The anatomy of coercive practices in healthcare settings.

Background: In healthcare settings, there can be a fine distinction between genuine performance management and vexatious complaints occurring in the context of bullying. The most common manifestation of such behaviour involves repetitive interpersonal abusive behaviours within the context of a power hierarchy. These interactions might well be experienced as bullying behaviour; however, the interpersonal dynamics underpinning such behaviours remains largely unexplored.

Objective: This paper offers a psychological perspective on bullying and harassment and adopts a psychodynamic case study approach, utilising a case vignette involving a senior and junior doctor within a general practice context. Conflict can be mitigated by understanding the intra- and interpersonal dynamics that interfere with rational performance management.

Discussion: Psychological processes such as projection, displacement and projective identification are useful in understanding the genesis of bullying and harassment within demanding workplaces. Reflecting upon the psychological processes underpinning such conflict might help mitigate coercive workplace behaviour.