Category: Uncategorized

Sharing Our Stories: Writing for Wellness

September 19th, 2014 in Uncategorized 0 comments

The registration is now open for the new Writing for Wellness series. 

The emphasis in today’ clinical practice is on providing patient-centered care. However, with inherent time constraints, clinicians don’t always have the opportunity to learn about the person behind the illness. To address this issue, a BMC physician and nurse educator have organized a workshop series to offer the chance for clinicians and others who interact with patients to write about their experiences.

The workshop is loosely based on the work of Rita Charon, a physician at Columbia University Medical School, who founded the Program of Narrative Medicine there.

Narrative writing is grounded on the premise that writing about the person behind the illness improves care, compassion, and ultimately satisfaction, for both patients and their health care providers. (For more information see  http://www.narrativemedicine.org.) Dr. Charon explains that narratives have the power to complement clinical practice by allowing writers to explore –and be moved– by the stories of illness. Columbia’s program is aimed at helping “physicians, nurses, social workers, mental health professionals, chaplains, social workers, academics, and all those interested in the intersection between narrative and medicine improve the effectiveness of care by developing these skills with patients and colleagues.”

The BMC workshop is free and open to clinicians as well as other caregivers. It is aimed at creating a safe environment for participants to write in facilitator-led small groups. The format will allow time for those who wish to simply exercise the chance to write, as well as for those who wish to publish their work in peer-reviewed journals (such as JAMA”s “Piece of my Mind” section). There will be opportunities to share writing and receive feedback from others in the group.

‘Boston Strong’ Resources: Remembering and Coming Together

April 10th, 2014 in Uncategorized 0 comments

#BostonBetter

http://www.bostonbetter.org/
https://twitter.com/BosBttr
https://www.facebook.com/bosbttr
http://www.bostonbetter.org/how-you-can-help/
A collaboration of Boston-area museums, libraries and archives, this project shines a light on tribute events, exhibitions related to the marathon bombing, and ideas for helping others.

Our Marathon: The Boston Bombing Digital Archive & WBUR Oral History Project

http://marathon.neu.edu/
A community project hosted at Northeastern University, Our Marathon is a crowd-sourced, digital archive of pictures, videos, stories and social media related to the Boston Marathon bombing. The
project sponsors believe that sharing stories from survivors, families, witnesses, visitors to the city, and everyone around the world touched by the event will speed the healing process.

Patriots’ Day Project

http://www.pathstodream.org/patriots-day-project/
In response to the 1-year anniversary of the Boston Marathon bombing, the Marjorie E. Korff Parenting At a Challenging Time (PACT) Program at Massachusetts General Hospital, in collaboration with The Clay Center for Young Healthy Minds, has launched the Patriots’ Day Project. This project creates educational tools reflecting the lessons learned from the bombing and its aftermath, resources intended to assist parents and educators as they face current and future challenges that impact the children in our communities.

The One Fund

https://secure.onefundboston.org/
One Fund Boston was formed by Governor Deval Patrick and Mayor Thomas M. Menino with the purpose of helping those most affected by the tragic Marathon bombings. This fund is still accepting
donations.

© 2014 Achieve Solutions
Call Us: 1-800-435-1986
Achieve Solutions® is a ValueOptions® website.

https://www.achievesolutions.net/achievesolutions/en/myachieve/

Discounted Fitness Memberships

January 16th, 2014 in Uncategorized 0 comments

Steal of the Year:

South End Fitness Center (BU/BMC employees):

  • Pool, basketball court, fitness studio, cardio and strength equipment
  • Free consult with fitness specialist
  • 3 month membership program at the rate of $ 120/3 months
  • $50 discount on a yearlong membership for BU/BMC with this special rate $ 310 a year

Located at 45 Hampton 35 Northampton St #4 (attached to BMC). Boston, MA 02118.Call 617-534-5822.

Two New Offers

Michelle Obama leading exerciseBurn Fitness Studios (BU/BMC employees) is opening in 2014 in the South End and is a boutique fitness studio offering specialized group exercise classes (indoor cycling and rowing, yoga, boot camp classes) and personal training. Visit their website for more information and check out the Pre-Opening Special and Sales, or email them directly to take advantage of a 10% corporate discount on any full-priced item. We fit you. Burn Fitness Studios 547 Columbus Avenue Boston, Ma 02118  02118  info@burnfitboston.com

Mount Auburn Club (BMC employees): The Mount Auburn Club located on the Watertown/Cambridge line, and is “Greater Boston’s most complete health, fitness, swim, tennis club and spa. “ Employees may receive a 2 week complimentary VIP membership and then 40% off a 8 week membership plus two 60 minutes coaching sessions (one evaluation and one program design session) and four 30 minute personal training sessions. For more information call 617.923.2255

Other Health Care Fitness Centers

Boston Sports Club (BU/BMC employees): Boston sports Club offers a Passport membership to BU/BMC employees, meaning an employee access  to 150 Clubs in the greater Boston area with the exception of the premium clubs in Waltham and Wellesley, Ma. Prices for members from $74.99/Month (a $49.99 dollar processing fee will be added to each membership). Enroll online, or call Jennyfer Shupack (917-351-6689) ext 1580) or email Jennyfer.Shupack@tsiclubs.com

Boston Ski and Sports Club  (BU/BMC employees): Boston Sports and Ski Club is Boston’s largest sports and social club for active professionals. Play sports, travel the world, socialize, ski & ride and get outdoors. Use the code BMC0809 to get a discounted annual BSSC membership. Save $15 dollars on the membership alone, plus discounts on trips, events, socials and outings.  Register at BSSC.com or call Nancy McGeoghegan (nancy@bssc.com) at 617-789-4070 ext.230      

Healthworks Fitness Centers for Women (BMC employees/BU) is regularly recognized as the top Health Club in Boston and one of the top clubs in the country.  With over 100 amazing group fitness classes per week, innovative small group training, the best Personal Trainers in Boston, spa services and a luxurious locker room, Healthworks is the ideal facility for every woman to achieve their fitness and wellness goals.  Healthworks offers a discounted enrollment fee and monthly membership rate to all BU/BMC employees.  If you are currently a member, simply go into your club and let them know you are a BMC employee to take advantage of the benefit.  If you would like to learn more, please come into the club or visit http://www.healthworksfitness.com for more details.

Fitness Together (BMC employees/BU): Back Bay, Cambridge, North End and South End Fitness Together, a personal training and small group personal training facility, offers a 15 percent discount with any customized personal training and nutrition program. Fitness Together creates a customized fitness programs and trains their clients one on one in private rooms or customized small group training that are fully equipped for strength training, cardio conditioning , and nutritional counseling. www.fitnesstogether.com/backbayboston  Call 617-247-3900

Nurse Achieve (BU/BMC employees) is a complete fitness program designed for all levels with the goal of creating optimal health. The program is on the campus Monday through Friday   4:00-5:00 pm located at 85 Concord Street. Boston, Ma 02118 (on BMC campus).  For more information Contact Robert Sullivan rsullyfit@gmail.com

Pathways to Wellness (BU/BMC employees): Located at 1601 Washington Street 3rd floor, a nonprofit public health organization It provides equal access to high quality holistic therapies including acupuncture, shiatsu and Chinese herbal medicine. Discounts are available on individual and group acupuncture sessions as well as smoking cessation programs. Call to make an appointment and be sure to bring your BU/BMC identification Badge with you to the appointment Call617-859-3036.

Three Session Workshop offered for Health Care Providers: Writing to Heal

January 2nd, 2014 in Uncategorized 0 comments

The emphasis in today’ clinical practice is on providing patient-centered care. However, with inherent time constraints, clinicians don’t always have the opportunity to learn about the person behind the illness. To address this issue, a BMC physician and nurse educator have organized a three-session workshop series to offer the chance for clinicians and others who interact with patients to write about their experiences.

The first of the three sessions will be held on Thursday, January 9 from 5-7 pm in the General Internal Medicine department in the Crosstown Building, second floor. The workshop is loosely based on the work of Rita Charon, a physician at Columbia University Medical School, who founded the Program of Narrative Medicine there.

Narrative writing is grounded on the premise that writing about the person behind the illness improves care, compassion, and ultimately satisfaction, for both patients and their health care providers. (For more information see  http://www.narrativemedicine.org.) Dr. Charon explains that narratives have the power to complement clinical practice by allowing writers to explore –and be moved– by the stories of illness. Columbia’s program is aimed at helping “physicians, nurses, social workers, mental health professionals, chaplains, social workers, academics, and all those interested in the intersection between narrative and medicine improve the effectiveness of care by developing these skills with patients and colleagues.”

The BMC workshop is free and open to clinicians as well as other caregivers. It is aimed at creating a safe environment for participants to write in facilitator-led small groups. The format will allow time for those who wish to simply exercise the chance to write, as well as for those who wish to publish their work in peer-reviewed journals (such as JAMA”s “Piece of my Mind” section). There will be opportunities to share writing and receive feedback from others in the group.  The program leaders are Jane Liebschutz, MD, Ellen Kolton, MPH, Patient Advocate, and Susan DiCristofaro, RN MS OCN.

To attend, please register.

5 Steps to Better Sleep

November 20th, 2013 in Uncategorized 0 comments

sleep
  • Take a warm bath with 2 hours of going to bed
  • Set your temp at 68 degrees Fahrenheit.
  • Establish a regular bedtime.
  • Sleep on soft sheets with the right weight blanket.
  • Sleep in a darkened room.

Six Months Later: Schwartz Rounds Tackles Healing Process of Caregivers in the Wake of Marathon Bombings

November 12th, 2013 in Uncategorized 0 comments

It has been six months since Marathon Monday, a day that in years to come will never be the same for many Bostonians. On Oct. 15, BMC’s Schwartz Center Rounds marked the anniversary and served as an opportunity for staff to gather as a community and assess its collective healing progress.

Schwartz Rounds
Schwartz panelists address the crowd

Schwartz Center Rounds are held in more than 200 facilities in 32 states and commemorate Kenneth Schwartz, a Massachusetts health-care lawyer diagnosed with lung cancer in 1994 who believed in nurturing the compassion in medicine. The rounds provide a forum where BMC caregivers from multiple hospital disciplines come together to discuss the emotional impact and challenges of patient care based on an actual case. The Oct. 15 rounds however, focused on a different theme; the events of the Boston Marathon tragedy and the importance of caregivers’ self-healing.

Thomas Barber, MD, Schwartz Rounds Physician Leader, and Carol Mostow, LICSW, Schwartz Rounds Facilitator, introduced the topic of remembering vulnerability, celebrating strength and integrating lessons for everyday work six months after the Marathon. Panel speakers included Jared Greer, Certified Radiology Technician; Doug Comeau, DO, CAQSM, FAAFP, Director of Sports Medicine; Jeffrey Kalish, MD, Director of Endovascular Surgery; and Elizabeth Dugan, LICSW, Manager, Violence Intervention Advocacy Program. Each panelist provided their unique perspective and experience of the April 15 tragedy.

Comeau told the audience that he was stationed in a medical tent at the Marathon finish line and spoke of the chaos that ensued following the bomb.

“The ground shook like fireworks were going off and there was complete panic. I didn’t know if my team, the people I had worked with for so many years, was alive,” he recalled. “That kind of vulnerability stays with you.”

Greer was working when the influx of patients from the marathon hit BMC.

“It was complete chaos,” he said. “But one good thing that came out of it is the renewed respect that I have for my colleagues. Everyone pulled together and my relationship with other departments was completely changed, in a good way, and it made me proud to work here.”

Kalish, as a member of the surgical team who operated on many of the most gravely injured patients, also spoke of the camaraderie.

“The usual hierarchy was gone. Everyone worked together and did whatever needed to be done. From nursing to transport to housekeeping, everyone pitched in and it created an extremely productive environment,” he said. “Quite frankly, this is a model that we should be using more often.”

Dugan offered insight on how violence affects many of the patients BMC sees every day and challenged the room to acknowledge their success in caring for the patients that day and carry it forward to future patients.

When the platform turned to the audience for reflection, the mood was hopeful as participants spoke about taking the time to focus on getting help to move past such a tragic event.

“One of the charges of running a marathon is the cheers you get along the way,” summed up Mostow. “By acknowledging the amount of tragedy we see, we are showing compassion for ourselves. Everyone needs to be cared for. Caregivers are no exception.”

BMC continues to offer a range of support services to staff as they heal. To learn more, visit the Human Resources section of the BMC intranet.

Fall activities

November 12th, 2013 in Uncategorized 0 comments

Autumn can be a busy time with back to school homework, sports and clubs.  There are lots of fun activities outside of school that can help you relax or get some activities in on the weekends. Below are links to websites where you can get ideas and suggestions. The activities vary by age and interests and there is something for everyone in your family. Also, visit the bWell Center on the 5th floor of the Yawkey Building for even more ideas.

Free Activities – a list of free family-friendly activities in MA

Boston Youth Zone is the place to find activities, opportunities, after-school programs, and other fun things for Boston’s kids and teens to do.

Boston Navigator is the place to search for youth programs in Boston

The 4 Minute and 7 Minute Workout: Too good to be true?

June 28th, 2013 in Uncategorized 0 comments

Could it really be true that we now only have to exercise for 7 minutes or even 4 minutes to get the same benefit as slogging it out at the gym or in our step aerobics class?  The answer is Yes and No.

First, the yes.  Studies have shown that doing short bursts of intense workout can give the same cardiovascular and metabolic benefits as doing less intense exercise for longer duration.  Doing these intense exercise bursts can improve heart conditioning and also improve insulin sensitivity, one of the main culprits in type II diabetes. A recent study found that overweight, sedentary but healthy middle aged men improved their blood pressure and blood sugar profiles after doing a 4 minute intense workout (with 3 minute cool down) three times per week compared to those doing a longer workout. The workout included running on a treadmill at 90% of maximal heart rate. Maximal heart rate is calculated at 210- age.  For someone who is 40 years old, 90% maximal heart rate is 153 beat per minute (210-40=170 x 0.9= 153).  The creators of the exercise suggest that this is “only being able to use single words during exercise.”  The workout did not show any weight loss benefits.  While the researchers testing the protocol used running on a treadmill, this could be translated to bicycling, swimming or other aerobic exercise as long as the intensity can be raised to 90% of maximal heart rate.

The 7 minute workout presented in the American College of Sports Medicine’s Health & Fitness Journal shows that results equivalent to longer weight training and aerobic exercise can be achieved using a high-intensity circuit training (HICT) that depends on just body weight and props such as a chair or a wall. It includes a set of 12 exercises that alternate use of large muscle groups to allow proper recovery for each group while continuing to working on a different group.  The high intensity is just that – doing 30 second intense intervals with 10 second rest periods, at 8/10 scale of discomfort.  HICT has the potential to be beneficial in decreasing body fat, increasing aerobic endurance, and muscle mass. The circuit can be repeated two to three times. HICT addresses time constraints of busy individuals to deliver numerous benefits in much less time than traditional exercise programs. (See links below for articles that show the workouts.)

Sounds great? What’s the downside?  First, the workouts have been shown to improve blood pressure, blood sugar and muscle capacity. However, they have not been shown to reduce weight.  That comes with burning more calories with longer exercise and also diet control. That being said, including some interval training with current exercise routines should be able to help ramp up the impact of the exercise.  Instead of jogging for one-half hour, one could consider doing 5 minute warm-up, 10 one minute sprints followed by ninety-second slow walk/jog for the same total time but improved cardiovascular effort.  Or substitute three cycles of the 7 minute workout protocol (with a 5 minute rest in between). See the illustrations of the exercises at NYT Health/Science or ACSM’s Health and Fitness Journal.

Any other caution?  These exercise protocols are INTENSE and are not appropriate for someone with medical conditions. Individuals should be able to safely perform all of the exercise positions without high risk of injury secondary to poor positioning.  The long term goal of the individual is also something to consider.  These high intensity workouts necessarily have discomfort as part of the workout, which may be off-putting and take away the desire to work out.  The more important goal is to build in exercise for long term health and wellbeing. It is proven that people exercise because they enjoy it and the positive affects. It may be difficult to maintain these workouts that are at best considered “uncomfortable”.

While these 2 new theories of intense workouts may be beneficial for some, it is proven that doing any type of exercise, at a moderate intensity level, is a wonderful way to begin your journey to better health. To combat the need for time to exercise as the excuse, walk your dog, park far away from work and walk, and take the stairs instead of the escalator. “Any type of progressive strength- training, regardless of movement speed, will elicit gains in muscle hypertrophy with concurrent enhancements in strength and power.” (Mannie)

There are several considerations with starting HICT. First, it is important to receive prior medical clearance prior to beginning any exercise program to ensure safety, especially for those who do not already have some experience with exercise. HICT requires an increased demand and caution is advised for those who are “overweight, obese, detrained, previously injured, elderly, or for individuals with co morbidities.” The 7 and 4 minute workout are also not suited for people with hypertension and heart disease. Even in a very healthy individual, intensities and positions of exercise may need to be modified at the start.

Second, proper form and technique of exercises is more important than speed to decrease the potential of injury, and increase the maximum benefits. Several studies have shown that controlled movement speed allows the muscles to properly perform the work, reduces the probability of an injury of the muscle, maintains more muscle tensions, and produces more force output in comparison to short, heavy, and quick movements (Mannie).

Lastly, although HICT may be beneficial in overall health, it does not address specific endurance, strength, or power. Specific performance goals need a specific training regimen.

Take Home Points:

  • High Intensity Circuit Training and high intensity exercise are effective at getting in shape in short time periods. They have health benefits, such as lowering blood pressure and blood sugar.
  • Adding intense exercise intervals to an existing exercise program may be one way to get more “bang for the buck”.
  • Doing high intensity exercise circuit can put someone at risk for injuries, particularly if they are not already exercising or have medical conditions.  They should get medical clearance from their physician.
  • For weight loss, short interval programs will not be effective enough alone.

By Karen Mattie, MSPT, Rehabilitation Director, BMC and
Jane Liebschutz, MD MPH FACP, Associate Professor of Medicine and Social and Behavioral Sciences, BUMC, BMC

Resources:

Mannie, Ken.  Power Points in High Intensity Training. Coach & athletic director.  Jan 2001. Vol 70 Issue 6.p6.3p

Klika, Brett.  Jordan, Chris.  High-intensity circuit training using body weight: Maximum Results with Minimal Investment. American College of Sports Medicine. Health & Fitness Journal. Vol 17/ NO.3. Copyright 2013

Pedro E. Alcaraz, et al. Similarity in adaptions to high-resistance circuit vs. Traditional strength training in resistance-trained men. Journal of Strength and Conditioning Research. Vol 25, Num. 9 / Sept 2011.

Tjønna AE, Leinan IM, Bartnes AT, Jenssen BM, Gibala MJ, Winett RA, Wisløff U. Low- and high-volume of intensive endurance training significantly improves maximal oxygen uptake after 10-weeks of training in healthy men. PLoS One. 2013 May 29;8(5):e65382

Talking with Young Children about the Boston Marathon Tragedy

April 16th, 2013 in Uncategorized 0 comments

The events at the Boston Marathon were overwhelming and incomprehensible for all. Parents and professionals face the task of deciding what to tell young children and how to tell them in a way that provides the necessary information but is neither too scary nor too overwhelming for them. This is not easy because we as adults do not have the answers, and many of us are struggling with strong feelings of terror, horror and sadness.

Before you talk to your child, it is important that you take stock of your own thoughts, beliefs, and reactions. Children, especially young children, are keenly aware of their parents’ emotional responses. Your feelings and responses give children important cues about how they should react. If parents communicate a great deal of worry or fear, their children may react similarly. Because we as adults are likely to have strong feelings about these events, it is also important that we have support and connection with others so that we are not alone with these intense feelings.

Your relationship with your child as a parent or caregiver is the most important ingredient of help that you provide. Your ability to hear your child’s worries, to accept them, and to provide comfort is the foundation of any discussion about a scary event. If you as a parent or caregiver are able to keep the communication open and be available for your child, you have laid the foundation for providing the best support possible.

It is important to remember that young children communicate their thoughts and worries in more ways than by verbal expression alone. Children may draw pictures or use dramatic play or storytelling to tell us their thoughts. We can help by making sure that children are given multiple ways to communicate and that we are sensitive to reading cues from these different expressions.

All families are different. Families cope with stress in many ways, using strengths that are drawn from religious or spiritual beliefs, traditions and relationships.  There is no set script of words to use. The information we provide here is intended to give parents and professionals some guidelines to think about. It is not comprehensive, nor does it take into account every situation that you may face with a child.

Common Questions from Parents

Should I talk about the bombings with my child? Perhaps because he/she is so young, I should not mention it.

If your child is old enough to go to pre-school or kindergarten, it is likely that they will hear something about the bombings. Even a three-year-old may hear words or observe adults who are upset or worried. It is far better that your child get information about what happened from you than from another source. By initiating a discussion about it, you give the message that it is OK to ask questions and to talk about it again.

How do young children understand terrible events such as the bombings?

Children’s capacity to understand depends on age and ability to comprehend the world. They will not understand events in the same ways that adults do. They may know about an event because they hear adults talking or see the news, but they cannot really understand the complexities of these events. In the absence of information that is geared to their age level, they may make up their own version of the story. Here is a general summary of how children will think about the events like those at the Boston Marathon.

Toddlers: They will have no understanding of the events apart from the reactions of their parents or caregivers. They are sensitive to the emotions and stress level of their parents. The ways that parents manage feelings of anger, sadness or worry affect a child’s reaction.

Pre-schoolers: They have more ability to understand and if curious or concerned, are deserving of a brief explanation. However, they may question whether these events are real or not. Their capacities for distinguishing reality from fantasy are limited. Their main worry is likely to be about the safety of their parents and themselves: “Who will take care of me?”

Kindergarteners: They will have more understanding of cause and effect, but they still see the world in reference to themselves. Children will worry about safety, where the perpetrator is now and about whether the perpetrator has been arrested. They may worry about whether this could happen to them.

Young school-age children: They have a sense of right and wrong, good and evil, and will be more focused on why this happened. They think in absolute terms; there is no gray area as children of this age attempt to make sense out of these events. They will need more information. They, too, may voice worries about their safety and why the person or persons did what they did.

How or what should I tell my child?

Deciding what to tell your child is difficult. It is important to start by asking if the child has heard anything about what happened. This gives you an opportunity to learn what the child knows, how he/she knows it and what misunderstandings your child may have about the events. Children should have access to the basic information, but only as much information as they can understand. The decision about how much to tell a child depends on the child’s age and developmental stage. A three-year-old needs different information than does a six-year-old. For example, to a three or four-year-old, curious or concerned about the recent events, you might say: “I want to tell you about a bad thing that has happened.  It happened in a town that’s far away from here. Some of the people were hurt by a bomb and some died. Many people are very sad about this, but we are safe here.”

For a five or six-year-old, the explanation would be somewhat different. “This is hard to talk about. A lot of people are talking about a bad thing that happened. Somebody with a bomb hurt some people at a race called the Boston Marathon.  It is not close to us here. Some people were hurt and some died. The police and rescue workers are helping to take care of the people. We are sad about this. But we are safe here.”

For a seven or eight-year-old: “You may have heard about an awful thing that has happened. A lot of people are talking about it and it has been on TV. Somebody set off a bomb at a race called the Boston Marathon. It is not close to us here. Some children and grown-ups were hurt and some died. We don’t know why this happened.  We hope this never happens again. The President of the United States talked about it on television. He is working with police and other people to try to make sure that this does not happen again.”

All children need reassurance that we as parents and adults are doing everything we can to keep them safe.   Any discussion about violent incidents should include reassurances about the child’s safety and the safety of the parent/family. In addition, you may wish to add that the leaders of our country and many policemen and other helpers such as the FBI are working to make sure that this does not happen again.

How should I expect my child to react to this kind of information?

Children will react in a range of ways. The reaction depends on the age, personality, and developmental ability of the child to understand the complexities of the events. Some will ask many questions. Others may show little reaction. Common reactions may include: worries about safety, asking the same questions repeatedly, asking no questions and not wanting to talk about it, sleep problems or bad dreams, increased clinginess with parents or caregivers, increased preoccupation with the tragedy or daydreaming; or reverting to less mature behaviors (thumb sucking, for example). These reactions are normal reactions to abnormal events, and parents should not worry about them. It takes time for all of us to calm down from events like these.

Some children will be pre-occupied with worry or questions about the terrorists. “Who did it?” “Why did they do it?” “Has he/they been caught?” “Will this happen in my town?” These questions are normal because young children are in the process of developing morals and an understanding of right, wrong and consequences for behavior. In addition, these questions can reflect the basic fears of safety. The underlying question is “Am I safe?” or “Is my family safe?”

Some children will have no apparent reaction and seem unconcerned about what they are told. Others may laugh or make an inappropriate response to the news. They may seem to be callous or uncaring about the gravity of the situation. Children have different ways of taking in information and parents should not worry about these reactions. Parents should not push a child to talk about it, but rather leave the possibility open for future discussion.

When should I worry about my child’s reactions to traumatic news?

Remember that children’s responses to a terrible catastrophe are usually appropriate and understandable. Some children will be preoccupied for a few days; others may continue to talk about it for several weeks. Some children may not talk about it for days or weeks. If the intensity of your child’s reaction does not diminish or if your family has been more directly affected by the tragedy, you may consider outside help for your child. If your family has suffered other stresses or losses, your child’s reactions may be more intense. If your child’s reactions are noticeably different from those of his/her peers, you may want to seek advice.  Remember that you know your child better than anyone, and if you are worried, seek help. You may talk with other parents, your child’s teacher, the school psychologist or guidance counselor or your child’s pediatrician to get advice on how to help your child. Even very young children may benefit from therapeutic intervention if they are extremely distressed.

Summary: Do’s and Don’ts for Parents

  • Take the time to be aware of your own feelings and reactions. Children are keenly aware of their parent’s emotions and worries. If you are too upset, anxious or worried about troubling current events, wait to talk with your child, or ask someone else who is close to them to do so.
  • Be willing to talk to your child about the bombings particularly if you think he/she might know something about this event.
  • Limit your child’s access to television, newspapers and magazines with graphic images of violence. For very young children, avoid exposure to the media altogether.
  • Spend extra time with your children if possible. Be available to answer questions.
  • Take your child’s questions seriously and be prepared to answer the same question repeatedly.
  • Give your child enough information to answer his/her questions, but no more.
  • Don’t worry if your child does not talk about this very much. Children have different styles and timetables for processing information.
  • Pay particular attention to bed-time routines and take extra time for being close to your child.
  • Maintain the daily routine. Predictability and routine are comforting for children.
  • Offer your child opportunities to help or to do something positive. Children feel better when they can offer concrete assistance.

For further information or referral call the Child Witness to Violence Project at Boston Medical Center at 617-414-4244.

Resources:

The National Association of School Psychologists has prepared tipsheets for parents and teachers to help children, teenagers and adults cope with tragic situations. There are also fact sheets for parents available in other languages. Please feel free to share them with families who may find them helpful:

In Egnlish
In Spanish
In Arabic
In Chinese
In Farsi
In Korean
In Vietnamese

The National Child Traumatic Stress Network: resources on terrorism and psychological first aid in different languages

The American Academy of Pediatrics: www.AAP.org

The Child Witness to Violence Project: www.childwitnesstoviolence.org

American Academy of Child and Adolescent Psychiatry: www.aacap.org

 

Child Witness to Violence Project
Boston Medical Center

Bullies at Work

March 26th, 2013 in Uncategorized 0 comments

Susan was working at her computer late on a Friday afternoon when Jim came in to her office looking angry.   He stood over Susan’s desk and leaned forward.   He asked in a loud voice: “Why did it take so long for you to finish writing that proposal?”  Susan, a small shy woman felt intimidated and defensive.  She responded to Jim that she had to research background information to  prepare a careful proposal and that had taken extra time.  Jim, a large man, interrupted, took off his glasses, opened his eyes wide and glared at her, criticizing how she had written the proposal.   Susan spoke up and reminded Jim that he was not her supervisor.  She asked Jim to leave her office.  Jim refused and continued to stand over her desk for several minutes before he finally left.  Susan was deeply shaken.   Her heart was beating quickly and she felt frightened, belittled and humiliated.   Over the weekend, she had difficulty sleeping and engaging with her family.  She was fearful of returning to work on Monday, and she had trouble concentrating.

Robert Sutton, PhD wrote about bullies in “More Trouble than They Are Worth” (Harvard Business Review of February 2004) and later expanded his theme into a book, The No Asshole Rule.  He lists common everyday behaviors, the Dirty Dozen, that bullies use:

The Dirty Dozen

  • Personal insults
  • Invading one’s personal territory
  • Uninvited physical contact
  • Threats and intimidation, verbal and non-verbal
  • “Sarcastic jokes” and “teasing” used as insults
  • Withering email flames
  • Status slaps intended to humiliate their victims
  • Public shaming or “status degradation” rituals
  • Rude interruptions
  • Two-faced attacks
  • Dirty looks
  • Treating people as if they are invisible

Leah Harris PhD conducted a study of more than 175 four-year colleges to ask in-depth questions about workplace bullying in American higher education administration.  She found that 62% of respondents stated they had been bullied or witnessed bullying in American higher education.  This is 58 % higher than the rate reported by the general workforce.

Here are some of the types of bullies you might encounter at work:

Types of Bullies

  • Garden variety bullies are like Nancy.  They can be male or female.  They engage in aggressive, abusive or abrasive behaviors.  Either intentionally or unintentionally, they threaten, intimidate, insult, isolate or humiliate their targets.  They may use emotional intensity to manipulate others to insure that they accomplish their goals.
  • Queen Bees.  The Wall Street Journal of March 6, 2013 featured an article by Peggy Drexler, The Tyranny of the Queen Bee. She writes: ”This generation of queen bees is no less determined to secure their hard-won places as alpha females.  Far from nurturing the growth of younger female talent, they push aside possible competitors by chipping away at their self-confidence or undermining their professional standing.  It is a trend thick with irony: The very women who have complained for decades about unequal treatment now perpetuate many of the same problems by turning on their own.”   Drexler describes smart, high achieving women who are unkind to other women.  They can be verbally abusive, dismissive of new ideas, excluding women from meetings.  Their victims feel demoralized, humiliated, confused, angry and discouraged.
  • Kiss Up/Kick Down is another form of bullying at work.  These bullies are charming, ingratiating and hard working for their peers or superiors.   But they treat their subordinates with contempt and the behaviors listed above.
  • Good cop, bad cop.  An insidious form of bullying occurs when one person, often a boss, shares  his/her thoughts or beliefs about what’s wrong with the people or the workplace with a designated employee, who then picks up  the cues and may exert pressure on other employees, believing that is the desire of the boss.  Erin, a newer director, shared with Scott that she was frustrated at the slow pace of employees to adjust to change.  Scott wanted to help Erin and earn her good will.  He began to badger employees, insisting on deadlines for mutual projects and generally trying to enforce change.  Erin was the “good cop” while Scott was the “bad cop”.
  • Genius bully.  Walter Isaacson writes about Steve Jobs as a genius bully.   Because of his extraordinary talents in design and marketing, people tolerated him bullying waiters, colleagues and girlfriends with name calling, tantrums and disrespect.  He would find weak spots in people and exploit them, often publicly humiliating them.  In some organizations, including academia,  these brilliant  bullies seem to get away with their behavior.
  • Cyberbullies.  Technology has created more opportunities for bullying or cyberbullying.  Meek employees can become tyrants on emails and social media, involving bystanders with “reply all” or CC/BCC.  Rumors or disinformation about others may be circulated electronically.
  • Harrassers. Sexual harassment is defined as sexual advances, requests for sexual favors, and any other verbal or physical conduct of a sexual nature, whether intentional or unintentional, that is not wanted.  If a bully targets someone because of their race, color, religion, sex, age, national origin, physical or mental disability, sexual orientation, gender identity, genetic information, military service, or because of marital, parental, or veteran status, they are subject to formal investigation and action through the Office of Equal Opportunity.
  • Victim Bullies. They are self-absorbed, self-pitying people who believe that they have been mistreated or exploited.  They believe their demands should be met because they feel that they have been victims.  Rarely empathic with the views and needs of others, they may insist on their agenda.  Their sense of being wronged justifies that their expectations should prevail.   As a result, people feel intimidated and bullied.

Effects on target

Targets like Susan experience stress-related emotional and physical symptoms:

  • Depression
  • Anger
  • Frustration
  • Fear
  • Distracted, poor concentration
  • Loss of loyalty to organization
  • Hopelessness
  • Obsessional thinking about  the job
  • Feelings of worthlessness
  • Difficulty sleeping
  • Lowered energy
  • Tearfulness
  • Increased blood pressure

Effects on Bystanders

How are bystanders and witnesses affected by bullying?  The ripple effect on people and organizations can be devastating, as bystanders are targets of bullies, too.  They lose trust in their colleagues.  Communication diminishes and creative avoidance increases.  People use emails and voice mails to avoid interacting with a bully.  Coalitions or cliques form.

Cost to organization

What is the business cost to an organization that has a bully?   Employees with bully or queen bee supervisors left their jobs more frequently, or had reduced job productivity and loyalty to their organizations.  For the organization, the cost of recruiting and training an employee is upwards of twice his salary, according to the Wall Street Journal.   High turnover damages morale and contributes to a negative organizational culture.   Certain employees in an organization spend inordinate amounts of time to deal with the financial, physical, emotional and legal issues generated by bullies.  These employees include the direct managers, HR professionals, EAPs, equal opportunity administrators, legal counsels, and senior executives.

What Can Individuals Do About Bullies?

If you believe that you are a target of a bully:

  • Talk to people including your family and friends, and consult with the university resources listed below.
  • Come up with a specific plan to talk to the bully.  Practice making your points.
  • Describe the behavior objectively.  Tell him/her how it affects you and ask him to stop, that the behavior is unacceptable.  As an example that Susan might say: “Jim, when you stand over me and take off your glasses to look at me, I feel intimidated.  I’d like you to stop that behavior.”
  • If you are fearful, you might ask someone else to be present.
  • You may want to tell your supervisor about your concerns.
  • Keep a journal of the bullying episodes with details of the behaviors.  Include dates and times.  Keep copies of emails, voice mails or other documents.
  • Avoid being alone with the bully if you can.
  • If the behavior occurs after you have told him that you are not comfortable, walk away from the situation.
  • If a number of people are aware of or have been the target of a bully, they should inform the manager.  If the manager does not respond, people should consult with the university resources listed.

What Can Organization Do About Bullies?

Leadership needs to invest and believe in creating a culture of respect for everyone.  Although many organizations have written policies, leaders need to have their behavior be consistent with their stated values.  Intolerance for bad behavior should be consistent.  When hiring, references should be consulted about a recruit’s specific behavior.  On the job, managers should be trained on how to identify and deal with bad behavior.  Many managers simply avoid a confrontation with a bully because it’s unpleasant.   Employees should receive regular feedback on all aspects of their performance, particularly teamwork.   Performance evaluations should not be the first time an employee hears that his behavior is not acceptable.  Teaching employees how to fight effectively with programs such as Difficult Conversations or Constructive Confrontations empowers them and may reduce the corrosive effects of ongoing bad behaviors.

If you believe you may be the target or victim of a bully, please contact Employee Relations at 617-414-1704 (BMC) or Faculty Staff Assistance Office at 617-353-5381 (BU).

    By Bonnie Teitleman, LICSW