France ST-HILAIRE Mental health at work: The relational side Prospective Exam (Examen prospectif) EXD-66911 presented to the Faculté des études supérieures de l Université Laval for the Ad Hoc doctoral programme of administrative sciences Juin 2008 Université Laval Québec France St-Hilaire, 2008
Table of contents Table of contents...2 List of tables...4 List of figures...5 Foreword...6 Introduction...8 1. Mental health at work: A vast subject...10 2. The concept of stress: A brief overview...10 2.1 Conceptualization of stress...10 2.2 Components of stress...11 2.3 Stress models: An outline...12 2.3.1 The person-environment fit theory...13 2.3.2 Demand-control-support model...15 2.3.2.1 Social support: An overview...16 2.3.3 Model of effort-reward imbalance at work...17 2.4 The multidimensional theory: A strain-focus approach...19 2.4.1 Dimensions of burnout...19 2.4.2 Burnout: A relational model...21 2.5 Managers practices: An emerging model...22 3. Emotion and stress: Two areas...24 3.1 Emotions: An overview of its definition(s) and mechanisms...25 3.2 Emotional regulation...27 3.3 Emotions in the workplace...27 3.4 Emotional labor: Definitions and mecanisms...28 3.5 The effects of emotional labor on health...29 3.6 The importance of emotions in the relationship...31 4. Definition and dimensions of relationship...32 4.1 The idea of relation...32 4.2 The need to belong: The centrality of relationships...34 4.3 Attachment theory...35 5. Models of mental health at work: A relational analysis...37 5.1 The person-environment fit theory...37 5.2 Job demand-control-support model and effort-reward imbalance model...38 5.3 The multidimensional theory...41 5.4 Management competencies...41 5.5 Emotion model...42 2
6. Toward a theoretical framework...43 Conclusion...47 References...48 3
List of tables Table 1 Adaptated table of psychological hazards at work...12 Table 2 Reproduction of the competencies for preventing and reducing stress at work...23 Table 3 Reproduction of the interpretation of factors and sub-clusters...24 4
List of figures Figure 1 Reproduction of the psychological demand/decision latitude model...15 Figure 2 Illustration of the theoretical framework...45 5
Mental health at work: The relational side Foreword In my first exam, I presented a brief overview of the research on leadership, and in particular, I examined in depth certain theories from a relational approach. We have thus seen that transformational leadership and authentic leadership essentially concentrate on presenting a portrait of the leader s characteristics, and touch little upon the role of followers. The leader-member-exchange theory and shared leadership, however, are more conducive to a relational approach. Indeed, in the LMX perspective, both parties (leader and follower) are implied; the dimensions of LMX account for the building of relationships, and this approach accounts for the fact that relationships differ from one subordinate to the next. Furthermore, shared leadership goes a step further than LMX, in that it introduces the idea that leadership is not merely a hierarchical relationship. However, despite the contributions of these theories and models, the interactional process (i.e. the influence of other interactants) in the construction of leadership is not taken into account. Finally, relational leadership, as its name implies, is definitely a relational approach to leadership; this theory advances a promising way of rethinking, reconceptualising, and remeasuring the social influence process in leadership. I also presented an overview of the followership concept: although this concept is relatively recent (notwithstanding some exceptions in earlier research which included this concept), the literature on followership will be very relevant to our understanding of this neglected side of the leader-follower relationship. However, it will be essential not to fall into the trap of a descriptive or prescriptive model of the good follower. In light of the first exam, I concluded that the majority of the literature on leadership expresses a prescriptive approach which focuses on the leader s traits or behaviors rather than on the process of leadership. Moreover, most theories/models have ignored the role of the follower. Furthermore, it will be important to introduce and analyse the social influence process in light of the literature on power. Most recent theories have been more concerned with an assessment and an understanding of the process of leadership. Relational leadership goes even further with the idea that this individual s capacity to influence is the result of a social dynamic. Relational leadership is perhaps the most promising model to date to further our understanding of the true nature of leadership. Thus, it would be pertinent to begin work on the clarification of certain key concepts within this theory; to this end, we may draw from other theories which can serve as a blueprint for the relational leadership theory. 6
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Introduction First off, I would like to reiterate that within the context of my Ph.D. dissertation, I am interested in (1) the impact of superior s management skills (and his or her environment) and subordinate s working skills (and his or her environment) on the building and the quality of their (hierarchical) relationship and (2) the impact that this hierarchical relationship has upon the mental health of workers (both superior and subordinate). In my retrospective exam, I addressed how leadership theories are oriented toward relationships. More precisely, my first exam dealt with the following questions: (1) Which theories best elucidate the relationship between superiors and subordinates, and (2) how is the concept of relationship theorized? However, this paper will present an overview of the vast area of mental health at work, concentrating especially on the relational dimensions of the models and approaches of this area of research. Moreover, I will give a brief overview of my Ph.D. dissertation project. Thus, the objectives of this exam are threefold: (1) to synthesize the main models of mental health at work, (2) to analyze these models from a relational perspective, and (3) to propose an outline for a theoretical framework. For the sake of precision, cohesion, and originality, I have chosen the main models and theories of two research traditions: organizational stress and emotion at work. I will first address the concept of stress, a major current research trend on mental health at work. I will also present certain theoretical models which attempt to account for the relationship between situations that produce stress and the subsequent appearance of strain 1. As Sonnentag and Frese explain, [t]hese models specify the configuration of workplace factors that are associated with strains that is, stress reactions. (Sonnentag & Frese, 2003: 458) As they see it (ibid., 2003), the major models in this area are the person-environment fit theory, the demand-control-support model, and the effort-reward imbalance model; 2 Cooper, Dewe, & O'Driscoll, 2001 agree wholeheartedly with these models 3. Thus, I will present an overview of the person-environment fit theory, the demand-control-support model, and the effort-reward imbalance model. Moreover, since I want to analyse outcomes linked to mental health at work, and since this model is significant in the literature, I will present Maslach s multidimensional model of burnout. Finally, I will summarize an emergent model: the management competencies model. Secondly, I will present the concept of emotion, i.e. its definition(s) and mechanisms, in order to address the issue of emotion at the workplace. I will put special emphasis on a central concept in this area: emotional labor. Thirdly, I will 1 I will come back to this concept further on. 2 The authors add the vitamin model, which is not mentioned in organizational stress reviews. 3 They add to these models: McGrath (1976), Cox & Mckay (1981), Cummings & Cooper (1979). 8
present my conception of the relationship according to two aspects: the need to belong and attachment theory. Fourthly, I will discuss the six models previously mentioned from a relational viewpoint. Finally, I will propose a theoretical framework for my dissertation in preparation for the final project. 9
1. Mental health at work: A vast subject To address mental health at work is to cover a large range of research studies and theoretical models. Indeed, researchers in psychology, medicine, and management (among other fields) have studied the question of mental health in organizational settings. Siegrits underlines this point: The first challenge concerns the difficulty of computing the knowledge from a wide range of disciplines dealing with the issue of work and health. In particular, material from diverse sources such as social, health, and organizational psychology; occupational sociology; and epidemiology, psychosomatic, and behavioural medicine has to be integrated. (Siegrist, 1996: 27) Moreover, the concepts involved with mental health are rather numerous: sometimes mental health is viewed as an outcome (e.g. stress, burnout, General Adaptation Syndrome (GAS), psychological distress, psychological well-being, emotional well-being), and sometimes as an antecedent or as a process (e.g. personality disorders, stress, emotional labor at work). Of course, these concepts are not equivalent, but constitute different angles to study mental health in organizational settings. Thus, I do not presume to survey this entire area of research, but rather to give the readers an overview of mental health in organizational settings. 2. The concept of stress: A brief overview As of yet, there is no consensus amongst researchers regarding the definition of stress or the process it entails. Furthermore, stress can be measured as both a dependent and an independent variable, and can be studied as a process as well as an outcome (Cooper et al., 2001). Indeed, stress has been studied from many different perspectives, and both theoretical and practical foundations are at stake in these discrepancies 4. 2.1 Conceptualization of stress As mentioned before, the concept of stress can be seen as reponse-based model, as a stimulus-based model, and as a process (Cooper et al., 2001). The reponse-based model stems from the field of medicine, and more specifically, from the work of Seyle (1956). This model was the basis of General Adaptation Syndrome (GAS), which is characterized by the appearance of emotional and behavioral symptoms in 4 Although is not my intention to discuss this point, we ought to keep in mind this lack of consensus regarding the concept of stress. 10
reaction to one or more psychosocial stress factors 5 (Association, 1994: 733). In the words of Cooper et al. (2001) Stimulus-based definitions of stress have their roots in physics and engineering, the analogy being that stress can be defined as a force exerted, which in turn results in a demand or load reaction, hence creating distortion. (Cooper et al., 2001: 18) 6. Proponents of the interactional approach to stress (or the process approach) measure stress in terms of the statistical interaction between the stimulus and the response (Cooper et al., 2001:11); it is a causeeffect model which principally concerns itself with external environmental structures rather than internal cognitive processes. According to Cooper et al., whereas the interactional definition of stress focuses on the structural features of the person s interaction with his or her environment, transactional definitions are more concerned with the dynamics of the psychological mechanisms of cognitive appraisal and coping that underpin a stressful encounter. (2001: 12) Thus, it appears that stress (in organizational settings) must be viewed from the perspective of a transactional approach Cooper et al., (2001); Cox, Griffiths, & Houdmont, (2006): this model allows for elaborate analyses of the stressor-response-outcome relationship. According to Cox et al., 2006, stress is essentially conceived as an excessive pressure. However, according to these researchers, pressure does not necessarily have an adverse effect on health; however, negative pressure does imply detrimental health effects. This definition is part of the transactional approach. Stress is the degree of match (or mismatch) between the demands and pressures on the person and his or her ability to cope with them. The concept of excessive pressure derives from the notion of mismatch. (Cox et al., 2006: 2) 2.2 Components of stress Stress is composed of four main components: stress (the process), stressors (stimuli), strain (responses to the stressors), and outcomes (consequences of strain) (Cooper et al., 2001). The components of stressors are manifold: physical stressors (e.g. noise, danger), task-related job stressors (e.g. overload), role stressors (e.g. role conflict and role ambiguity), social stressors (e.g. poor relationships), work schedule-related stressors (e.g. working time), career-related stressors (e.g. job insecurity), traumatic events (e.g. major accident), and stressful change processes (e.g. downsizing) 5 Free translation from French. 6 As mentioned by Cooper et colleagues (2001), these models have limitations (see later authors for more information). 11
(Sonnentag & Frese, 2003). Cox et al. (2006) claim that the sources of psychological hazards are twofold: context of work and content of work. The following table lists the hazards. Table 1 Adaptated table of psychological hazards at work Context of work Content of work organizational culture and function role in organization career development decision latitude / control work environment and work equipment task design workload / workplace work schedule interpersonal relationships at work Home-work interface Many organizational stress research studies have analysed the impact, the prevalence, and the nature of the stimuli (stressors, stress factors) on mental health. Indeed, we have an abundance of data on the impact of stressors on mental health. Stress reactions (strain or the consequences of stress) can take several forms and can act on different levels: individual, organizational, or non-professional. At the individual level, stress reactions can be physical (e.g. cardiovascular problems, musculoskeletal diseases, and long-term physical illness), behavioral (e.g. reduced performance and long term turnover) or affective (e.g. temporarily disturbed mood, or longer-term depression or burnout). Stress reactions can also have an impact at the organizational level: for example, interpersonal conflicts can lead to greater turnover. Finally, stress reactions can have consequences outside work, i.e. in private life. At the long term level, other areas of the individual s life can suffer from the consequences of stress reactions, such as chronic physical illness and diminished personal well-being (Sonnentag & Frese, 2003). 2.3 Stress models: An outline In the occupational stress literature, the relation between stress in the life of an individual and the consequences of this stress on health is well-documented. The central objective of most stress models is to 12
elucidate the relationship between stressors (or stressful situations) and strain reactions. Thus, in the following section, I will briefly present the following theoretical models in turn: the person-environment fit, the demand-control-support model, and the model of effort-reward imbalance at work. These models elaborate on the importance of the equilibrium between both individual and context (or the environment). Thus, if an individual is more predisposed to stress than others, certain environments will be more stressful than others for that individual. 2.3.1 The person-environment fit theory Originally developed by French, Caplan, and Harrison, 1982, the person-environment fit theory has its roots in the interactive perspective of psychology, which stipulates that well-being, behaviour, and attitude cannot be explained by the individual or the environment in isolation, but rather by the interaction of these two factors (Edwards, Caplan, & Van Harrison, 1998). The person-environment theory has been the inspiration behind the majority of stress models (Cooper et al., 2001). The idea underlying person-environment fit theory is the misfit between the individual and his or her environment; i.e. stress stems not only from the individual or the environment, but from a conflict between the two (Edwards et al., 1998). This conflict or misfit can be of three types: between the needs of the person and the stimuli (or supplies ) from the environment (needssupplies fit); between the demand from the environment and the abilities of the person (demands-abilities fit); between the objectivity and subjectivity of the environment and the person, respectively. 7 More precisely, an individual can have specific needs, such as the need for control, autonomy, or affiliation/social support/nurturance (Caplan, 1987). For example, Caplan (1987) mentions that an individual may need a certain level of task clarity; the work environment may or may not fulfill this need. Furthermore, the level of task clarity may be subjective: this is the needs-supplies fit. The demands-abilities fit is characterized by the worker s skills or by his or her aptitude for a given role. Thus, certain jobs require different skills, such as mathematical, social or analytical skills (Caplan, 1987). The worker's aptitude (or lack thereof) for a given task will determine the degree to which there is a "fit" or "misfit". Caplan summarizes the distinctions between these two concepts very well: 7 Commensurate dimensions is an aspect of the model (as we will see further on), but not a way of misfit. 13
In an exchange process, needs-supplies fit may represent the perspective of the employee asking what can I get out of this job? and of the employer asking what do I have to provide in order to keep this employee? On the other hand, demands-abilities fit represents the perspective of the employee asking what am I expected to provide in order to keep this job? and of the employer asking what do I want of the employee? (Caplan, 1987: 250) The objective and subjective dimensions refer to both the individual and the environment. Thus, the objective person and objective environment are described as the putative reality 8 (we supposedly refer to the facts and not to the perception of individuals). Thus, the objective person is characterized by the abilities, needs, and competencies of the worker, whereas the objective environment is associated with the supplies and the demands which really exist in this environment (Sonnentag & Frese, 2003). The subjective perspective is linked to the perception of the target (employee) (Caplan, 1987). Thus, four combinations of misfit are possible (Sonnentag & Frese, 2003): objective environment and objective person; subjective environment and subjective person; subjective and objective environment; subjective and objective person. The aspect of commensurate dimensions allows the conceptualisation and the measurement of the theory (Edwards et al., 1998). Thus, [ ] the degree 9 of fit between the person and the environment can be determined only if both refer to the same content dimension and can be measured on the same metric. Without commensurate dimensions, it is impossible to determine the proximity of the person and environment to one another, and the notion of P-E fit becomes meaningless. (Edwards et al., 1998: 31) Thus, strain appears when there is an imbalance between the person (his or her needs and abilities) and the environment (the demands and supplies of his or her surroundings). Because those needs, abilities, demands, and supplies are not satisfied, there is an ideal breeding ground for strain. To conclude, notwithstanding these interesting observations, it must be emphasized that there are few empirical studies to support the P-E fit theory (Cooper et al., 2001), and there is also a lack of longitudinal studies (Sonnentag & Frese, 2003) which have adequately tested this model. 8 As underlined by Caplan (1987), the idea of objective measure or what is the reality is a slippery ground. 9 Emphasis added. 14
2.3.2 Demand-control-support model Karasek s (1979) original model still conveys this idea of the ideal balance. In this case, it is a question of balance between job demand and job control. Essentially, job demand and job control can be low or high: when the demand is low and the decision latitude (job control) is low we have a passive job, whereas when the demand is high and the decision latitude is low, we have a job that produces a high level of strain. Conversely, a low job demand and high decision latitude represents a low strain job. Finally, a high demand and a high decision latitude is seen as an active job. According to Theorell, Karasek s model deals with factors that could be changed by means of organizational redesign (Theorell, 1998: 206) whereas Siegrist s model 10, the effort-reward balance, is a framework around the job situation. Figure 1 Reproduction of the psychological demand/decision latitude model Psychological demands Low High High Desicion latitude (control) Passive Low strain 3 Active 2 Psychological growth, development of new coping pattern Low 4 Highstrain 1 Risk of psychological strain and physical illness 10 I will come back to this model later. 15
The notion of control (here expressed by decision latitude) is central to the demand-control-support model. Indeed, the degree of control plays a significant role in psychological demand, and therefore upon health (Theorell, 1998). The decision latitude is the worker s capacity to influence decisions about the tasks, and to use and develop his or her skills (Theorell, 1998). More precisely, decision latitude is composed of two dimensions: authority over decisions and intellectual discretion. Authority over decisions refers to the capacity to make decisions about one s work, whereas intellectual discretion refers to the control that an individual has over the use and the development of his or her skills (Theorell, 1998). Karasek and Theorell (1990) have integrated the dimension of social support into Karasek s original (1979) model. Thus, the original model has been transformed into an updated demand-control-support model. In short, within this model, social support (from supervisor and coworkers) acts as a buffer, i.e., social support attenuates the negative effects of high demand and low control. Obviously, the absence of social support in a context of high demand and low control presents the greatest potential for strain. Since social support is a crucial factor in mental health at work, the following section must necessarily go beyond Karasek s model. I must emphasize the importance of social support, because as we will see, it is an important relational dimension 11. 2.3.2.1 Social support: An overview As for the concept of stress, social support is a central point of confusion. Caron and Guay (2005) underline the importance of not blurring the boundaries between the concepts of social support, personal social network, and social integration. Essentially, the social network refers to the whole of an individual s social links, whereas his social integration is the degree to which an individual participates in social relationships. 12 Cohen, Gottlieb, and Underwood (2000) as reported by Caron & Guay (2005) define social support as the exchange of certain social resources, such as emotional resources (e.g. showing interest), instrumental resources (e.g. giving help), or informational resources (obviously, giving information) by non-professionals. These resources are given in a context in which an individual responds to another s perception of the need for those resources. The social support takes place within interactions with members of the social network. House, 1981 describes social support in much the same way (in terms of instrumental, emotional, and 11 I will come back to this concept further on. 12 For more details on distinctions between theses concepts, see Caron & Guay (2005). 16
informational resource sharing), but adds what he calls appraisal support. As reported by Cooper et al., appraisal can be defined as providing feedback about the person s functioning that may enhance his or her self-esteem (2001: 141) There is a clear relationship between social support and health (e.g.: Schwarzer & Leppin, 1991); DeFronzo, Panzarella, & Butler, 2001; Caron & Guay, 2005; LaRocco, House, & French, 1980; Cohen et al., 2000). However, if there is a consensus regarding the influence of social support on health and psychological strain, there is no consensus about the way in which social support influences health (Cooper et al., 2001; Schwarzer & Leppin, 1991). Social support has also been considered as a direct effect (the greater the social support, the greater the perception of stressors); a mediating variable (the greater the social support, the less the stressors have an impact on the individual); and a moderator 13 (the degree of the individual s social support influences the relationship between stressors and strain) (Cooper et al., 2001). In the area of mental health at work, social support is an important variable and dimension in studies on stress. Social support is most often conceptualised as a buffer of stress (Ganster, Fusilier, & Mayes, 1986); in other words, social support moderates the stress-strain relation. (Ganster et al., 1986: 103). Social support can directly influence the effects of strain, or rather act as a buffer on the effects of stressors (Beehr, King, & King, 1990). Thus, if a work environment is polluted with many different stressors or with a few powerful stressors, they will not necessary have an impact (or the same impact) on workers. If workers have resources, they can cope 14. Thus, in organizational stress, social support is often considered as a resource. Many studies have examined the effect of social support on mental health In the case of Karasek s model, social support acts as a buffer. 2.3.3 Model of effort-reward imbalance at work Johannes Siegrist s effort-reward imbalance model is a variant of the P-E Fit theory (Sonnentag & Frese, 2003). For good reason, this model is also based on the idea of equilibrium. In this case, it is a question of the balance between effort and reward. 13 Also called the buffering effect. 14 Coping can be define as a constantly changing cognitive and behavioral efforts to manage specific external and/or internal demands that are appraised as taxing or exceeding the resources of the person. (Lazarus & Folkman, 1984: 141) 17
The effort is produced by the individual as a response to a demand. The demand can be of either an intrinsic or an extrinsic nature. An intrinsic demand is the personal side of a demand, i.e. an individual s motivation, his or her need for control. In short, it is pressure 15 that an individual puts on himself or herself. The need for control is a [ ] personal pattern of coping with the demands at work. It is likely that persons with high need for control spend high costs in terms of energy mobilization and job involvement even under conditions of relatively low gain. This may be explained partly by the characteristics of their perceptual and attributable style, partly by the self-gratifying experience of being in control of a challenging situation. (Siegrist, 1996: 30) Extrinsic demand refers to the situation, i.e. the exigencies related to the situation, exigencies over which the individual has no control. The reward comes from three transmitter systems 16 : money, esteem (approval), and status control (Siegrist, 1996, 1998). To summarize briefly, inadequate esteem, consideration or remuneration concomitant with great efforts will positively correlate with distress. Siegrist (1996, 1998) emphasizes the third transmitter system (status control): The notion of status control evolved from our interest in those aspects of occupational life that threaten a person s self-regulatory functions, his or her sense of mastery, efficacy, and esteem by evoking strong recurrent negative emotions of fear, anger, or irritation (Siegrist, Siegrist, & Weber, 1986: 192). In other respects, Siegrist claims that, contrary to other models (such as the demand-control model), the model of effort-reward imbalance at work does not put the focus on control, but rather on reward: The core assumption of this model maintains that the work role in adult life defines a crucial link between self-regulatory functions such as self-esteem and self-efficacy and the social opportunity structure. In particular, the availability of an occupational status is associated with recurrent options of contributing and performing, of being rewarded or esteemed, and of belonging to some significant group (e.g. work colleagues) [ ] Effort at work is spent as part of a socially organized exchange process to which society at large contributes in terms of rewards. (Siegrist, 1998: 192) 17 Thus, because the lack of reciprocity between effort and reward is a stressful experience, this discrepancy is associated with strain. In other words, high effort accompanied by low reward causes stress. Essentially, the 15 Not in a negative way. 16 So called by Siegrist (see, among others, 1996, 1998). 17 I will come back to that difference between control and reward further on. 18
model of effort-reward imbalance at work claims that lack of reciprocity between costs and gains (i.e., highcost/low-gain conditions), defines a state of emotional distress with a special propensity to autonomic arousal and associated strain reactions. (Siegrist, 1996: 30) While the demand-control-support model addresses the notion of relationship as a social support dimension, Siegrist s model deals with the idea of reward, which, it is implied, is within the context of a relationship. These concepts will be dealt with in greater depth later on. 2.4 The multidimensional theory: A strain-focus approach In light of the previous models, the multidimensional theory of burnout is quite different from other models. Indeed, burnout is a stress response, a negative outcome of the process of stress. More precisely, [b]urnout is defined as a psychological syndrome of exhaustion, cynicism, and inefficacy, which is experienced in response to chronic job stressors. (Leiter & Maslach, 2004: 93). Although burnout is widely recognized as a health hazard (by physicians, organizations, and researchers), to date, the psychiatric diagnostic of burnout is either depression or GAS; burnout is not at least, not yet a psychiatric disorder 18. According to Maslach, the roots of the three dimensions of burnout 19 come from the reality of people and not from theoretical foundations: The term itself illustrates this point: burnout had popular origins, not academic ones. (Maslach, 1998: 69). 2.4.1 Dimensions of burnout There are three principal dimensions of multidimensional theory (or burnout model): emotional exhaustion, depersonalization, and reduced personal accomplishment (Maslach, 1998; Maslach & Jackson, 1986; Brotheridge & Grandey, 2002). Among these three dimensions, emotional exhaustion is the central quality of burnout - that is to say, it is the most analyzed, the most frequent, and the most obvious dimension (Maslach, 1998; Maslach, Schaufeli, & Leiter, 2001). Although emotional exhaustion is an essential criterion to consider when dealing with the concept of burnout, it is by no means the only one, and is an insufficient one at that. 18 Currently, some researchers, such as Sonia Lupien (e.g.: Pruessner, Hellhammer, Pruessner, & Lupien (2003)), are researching the differences in the physiological markers between depression and burnout, stress and burnout. 19 Also called the multidimensional theory. 19
Emotional exhaustion represents the individual side, the individual s experience of stress and leads to feeling tired and worn-out emotionally. Dehumanization (or cynicism) is part of the interpersonal aspect of burnout. This dimension is manifested by an attitude of detachment from and callousness toward coworkers and work in general. When emotional exhaustion is too strong, depersonalization is likely to occur. Reduced personal accomplishment refers to the individual s evaluation, that is to say, to his or her selfevaluation of his or her performance; the individual feels inefficient and unproductive at work. These feelings of inefficiency correlate with and are often caused by exhaustion and cynicism (Brotheridge & Grandey, 2002; Leiter & Maslach, 2004; Maslach, 1998; Maslach & Jackson, 1986). Although burnout shares some features of depression disorder and anxiety 20, both are nonetheless distinct. According to Maslach (1998), five characteristics distinguish burnout from depression: dysphoric symptoms (mental and behavioural) are more significant than the physical symptoms; symptoms are linked specifically with work; burnout or symptoms of burnout can appear without a history of psychological or psychopathological disorders; negative behaviors and attitudes lead to diminished work performance and effectiveness (Maslach, 1998: 79) Furthermore, the multidimensional theory does not concern only the burnout aspect but also the notion of engagement 21, in opposition to burnout, has been developed by the work of Leiter & Maslach (1998). Thus, the relevance of multidimensional theory lies in the fact that it is not merely a reaction/response stress model, but according to Maslach (1998), a continuum: we can experience not only burnout, but also its opposite, engagement: The concept of a burnout-to-engagement continuum enhances our understanding of how the organizational context of work can affect workers well-being. It recognizes the variety of reactions that employees can have to the organizational environment, ranging from the intense involvement and satisfaction of engagement, through indifference to the exhausted, distant, and discouraged state of burnout. (Maslach, 1998: 73) 20 For more information see Maslach & Jackson, 1986). 21 Leiter and Maslach (2004) emphasize that, here, the concept of engagement differs from the concept of organizational commitment, job satisfaction, or job involvement as conceptualized in organizational psychology literature. For more details, see Leiter and Maslach (2004). 20
More precisely, engagement is defined by the following dimensions: energy (opposed to exhaustion), involvement (opposed to depersonalisation), and sense of efficacy (opposed to reduced personal accomplishment); in short, it is the positive side of the engagement/burnout continuum. 2.4.2 Burnout: A relational model Unlike previous stress models and other stress reactions, the distinctive and relevant feature of multidimensional theory is that it emphasizes the relational perspective and the social context of the stress experience; it is a multidimensional and socially contextualized model. As Maslach argues: The significance of this three-dimensional model is that it clearly places the individual stress experience within a social context. What has been distinctive about burnout (as opposed to other kinds of stress reactions) is the interpersonal framework of the phenomenon. The centrality of relationships at work- be it relationships with clients, colleagues or supervisors-has always been at the heart of descriptions of burnout 22. These relationships are the source of both emotional strains and rewards, they can be a resource for coping with job stress, and they often bear the brunt of the negative effects of burnout. (1998: 69-70) Although certain relationships are essential and can provide positive outcomes (e.g. by virtue of the social support they provide), some relationships can also be deleterious to individuals. Indeed, Leiter and Maslach have showed the importance of relationships in relation to burnout: A post hoc analysis suggests that there are direct negative relationships between unpleasant supervisor contacts and organizational commitment and a positive relationship with pleasant coworker contacts and organizational commitment, in addition to the relationship with burnout. Together, the results suggest that interpersonal relationships at work may be instrumental in explaining the variation in stress reactions within a worksetting which is homogeneous in regard to job stressors. (1988: 305) Thus, the experience of stress is certainly an individual experience, but it is experienced in a social context through social relationships (Maslach, 1998). Moreover, according to Leiter and Maslach (2004), social support from supervisors, coworkers and family was the first variable to be analysed in burnout research. Supervisor support has been more consistently associated with exhaustion, reflecting the supervisors impact on staff members workload. Coworker support is more closely related to accomplishment or efficacy, reflecting the value staff members put on the expert evaluation by their peers. (Leiter & Maslach, 2004: 98) 22 Emphasis added. 21
2.5 Managers practices: An emerging model The more recent Managers practices model is also concerned with mental health at work; more specifically, with the influence of managers practices (or competencies) on employees mental health (or stress). In brief, managers can be viewed either as a protective factor from stress, or as a risk factor to induce it. Indeed, in terms of mental health at work, managers are key players, in the sense that they have the capacity to act on the main acknowledged risk factors: workload, participation in decision making, employee recognition, and so on. The scientific literature clearly shows that managers behaviour has an impact on employees physical and mental health. For example, a manager s abusive supervision considerably increases stress among employees (e.g.: Tepper, 2000), whereas the support they provide can considerably reduce employees stress levels (Viswesvaran, Sanchez, & Fisher, 1999). However, one thing which remains unclear is which management practices have an impact on mental health. As Gilbreath and Benson point out, [i]t is likely that there are particular types of supervisor behaviours that promote employees psychological well-being, and it will be important to know what they are. (Gilbreath & Benson, 2004: 263). Some studies have thus begun to identify specific management practices that have an impact on mental health (e.g. Yarker et al, 2007; 2008). For example, in their first research phase, a content analysis of 382 interviews with managers (166) and employees (216) from 5 different areas (education, finance, local government, central government and healthcare), Yarker, Donaldson-Feilder, Lewis, and Flaxman (2007) have come to identify 19 competencies identified as having an impact on work stress. These competencies are summarized in Table 2. 22
Table 2 Reproduction of the competencies for preventing and reducing stress at work Management competencies managing workload resources dealing with work problems process planning and organisation empowerment participative approach development accessible/visible health and safety feedback individual consideration managing conflict expressing and managing emotions acting with integrity friendly style communication knowledge of job taking responsibility empathy seeking advice In the second phase of their research, Yarker, Lewis, and Donaldson-Feilder (2008) have developed a stress management competency indicator tool. Their analysis allowed them to identify 4 factors: respectful and responsible: Managing emotions and having integrity; managing and communicating existing and future work; reasoning/managing difficult situations; and managing the individual within the team. These factors were then divided into sub-clusters, as shown in table 3. 23
Table 3 Reproduction of the interpretation of factors and sub-clusters Factors Factor name Sub-clusters 1 respectful and responsible: Managing emotions and having integrity integrity managing emotions considerate approach 2 3 4 managing and communicating existing and future work reasoning/managing difficult situations managing the individual within the team proactive work management problem solving participative/empowering managing conflict use of organisational resources taking responsibility for resolving issues personally accessible sociable empathetic engagement This model is integral to the relationship between the manager (or supervisor) and the employee. Indeed, it is plain to see that the competencies enumerated here cannot but be experienced within the manageremployee relationship - all the more so regarding such relationship-oriented competencies as respectful and responsible: Managing emotions and having integrity and managing the individual within the team. This idea will be dealt with in greater depth later on. 3. Emotion and stress: Two areas In addition to the research on models of stress, there is a significant body of research on emotions at work and their influence on psychological and physical health (e.g.: Brotheridge & Grandey, 2002; Morris & Feldman, 1996; Pugliesi, 1999; Scaubroeck & Jones, 2002; Zapf, 2002). However, stress models and emotion models at work are rarely addressed in tandem. Moreover, this separation of both research areas can be explained by the conceptualization and the definition of the concept of stress and emotion. Is stress an emotion, or is emotion a component of the stress process? For some psychologists, stress is not considered an emotion, but as a source a component that generates emotions. For others, stress is a consequence of felt emotions. For example, in people s lives, events and difficulties make demands they cannot cope with. These are the stresses [sic]. Children may experience loss of parents, or a parent not caring for them, or two parents fighting all the time. If a child is stressed, that child s emotional state and behaviour can become disordered (Oatley & Jenkins, 1996: 248). Nevertheless, the concept of stress is 24
intrinsically linked to emotions. For Lazarus, stress can be considered an aspect of emotion: Everything that could be learned from stress in the understanding of human adaptation and dysfunction can also be learned form the study of the emotions. (Lazarus, 1993: 36). Although the importance of the concept of stress can be debated, it is my view that we must not underestimate the significance of existing research on emotions regarding our understanding of mental health. As mentioned by Cooper et al., the lack of explicit attention to emotions in job stress research is disconcerting. (2001: 70) The model of burnout, for example, illustrates well this congruence with emotion: burnout includes, among other things, the dimension of emotional exhaustion. Recall that [t]he initial work on burnout did not begin with a clearly-defined phenomenon or a particular theoretical model. Indeed, the research did not even begin with a focus on burnout at all. Rather, it emerged out of a program of research on emotion-how people understand their feelings and how they cope with these 23 when they become especially intense (Maslach & Schaufeli, 1993). (Maslach, 1998: 70) Beyond this distinction, research on emotion is illuminating with regard to our understanding of mental health at work. Thus, work on emotion in the workplace provides another point of view on mental health in organizational settings. However, though the literature on emotions and health is copious, the interest in emotions in the context of the workplace is quite recent (Zapf, 2002); Richard, 2006). The aim of the next section is to present the links and the associated concepts of emotion and mental health at work 24. 3.1 Emotions: An overview of its definition(s) and mechanisms First of all, I want to emphasize that defining the concept of emotion is no slight task. Indeed, several authors stress the persisting difficulty of appreciating the finer strokes from the broad brush often used to portray this concept (e.g.: Oatley & Jenkins, 1996; Zerbe, Härtel, & Ashkanasy, 2000; Gallo, Ghaed, & Bracken, 2004). For Mandler, too many psychologists still fail to accept today, that there is no commonly, even superficially, acceptable definition of what a psychology of emotion is about (Mandler, 1984: 16). Ashkanasy, Hartel, and Zerbe (2000) claim that we can accept that several definitions exist, because a universal definition is impossible. In addition, there is no consensus among others about the distinction (if indeed there is a distinction to be made) between emotion, feeling, mood, or affect (Russell & Lemay, 2000). 23 Emphasis added. 24 The relation between emotion and physical health is quite well demonstrated. By a way of example, there is a relation between negative emotions and asthma (e.g.: Friedman & Booth-Kewley, 1987); negative emotions and diabetes (e.g.:lustman, Frank, & McGill, 1991) or anger and aggressiveness emotions and coronary heart diseases, as blood pressure works (e.g.: Rutledge & Hogan,2002; Kop, 2003). 25
According to Oatley and Jenkins, the definition of emotion is the following: 1. An emotion is usually caused by a person consciously or unconsciously evaluating an event as relevant to a concern (a goal) that is important; the emotion is felt as positive when a concern is advanced and negative when a concern is impeded. 2. The core of an emotion is readiness to act and the prompting of plans; an emotion gives priority for one or a few kinds of action to which it gives a sense of urgency so it can interrupt, or compete with, alternative mental processes or actions. Different types of readiness create different outline relationship with others. 3. An emotion is usually experienced as a distinctive type of mental state, sometimes accompanied or followed by bodily changes, expressions, actions. (1996: 96) In short, an emotion constitutes an answer to the evaluation of an event, which in turn leads to certain actions. Emotions can be considered either as stable dispositions or as situational reactions to precise stimuli. When emotions are conceived from the dispositional view, they are considered to be the result of a general temperament of an individual and are thus stable in time and are relatively unpredictable for each situation. Conversely, within a situational perspective, each individual emotion is associated with a precise stimulus and is predictable according to the situation: for example, seeing a newborn causes happiness, whereas seeing a bear causes fear, regardless of individual predispositions. Thus, emotions are complex and are influenced by both individual and environmental variables: on the one hand, individuals can be predisposed to specific emotional experiences, while on the other hand, context and conditioned emotional stimuli also impact the nature of these emotional experiences. As we shall see, this remark will be pertinent for my project as we will examine the effect of work organization on emotions. As for the disposition/situation distinction, a further classification of emotions into two category types is also possible, i.e. positive and negative emotions. While negative emotions are frequently correlated to various adverse effects and psychopathology (e.g. anxiety, depression, personality disorders), positive emotions are generally viewed as a protective factor. However, this relation between positive emotions and the protective factor can often be blurred. Well-being and euphoria can led to a maniac state and externalization disorders, such as conduct disorders, delinquency, and substance abuse. These considerations accentuate the crucial role of emotional regulation, which serves to attenuate immediate reactions and action tendencies, which, in their turn, modulate subjective experience and an appropriate expression of emotions. 26
3.2 Emotional regulation People differ in their way of coping with emotions. Emotional regulation develops during childhood, in tandem with language acquisition. It is during this period that children learn to express their emotions of rage or joy, for example Oatley and Jenkins (1996). Even if emotional regulation is a complex concept, Thompson essentially defines it as the extrinsic and intrinsic processes responsible for monitoring, evaluating, and modifying emotional reactions, especially their intensive and temporal features, to accomplish one s goals (Thompson, 1994: 27). While an individual can not cope with or control his or her emotions, we speak of emotion dysregulation, which is linked to psychopathology (Oatley & Jenkins, 1996). 3.3 Emotions in the workplace The workplace context is unique in that it calls for the management, the regulation of emotions (see, among others, (Lhuillier, 2006). Indeed, according to the job type or the worker s position, workers can be required to manage or regulate their emotions. For example, in the services sector, workers have to control their emotions on a regular basis; a large part of their job entails this type of control (an obvious example would be employees working in complaint offices or in support relationships). In addition, relationships with colleagues and superiors are fertile ground for the development of strong emotions, both positive and negative. For example, recognition or rewards from a superior or, conversely, victimization or discrimination can both lead to positive or negative strong emotions. Indeed, much of the literature relating to emotions in the workplace address, for example, the following issues: emotion and organizational behavior, emotion and leadership, or emotion and performance. I want to underline that those concepts are not approached from a mental health perspective. However, the construct of emotional labor deals with emotions felt in the workplace context, and more particularly, on the regulation of emotion in the workplace. As mentioned by Lhuillier, for example, emotions can be both the effect and object of work. Emotions are the effect because work activity is trying for the individual, and are thus the cause of work. This perspective of suffering in work has lead toward research on organizational stress. In other respects, emotion is seen as an object, because it can be considered as a tool or ressource, i.e. we work from emotions, as we work from intelligence 25 (Lhuillier, 2006). 25 Some parts of the author s words are a free translation from French. 27