The Mind-Body Connection:

Workplace Conflict, Stress & the

Risk of Injury
Typically, workers are familiar with the dangers of heavy lifting, improper workstation set-up
and unsafe working conditions. But workplace conflict, given its relationship to stress, can be
equally dangerous to people's physical and emotional health. It can even increase an individual's
risk of injury.

Jul 28, 2004

Most everyone will admit to feeling the effects of stress at work at least periodically,
effects such as sleeplessness, anxiety, and depression. From our experiences in
workplaces throughout North America and Australia, we have found that people are
generally willing to openly acknowledge certain causes of stress as being present in their
workplace, including overwork and concerns about corporate downsizing. Yet another
prominent cause of stress is less often acknowledged in workplaces: conflict.

Consider this scenario that we ran into recently:

At Company X, there has been long-standing negativity between two groups of

employees. The tension has escalated over time, and appears to have somehow
"infected" other departments the workforce seems polarized, and the condition has
proven resistant to team building initiatives and workshops. At the same time,
managers are wrestling with frequent absenteeism, lowered productivity, and
increasing injury rates. They hear complaints that employees just don't want to come
to work anymore because they're always worried about the "poisoned" environment.
At committee meetings involving HR, Health & Safety, and Operations managers, the
issues of bad feelings, absenteeism, productivity and injuries keep arising in different
conversations, leading to the question: "Are these issues connected in some meaningful
way?"

The answer, of course, is yes. The common linkage to these problems in Company X is
stress.

Interpersonal conflict in an organization results in increased stress levels for almost

everyone who comes in contact with it, whether or not they are directly involved. As
stress levels among workers increase, absenteeism rises and productivity suffers. And,
not surprisingly, workers dealing with the effects of stress are more likely to fuel existing
conflict, since their ability to objectively deal with emotionally charged situations
diminishes. To add to the complexity, even intense conflict may become so ingrained in
the procedures and daily interactions of an organization that it may blend into the
background, so that the steps to remedy the situation may not be obvious amidst the
negativity.

This cyclical nature of conflict and stress not only affects the mind, it also affects the
body and contributes to injury rates. It is widely understood that putting the body under
prolonged or chronic stress can lead to illnesses such as heart disease and ulcers. But the
combination of conflict and long-term stress can also put the body at risk of injury.
People are also less able to focus on the mechanics of their tasks, and make mistakes
that cause injuries. This has prompted many organizations to look at "mind-body"
programs as a comprehensive way to prevent and manage conflict, stress and injury.

To fully understand the linkages, let's look at conflict and stress separately, how they
contribute to injuries, and then how to deal with all three as a whole.

Conflict
Conflict relates to the negative feelings experienced between people and groups in
problematic relationships, feelings such as anxiety, fear, anger, contempt and revulsion.
In the workplace, conflict is commonly associated with specific types of behavior,
including those we often hear described as dysfunctional communications, authoritarian
management, aggression, backstabbing, disrespect, and office politics. Whatever form
the associated behaviors take, the effects of conflict are pervasive rarely does conflict
only involve two people. Rather, conflict, if left unresolved, tends to both intensify and
spread over time, eventually affecting whole groups of people and sometimes the entire
workforce.

Most people affected by conflict describe a feedback loop. Each encounter in a conflicted
relationship erodes trust and creates resentment, further fuelling the conflict and
making disagreements even more likely. To appreciate this dynamic, it is useful to
differentiate between a dispute and conflict.

In our work, we use the term "dispute" to refer to a disagreement over how to answer
questions like "what happened?" or "what's going on now?" or "what will we do?" People
have to deal with many such questions in the workplace each day, and they often have
different ideas of how to answer them. A dispute, then, is a contest over the way that we
will answer certain questions. Disputes are about facts.

Conflict, on the other hand, refers to the negative feelings people can come to associate
with their relationships with each other. We can all think of workplace relationships that
have been characterized primarily by feelings of fear, anger, contempt, or revulsion. In
that situation, any interaction with the other person, whether a boss, co-worker or
client, will evoke those negative feelings. A conflict is not about answering questions, or
even about specific interactions. Rather, a conflict is about feelings.

Once people are truly in conflict, the facts involved in some particular dispute are not
the cause of ill feeling and poor communication; they are simply the flash points around
which the feelings will surface with greater intensity. We know this, because just
answering the questions does not make the feelings go away, and each further
interaction thereafter becomes an opportunity for the unresolved feelings to erupt in
instances of problematic behavior.

Real-Life Conflict

Let's take an example that we observed in an actual workplace (names have been
changed).

Choi Ping and Ted are all part of the seven-person sales team at Orange Inc., a small but
profitable electronics distributor. Sales are way up, which has been great for revenues,
but the company is having to deal with challenges in meeting demands for products in a
timely manner due to sourcing problems. Every day the Orange Inc. sales team needs to
make difficult choices as to which orders are to be given priority. Each member of the
team knows that the decisions will impact on their relationship with their customers,
and ultimately on their earnings: they will have to deal with irate customers unhappy
with being told that they will have to wait longer than expected for delivery, some of
whom will simply take their business elsewhere.

Choi Ping has a difficult relationship with Ted. Her stomach knots whenever she sees his
face, and she feels herself becoming defensive and even tearful during the team's daily
meetings when she sees him squaring up to push his position as to why his clients'
orders should be filled. Often she finds herself either withdrawing at the meetings,
disengaging from the discussions until she can no longer bottle her frustrations; then
she explodes at him, sometimes barely managing to control her tears of rage and
frustration. She has all sorts of justifications that she can give for her feelings reasons
that she can point to in this regard: Ted is rude, pushy, self-centred and dismissive of
other people's concerns. The situation is so bad that she has actually taken to calling in
sick a few days a month just to keep her sanity. When she's in the office, she won't go to
the coffee room if Ted is in there, and won't attend social functions.

Ted feels angry and resentful towards Choi Ping. She appears to him as irrational and
unpredictable during the daily meetings: one moment it looks like she doesn't care
about what decisions are being made, and the next she's stomping all over him with
accusations about his being unfair and selfish. She obviously expects that her clients will
be given priority over his. This seems hugely unfair, as Choi Ping isn't the hardest
worker out there she's always calling in sick for no reason. He finds the whole situation
embarrassing and frustrating, in large part because he doesn't know what to do about it.
He'd rather not have to interact with her at all, and is thinking of quitting if the company
doesn't fire her.

In our example, members of the sales team, including Choi Ping and Ted, are in dispute
daily over which orders will be fulfilled. Answering the question on a given day as to
which orders will be left unfulfilled is resolvable in any number of ways: by majority
vote, by flip of a coin, by deference to the decision of the team leader, by talking it
through until a consensus is reached, etc. But answering the questions will not take care
of the conflict between Choi Ping and Ted.

This is the reason that many organizations fall short of adequately addressing conflict in
their workplaces: they focus on the dispute rather than the conflict. In the case of Ted
and Choi Ping, it is clear that the manager and everyone else will end up disappointed
and frustrated if attempts to deal with the situation focus solely on answering the daily
question of "whose clients will be left unsatisfied?"

Companies perpetuate this overemphasis on disputes at the expense of conflicts through

their over-reliance on the disciplinary framework. Typically the problems of anger,
resentment and frustration (and the associated reactive behaviors) become subsumed in
questions over right and wrong. We translate the whole problem of relationships into
 one of discipline, by distilling the situation into questions like "who did it?" and "what
do we do to that person?"

We can imagine that the sales manager at Orange Inc. may well default to dealing with
the situation involving Choi Ping and Ted as a disciplinary matter. In that case, he or she
will have to decide between the competing views that Choi Ping and Ted put forward as
to who is the problem, and what should be done to teach that guilty party the right way
of acting.

When managers or supervisors address relationship problems by deciding between

competing complaints or stories, there are only three responses available:

 Declare one argument to be the winner, and discipline the person(s) about whom the
complaint was raised.

 Declare no argument to be the winner, and hope that that settles it.

 Declare that the complaint was vexatious and discipline the person(s) who made the
complaint.

The problem is that none of these responses will address the underlying conflict, and all
three are more likely exacerbate it by maximizing the differences and discrepancies
between the disputants.

With workplace conflict, then, the challenge is to implement procedures and policies
that will properly manage it rather than to exacerbate it, and to recognize how
unresolved conflict leads to long-term stress in employees.

Stress

NIOSH defines job stress as "the harmful physical and emotional responses that occur
when the requirements of the job do not match the capabilities, resources or needs of
the worker." While many of us would think of "requirements" as specific job demands or
 tasks, it can also refer to employees dealing with ongoing conflict as part of they daily
work routines. When this occurs, there is a serious disconnect between the job
"requirement" of working under psychologically damaging conditions, and what
workers need to perform their jobs to the best of their abilities.

When stressful situations go unresolved the body is kept at a constant state of arousal.
We are all familiar with the "fight-or-flight response", which primes the body for
immediate action in the face of danger by pumping up adrenalin levels, increasing heart
and breathing rates, and triggering other physiological reactions, returning to normal
once we have take action and dealt with the situation. Long-term stress locks the body in
a continuing cycle of arousal that imposes significant wear and tear on biological
systems, compromising the body's ability to repair and defend itself. As a result, the risk
of illness and injury escalates.

Studies have shown that health care expenditures are nearly 50% greater for workers
who report high levels of stress. While differences in individual characteristics such as
personality or coping style do need to be taken into account, there are working
conditions that are stressful to most people. A workplace characterized by unresolved
conflict is just one of those conditions.

Workplace conflict as we outlined in the previous section can involve many different
stressors:

 Continued disagreements.

 Poor communication, including the use of demeaning language or withholding

necessary information.

 Bullying, harassment or discrimination.

 Escalating tensions sometimes culminating in workplace violence.

 Often, managers do not observe these stressors because those involved keep the
behavior relatively hidden. Other times, the stressor is so rooted in a particular
management style that it is not recognized as harmful. Whatever the case, unresolved
conflict can quickly lead to high levels of stress.

Post-Traumatic Stress Disorder

When unresolved conflict is allowed to manifest into overt hostility, there is an

increased risk of people suffering from a more extreme stress reaction, Post Traumatic
Stress Disorder (PTSD). PTSD results from the psychological damage that can occur
from witnessing, experiencing or participating in a highly traumatic event, in this case
an incident such as workplace violence or homicide.

When a workplace is hit with a terrifying event, the immediate concern is dealing with
the threat and aftermath at the specific time of the incident. Later, an added concern is
dealing with how the incident affected those involved psychologically, both the
employees who were directly "in the line of fire" and those who witnessed the event. But
in some cases, these psychological ramifications are overlooked as a workplace attempts
to return to normal.

In the context of a workplace, PTSD is not only taxing on the mental and physical health
of the person suffering its effects, it is also damaging to the workplace as a whole. For
the individual, symptoms of PTSD typically fall into three categories:

 Intrusion: the person has persistent frightening thoughts and memories of the event,
often referred to as "flashbacks."

 Avoidance: the person avoids reminders of the trauma, as well as close personal ties
with family, friends and colleagues. The person feels emotionally numb, sometimes
unable to express emotions at all.

 Hyper-arousal: the person acts as if he or she is constantly threatened by the trauma,

becoming suddenly irritable or explosive even when not provoked.
As with chronic stress, these symptoms have a significant impact on the workplace,
often leading to increased absenteeism, increased illness and injury rates, and lowered
productivity.

How Conflict and Stress Contribute to Workplace Injury

According to the Encyclopedia of Occupational Safety and Health, "stressful working

conditions interfere with safe work practices and set the stage for injuries at work." As
discussed above, the link between conflict and stress is not difficult to define. The link
between stress and injury, however, can be more ambiguous. Still, while the direct
associations continue to be researched, strong evidence suggests that where stress levels
are high, injury levels are also high.

There are both physiological and psychological explanations for this connection. In
terms of physiological responses to stress, researchers have found that the body releases
certain pro-inflammatory chemicals that can lead to tendon inflammation and swelling
in the joints both risk factors for developing disorders such as Carpal Tunnel Syndrome.
Other findings show that work-related stressors may be associated with the
physiological processes involved in low back pain and upper extremity disorders.

Psychologically, responses to stress often lead to poor safety compliance. The decline in
mental focus associated with on-going stress impairs our ability to attend properly to
tasks at hand, including routine actions and mechanics of motion. Workers who become
distracted by anxiety, anger or exasperation may fail to follow safety regulations,
exposing them to greater risk of injury. According to the International Labor Office, "of
all the personal factors related to the causation of accidents, only one emerged as a
common denominator: a high level of stress at the time the accident occurred."

The Case for "Mind-Body" Programs

As more and more workplaces experience situations similar to our Company X example,
"mind-body" programs are emerging as comprehensive measures to deal with
interrelated problems such as unresolved conflict, high absenteeism and turnover, low
productivity and high stress levels and injury rates. In essence, a "mind-body" program
combines such aspects as conflict prevention and management with proper ergonomics
and effective back care.

Ideally, a "mind-body" program should be implemented before the conflict-stress cycle

has started. One of the most critical preventative elements is workforce training that
emphasizes effective communication, emotional awareness, interpersonal skills and
group processes. When employees and managers are given the tools to deal with one
another and complex situations effectively, the propensity to engage in conflict is
lessened.

If conflict is already existing in the workplace, an effective "mind-body" program will

provide the organization with procedures to address the situation and to deal with
future problems in their early stages, rather than simply focusing on disputes and
allowing conflict to escalate. In such cases, we advocate an appropriate conflict
intervention in the first instance, followed by "facilitator" training for supervisors,
managers and designated employees in proven conflict management processes so that
they can take action in difficult circumstances, and can teach others how to prevent and
manage conflict.

To supplement the "mind" portions of the program, effective health management and
injury prevention practices also need to be in place. These include workforce training of
proper lifting techniques, ergonomics and back care, as well as workstation set-up and
stress reduction techniques such as breathing exercises.

Each individual workplace will have its own particular requirements of a "mind-body"
program. The key is to recognize the powerful connections between the mind and the
body, and to implement organizational responses that address the ways that conflict,
stress and injury are interrelated.

Richard Hart and John McDonald are directors with ProActive ReSolutions, a leading
provider of conflict management solutions. Susan Rock is a director with BodyLogic
Health Management, providers of award-winning injury prevention and health
management services. Together, they have developed "mind-body" programming that
combines their two areas of expertise, allowing organizations to implement
comprehensive workforce programs. For more information, visit www.proactive-
resolutions.com or www.backlogic.com. Contact them at info@proactive-
resolutions.com.