Bad managers cause poor health

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Egotistical, punitive and angry; there is a myth about what really terrible bosses are like. But are these managers really that common – or do other types of managers cause most of the suffering in modern-day work places? And can you get rid of the boss and improve the health of the employees?

Your boss affects your health. It may seem obvious, as your boss has a lot of power over your everyday stresses in that they determine your wages, workload, and protection against abusive behaviour in the work place. At a stretch, we could say that bosses have an impact on public health.

Yet, research on this matter is still in an early stage, explains Psychologist Anna Nyberg, who publically defended her doctoral thesis on the impact of leadership on subordinates' health a few years ago at Karolinska Institutet. She describes her research field as being relatively new, existing somewhere between two older fields. The first is leadership research, which has traditionally focused on understanding how leaders may influence productivity in an organisation by making employees perform better; health has never been a focus of this field. The second field is work environment research, which has centred around studying the health of employees, but has previously looked less at the importance of leadership, perhaps because it is hard to study.

Anna Nyberg. Foto Niklas Björling.“What managers do at their workplaces and how they affect their subordinates can be difficult to assess. Research is usually based on what employees themselves report about their bosses, and this may be coloured by the employees' general state of mind, as well as a number of other factors. However, if many employees describe their manager in a similar way, this probably paints an accurate picture,” says Anna Nyberg.

In 2009, she presented a highly anticipated study involving approximately 3,100 men employed at different companies within the Stockholm area. In the early 1990s, these men rated their managers' qualities in an survey. When Anna Nyberg consulted the Swedish National Board of Health and Welfare's health records, she noted that up until year 2003, 74 of these men had suffered a serious heart condition, such as a heart attack, in some cases ending in death. This was less common among men who had described seven good qualities in their managers, such as the manager being clear and supportive; see the information box on this page.  The conclusion was that when managers lack certain skills, the risk of suffering a heart attack increases by 40 per cent for men in this study. The results were widely circulated, even internationally.

“This was the first time leadership was so clearly connected to physical health. I think, in general, bosses have a great impact on us. They are people who have power over our lives by defining the boundaries of our work, where we spend a lot of our time,” says Anna Nyberg.

But what more do we know about people who are good managers? What characterises a manager who is clear-cut and supportive? Are there any common denominators?

Christer Sandahl. Foto: Erik Cronberg.“Not really,” says Christer Sandahl, Psychologist and Professor at the Department of Learning, Informatics, Management and Ethics at Karolinska Institutet.

According to him, there are probably individuals who are natural leaders, persons who are born with good leadership abilities and who are shaped into taking responsibility early on in life within a safe environment, for instance, by being given positions of responsibility early on at school – but these persons do not become managers more often than others. Nor is it possible to pinpoint a clear personality that is especially suited the managerial role; an introvert boss can be equally as good as an extrovert one, for example. The more so-called Big Five characteristics you have, the better. These characteristics are emotional stability, kindness, openness, determination and extroversion; though the latter is likely to be less important, as mentioned above. Nevertheless, a super-personality is not a prerequisite for success as a boss.

“Even those who fall into the normal zone in terms of the Big Five can become very successful leaders,” says Christer Sandahl.

It is possible, however, to determine unsuitable managerial traits. For example, a leader should not be unintelligent and should not have too many neurotic traits such as being compulsive or overly suspicious. The manager should not need constant approval and should not suffer from anxiety or depression. Nor is a narcissistic or manipulative disposition a positive trait in aspiring managers.

If you disregard the unsuitable ones, most people can be quite good managers if they really want it and are offered support in their role.

“At most, a personality test can help you weed out unsuitable managerial candidates, but it will not help you find suitable ones. My experience is that if you disregard the unsuitable ones, most people can be quite good managers if they really want it and are offered support in their role,” says Christer Sandahl.

The question is, how to make a good manager out of a managerial candidate? If it is as simple as stating that seven clearly described abilities will increase the health of employees, can we not just teach managers to act in this manner, and thus achieve a major impact on public health? Christer Sandahl's partly specialises in so-called intervention research, i.e., research which studies the effect of different measures, such as examining what happens to employees if managers undergo specific leadership programmes. One of the measures that has proven to be effective is the so-called backstage groups. These are types of support groups, in which eight to ten managers meet each other around once a month for a year. Each time they meet, a manager gets to describe a specific managerial problem that is analysed in depth together with the others in the group. As a consequence of this process, a deeper understanding of the problems develops, as do suggested measures for managers to continue to work on.

A study showed that this method led employees to perceive their managers as better, more confident and secure in their role. It can make managers clearer and more supportive. However, it is not possible to prove whether this affects the employee's health.

“But I think it can have a positive influence on how employees feel,” says Christer Sandahl.

Studying the issue is problematic. However, measurable health effects from a leadership intervention were studied in a highly anticipated doctoral thesis that was defended at the Department of Clinical Neuroscience at Karolinska Institutet in 2014, conducted by musician and leadership developer Julia Romanowska. The thesis focuses on helping managers to develop by putting them through a demanding artistic experience which is intended to take them out of their comfort zone.

The thesis involves both managers who take part in her own artistic concept called Schibboleth and managers who undergo a conventional leadership programme. On twelve occasions, the managers who were given the artistic experience watched performances that contained fragments of texts and music relating to concepts such as evil and abuse, but also to civic courage and dignity. After the performances, the managers reflected on the content, both individually and in a group. The core of the experience was thus to enter into other people's worlds and vulnerabilities and to face the importance of taking a stand in difficult circumstances and having the courage to act. After the artistic experiences, the managers exercised better leadership, according to the ratings that the employees gave on several occasions. Furthermore, the employees' blood tests showed better levels of stress hormones and improvements were seen in health surveys that evaluated fatigue, depressive symptoms and sleeping patterns. On the contrary, there was an increase in ill-health in the control group in which managers were given traditional leadership training.

“This proves what I have so clearly seen during my many years as a consultant in leadership; you cannot detach leadership from basic values. Good leadership is based on sound values and ethical conviction,” says Christer Sandahl.

He argues that if the senior management clearly signals that people's wellbeing is important, than this will trickle down through the organisation and reach the line managers, who have a more direct impact on their subordinates' health. But unfortunately, the opposite is quite often true. In 2010, 4,500 people, who were randomly selected from the Norwegian population, took part in a Norwegian study. They answered an extensive survey about their managers and then researchers deduced the manager's leadership abilities using the answers. According to the result, one in every three participants had been subjected to destructive leadership “pretty often” or “very often” during the past six months. Around three per cent had, on at least one occasion, been subjected to tyrannical leadership, meaning that the manager, for example, humiliates the employees or spreads rumours about them. This is typical psychopathic behaviour, where the leader uses his or her position to achieve his or her own goals.

Christina Björklund“These types of managers can dominate if organisations are stressed and if the senior management is weak and doesn't intervene. I don't have any advice to people who have managers who display psychopathic behaviour, more than that they should quit if they can,” says Christina Björklund, Associate Professor at the Institute of Environmental Medicine at Karolinska Institutet.

I don't have any advice to people who have managers who display psychopathic behaviour, more than that they should quit if they can.

However, it is unusual for managers to display psychopathic behaviour compared to other destructive behaviour, which is probably equally as unhealthy to be exposed to. According to the Norwegian study, approximately one in five participants had been exposed to so called evasive leadership in the past six months. An evasive manager runs away from responsibility, does not deal with difficult issues and avoids making difficult decisions. This creates a breeding ground for bullying and harassment, as does tyrannical leadership, according to another study from the same Norwegian research team.

It is hard to estimate the actual extent of adult bullying, in part because it is perceived as shameful by those subjected to it, and in part because bullying can be defined in many different ways. However, according to an investigation by the Work Environment Authority in 2010, eight per cent of all employees in Sweden are bullied. According to Christina Björklund, it is easier for abusive treatment to gain a foothold and grow at workplaces that are under general stress and poorly led; where employees have low control over their own work; where many employees come to work despite being sick and where managers are unjust and bad at encouraging their subordinates: in these work places, bullying occurs to a greater extent than in others.

“If you want to detect bullying at an early stage in order to prevent it, you have to work systematically with the work environment and leadership. And this is important, because bullying has a seriously negative impact on the health of persons who are subjected, even several years after the bullying has stopped,” says Christina Björklund. 

Seven managerial abilities that protect the employees' health

  • Being clear about what is expected, providing direction.
  • Giving a mandate and the required information to enable employees to independently perform their work tasks.
  • Not only giving orders, but also listening to subordinates and willing to embrace their suggestions to improve the workplace.
  • Being fair and not favouring certain behaviour or certain people in an unpredictable way; instead, follow the established direction.
  • Offering support – encouragement when work is going well, and friendly criticism if something isn't working.
  • Inspiring while demonstrating that work is fun and meaningful.
  • Creating a good group that can collaborate with one another.

Source: Anna Nyberg

 Text: Annika Lund, first published in the magazine Medical Science, no 1 2016

Environmental MedicineOccupational MedicinePsychology