Anger Management Blog

Disruptive Physician Behavior and JCAHO Standards

info@ami-tx.com — Sun, 07 Sep 2008 15:45:00 GMT

When I speak with hospital administrators, many times the topic of disruptive physician behavior comes up. Now that has some obvious reasons. Disruptive physician behavior can damage the hospitals reputation tremendously and it can cost the organization lots of money. It is actually estimated that unnecessary turnover rates alone costs health care organizations more than $150,000 per disruptive physician. Additionally, a new survey about physician-nurse relationships uncovers a strikingly high prevalence of disruptive physician behavior that is affecting nurse retention. It showed that disruptive behavior by physicians is contributing to fuel the nationwide nursing shortage, heavily impacting job satisfaction and morale for nurses.The survey results also revealed the seriousness of the issue and highlight a lack of physician awareness, appreciation, value and respect for nurses.

As a result, disruptive physician behavior has a negative impact on patient quality care and increases the likelihood of medical errors.Now what is disruptive physician behavior? There are many definitions available; however, the American Medical Association sums it up succinctly by “defining disruptive behavior as a style of interaction with physicians, hospital personnel, patients, family members, or others that interferes with patient care.” Obviously, disruptive behavior cannot be neglected and needs to be addressed at the organizational level. Of course every hospital has a process in place how they address those kind of interferences but unfortunately, the success rates are many times not as high as they envision them. So what else can be done to reduce disruptive behavior? When you look at the incidences closely, you can see that disruptive physician behavior is the result of a lack of self-management, a lack of interpersonal skills or both. No physicians gets up in the morning with the intention of cussing a nurse out, interrupting the success of their surgery by throwing instruments through the OR, or screaming at a hospital administrator. I don’t think that any physician has such bad intentions because then they would definitely not be suited for this profession and should look for a job where human interactions are non existent.

Instead, I look at disruptive physician behavior as a sign that their self-management and interpersonal skills are underdeveloped. At the end disruptive behavior is the symptom of an underlying cause, call it frustration with life, overwhelm with their professional responsibilities, inability to cope with the demands of life, incapability to effectively communicate with people. Handing the physician a warning or having a conversations with the physician about repercussions will not cure the behavior but rather only band aid on it. In order to get to the source of the behavior, the conversations and the revelations have to go deeper and need to address topics such as:- how to effectively control oneself in stressful situations- how to resolve conflict with a win-win outcome- how to communicate effectively in any kind of situation- how to resolve frustrations and strive to create more harmony and balance in one’s life and many more.

As a result, rather than educating and lecturing physicians about the negative consequences of their behaviors, hospitals need to invest time and resources into preventative workshops that address those skills, performing self-assessments, increasing staff awareness of the issue, opening lines of communication and creating great collaboration among peers.If hospitals don’t do this, the problem will continue to grow and patients, nurses, and the financial situation of the organization will continue to needlessly suffer. An ounce of prevention is worth a pound of cure.”- Henry de Bracton, De Legibus in 1240. I look forward to your comments and hearing from you.

By Iris Grimm

Anger Management Institute of Texas is a certified Anderson & Anderson ® provider.

Anger Management Classes and Anger Management - Executive Coaching available in Houston, Texas.

Gregory A. Kyles, M.A., LPC, CEAP, CAMF
Director, Anger Management Institute of Texas
Diplomate, President of Texas Chapter
American Association of Anger Management Providers
http://www.ami-tx.com
http://www.ami-tx.org
http://gregorykyles.wordpress.com
http://www.linkedin.com/in/gregorykyles
http://www.myspace.com/anger_management_expert

Costs of Coworker Bullying: Anger Management Training Needed in the Workplace

info@ami-tx.com — Fri, 05 Sep 2008 22:20:00 GMT

Workplace bullying has been a hot topic since the release of the 2007 Zogby survey, which showed that 49% of American workers report that they’ve been the target of a bully’s bad behavior. Employers have begun instituting tolerance training and implementing respectful-workplace policies. Awareness is key in preventing this prevalent workplace disease. One way to make top management place value on eliminating jerks at work is to talk dollars.

Bullying costs companies big money. Here are some of the ways that your bottom line is directly affected if you fail to eradicate bullying at work:

1. Targeted employees have higher absenteeism rates

Wouldn’t you? When the workplace becomes increasingly intolerable and unpleasant, people stop coming to work.

2. Decreased productivity

Those who do manage to get themselves into work are less productive. They’re nursing emotional wounds, meaning they’re more likely to hide in their office than dare engage with others at the risk of being put on the firing range. Stress-related illness is not conducive to high productivity, either. If you don’t feel well, you’re not putting your best efforts into your work.

3. High turnover

Replacing an employee can cost a business up to 3 times that employee’s yearly salary. And dedicated, enthusiastic employees are not easy to find. Yet, employees who are bullied at work will almost certainly leave. Some leave because of their health. Others leave because the bully has succeeded in sabotaging their reputation.

4. Unhealthy Employees Are Expensive

Employers have campaigned to rid the workplace of smokers, who are more costly to insure. Obese employees may be next on the list. But what about bullied employees? Targets are affected with depression, anxiety, post-traumatic stress disorder, which is especially common with male targets, and other stress-related illnesses. Physiological illnesses, such as headaches and backaches.

5. Infected-Workplace Syndrome

As devastating as these effects can be, they can, and likely will, get worse. Bullies are infectious and contagious. Other employees who witness bullying behavior feel sympathy for their coworkers and guilt for doing nothing about it. They shrivel up, just like the target, in the fear that the bully will turn his or her anger towards them next.

Posted by Molly DiBianca On August 18, 2008 In: Jerks & Bullies at Work

Anger Management Institute of Texas is a certified Anderson & Anderson ® provider.

Anger Management Classes and Anger Management - Executive Coaching available in Houston, Texas.

Effective Stress Management Skills

info@ami-tx.com — Thu, 04 Sep 2008 03:09:00 GMT

The only thing constant in life is change. And change is often coupled with stress. Stress occurs as we try to adjust and cope with the constant changes in our lives. It affects us physically and emotionally, positively and negatively. It can trigger feelings of depression, anger and fury. But it can also give us a sense of excitement and accomplishment as we try to cope with everyday challenges and pressures. When stress takes over our lives we often find ourselves victims of health issues like ulcers, high blood pressure and strokes.

A certain amount of stress is both welcome and necessary to curb our feelings of boredom and to add meaning to our lives. However, we have to check ourselves from going over-the-top and distressing about things that we have no control over. Stress can distract us from our goals since our vision often gets hazy and we fail to look at the bigger picture. If this happens you have to try to minimize stress in your life or at least attempt to take it in your stride.

Stress is experienced across all walks of life no matter how old you are. A student stresses about examinations and education, a teenager stresses about superficial things like clothes, cars and cell-phones, a field employee worries about incurring the wrath of his supervisor, a supervisor is anxious about reporting to the management. The management on the other hand stresses about responsibility towards the clients. Married couples have financial and child-related anxieties. So, no matter who we are, how old we are and how rich we are, there is no escaping this thing called stress. We have to learn to live with it just like we live with an annoying neighbor or a physical imperfection we’re not too happy about.

Stress management is of supreme importance if we don’t want stress to sneak in and take hold of our lives. There are some techniques we can use to control stress. Exercise is an ideal stress-buster. It helps you shape-up and prevents you from dwelling on disturbing thoughts. Yoga and meditation also relieve stress to an extent. Laughter is the best medicine. When we laugh we feel wonderful and momentarily forget our worries. Laughter therapy is used to reduce tension and anxiety attacks. Watching television and comedy shows provides a temporary escape. If you’re pious, you can also try praying or visiting your place of worship. It can help you experience a sensation of peace and harmony. Listening to soothing music and having a relaxing massage also alleviates stress. If stress is managed properly it can stimulate us to reach heights of success we wouldn’t normally have reached if those stressful situations weren’t around to fling us into action.

Stress and Anger Management: Stress and anger are closely related emotions. Stress that cannot be handled constructively spills into bouts of rage and fury. While stress is something that’s always within us, anger is a fleeting emotion that comes in moments of great stress and vanishes thereafter. Anger is much more destructive than stress. Therefore controlling and managing it is the need of the hour. Anger management techniques are similar to those of stress management. Counting to ten or even twenty can help when you feel like you’re bursting out of control. Avoid discussing sensitive and provocative issues when you’re experiencing a fit of temper. Expressing feelings and focusing on getting a positive attitude goes a long way in keeping stress and anger at bay.

The most important thing is to recognize and accept is that stress exists and if kept in check can actually become a good friend to have.

Anger Management Institute of Texas is a certified Anderson & Anderson ® provider.

Anger Management Classes and Anger Management - Executive Coaching available in Houston, Texas.

Gregory A. Kyles, M.A., LPC, CEAP, CAMF
Director, Anger Management Institute of Texas
Diplomate, President of Texas Chapter
American Association of Anger Management Providers
http://www.ami-tx.com

http://www.ami-tx.org
http://gregorykyles.wordpress.com
http://www.linkedin.com/in/gregorykyles
http://www.myspace.com/anger_management_expert

Anger Management Makes Unprecedented Inroads in Health Care, Criminal Justice and Business

info@ami-tx.com — Thu, 04 Sep 2008 03:07:00 GMT

Health Care

The Joint Commission on the Accreditation of Health Care Organizations is requiring new standards for “disruptive behavior” among professional healthcare staff. Disruptive physician behavior has been determined to increase medical errors and risk patient safety. These new requirements have created a Cottage Industry for specialized anger management facilitators nationwide. Resources designed to address this issue are now available on-site as well as locations in a number of major cities.

The dramatic rise in the incidence in “traumatic stress disorder” among returning Iraq veterans has increased the need for Clinical Social Workers, Psychologists and Psychiatrists to seek certification training in anger management since person directed aggression is a chronic problem for veterans with this diagnosis. As experts in the treatment of post- traumatic stress disorder, VA Hospitals and Veterans Resource Centers are aware of the need for specialized intervention for PTSD.

Criminal Justice

The state of New York joins California and Texas in offering anger management in jails and prisons for inmates whose original offense included person or property directed violence. Research conducted by the Bureau of Prisons in Canada and Australia have demonstrated the value of anger management in the reduction of recidivism in violent prison inmates. California now requires anger management for inmates as well as parolees prior to completion of their parole status.

Business And Industry

The average cost of litigation in alleged cases of a “hostile work environment” is $720.000 per case. Businesses small and large have quickly discovered that offering anger management for interpersonal conflicts at work is a saving rather than a cost.

Organizational anger management can be offered by Certified Anger Management Facilitators to small groups of 10 to twenty participants. These courses are between two and four hours. The are proactive and are designed for prevention. Prevention is far less costly than crises intervention following a violent incident at work.

For many years, “going postal” was used to describe employees whose workplace violence led to injury or death. Eight years ago, the U.S. Postal Service began offering anger management on the clock, without cost to any postal employee. In addition, employees who appeared to be experiencing stress or anger at work were mandated to take anger management classes. This approach was so successful, one rarely hears of violence in the Postal Service.

Pre-employment anger assessments are excellent in weeding out potentially aggressive employees. Pre and Post Tests are routinely used for employees mandated by their HR Managers for aggressive/inappropriate behavior at work.

In Summary

Anger management is one of the most rapidly growing interventions in human services. Anger management is a course offered in an individual coaching format for physicians and executives or in small groups for referrals from a wide range of organizations including Health Care, Criminal Justice and Business. All anger management courses must begin with a non-psychiatric evaluation that is designed to determine the clients level of function in recognizing anger, stress, assertive communication and emotional intelligence.

For anger management resources, visit the website of The American Association of Anger Management Providers at www.aaamp.org

By George Anderson, MSW, BCD, CAMF, CEAP http://www.andersonservices.com/

Anger Management Institute of Texas is a certified Anderson & Anderson ® provider.

Anger Management Classes and Anger Management - Executive Coaching available in Houston, Texas.

E-Rage: the new cause of office stress

info@ami-tx.com — Thu, 28 Aug 2008 02:04:00 GMT

August 20, 2008 by twentzphd

If you see one of your colleagues hitting, kicking or throwing their computer, they might be suffering from what Eclipse Internet calls E-rage.

Eclipse recently carried out a survey into the effects of email downtime on business owners and workers. They found that for some, the frustration of not having access to email can see them resort to extreme measures in an attempt to ‘fix’ the problem.

In Newcastle upon Tyne, a whopping 77% of office workers and company owners agree that e-mail downtime causes major stress at work. But it would seem that office workers in this city are less prone to E-rage than in other parts of the UK. Only 6% of workers in Newcastle would take out their frustration by kicking their PC compared to 18.5% in what appears to be a very angry Glasgow.

Mark Thomas from Eclipse Internet said: “We wanted to understand the impact of email downtime on small business owners. We know that in at least 40% of small companies email is set up and maintained by unqualified personnel. As a result, these companies are more susceptible to suffering the consequences of E-rage. For those companies that do outsource their email, levels of E-rage are much lower.”

Coincidentally, Eclipse Internet provides businesses with a service designed to reduce email downtime. Who’d have thought it?

Anger Management Institute of Texas is a certified Anderson & Anderson ® provider.

Anger Management Classes and Anger Management - Executive Coaching available in Houston, Texas.

Work Bullies

info@ami-tx.com — Mon, 18 Aug 2008 04:12:00 GMT

Work bullies can ruin a culture, destroy productivity and make your life — and those of everyone else they target — miserable.

And it’s not just bullying bosses who are the problem. Co-workers and employees also use bullying behavior, which creates a hostile workplace.

Excluding lethal weapons, here are the top dozen techniques bullies use to ruin a workplace.

-Yelling, physical threats and throwing things. This in-your-face method makes targets think actual physical attacks will follow.

-Verbal abuse, emotional intimidation and personal insults in private and public. This includes put-downs and demeaning, rude or cruel comments.

-Harassment based on race, religion, gender and physical attributes. Sexual contact, lewd suggestions, name-calling, teasing and overtly nasty personal jokes. Stealthy bullies often follow their put-downs or threats by laughing and saying “I was just kidding” to make it hard for their targets to fight back.

-Backstabbing, spreading rumors, manipulating, lying, distorting, hypocrisy and exposing your personal problems and performance mistakes. Repeated character assassination is another favorite technique.

-Taking the credit for the work of others. Never accepting blame, but instead spreading the blame to blameless employees. Withholding information and then cutting targets down for failing in a task because they didn’t know the crucial information.

-Anonymous attacks and cyber-bullying — flaming e-mails, personal innuendos, threats and porn. Invading the personal space and privacy of targets by rummaging through desks, listening to phone calls, asking personal questions and eating their food.

-Hypersensitive over-reactions, throwing tantrums. Bullies want to train others to walk on eggshells, back off in order to avoid a scene or beg forgiveness as if they really did something wrong.

-Dishonest evaluations, through praising and promoting favorites and destroying the careers of targets.

-Demeaning meetings: yelling, pointing fingers, interrupting, ignoring, derisive laughter or snorts, and nonverbal comments behind targets’ backs, such as rude noises, facial gestures, answering a phone or text messaging, or working on a computer.

-Forming cliques and ganging up to harass and demean. Perpetuating turf wars about budgets, hiring, etc.

-Micromanaging everything. Bullies make it clear they believe other people are so stupid and incompetent that the bully has to do everything to make sure it’s done right.

-Managing in a panic. Waiting until the last minute so everyone moves from crisis to crisis. Making every task a matter of life or death, so people are continually pressured.

Most bullies use combinations of these methods. The relentless application of these techniques reinforces humiliation, pain and fear. It can make the targets feel helpless and that the situation is hopeless.

We’ve all seen the effects of bullies and the hostile workplaces they create. Teamwork, productivity, responsibility, efficiency, creativity and reasonable risk-taking decrease. Promotions are based on sucking up to difficult people, not on merit. The best people leave as soon as they can.

Your operational system may look wonderful on paper, but the wrong people in the wrong culture always can find ways to thwart it. Your pipeline leaks money and profits plummet. It’s possible to turn these terrible situations around. But it takes time, perseverance and processes tailored for each specific situation. You also need a leader dedicated to wiping out these behaviors.

A common mistake in dealing with bullies is trying to educate, explain, understand, accept, forgive, beg, bribe, ignore, reason with or appease them. These approaches won’t convert dedicated bullies into reasonable, civil and professional people. These approaches only stop people who aren’t really bullies, but have behaved badly one time.

Determined bullies don’t take your understanding and acquiescing as kindness. They take your giving in as weakness and an invitation to abuse you more. Bullies bully repeatedly and without real remorse. They might appear to apologize sincerely, but you should accept only behavioral change, not good acting.

The best way to stop a bully is to stand up to them. Expose and isolate them. Or catch them doing something outrageous or illegal in front of witnesses.

LEICHTLING is a Denver-based leadership adviser. Contact him at Ben@LeichtlingAssoc.com.

Anger Management Institute of Texas is a certified Anderson & Anderson ® provider.

Anger Management Classes and Anger Management - Executive Coaching available in Houston, Texas.

Assertiveness Skills

info@ami-tx.com — Thu, 07 Aug 2008 03:22:00 GMT

Assertiveness is a way of thinking and behaving that allows a person to stand up for his or her rights while respecting the rights of others. Nonassertive people may be passive or aggressive. Passive individuals are not committed to their own rights and are more likely to allow others to infringe on their rights than to stand up and speak out. On the other hand, aggressive persons are very likely to defend their own rights and work to achieve their own goals but are also likely to disregard the rights of others. Additionally, aggressive individuals insist that their feelings and needs take precedence over other people’s. They also tend to blame others for problems instead of offering solutions.

Assertive attitudes and behaviors are at the heart of effective advocacy. A person with an assertive attitude recognizes that each individual has rights. These rights include not only legal rights but also rights to individuality, to have and express personal preferences, feelings and opinions. The assertive individual not only believes in his or her rights but is committed to preserving those rights. An assertive attitude is important in recognizing that rights are being violated. The passive person is so concerned with being liked and accepted that he or she may never recognize the need to advocate. The assertive person clearly expresses his or her rights or needs. They tend to face problems promptly and they focus on solutions rather than problems. The following will enhance your assertiveness skills.

Assertive listening is one of the most important advocacy skills we will discuss. The goals of assertive listening are: (1) to let the other know that you want to understand his or her point of view; (2) to understand accurately what another is saying; and (3) to let the other know that he or she has been understood. Remember that understanding is different from agreement. You can understand what another is saying but still disagree with him or her.

You can let others know you are interested in hearing and understanding their points of view in several ways. You can tell them you are interested. Here are some examples of how you could phrase such a statement:

I’d like to hear your views on….
I’d like to understand your views on….
Could you tell me about them?
I’m confused about your stand on….
Would you tell me more about how you see the situation?
I think we are approaching this from two different perspectives.
What does the situation look like from your perspective?
I ‘d like to hear your thoughts on

Looking directly at the other shows you are giving him, or her your attention. Leaning forward slightly communicates interest, while a relaxed, open posture communicates receptiveness to what the other party is saying.

Listening for accuracy takes concentration and requires you to give your full attention to what the other is saying. It is easier to listen for accuracy when you feel relaxed. If you are tense and your own thoughts are racing, excuse yourself for a minute and go to another room. Take a few deep breaths to relax and clear your mind before returning. Ask questions as they come up, especially if the answers are important to understanding additional points the other party is discussing. Saying “um hum” and nodding your head slightly will encourage the other to continue talking. Most people will discontinue talking without these mild encouragements.

Assertive Listening. You can test whether or not you have understood the other party by summarizing your understanding of what was said and asking for verification. This not only lets you know whether you have understood the other correctly, it also lets the other person know they have been understood. Some problem solving or negotiation sessions get stuck because people do not realize that they understand one another. Many times the issue is not confusion, but disagreement about what to do about the problem. Working out solutions is different from establishing an understanding and some issues remain unresolved because parties never get past the stage of establishing that all viewpoints are understood. Below are some examples of language you can use to test for understanding.

If I understand you correctly….
Is that what you meant?
I heard you say _____________, did I understand you correctly?
I heard you say ______________, did I understand you correctly?
Your view is _______________________, is that right?

Brain injury can interfere with the ability to process information. Consequently, it can impair the ability understand and make sense of complex information. This condition can be especially troublesome when such information is presented in a stressful context. It may become necessary to have statements or questions repeated or rephrased. Note taking on such occasions can be used to reinforce your understanding. Finally, you can test your understanding of the other party’s intentions by following the steps outlined above.

Nonverbal Assertiveness Even when we are silent we communicate a lot — through our eyes, facial expression, posture, gestures and personal appearance. Through these nonverbal behaviors we communicate who we are and how we feel. Others draw conclusions about our sincerity, credibility and emotional state based on our nonverbal behavior. Poor eye contact, slouching, nervous gestures and other nonassertive behaviors can convince others that what we have to say can be safely ignored. Awareness of our nonverbal behaviors is an important advocacy tool.

Elements of Nonverbal Behavior Nonverbal behaviors are harder to control than verbal behaviors, but with awareness and practice you can become effective in communicating non verbally as well as verbally.

1. Eye contact. Eye contact means looking directly at another, focusing on his or her eyes. Direct eye contact is assertive. Children often play at seeing who can stare the other down. The one who can maintain eye contact the longest wins and gains a sense of power. We are not suggesting you try to out stare others, but looking directly at another while you are speaking strongly suggests, even demands, that you be listened to and taken seriously. Looking down while speaking to another suggests timidity and weakens you in the eyes of others. Looking to the side as you speak suggests avoidance and insincerity and jeopardizes your credibility.

Maintaining eye contact while the other is speaking shows your interest in listening. There are times when you will want to minimize eye contact while others are speaking, perhaps to avoid revealing your reaction to what is said or to give you time to think. When this occurs, concentrate on note taking since this also gives the impression that you are listening.

2. Posture. The moment you walk into a room, your posture and carriage communicate messages about your confidence, how you expect to relate to others, your energy level and emotional state. Slouching may say “Don’t notice me” or “I’m tired and can be easily worn down” or “I’m not interested in being here”. Slouching does not invite the other to take you seriously. A tense and rigid posture communicates you are in a heightened emotional state. It may be interpreted as anxiety or anger depending on your other nonverbal behaviors. This kind of posture makes you look out of control. An erect and relaxed posture while standing and sitting communicates confidence, self-control, energy and an expectation that you be taken seriously.

When sitting, leaning forward slightly communicates interest and a sense of purpose. Leaning back communicates disinterest or disagreement. Crossing your arms and legs suggests a tense and closed attitude while uncrossed arms and legs suggests a relaxed and open attitude.

3. Facial expression. We say a lot through our facial expressions. Our face tells others the degree to which we are alert, interested, in agreement, or relaxed. It reveals the types of emotions we feel. It is best to keep your facial expression as neutral as possible.

4. Gestures. Gestures can be used to accentuate and support your message or to distract and discredit. Nervous fidgeting and tense jerky movements are distracting. These types of gestures and movements make you look out of control and seriously diminish your persuasive power. If you have trouble controlling nervous and fidgety movements, channel your nervous energy by taking notes. Hand and arm movements can be used to emphasize what you say. Do not emphasize everything, however. Be judicious in your use of gestures. Keep your gestures relaxed, fluid and moderate in size. Gestures which are too large make you look grandiose while gestures which are too small make you look nervous.

5. Personal Appearance. Whether we like it or not how we dress affects credibility. It also affects how we feel. Being extremely overdressed or underdressed in relation to others makes most people uncomfortable. Dress appropriate to the situation. If you do not know how to dress for a particular situation, ask questions of people who should know such things. The way in which you dress carries distinct messages about power. When dressing for business it is best to dress neatly, conservatively and as professionally as possible.

6. Tone of Voice. There are many aspects of voice that affect the impact your words have on others. The most important of these and the easiest to control are loudness and speed. Nervousness can make us speak too softly to be heard or so loudly that we distract from our message. Speak loudly and slowly enough to be heard and understood. It is also important to control how you end your sentences. Raising the pitch of your voice at the end of a sentence makes the sentence sound like question. A slight lowering of pitch at the end of a sentence makes it sound like a statement. Make your statements sound like statements in order to strengthen your message.

7. Negotiation and Communication in Meetings. The resolution of many advocacy problems will involve one or more meetings with service providers and administrators. You will use all of the skills we have discussed; problem analysis, information gathering, action planning and assertive communication in preparing for and participating in these meetings. In this chapter we will discuss additional advocacy techniques and pointers that can help you become a more successful advocate in meetings and negotiations.

8. Whose Territory. Where a meeting is held will have a subtle but powerful impact on you and everyone else who participates. People generally feel more comfortable and in control of the situation when they are in their own territory. Conversely they feel less comfort and less control when they are in someone else’s territory. Potential discomfort over being on someone else’s turf can be decreased by increasing familiarity with the individuals you will negotiate with and increasing familiarity with the site of the proposed meeting.

If you have control over where the meeting is held, request that it take place a neutral location. It’s a good idea to arrive at the meeting location early. This will give you a chance to become familiar with and feel more comfortable in the meeting space. Secondly, it will give you some control over the seating arrangement. Some seating arrangements create a sense of equality among participants at meeting whereas others create a power imbalance.

A round table has no head seat and thus creates a feeling of equality. Since there are no sides to a round table it also minimizes an “us versus them” atmosphere. A square table can also be used to equalize power. Although it is likely to enhance the feeling of taking sides. The head chair at an oblong table connotes power. If you are faced with an oblong table, sit in the head chair if possible.

The person who sits behind a desk during a meeting enhances his or her power considerably. In addition, the desk can, create a sense of defensiveness and act as a barrier to open communication. If you can, try to get the other party out from behind his or her desk in order to equalize the power.

The Numbers Game

Before the meeting, find out who the other party plans to have present. You will want to know their names and roles within the organization. If the other side plans to have several people present, bring several people with you. Equalizing the number of people representing each side will help to equalize the power. It will also allow you to assign tasks to your supporters, taking some of the pressure off of you.

Controlling the Agenda

It’s a fact of life, every party to a meeting brings along his or her own agenda. It does not matter whether the meeting is formal or informal, planned or “spontaneous;” the other party will have an agenda or set of objectives they wish to accomplish and a strategy for accomplishing their objectives. They may not describe this agenda to you but they will have one nonetheless.

You must have a set of objectives and a plan to accomplish them also. If you do not, the other party will control the content and the outcome of the meeting. Use an advocacy plan as discussed earlier in this chapter to develop your objectives and strategy for the meeting.

When you get to the meeting, negotiate an agenda to which all parties agree. The agenda should state the issues to be discussed and the order in which they will be discussed. Frequently, it is a good idea to define issues that will not be addressed during the meeting. Sometimes, such items are raised in an effort to throw opponents off track. When such matters are raised, calmly explain that you are not prepared to discuss it at this time, and offer to schedule a meeting to discuss it. Ordering of items on the agenda is also important; you might want to tackle less controversial issues first if there are several issues to be decided. This will give everyone a sense of progress and accomplishment and will create a more cooperative basis for tackling more troublesome issues later.

It is also a good idea to agree on how long the meeting will last since you or other participants may have commitments later in the day. If time constraints will not allow all issues to be dealt with, arrange for an additional meeting so that you will not be pressured into unacceptable compromises because of time limitations.

Time to Think

As you developed your advocacy plan you listed your objectives, organized your information, identified the types of arguments the other party might use and thought of how you might respond to those arguments. Despite all of your preparation, surprises will occur. The other party may propose arguments you had not thought about, ask for information you don’t have or propose a solution you are not sure you are willing to try. If this occurs, ask for a short break to allow time to think about how you want to respond. Even after a break do not feel that you must respond immediately, ask for more time to research and consider your options.

It is also important to ask for a break if you feel you are losing emotional control. You will not negotiate at your best when your thinking is clouded by intense anger, anxiety or other emotions. Resist the temptation to simply walk out since you gain nothing by this and will seriously damage your credibility. Asking for a break is perfectly acceptable: so is asking that the meeting be adjourned until a later time. If you decide to take a break, leave the room otherwise, the other party is likely to engage you in small talk and deprive you of your opportunity to plan your next step.

Don’t Get Caught In These Traps

There are several strategies that are commonly used to throw opponents off track. Just being aware these strategies will better prepare you to handle them if they are used.

Use of Jargon: It is common for professionals to use jargon. By this we mean technical terms, specialized words abbreviations that are not likely to be used in everyday conversation of the average person. In negotiations, professionals may intentionally use a lot of jargon in order make nonprofessionals feel ignorant, to keep them out of conversation or to diminish their credibility.

Resist the temptation to pretend you understand jargon. Ask that all terms you do not understand be defined in plain English and ask others to avoid using abbreviations with which you are not familiar. It is unfair to expect the average person to understand jargon. Do not allow yourself to feel less competent or less powerful just because you are not familiar with certain types of specialized jargon.

It’s also important to learn to say “I don’t know” comfortably. You should not be expected to know everything although, at times, you may be asked questions you are not expected to know the answers to in order to throw you off guard. Again, be sure to ask for clarification and/or more time.

Creating Guilt: Often the other party will attempt to convince you that the problem is your fault of the product of your own doing, when in fact it is not. If you feel it is your fault, you will get caught in a guilt trap. If the other party is able to make you feel responsible for the problem, he or she is getting ready to convince you that you, and you alone, are responsible for the solution. Resist this common and usually effective diversionary strategy. Such transparent attacks are irrelevant and you should say so. Instead of falling into such obvious traps, calmly steer the conversation back to the point.

Use of Ultimatums: The use of ultimatums is unwise. Do not do it. An ultimatum is the use of an uncompromising, “take-it-or-leave-it” position. It is likely to cut off valuable options and will definitely make you appear unreasonable, creating sympathy for the other party. Skilled advocates and negotiators do not use ultimatums.

If other party issues an ultimatum, question them about it. Ask what options and alternatives were considered before deciding on their position. Suggest that perhaps not all options were considered. Suggest that there may be additional positions to consider. Ask if there are any exceptions to the ultimatum. Try to think of examples where they would be likely to make exceptions to the ultimatum. Your goal in asking questions is to show that you are unwilling to accept a “take-it-or-leave-it” offer and want to explore additional alternatives. Furthermore, you want to jog the other party’s thinking so that they also are willing to look at possibilities beyond the ultimatum they have issued.

Communication and negotiation in meetings is complex, challenging and fascinating. We suggest that you build your own skills by attending meetings with other advocates and playing the role of observer and note taker. As an observer, the pressure will be off you and you will have more freedom to analyze and learn. As a side benefit, your presence provides support to the advocate and he or she may return the favor to you when it is your turn to advocate.

Writing Letters

We have all written letters — writing letters is nothing new. However, sometimes the idea of writing a letter as an advocate makes it impossible for intelligent people to put words on paper. This problem arises when a letter written as part of an advocacy effort is seen as radically different from a regular” letter”. The letters you will write as an advocate are simply business letters. Even if you have never written a business letter, you’ve read many and you know what they look like.

A second barrier that makes an advocacy letter seem difficult to write is the notion that you must tell your entire story in the letter. This notion makes the task of writing seem overwhelming. But in fact, it is unwise to tell your whole story in a letter. The idea that you must tell the whole story arises when you feel you must justify your position or request. This usually is not necessary.

As an advocate, most of your letters will be written to accomplish a fairly simple and specific objective such as: to request a meeting in which the problem will be discussed, to request information, to make an appointment to review a case file, or to thank others for their cooperation. A letter is the best way to make such requests, since it is more likely to get a response than a telephone request is. Such letters should be short and to the point. There will, of course, be some occasions when your objective requires a longer letter with more detail. For example, a letter filing a formal complaint, a letter to your lawyer, doctor of congressperson or to the editor of a newspaper may require more detail. But these letters too should be as concise as possible.

Materials and Style

Your advocacy letters are business letters and should be consistent with standards for good business correspondence. Save your prettiest stationery for writing to your friends. Instead use plain white typing paper or simple stationery with your name and address and telephone number imprinted. To ensure that your letter is legible and looks professional, type it or ask a friend to proof read it for you.

Use a business style in setting up your letter. When your letter is finished, check it very carefully to make sure you have not made any errors in spelling, grammar, punctuation or in typing. Careless errors will decrease your credibility and may cause your reader to conclude that you are not serious enough about your request to ensure your letter is correct.

Writing the Letter

It’s a good idea to make a short outline or list of points you want to include before you write your final copy. This will help you organize your thoughts and will result in a well organized letter. It will also help ensure that you don’t forget anything important.

The outline should contain the following points:

1. A sentence or two that states your purpose for writing the letter.
2. Sentences that provide further detail on your request.
3. A statement summarizing your request and asking for a response to your letter. Make sure to include the date by which you want your response and information on how you want to be contacted.

Always keep a copy of the letter for your records. We recommend that you send the letter by certified mail and request a return receipt so that you know the letter was delivered and accepted. Keep the receipt as part of your record. It’s also a good idea to note the date by which you expect you, reply on your calendar.

If you do not receive a reply by the date requested, call to find out when the other party will respond to your request. If necessary, write a second letter, pointing out the fact that you have made a request but have not yet received a reply. When dealing with agencies or businesses you might want to send copies of your letters to regulatory or advocacy agencies. The Better Business Bureau, your legislators and congresspersons. In personal matters you might want to send copies to persons that have the ability to influence the person you have written to. In both instances this tactic creates an incentive for the other party to respond to you.

Adapted from: “Don’t Get Mad Get Powerful, A Manual for building Advocacy Skills,” MI P&A

Anger Management Institute of Texas is a certified Anderson & Anderson ® provider.

Anger Management Classes and Anger Management - Executive Coaching available in Houston, Texas.

Empathy vs. Anger

info@ami-tx.com — Wed, 30 Jul 2008 15:13:00 GMT

Empathy is the ability to communicate and lead by understanding others’ thoughts, perspectives, and feelings.

Benefits of being of being able to empathize with others include higher self-esteem, more self-confidence, stronger personal relationships, and improved working conditions.

We usually empathize most easily with people we know and care about.

Empathy is built through and understanding of ones self, or self-awareness. The more individuals can understand their own thoughts, feelings, and emotions, the more they can understand someone else’s.

Empathy is a learned behavior. Like all skills, empathy can be taught, practiced and enhanced.

To be human implies the ability to communicate, understand and get along with other human beings. The failure to read another persons’ feelings can be a major problem in the human experience. With empathy, humans can possess a higher degree of sensitivity towards others.

The absence of empathy is directly related to criminal behaviors and problems in managing anger and stress.

The roots of empathy sprout at a very your age (1 to 2 years old). Research has shown that, while infants possess a capacity to learn how to be empathic, they must be shown how to use and develop and already existing abilities. Infants learn empathy from caregivers. In turn, infants learn how to understand other’s feelings. A lack of empathy in the parenting process results in a lack of empathy when children become adults.

Acceptance is the ability to recognize that family, friends, classmates and co-workers have a right to their feelings.

Improve your communication skills. This will lead to better understanding and increased empathy. Some basic tips to improve communication:

Learn to listen with your heart. Pay close attention to nonverbal messages. Nonverbal messages are so powerful because:

1) They tend to be more trusted.

2) They seem more emotionally charged.

3) They express universal feeling.

4) They are a more natural form of communication.

Empathy is one of the four pillars of anger management. The other three topics are stress, anger and communication. All anger management programs must include a Pre and Post Test for each participant.

By George Anderson, MSW, BCD, CAMF, CEAP http://www.andersonservices.com

Anger Management Institute of Texas is a Certified Anderson & Anderson® Provider

Anger Management Classes available 7 days a week in Houston, Texas.

Anger Management and the Legal Profession

info@ami-tx.com — Wed, 09 Jul 2008 03:36:00 GMT

Anger May Help Lawyers Win in Court, but Not at Home

by Steven Stosny (Published in the Legal Times, 5-19-97)

Among professionals, attorneys may be the most susceptible to anger and resentment problems that lead to diminished performance on the job, greatly increased risks to health and psychological well-being, and ultimately, to unhappiness at home.

Virtually all my non-court-ordered clients with anger problems are attorneys whose continual irritability has disrupted their lives, including a few judges who fear that their anger at attorneys will unfairly influence their rulings.

The high rates of divorce, domestic violence, and alcoholism among attorneys are indications of this susceptibility that may have more to do with habits of motivation and concentration than with the stress of the job.

The practice of law requires diligent attention to a great many details that are not inherently interesting. To sustain intense focus and adequate energy levels in the absence of interest/excitement, the brain often taps into its most accessible reserve of energy, one of the more than a dozen forms of anger/resentment.

In reviewing a dull document, for instance, the brain might look for something to get peeved at, which provides the energy and focus necessary to complete the task. The brain must find provocation, however obscure, for a dominant-submissive response that evokes fear of defeat, failure, or humiliation (or fantasies of victory and dominance) to get its jolt of focusing energy.

This innocent use of anger as motivation does nothing less than put the sense of self at stake even in the most mundane tasks. Repeated over time, the entire personality shifts to a defensive adjustment. Even trivial disappointments seem like failure and rejection when consumed in a joyless drive and surrounded by a moat of irritability.

Because it acts on the entire central nervous system as an amphetamine, anger arousal always ends in a physiological “crash,” often experienced as depression when the issues stimulating the anger remain unresolved. Think about it. The last time you got angry, you got depressed afterwards. The angrier you got, the more depressed you got. And that is merely the physiological response, even if you kept from doing something while angry that you were ashamed of, like hurting the feelings of someone you love.

To escape the pain of depression, the brain will look for excuses to get angry. Thus, anger springs a terrible addictive trap by providing immediate relief from the depressed mood that it eventually worsens.

Anyone can become an anger junkie, using some form of anger for:

o Energy/motivation. You can’t get going or keep going without some anger or irritation.
o Confidence, a stronger sense of self, you only feel certain when you’re criticizing someone or angry with someone.
o Anxiety reduction. Anger makes you feel more at ease, especially in new or uncertain situations.
o Relief of depression. You tend to need a morning jolt of anger.

The addicted brain compulsively justifies the anger it craves, ignoring all contrary evidence in the process. Thus, judgment and reasoning are greatly impaired during anger arousal. Failure to comprehend most relevant possibilities that justify anger. That’s why people justifying their anger can sound like alcoholics claiming that they drink for the unique nutritional value of booze.

Regardless of personal levels of intelligence, during anger arousal, we perform generally as if we have a learning disability. Laboratory experiments have shown that even subtle forms of anger impair problem solving and general performances.

In addition to increasing error rates, anger narrows and rigidifies mental focus, obscuring alternative perspectives. The angry person has one “right way” of doing things, which, if selected in anger, is seldom the best way.

With the lone exception of hurting someone, there is nothing you can do angry–or resentful, irritable, grouchy, impatient, or chilly–that you can’t do better not angry.

Health Risks

The effects of anger on health have more to do with duration than with frequency and intensity. The normal experiences of overt anger lasts only a few minutes. But the subtle forms of anger–resentment, impatience, annoyance, irritability, grouchiness, and “attitude”–can go on for days at a time. The effects of anger on health have more to do with duration than with frequency and intensity. The normal experiences of overt anger lasts only a few minutes. But the subtle forms of anger–resentment, impatience, annoyance, irritability, grouchiness, and “attitude”–can go on for days at a time. A person with continual episodes of anger has a five-time greater chance of dying before age 50. Anger elevates blood pressure, increases threat of stroke, heart disease, cancer, depression, and anxiety disorders, and in general, depresses the immune system (angry people have lots of little aches and pains or get frequent colds and bouts of flu, headaches, or upset stomachs.)

To make matters worse, angry and resentful people tend to seek relief from their ill moods through other health-endangering habits, such as smoking and drinking, or through compulsive behavior such as workaholism and perfectionism.

A person with continual episodes of anger has a five-time greater chance of dying before age 50. Anger elevates blood pressure, increases threat of stroke, heart disease, cancer, depression, and anxiety disorders, and in general, depresses the immune system (angry people have lots of little aches and pains or get frequent colds and bouts of flu, headaches, or upset stomachs.)
To make matters worse, angry and resentful people tend to seek relief from their ill moods through other health-endangering habits, such as smoking and drinking, or through compulsive behavior such as workaholism and perfectionism.

According to Professor Arthur Miller of Harvard University Law School, good attorneys make opposing arguments seem like rank obscenities. This might be sound strategy in the courtroom—it may also explain why my clients who are judges see lawyers as impediments to their work—but it creates disaster in attachment relationships.

The formula for success in love relationships is quite the opposite: Validating the perspective of loved ones must precede disagreement. In fact, disagreement is not nearly as important as validation of emotions. People get the angriest, which means the most hurt, not about getting their own way, but when they feel misunderstood or disregarded by loved ones.

If adversarial skills work at all in the home they must be applied first to the building the case of loved ones, then fairly and compassionately comparing it to your own.

Winning is a goal for the courtroom, but in families, it causes only resentment, covert hostility, and intimacy barriers. Virtually every sexual problem I have ever seen in couples has its roots in resentment. When one person in a family wins, everybody loses.

A common myth about anger problems is that they only involve hurting someone or destroying property. But this is only one of dozens of kinds of anger problems. You have an anger problem if some subtle form of anger/resentment—that you might not even be aware of—makes you do something that is not in your best interest or keeps you from doing what is in your best interest.
This could be simply putting a chilly wall between you and your loved ones, or a continual impatience that keeps you from noticing the compassion of others.

Practitioners most vulnerable to anger/resentment problems are the most actively adversarial, in general, trial lawyers.

Next are those faced with job insecurity on top of highly stressful work conditions: associates in general and partners in struggling firms. Lawyers with poor social supports and family problems and those who must fight invisible barriers of sexism and racism are also highly vulnerable.

To assess your risk of developing an anger/resentment problem, ask yourself: “Do my emotional responses seem like the fault of someone else? Does it seem that other people are trying to ‘push my buttons?’ Is the first thing that occurs to me when a problem arises ‘Who’s to blame?’ or ‘How do I get even?’”

Anger Management Institute of Texas is a certified Anderson & Anderson ® provider.

Anger Management Classes available 7 days a week in Houston, Texas.

Angry Men Grieving Underneath

info@ami-tx.com — Wed, 02 Jul 2008 14:44:00 GMT

Angry men really grieving underneath, says author

Scott McKeen. Edmonton Journal. Edmonton, Alta.: Jun 23, 2008. pg. A.10

This one's for men who seethe inwardly, men who rage outwardly and men whose reflexive anger protects them from hurt feelings.

In other words, it's for the vast majority of men in our society. Last Monday I wrote about the psychological void in most men caused by emotionally distant fathers.
Today's column is about how that void is oft filled with anger -- one of the few emotions men feel safe to express, along with laughter and lust.

Calvin Sandborn's book, Becoming the Kind Father, is today's inspiration. Sandborn is in town to give a workshop on the topic of male anger.

Lest you think his book and workshop is only for violent spouses, think again. Physical violence is the rare but shameful expression of a common darkness in the hearts of men.
And lest you think I'm siding with radical feminism, you are so wrong. I do not believe men are inherently violent or angry. Nor are they born emotionally stunted. In fact, studies show male babies to be equally or more emotionally expressive as female babies.

The sad fact is that both boys and girls are warped by societal expectations -- by what Sandborn calls patriarchy.
"I know, all red-blooded men cringe when they hear that word, patriarchy," says Sandborn. "But in our resentment against feminist criticism, men have missed a vital point. Patriarchy has stolen our hearts and is killing us."

The theft, according to Sandborn, is of the ability to express, process or even feel a normal array of human emotions.

Patriarchy stresses power over weakness and individual achievement over community and intimacy.
Girls lose their voice, their power, under such pressures. Boys learn to be ashamed of their sensitive or "sissy" feelings. So boys suppress such feelings, though they can't ever outrun them.
Sandborn says men, if made to feel ashamed, sad or hurt, react by getting angry at the cause, be it a boss, spouse, child or friend. The "other" gets blamed for making him feel what he shouldn't feel as a man -- vulnerable.

"He gets mad, the adrenaline starts flowing, he feels powerful and before you know it, he's not feeling sad anymore," says Sandborn, a University of Victoria law professor who grew up with a raging alcoholic of a father.
"The point is, if you scratch an angry man, you'll often find a grieving man underneath -- a guy who has never learned how to identify and process his vulnerable feelings."
According to Sandborn, no one is victimized by the angry man more than the angry man himself. What he learned from his father, he learned well.

"Most men don't have very good relations with their fathers," he says. "Perhaps 10 or 15 per cent of sons report a good relationship. Others report angry fathers, critical fathers, emotionally distant fathers, absent fathers."
Essentially, how the father treated the son is the way the son now treats himself. The critical voice now lives in his head.

"As Shakespeare put it, the voice of a father is like the voice of God," says Sandborn. "And that critical voice is often incorporated into the ongoing internal narrative that we use to define our world."
Expressing anger doesn't work for angry men, either. A feedback loop starts when anger is expressed at a loved one, for example. Anger leads to guilt, leads to self-loathing, leads to more anger.
This all comes at great cost. Not only are families hurt by angry men, so are the men themselves. Stress kills angry men at a rate much higher than others. Men are twice as likely to become alcoholics -- four times as likely to take their own life.

The answer? To begin, men must soften the cruel self-talk by adopting a patient and supportive inner voice. As Sandborn says, a man can become his own kind father.
"This makes all the difference. By treating himself with compassion, a man allows his heart to re-emerge -- he re-establishes a relationship with self. And for the first time, close relationships with others become a real possibility."

He advises men to pay more attention to their feelings. Give yourself permission to feel things. The truth is that feelings, with permission, will rise and then pass. Admit your guilt or sadness to yourself. But use a gentle voice. Everyone is flawed. Everyone makes mistakes. No one is a perfect husband, father or friend.
Remember, too, that anger is natural when a person feels attacked. But Sandborn says we can express angry feelings without losing our temper. Often, what we want to express to the other person is not our anger, but our hurt feelings.

Sandborn was raised by an angry father. He became an angry man. Yet he knew in his heart it wasn't the kind of father, spouse and man he wanted to be.
"I know people can change because I have," says Sandborn. "And so have many other men."

Anger Management Institute of Texas is a Certified Anderson & Anderson® Provider

Anger Management Classes available 7 days a week in Houston, Texas.