingya society members and the mentoring of Dr. Jerryson, this work is dedicated to the rehumanization and devictimization of the Rohingya.
This essay frames systemic patterns of mental abuse against women of color and Indigenous women on Turtle Island (North America) in terms of larger design-of-distribution strategies in settler colonial societies, as these societies use various forms of social power to distribute, reproduce, and automate social inequalities (including public health precarities and mortality disadvantages) that skew socioeconomic gain continuously toward white settler populations and their descendants. It departs from traditional studies in gender-based violence research that frame mental abuses such as gaslighting - commonly understood as mental manipulation through lying or deceit - stochastically, as chance-driven, interpersonal phenomena. Building on structural analyses of knowledge in political epistemology (Dotson 2012a; Berenstain 2016), political theory (Davis and Ernst 2017), and Indigenous social theory (Tuck and Yang 2012), I develop the notion of cultural gaslighting to refer to the social and historical infrastructural support mechanisms that disproportionately produce abusive mental ambients in settler colonial cultures in order to further the ends of cultural genocide and dispossession. I conclude by proposing a social epidemiological account of gaslighting that a) highlights the public health harms of abusive ambients for minority populations, b) illuminates the hidden rules of social structure in settler colonial societies, and c) amplifies the corresponding need for structural reparations. Copyright © The Author(s), 2020. Published by Cambridge University Press on behalf of Hypatia, a Nonprofit Corporation.
Gaslighting is an insidious, pernicious form of bullying that is gaining notoriety in nursing academia anecdotally. Attempting to identify the behaviors associated with gaslighting are difficult because of the subtle nature with which gaslighting is performed by the perpetrator. Traditional tools/models used for identifying bullying and horizontal violence are not sensitive enough to pick up gaslighting behaviors. Perpetual lies and mistruths, vexatious or frivolous complaints, praise and positive reinforcement, the use of blame or mobbing, and coercion are some of the tactics a gaslighter will use to create confusion and chaos for the gaslightee. The psychological harm for the gaslightee can lead to self‐doubt, hypervigilance, depression, anxiety, addiction, and suicidal ideation as well as the physical symptoms associated with stress. Left with very few choices the gaslightee either adheres to the behavior or leaves. It is important to raise awareness and perhaps education and training of this form of bullying behavior because of the deleterious effects it has personally and professionally.
The nationwide shortage of PPE for health care workers has been well documented. Reporting on this issue has been complicated by hospitals' imposition of gag orders on physicians and health care workers. There are harms that result from imposing these gag orders that go beyond the obvious harms to public and employee health and safety. Using Hirschman's ‘Exit, Voice, and Loyalty’ (1970) as a framework demonstrates that these orders represent a dangerous concentration of power in employer hands — health care workers are reduced to functionaries. Hirschman's argument, in part, is that organisations should seek to balance the availability of exit, voice, and loyalty for employees. Restricting employee options in morally untenable situations to exit only leads to direct and indirect harms. These gag orders are a pernicious practice, and bring with them long-term negative implications for employee morale, employee effectiveness, and public service.
Purpose
This paper aims to present directions for future research by linking the academic fields of workplace bullying and whistleblowing together. This article also suggests implications as to how to deal with the health consequences that can develop after such workplace experiences.
Design/methodology/approach
The paper describes empirical research on the link between whistleblowing and workplace bullying, and suggests how to deal with the health consequences that develop in relation to workplace bullying after whistleblowing.
Findings
Empirical research has documented the link between whistleblowing and workplace bullying and the devastating effects on health that may follow (e.g. depression and symptoms analogous to post traumatic stress). Implications for practice are as follows: first, to provide clear examples of unwanted workplace behavior; and second, to help clinicians to gain a balance between the client's need to re‐tell and the need for psychological treatment.
Research limitations/implications
Future studies on workplace bullying are encouraged to be aware of the link to potential previous whistleblowing, and to study therapeutic interventions for employees exposed to bullying, and who also have reported wrongdoing at work.
Practical implications
The practical implications are to provide clear examples of unwanted workplace behavior, and to balance the need for re‐telling against the need for treatment for possible depression and trauma.
Originality/value
This paper provides valuable information for researchers, practitioners and clinicians in the field of workplace behavior in general and in the field of managerial psychology in particular.
This essay discusses the fraud triangle, or how factors such as opportunity to cheat, motivation to cheat or ability to rationalize or justify dishonest behavior lead to dishonesty. The fraud triangle is applied on behavior of professionals active in fields such as medicine, education, research and science or clergy. Evidence shows that even in these fields, which attract more altruistic individuals, the fraud triangle factors predict emergence of behavior in breach of ethical standards. In the conclusion several measures for reducing dishonesty are discussed. Disciplines such as forensic economics or behavioral ethics are emphasized to provide wider variety of tools to detect and reduce dishonest behavior.
External mechanisms and batterer behaviors have commonly been cited as to why women remain in intimate partner violence relationships. However, past research has generally minimized the focus on individual psychological elements of victims that perpetuate their commitments to abusers. The current review proposes the potential for cognitive dissonance resolution as an underlying mechanism to affect female victims’ stay/leave decisions while in domestically violent relationships. High and low levels of self-esteem differentially affect the resolution of cognitive dissonance as explained by self-consistency and self-affirmation theories. Theories of commitment including the foot-in-the-door principle, justification of effort, and the investment model are applied specifically to the arousal of dissonance in victims. The importance of taking into account the mechanisms of dissonance arousal and subsequent reduction techniques are proposed for treating this population and preventing similar relationships in the future.
This paper draws on the theoretical arguments outlined in Hayes (2014) to frame critical analyses of two real life domestic violence narratives. The authors are both academic criminologists and victims/survivors of domestic violence, but within differing contexts – one a conventional heterosexual relationship, the other a female same-sex relationship. Their experiences are intertwined in an extensive collaborative auto-ethnographic analysis that spans seven years of working and socializing together, in which each provided a sounding board and support for the other. The analysis therefore documents two personal journeys. Auto-ethnography is a methodology that “seeks to describe and systematically analyze (graphy) personal experience (auto) in order to understand cultural experience (ethno)” (Ellis, Adams, and Bochner, 2011). The methodological approach taken by the authors is analytic rather than evocative, in the sense that we focus on collaboratively analyzing our dual experiences, rather than simply narrating them. We occupy the dual role of researcher and researched, and turn our gaze both inward and outward (Olson, 2004: 6). The academic and theoretical are intertwined with the personal and subjective to elicit an evocative and yet empirically validated study. The theoretical underpinnings of romantic love distortion, misogyny and sexism are used to frame these experiences of domestic violence and the differing sexualities of the authors provide a rich context for exploring the ways in which domestic violence victimization experiences are impacted by gender, sexuality, and heteronormative discourses of love, sex and relationships.
The Hoffman Report (Hoffman et al., 2015) documented devastating information about the American Psychological Association (APA) and the profession of psychology in the U.S., prompting a public apology and a formal commitment to right their wrongs (APA, 2015). In the current paper, we utilize betrayal trauma theory (Freyd, 1997), including betrayal blindness (e.g., Freyd, 1996; Tang, 2015) and institutional betrayal (Smith & Freyd, 2014a), to understand and learn from APA's behaviors. We further situate this discussion in the context of inequality, both within APA and amidst American society generally. We detail how the impact of APA's institutional betrayals extended beyond the organization, its members, and the psychology profession, highlighting the potential for disproportionate harm on minorities, including: those who were tortured; Muslims, Middle Easterners, Afghans, and non-Americans who were not tortured; and other minority individuals (Gómez, 2015d). Acknowledging, understanding, and addressing APA's institutional betrayals offers the organization the opportunity to take meaningful corrective and preventive measures. We propose several institutional reparations, including making concrete changes with transparency and conducting self-assessments to inform further needed changes (Freyd & Birrell, 2013). By engaging in institutional courage, APA has the potential to grow into an ethical governing body that fulfills its mission to "… advance the creation, communication and application of psychological knowledge to benefit society and improve people's lives" (APA, 2016).
Whistleblowing by health professionals is an infrequent and extraordinary event and need not occur if internal voices are heard. Mannion and Davies' editorial on "Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations" asks the question whether whistleblowing ameliorates or exacerbates the 'deaf effect' prevalent in healthcare organisations. This commentary argues that the focus should remain on internal processes and hearer courage .
The Jerry Sandusky scandal erupted nationally in November 2011, dragging with it accusations of child molestation, manipulation, perjury, and ultimately a blatant disregard for the suffering of 10 young victims. This article examines how senior university officials covered up the scandal and inevitably allowed Sandusky to continue molesting children for over 15 years. University officials broke the law by failing to report the abuses, and later when they lied to the investigating grand jury assigned to the case. Using Sykes and Matza’s techniques of neutralization, we explain how university officials downplayed these victimizations to preserve the reputation of Penn State.
A college freshman reports a sexual assault and is met with harassment and insensitive investigative practices leading to her suicide. Former grade school students, now grown, come forward to report childhood abuse perpetrated by clergy, coaches, and teachers—first in trickles and then in waves, exposing multiple perpetrators with decades of unfettered access to victims. Members of the armed services elect to stay quiet about sexual harassment and assault during their military service or risk their careers by speaking up. A Jewish academic struggles to find a name for the systematic destruction of his people in Nazi Germany during the Holocaust. These seemingly disparate experiences have in common trusted and powerful institutions (schools, churches, military, government) acting in ways that visit harm upon those dependent on them for safety and well-being. This is institutional betrayal. The purpose of this article is to describe psychological research that examines the role of institutions in traumatic experiences and psychological distress following these experiences. We demonstrate the ways in which institutional betrayal has been left unseen by both the individuals being betrayed as well as the field of psychology and introduce means by which to identify and address this betrayal.
Purpose of review:
The issue of workplace bullying has become an area of research interest in the last 3 decades. Much of the extant literature is published in the business management journals. This is problematic as the targets of workplace bullying may need psychiatric treatment; as a discipline, therefore psychiatrists may benefit from a deeper understanding of the nature of workplace bullying and its sequelae.
Recent findings:
There is still no agreed upon definition, although most definitions include similar criteria. Managers and human resources personnel frequently have difficulty identifying and effectively managing workplace bullying. The consequences for the targets of bullying can be severe; they may need psychiatric treatment and it can have a lifelong impact. There is a paucity of research into effective prevention and intervention programs. Preventive measures that focus on the whole workplace culture or on targets alone have mixed results. Workplace policies and procedures may lessen the prevalence and incidence of bullying, but often competing interests of senior management, human resources personnel, supervisors and workers may mitigate any antibullying interventions.
Summary:
Although psychiatrists are likely to treat the targets of bullying, bullying has yet to attract much attention as a research topic in psychiatry. Although the consequences of bullying can be severe for both targets and workplaces, prevention strategies are hampered by competing interests.
In this in-depth case analysis of the massive Guadalupe Dunes oil field spill in California's San Luis Obispo County, it is argued that understanding community members' interpretations of risk requires attention to the broader social and historical contexts within which interpretation occurs. This conceptualization differs from conventional approaches to studying risk that tend to treat the phenomena more narrowly, as discrete "variables" that can be measures objectively by experts or that can be assessed as reactions of lay people to single, isolated events. The main finding from this study is that community members' interpretations of the risks posed by the Guadalupe Dunes spill (the largest in U.S. history) were affected profoundly by the social and environmental history of the local area. In this case, perceptions of present and future risk associated with the massive contamination of Guadalupe Dunes grew more from impressions of the way corporate and governmental institutions in the area mishandled this and previous oil-related hazards than from fear of health risks associated with the discrete Guadalupe Dunes event. Community members reacted to the threat from the immediate event but also experienced a more encompassing sense of risk associated with a perceived breach of on the part of corporate and governmental institutions. From their impression of institutional neglect, misconduct, and cover-up, they developed a sense of institutional failure and feelings of betrayal and anger. As this case suggests, when a complete breakdown in trust of this kind occurs, community members' perceptions of and reactions to risk can be seen as "rational" but cannot be understood as merely calculative responses to the physical hazards associated only with the immediate, discrete event. By reporting how community members and other members of the lay public experienced this more encompassing sense of risk, this study illustrates the critical importance of context in risk research. Implications for developing theories of risk perception are discussed.
Whistle-blowing represents an influence attempt in which organization member(s) try to persuade other members to cease wrongdoing; sometimes they fail; sometimes they succeed; sometimes they suffer reprisal. We investigated whether women experienced more retaliation than men, testing propositions derived from theories about gender differences and power variables, and using data from military and civilian employees of a large U.S. base. Being female was correlated with perceived retaliation. Results of structural equation modeling showed significant gender differences in antecedents and outcomes of retaliation. For men, lack of support from others and low whistleblower's power were significantly related to retaliation; for women, lack of support from others, serious wrongdoing, and the wrongdoing's direct effect on the whistleblower were significantly associated with retaliation. Retaliation in turn was negatively related to relationships with the supervisor for both men and women, and positively related to women's---but not men's---decisions to blow the whistle again, using external channels. We finish by discussing implications for theory and practice.
After the reports of human rights abuses by the US military in Guantanamo Bay, Iraq, and Afghanistan, questions have been raised as to whether certain detention and interrogation procedures amount to torture.
To examine the distinction between various forms of ill treatment and torture during captivity in terms of their relative psychological impact.
A cross-sectional survey was conducted with a population-based sample of survivors of torture from Sarajevo in Bosnia and Herzegovina, Banja Luka in Republica Srpska, Rijeka in Croatia, and Belgrade in Serbia.
A total of 279 survivors of torture accessed through linkage sampling in the community (Banja Luka, Sarajevo, and Rijeka) and among the members of 2 associations for war veterans and prisoners of war (Belgrade).
Scores on the Semi-structured Interview for Survivors of War, Exposure to Torture Scale, Structured Clinical Interview for DSM-IV, and Clinician-Administered PTSD (posttraumatic stress disorder) Scale for DSM-IV.
Psychological manipulations, humiliating treatment, exposure to aversive environmental conditions, and forced stress positions showed considerable overlap with physical torture stressors in terms of associated distress and uncontrollability. In regression analyses, physical torture did not significantly relate to posttraumatic stress disorder (odds ratio, 1.41, 95% confidence interval, 0.89-2.25) or depression (odds ratio, 1.41, 95% confidence interval, 0.71-2.78). The traumatic stress impact of torture (physical or nonphysical torture and ill treatment) seemed to be determined by perceived uncontrollability and distress associated with the stressors.
Ill treatment during captivity, such as psychological manipulations, humiliating treatment, and forced stress positions, does not seem to be substantially different from physical torture in terms of the severity of mental suffering they cause, the underlying mechanism of traumatic stress, and their long-term psychological outcome. Thus, these procedures do amount to torture, thereby lending support to their prohibition by international law.
Psychological trauma, particularly trauma involving betrayal, has been linked to health problems. Betrayal trauma is also characterized by dissociation and difficulty remembering as victims face conflicting demands presented by a harmful but important relationship. Institutional betrayal is related to, but distinct from, interpersonal betrayal and in need of research on its unique effects. The current study has two related goals. First, the association between institutional betrayal and health problems is examined. Second, the previously documented association between institutional betrayal and dissociative symptoms is re-examined, while controlling for betrayal trauma. This study utilizes a sample of 302 college students (70% female, 63% Caucasian) who reported their trauma history (Brief Betrayal Trauma Survey), institutional betrayal history (Institutional Betrayal Questionnaire), distress related to health problems (Patient Health Questionnaire), and dissociative symptoms (Wessex Dissociation Scale). We found that institutional betrayal is uniquely associated with both health problems and dissociative symptoms even when controlling for betrayal trauma exposure. Findings add to the understanding of how institutional betrayal is uniquely associated to trauma-related physical and mental health outcomes. Small effect sizes, likely due to low base rates of health problems and dissociative symptoms in college students, and problems generalizing these results to clinical samples are discussed.
This study is the first to expand the investigation of study-abroad risks to include a range of traumatic experiences for male and female students and to examine effects of institutional betrayal (i.e., an institution’s failure to prevent trauma or support survivors). In an online survey of 173 university students who had studied abroad, many respondents (45.44%, n = 79) reported exposure to at least 1 traumatic experience while abroad, most frequently natural disasters, sexual assault, and unwanted sexual experiences. Of students exposed to potentially traumatic events, more than one third (35.44%, n = 28) also reported at least 1 form of related institutional betrayal, which uniquely correlated with posttraumatic distress in some participants, when controlling for lifetime trauma history.
Boards of nursing and professional associations have a strong belief that nursing practice must emphasize patient advocacy and the importance of the nurse's role in the protection and safety of patients. Though nurses are educated about their responsibilities regarding advocacy and safety, many have difficulty navigating workplace impediments that restrict their duty to advocate for patients. This was not the issue for two Winkler County, Texas, nurses who reported concerns about a physician's dangerous medical practice to the Texas Board of Medicine. Not only were the nurses fired from their long-standing jobs for reporting the physician's unsafe practice, they were also criminally indicted for a third-degree felony. This article reviews the case of these nurses and the subsequent legislation initiated by the Texas Nurses Association and supported by the Texas Board of Nursing to prevent such occurrences in the future.
What has come to be called ‘whistleblowing’ has grown enormously in the US over recent decades and it is spreading rapidly around the world. The research on which this paper is based develops a sample of whistleblowers from all walks of life and all regions of the US. This article focuses specifically on the treatment of whistleblowers in the non-profit sector.
In examining the political meaning of the act of whistleblowing, the author describes whistleblowing as an act of parrhesia. In ancient Greece this was a citizen request to speak freely and frankly. In the case of the whistleblowers, they are moved to speak publicly and candidly, even without permission to do so, in defense of the substantive purposes of the organization that employs them.
This study finds that there is little difference in how whistleblowers are treated in the three sectors of our economy. In the majority of cases in this sample, the organizational managers against whom the whistleblowers level claims of wrongdoing, seek quickly to discredit, defame and terminate them.
The author’s research does find that most employees in non-profit organizations view their employer as reasonably open to their inputs. Nevertheless, these positive perceptions of the employer are destroyed among those employees who witness what they define as wrongful or illegal conduct on the part of their employer, and particularly where the employee brings their observations of corruption to “higher-ups” in the organization and sees no corrective action take place. The retaliation that too often follows their disclosures of corrupt practices leaves them with a magnified sense of their own integrity, a new political identity, and an indelible sense of distrust toward senior managers and hierarchal organizations in general. The paper concludes with some suggestions as to how non-profit organizations could respond in a more constructive way to dissenting viewpoints.
This paper contributes to the development of conceptual work on collective corruption in the private sector. Based on a routines-as-practice perspective, we conceptualize collective corruption as routines which are established patterns of organizational actions that are made up of rules as their basic building blocks, the interpretation of these rules in the context of an organizational framework and the actual observable performance patterns. Drawing on 24 interviews with representatives of law enforcement authorities, auditing and law firms, non-profit organizations and anti-corruption units in the public sector, we provide a framework that combines theoretical reasoning with qualitative data analysis in order to describe the dynamics of corrupt routines. Our results disclose their main characteristics and highlight how the specificity of rules, lack of control, the power to influence subjective understandings and actions as well as group processes influence the relations between rules, their interpretation and performances and, thus, give rise to corrupt routines.
A former nurse at a Welsh hospital investigated over poor care has said she was left 'suicidal' because of the treatment she received from senior staff after raising concerns about patient care.
The nurse whistleblower who helped expose the Mid Staffs scandal has warned front line staff were still being ignored when trying to raise concerns about poor care, and that major problems remain in the NHS.
Purpose
– Why do some healthcare professionals report incidents while others fail to do so? In a previous paper, the authors explored the culture of hospitals in Ireland and the response to those who reported poor care. In this paper the authors aim to advance understanding of reporting behaviour by exploring differences between those who report incidents and those who choose not to report.
Design/methodology/approach
– An exploratory quantitative research design was utilised for this study. Data from eight acute hospitals in the Health Services Executive (HSE) regions in Ireland – two hospitals from each of the four regions and nursing staff on three wards within each hospital – provided the sample. A total of 575 anonymous questionnaires were distributed.
Findings
– Eighty‐eight per cent of nurses working in acute hospitals have observed an incident of poor care in the past six months, but only 70 per cent of those reported it. Non‐reporters are significantly more likely than those who have reported incidents to cite “not wanting to cause trouble” and “not being sure if it is the right thing to do” as reasons for their reluctance to report. “Fear of retribution” was the most common reason given by non‐reporters for their reluctance to report.
Originality/value
– The findings show that reluctance to report is mainly influenced by fears of retribution, not wanting to cause trouble and not being sure if reporting an incident is the right thing to do. Managers and policy makers within healthcare environments need to provide more reassurance for staff and put in place better measures to protect staff from negative repercussions that might arise from whistleblowing.
A nurse is calling on prime minister David Cameron and secretary of state for Northern Ireland Theresa Villiers to investigate the 'dysfunctional whistleblowing system' in the country.
This study examined reasons a registered nurse would report a wrongdoing within a public teaching hospital. Of a group of 238 initial respondents, 30% reported they had observed a wrongdoing in the past year, with 68 nurses indicating they had reported a wrongdoing in the past year. The latter group was the focus of this study. They indicated through a self-report survey that incidents threatening the well-being of patients and their professional ethics were more likely to be reported within their organizations. Observer anonymity was perceived to have a small, but important effect on nurses reporting a wrongdoing in this sample. A manipulation check of the initial 238 respondents revealed a very strong tendency for nurses to overlook a serious mistake by a close peer who had a reputation of being a "competent" nurse.
Research has documented the profound negative impact of betrayal within experiences of interpersonal trauma such as sexual assault (Freyd, 1994, 1996; Freyd, DePrince, & Gleaves, 2007). In the current study of college women (N = 345, 79% Caucasian; mean age = 19.69 years, SD = 2.55), we examined whether institutional failure to prevent sexual assault or respond supportively when it occurs may similarly exacerbate posttraumatic symptomatology-what we call "institutional betrayal." Almost half (47%) of the women reported at least one coercive sexual experience and another 21% reported no coercion, but at least one unwanted sexual experience (total reporting unwanted sexual experiences, N = 233). Institutional betrayal (e. g., creating an environment where these experiences seemed more likely, making it difficult to report these experiences) was reported across different unwanted sexual experiences (47% and 45% of women reporting coercion and no coercion, respectively). Those women who reported institutional betrayal surrounding their unwanted sexual experience reported increased levels of anxiety (R-2 = .10), trauma-specific sexual symptoms (R-2 = .17), dissociation (R-2 = .11), and problematic sexual functioning (R-2 = .12). These results suggest that institutions have the power to cause additional harm to assault survivors.
There are no known studies to date examining the risk of posttraumatic stress disorder (PTSD) associated with sudden and dramatic
personal financial loss. A Web-based, online, nonprobability convenience survey of 172 Madoff victims (56 percent female;
mean age, 60.9 years) using the Posttraumatic Stress List Checklist, civilian version was conducted eight to 10 months following
the focal event. Sociodemographic information and data concerning anxiety/depression and health-related concerns were gathered
by self-report questionnaire. A five-point Likert-type scale was used to assess victim response to government regulatory systems.
Results demonstrated that a majority of respondents (55.7 percent) met criteria for a presumptive Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) diagnosis of PTSD, and as a group, respondents acknowledged high levels of anxiety (60.7 percent), depression
(58 percent), and health-related problems (34 percent). Victims overwhelmingly affirmed a substantial loss of confidence in
financial institutions (90 percent). This raises a public health concern as to governmental response and counseling needs
during times of severe economic trauma.
Nurses involved in whistleblowing often face economic and emotional retaliation, victimization and abuse. Yet for many nurses, one major part of their whistleblowing experience is the negative impact it has on their families. This paper reports findings from a qualitative study pertaining to the effects of whistleblowing on family life from the perspective of the nurses. Using a narrative inquiry approach, fourteen nurses were interviewed who were directly involved in whistleblowing complaints. Data analysis drew out three themes: strained relationships with family members, dislocation of family life, and exposing family to public scrutiny. The harm caused to the nurses involved in a whistleblowing event is not restricted to one party but to all those involved, as the harrowing experience and its consequences are echoed in the family life as well. It is important for organizations to seek strategies that will minimize the harmful effects on nurses' families during whistleblowing events.
To highlight and illuminate the emotional sequelae of whistleblowing from whistleblowers and subjects of whistleblowing complaints.
Whistleblowing has the potential to have a negative impact on individuals' physical and emotional well-being. However, few empirical studies have been conducted using qualitative methods to provide an in-depth exploration of the emotional consequences for those involved in whistleblowing incidents.
Qualitative narrative inquiry design.
Purposive sampling was used to recruit participants who had been involved in whistleblowing incidents. During interviews participants' accounts were digitally recorded and then transcribed verbatim. Data were then analysed by two researchers until consensus was reached.
Findings revealed that participants' emotional health was considerably compromised as a result of the whistleblowing incident. Analysis of the data revealed the following dominant themes: 'I felt sad and depressed': overwhelming and persistent distress; 'I was having panic attacks and hyperventilating': acute anxiety; and, 'I had all this playing on my mind': nightmares, flashbacks and intrusive thoughts.
While it has been previously acknowledged that whistleblowing has the potential to have a negative impact on all aspects of an individual's life, this study notably highlights the intensity of emotional symptoms suffered by participants as well as the extended duration of time these symptoms were apparent.
As professionals, nurses, as well as organisations, have a responsibility to identify those who may be suffering the emotional trauma of whistleblowing and ensure they have access to appropriate resources.
To examine changes in health habits (sleep, alcohol, and exercise) and the effects of an educational intervention promoting self-care on the emotional and academic adjustment of first-year medical students.
Fifty-four medical students completed questionnaires that assessed various health habits, alcohol use, depression severity, and areas of life satisfaction at the beginning of the semester, at mid-term, and at finals. Approximately half of the students received written feedback or participated in an educational discussion group at mid-term.
The students demonstrated significant changes in health habits, with increases in alcohol consumption and decreases in exercise and socialization. The changes in health habits were predictive of both emotional and academic adjustment, with students who decreased in positive health habits, particularly socialization, being more depressed at finals. The feedback and educational interventions influenced some sleep and exercise behaviors, but the groups did not differ in overall emotional or academic adjustment.
First-year medical students show significant changes in health habits as they adjust to medical school. An educational intervention demonstrated promising effects in changing these patterns, but self-care needs to be further elaborated to address the specific challenges associated with acute adjustment as well as with long-term stressors.
Whistle-blowing: an integrative literature review of data-based studies involving nurses
- Jackson
The professional consequences of whistle-blowing by nurses
- McDonald