Psychological intimidation at workplace or in other words “mobbing” is a very common problem. Although it is a new terminology in psychology and law, it has been around since the beginning of business life. As a definition “mobbing assault at workplace is, systematically and persistently directing intimidating, self-confidence staggering, insulting, exclusionist, ignoring, unfair words and/or behaviors toward a targeted person, by employer or one or more employees” [1]. That means; a specifically targeted person should be exposed to bad behaviors and words intentionally and systematically. Mobbing has emerged more frequently comparing to other kinds of assaults that results higher rates of adverse effect on employees and work life [2]. Another near-synonym of mobbing is the term “Bullying”. Bullying is defined as perpetual psychological and physical oppress targeted to a weaker person by a more powerful person or group [3]. Generally, “bullying” term address the intimidation at school and “mobbing” for the workplace [4]. Also, mobbing means suppression of someone’s self-respect, abstraction from social processes, whereas bullying is a continuous psychological and especially physical assault or threat targeted toward a weak person or a group by a more powerful person/group at any settings [5,6].

The number of mobbing victims is prominently higher than victims of other kinds of assault and harassments. Based on the results of a study publish by International Labor Organization (ILO) in 1998; in the previous year 2% of employees (3 million) has been exposed to sexual assault, 4% (6 millions) physical violence and 8% (12 millions) mobbing [7]. In many countries, documented harassment rate is up to 17% [7]. In 60 countries including Turkey, there are legal regulations for mobbing [8]. In Italy, more than one million workers have been exposed to harassment [9]. Again in some regions in Italy, there are some legal regulations to fight against mobbing and some of the disturbances that have been occurred due to psychological assault have been considered as occupational accidents [10]. In France, mobbing is a crime and has a penalty of one year of imprisonment and 15000 Euros. In a survey conducted in the health sector in Portugal, 60% of health professionals were subjected to bullying cases and 51% of verbal abuse last year [11]. Workplace bullying has negative acts on work and employer costs [12].

It is hard to believe, but it is very common also in health care professionals, although health care professionals are potential victims of violence [13]. Among health care professionals, mobbing is rising [14]. Residents, especially females, also have experienced mobbing during residency program. Even, committing suicide (2%), addiction (16%), severe depression (18%), panic attack (8%), more accidents (7%) and tendency of violence (15%) are shown because of mobbing exposure [15]. Mobbing at workplace conclude with higher psychological distress and low job satisfaction [16]. It causes loss of time and money, raise of healthcare costs [17].

There are downwards (from managers against subordinates), horizontal (from one colleague to another) and upwards (from subordinates against managers) types of mobbing [17]. In this article, we try to find out the reasons, understand the process and effects, so that to determine suggestions and precautions. Our second aim was to call attention to this important issue.

Role conflict, workload, role ambiguity, job insecurity and cognitive demands seem as the most relevant predictors of being a target of workplace bullying [12]. Psychological harassment has some stages [10]. Since it is nearly impossible to apply all the manners and behaviors aiming accusation, emotional torment, humiliation, harassment and exclude a person from his workplace at the same time, mobbing is applied as a gradual process. Usually mobbing starts with attack to employees’ honor, trueness, honesty, credibility and professional competency and continues with again attack to personal image, work ethics and personal life of the victim. Leyman has indicated five stages for the mobbing process [18]:

- Disagreement stage: it occurs with a disagreement in a critical incident. It is not a mobbing yet, it might be either settled or turn into mobbing.

- Aggression stage: The disagreement has not been settled. At this stage, psychological assaults have been started.

- Institutional power stage: The person, who has been applying mobbing, tries to involve the management in to the issue. The management is misdirected by that person and therefore the victim becomes obligated to cope with an organized and institutional power.

- Description stage: In this stage the victim has been described and considered as ‘ineffective’, ‘rebellious’, ‘difficult’, ‘other’, ‘opponent’ or as a ‘person with psychological problems’. With misjudgment and prejudiced manner of the management, this negative cycle accelerates.

- Expulsion stage: This stage contains resignation, dismission and enforcement to change the job. The concussion due to this trauma triggers the stress disorder. Emotional breakdown and later on psychosomatic diseases follow the dismission. In this stage the victim, lives the effects of this trauma not only in his/ her work life, but also in his/her personal life.

What makes us to think a Behavior as Mobbing?

It is very important to distinguish which behaviors are indicating mobbing. Behaviors that promote organization’s development should not be counted as mobbing [19]. Signs indicating the presence of mobbing at a workplace have been analyzed in two groups based on both behavioral and physiological levels [19];

Behavioral indications of mobbing [20]

The things like computer, printer, telephone and light that a person uses at his workplace, may suddenly get lost or break down; the arguments with colleagues would become more intense and more frequent than before; when the person enters the office of others, the ongoing conversations would suddenly stop or the subject might be altered; the victim’s behavior can be limited by various rumors; the tasks below the level of knowledge or talent or the victim might be given; the victim might feel that all the works that he/she do, are always watched or controlled by others; victim is always criticized and underestimated by others; victim could not get any response for his written or verbal21 requests; victim is continuously suppressed so that to be provoked to give out-of-control reactions by others; victim is not invited generally to workplace celebrations and other social activities; victim is mocked at his/her appearance and dressing style; all his suggestions regarding his work is ignored. Additionally, Knorz and Zapf have identified 39 more indications of mobbing [21].

Physiological markers of mobbing [19]

Neurologic: distress, panic attack, syncope, depression, head ache, dizziness, memory loss, distractibility and insomnia; Dermatologic: itching, flushing, eczema; ophthalmologic: Blurred vision, blackout; musculoskeletal system: pain in back and neck muscles, leg weakness; cardiologic: palpitation, myocardial infarction; gastrointestinal: burning, heart burn, dyspepsia, gastritis, ulcers; pulmonary: asphyxia, dyspnea

It seems that reasons like jealousy, hostility, group pressure, getting benefits, competition can lead to mob others, especially who are better, more hardworking, have better qualifications, skills and abilities [17].

The reasons of mobbing can be categorized under three groups; personal, institutional and social reasons.

- Personal reasons: it starts with a conflict, and is related to this conflict or a behavior. The victim would be either dismissed or forced to leave the work. However both leaving the work or being dismissed usually don’t end the psychological assault, because the victim would work in a similar work and the references would be negative. Some studies show that some characteristics of both victim and perpetrator raise the tendency for mobbing. The victims of mobbing are usually honest, hardworking, sociable, qualified, not in need to sell themselves to others, with high self-confidence, partially judgmental but not accusive persons [22]. It has been reported that the persons who can review their behaviors, can produce new ideas and point of views, with high social intelligence, flexible, emotional, with high empathy are more likely to be a victim of mobbing [19]. Mobbing offenders are shown to apply psychological assault to hide their own deficiencies [19]. These persons generally demand excessive attention, need to be praised excessively, praise their supporters and cannot tolerate even constructive criticisms.

- Institutional reasons: hierarchical organization structure of some institutions induce authoritarian administration manner, which leads to a favorable situation for mobbing [19]. Hierarchical organization makes a favorable ground for a mobbing offender to hide himself. Misinformation of managers leads to continuation of this behavior and therefore in longterm, opens a road for psychological harassment to become a management method.

- Social reasons: the prevalence of mobbing is closely related to social, cultural, economic and moral norms of the society. Lack of care for competency, lack of self-confidence, citizenship and friendship networks trigger the mobbing behaviors at a workplace [23].

Psychological harassment is a social problem with multiple aspects. Not only victims, but also their families might be affected socially and economically [24].

Possible effects on the victim

Generally, it may cause physical and mental also behavioral disorders, social problems and economic loss. Sleep disorder, crying spell, loss of concentration, anger and stress, permanent sleep disorders, digestive system disorders, alcohol and drug abuse, treatment expenses, running away or staying away from job, deep depression, panic attack, myocardial infarction or other serious problems, accidents, violence against third persons, suicide attempts are some of these possible outcomes. Five possible effects of psychological harassment at workplace on victims have been indicated [25]:

• Inhibition of self-manifestation (interruption, loud scolding, continuous criticism)

• Assault on social relations (ignoring the person, cutting off communication)

• Offending the reputation (false rumors and accusations)

• Offending the professional position (giving unskilled positions or constantly changing position of the person)

• Direct offence to the victim’s health (giving heavy works, physical violence threatening, sexual harassment, offending beliefs and values)

Possible effects on workplace: beyond the adverse effects of psychological harassments on the victims, it has also adverse impacts on the workplace. This process triggers loss of productivity and work time for both offenders and the victims. Besides, it again triggers the conflicts and disagreements between workers and managers. In case of divulgence, reputation of the workplace would be harmed.

Possible effects on society: mobbing can impair coworker relations and working environment and as a result it may comprise unhappy individuals and families in the society. Expenses and the time for the health controls may increase. Thereby, psychological harassment at workplace damage victim’s social relations and also puts burden on both employers and government. Workforce loss as a result of psychological harassment at workplace, cause heavy damages in economy of country. Worldwide, 6 million workday losses occur annually [26]. According to the report of National Institute of Occupational Health, a total cost of about four billion dollars due to workplace violence on workers has been reported in 1992 [19]. In England, despite a decrease in occupational accidents, work related diseases are growing in recent years. Mobbing is being thought as a potential reason of this outcome [27]. A total cost of stress and stress related diseases increases from 5 to 12 billion dollars globally [28].

In Turkey, 12^th article of constitution regulates basic rights and freedoms. Besides, according to the 48^th article, everyone has the freedom to work and contract in any desired field. 49^th article includes provision related to working rights. In conclusion, individual rights and freedoms are conserved by the state. It means that violation of freedom of an individual should be interpreted as violation of constitutional rights. According to the 96^th article of Turkish criminal code law (TCC), any person who causes suffering of another person by his acts is sentenced to imprisonment from two years to five years. Again in TCC 106 offence of threat, in 107^th article blackmailing, in 115^th hindering freedom of belief, thought and opinion, in 117^th offending of freedom of work and occupation, in 118^th hindering union rights, in 120^th unjust search, in 121^th hindering petition right, in 122^nd discrimination offence, in 125^th offence of libel, in 132^nd violation secrecy of communication between the parties, in 133^rd listening non general conversations between the individuals without the consent of any one of the parties, in 134^th violation secrecy of private life, in 135^th unlawfully recording the personal data, in 257^th malpractice offence, in 281^st taking away the assets acquired as a result of an offense, in 283^rd fail to notify the authorized bodies about the known place of a person, are other offences as potential tolls for mobbing that have been regulated by law.

According to the 77^th article of Labor Law (Number 4857), regarding to ensure occupational health and safety in their establishments, employers shall take all the necessary measures and maintain all the needed means and tools in full; and employees are under the obligation to obey and observe all the measures taken in the field of occupational health and safety. And again, second paragraph of the same article, in order to ensure compliance with and supervision of the measures taken for occupational health and work safety at the establishment, the employer must inform the employees of the occupational risks and measures that must be taken against them as well as employees’ legal rights and obligations and, in this connection, he must provide the employees with the necessary training on occupational health and safety. The obligation of the employer to provide safety of employees also involves prevention of psychological harassment. 5th article of the same law regulates employer and employee relations to prevent discrimination.

As mobbing can be assumed as a preventable disease, we can talk about primary, secondary and tertiary prevention from this important issue [29]. Primary intervention can be said as interventions before mobbing occurs, where secondary interventions are coping strategies of the victims. Finally, tertiary ones are the precautions reducing harmful effects after bullying. Problem-focused coping strategies (like active coping, direct coping, etc.) can be seen as an effective way of coping more than emotion-focused ones (like wishful thinking, avoidance, suppression, etc.) [12]. It’s possible to take some individual and institutional precautions in order to prevent mobbing. These can be categorized in two groups as individual and institutional [27]:

Individual recommendations

If an individual feels psychological harassment, he should evaluate his current circumstances and should take the following measures:

• Primarily should stay calm and avoid clash

• If the assault is coming from senior management staff, senior management should be informed properly

• Proofs like writings, notes, massages, e-mails should be kept and saved by the individual

• Should negotiate with witnessed colleagues

If individuals could not get a result from these recommendations, they should dial “170”, the contact number of Ministry of Labor and Social Security, to receive medical and legal support or get help from expert psychologists, or can resort to jurisdiction.

Institutional recommendations

Due to difference in production quality, quantity and sector and also variations of management methods psychological abuse techniques also differs. Institutions should have information in case of occurrence of mobbing elements, and in order to protect their institutional structure, public reputation and their brand equity, must take some measures. For preventing psychological abuse/harassment in workplace, the following precautions should be put into practice [30]:

• Institutions should develop policies preventing psychological abuse/harassment

• Informational and educational activities targeting employees and managers are needed

• Designating disciplinary punishments and rehabilitation for Mobbing attempters

• Should take in consideration all mobbing complaints and develop solutions, also should protect the privacy while investigating the allegations

Besides recommendations above, national legislations should be provided [17]. In order to provide occupational health and safety and also to establish peaceful working environment, preventing of psychological abuse/harassment is crucial. For this reason, for protecting employees from psychological abuse/harassment, prime ministry has issued a circular letter [31]. According to this, all employers have to take all the measures needed to protect their employees from all kind of abuse and harassment. Like diseases, it is more effective, cheap and easy to prevent, rather than cure. It is too late, if you let this terroristic act to reach its final phase [19], as WHO declared, this a preventable [7].

In conclusion, psychological abuse/harassment is an important problem that is needed to be urgently solved. It causes more costs and psycho-physical harms, and less job satisfaction and effectiveness. It is important to distinguish which behaviors are indicating mobbing. Most crucial element to fight is to derive awareness. Like diseases, it is more effective, cheap and easy to prevent, rather than cure. There are primary, secondary and tertiary prevention for mobbing. Each segment of the society has responsibilities. In order to fight against psychological abuse/ harassment, being aware of the ongoing process, taking precautions, making necessary legislations, providing the true information and raising awareness, are the first steps should be taken. With the raising awareness and diagnosing violence, bullying and mobbing, most of the precautions can be taken. Even existing of legislations and regulations, it is more important to apply them properly. Although it is not easy to change the traditions, procedures of business and labor, with increase of public awareness and proper legislations, we hope that there will be a decrease in prevalence of mobbing.