Sunday, November 1, 2015

The Wages of Rudeness

I have often argued for the virtue of being polite, courteous and considerate. I have often been derided for it, too.

Rudeness, I have suggested, is bad for you. It is bad for your mental health, your effectiveness, your relationships and your performance. Unfortunately, we live in a world where everyone is systematically rude. People even take pride in their rudeness. They defend it as honest and authentic. You will undoubtedly take it as retrograde and anachronistic, but the truth is: rudeness is traumatic. It disrupts your psyche and makes it more difficult to function.

If you think that you can overcome the negative effects of rudeness by getting in touch with your feelings and understanding your Oedipus complex, you need a lot of help.

In a world where we are constantly speaking about traumatic abuse, about PTSD and the like, it seems rather small minded to count rudeness among the traumas that we do not know how to deal with. Compared to the more dramatic traumas, rudeness is more like death from a thousand cuts. It is more difficult to deal with because we do often fail to recognize it when it happens.

Why do we place so much emphasis on painful and dramatic traumas? I would suggest that we are so insensitive to pain, so numb to it that we are only roused by something horrifying and dramatic. Rudeness seems trivial by comparison.

Travis McKnight reports in New York Magazine on a study performed in an Israeli hospital. The study wanted to judge the effects pf rudeness on  the effectiveness of a medical team. What happens when one person, like the team leader, is rude to others and what happens when someone who is presented as an outside expert criticizes and denigrates the group’s performance?

McKnight opens thusly:

Imagine this: You’re a cardiac surgeon who is pushing into the five-hour mark of a complicated seven-hour surgery. You ask a nurse for a specific tool, and he drops it. It’s now contaminated and useless. The nurse stands dumbstruck until you snap at him to hurry up, grab another tool, and stop being so clumsy. You were rude, but he deserved it, right? He’ll get over the uncivil remark and everybody will move on. But that "moving on" actually might not happen — according to a recent study, rude comments in high-pressure medical settings could have potentially deadly effects on patients.

Before going any further, note this: since nursing has always been a majority female profession McKnight feels obliged, by the moronic rules of political correctness, to refer to nurses by masculine pronouns. If the person in question were practicing a male dominant profession, if he were a football player or Navy SEAL, the politically correct reference would be a feminine or a plural pronoun.

It’s called: dumbing down America.

To return to our subject, the research showed that rudeness caused a significant and instantaneous drop in group effectiveness:

The study, "The Impact of Rudeness on Medical Team Performance: A Randomized Trial," which was published in the September issue of Pediatrics, shows that a rude comment from a third-party doctor decreased performance among doctors and nurses by more than 50 percent in an exercise involving a hypothetical life-or-death situation. “We found that rudeness damages your ability to think, manage information, and make decisions,” said Amir Erez, an author on the study and a Huber Hurst professor of management at the University of Florida. “You can be highly motivated to work, but if rudeness damages your cognitive system then you can't function appropriately in a complex situation. And that hurts patients.”

Two groups of physicians were told that they were being observed by an outside expert. One group was told that they and their colleagues were incompetent. The other group received a more neutral message: they were merely told that they were being observed. Note well, they were not offered unearned praise to inflate their self-esteem.

McKnight continues:

Before beginning, the teams were informed that a leading ICU expert from the United States would be observing them via webcam. The researcher running the experiment then dialed a fake phone number and played a (prerecorded) message that was supposedly from the observer. The message informed half of the participants that he had observed other medical teams and was “not impressed with the quality of medicine in Israel,” but told the control group simply that he had observed other teams, without making any rude comments or insults. Ten minutes into the simulation the teams were interrupted by another prerecorded message from the researcher. He told the control group that he hoped the workshop helped them improve as physicians; he told the other teams, however, that the Israeli physicians and nurses he’d been observing “wouldn’t last a week” in his department.

Note the following point, often argued in psycho literature. One accepts without hesitation that the behavior is rude. But, the observer is also being very critical. 

How many times have people told you that the best way to motivate people is to emphasize their faults, to criticize them openly and honestly? How many times have people told you that in a healthy relationship participants feel comfortable criticizing each other, telling them what they are doing wrong, emphasizing their inadequacies? Heck, how many people rationalize the behavior of psychoanalysts-- systematically rude as it is-- on the ground that their patients need to learn how to deal with rudeness and to hear the harsh truth?

I have often taken exception to such mindless psychobabble. This experiment tells us that criticism is rude and that it produces a trauma. It ought to bee a cautionary lesson for tall.

In the experiment, the results were shocking:

The rudeness had dramatic effects. The teams who experienced it struggled to cooperate, communicate, and do their jobs effectively, all of which caused their performance to plummet: They misdiagnosed the illness; they forgot instructions; they didn’t ventilate the patient well; they didn't resuscitate well; they didn’t ask for help when they needed it; doctors asked for the wrong medication, and nurses mixed the wrong medication. Overall, the rude comments appeared to cause a 52 percent difference in how well teams diagnosed the disease, as measured by three independent judges who were blind to the study’s thesis, and a 43 percent difference in how well they treated it. In the real world, as Erez pointed out, these performance discrepancies could have made the difference between the tiny patient living and dying.

Keep in mind, we are talking about trained professionals. If professionals are that sensitive to criticism, how sensitive would amateurs be?

Physicians are more likely to make mistakes if they are told, by someone they believe to be an expert, that they are incompetent. Worse yet, once they are traumatized, they lose the ability to recognize that they are making mistakes.

Perhaps, they are trying to fulfill expectations, to affirm the expert judgment. It is remarkable that this becomes more important than healing their patients.

Once they are traumatized by rude and critical remarks their minds shift into healing mode. Their minds redirect energy away from the task at hand and toward recovering the equilibrium lost to the rude behavior:

McKnight offers another example:

Christine Porath, an associate professor at Georgetown University who is an expert on the effects of incivility and is not involved in Erez’s study, said she wasn’t surprised by the Pediatrics study’s findings. Her research shows that people spend time and energy processing why rude comments were made toward them and how it affects them, which saps away mental resources from the task at hand. “What we found is that being around any kind of rudeness takes people off track and makes it so they have a very difficult time focusing,” Porath says. “And that's the biggest explanation we find for performance decreasing.”

Rudeness, like criticism, traumatizes. It disrupts both routines and group harmony. It renders people more ineffective. In a hospital it costs lives, but surely in other business and personal contexts it is no less corrosive.


David Foster said...

There have been aircraft accidents and near-accidents because the First Officer (copilot) was reluctant to bring something to the attention of the Captain, or the flight crew was reluctant to be properly assertive with Air Traffic Control, because of fear of a rude response or excessive deference to the (real or perceived) hierarchy:

Recruiting Animal said...

Aren't there different kinds of people based on the structure of their brains? Some people are extremely sensitive and others are thrill seekers? And, aren't people shaped also by their upbringing which varies from home to home? And wouldn't these differences be relevant in this setting? I imagine that some people are shattered by criticism because they over-react to everything and are already inclined to think that they are awful whereas for others it would just be a blip on the radar. "Am I doing something wrong? I don't see it. Point it out and if I agree I'll make a change."

Anonymous said...

The beatings will continue until morale improves.

A blow from a whip raises a welt. But a blow from the tongue smashes bone.

The latter phrase is an obscure line from Hebrew scripture which reveals a spiritual or psychological truth via hyperbole.

There is a problem, however, for survivors of verbally and emotionally abusive childhood: the polite society did nothing to spare a child from abuse that often occurs in relative privacy. Although mean spirited parents, teachers, and other adults abound in society. Their sadistic acts of verbal abuse occur in public too.

Psychology has a term for the karma of verbal abuse: the inner critical voice. Saint Paul probably had an inner critical voice which caused him to utter this phrase, "As for me The Lord has given me a thorn in the flest, an angel of Satan to beat me and keep me from becoming proud. Three times I asked the Lord that this might leave me ... " Satan, in Hebrew, means Adversary, Accuser (an internalized role similar to the expressed role of a legal prosecutor).

Polite society is held in contempt by a person who has internalized criticism from an early age. The means of showing such contempt would vary but can be recognized in the extreme. Polite society can be quite sadistic or passive in letting others suffer while going about its superficial business.

The karma of the inner critical voice is not going to come to an end simply because a few apes argue that being polite is more beneficial than being rude. Jesus told his disciples that you cannot take the possessions of a strong man (Satan) unless you first enter into his house and bind the strong man. He also said make friends with the adversary on the way to court. These are metaphors for internalizing the voice of the inner critic and binding it. How many parents can control their impulse to criticize children? In my experience not many. So the karma continues ...

Ares Olympus said...

Its hard to disagree with this, although Recruiting Animal is also right that sensitivity varies and people have different standards of rudeness. And the differences might be cultural as well as personal.

Like in New York City, where people are in a hurry, people might expect rudeness, but appreciate it because you know where you stand with a direct person. In contrast a mid-western passive-aggressive personality who can never say one honest thing about what's bothering them until you stop everything you're doing and sit down with them for an hour, and plead for them to say something direct that risks sounding rude. So there are extremes on both sides to be avoided.

I think Marshall Rosenberg tried to face this conflict, from both sides of overt and covert agression, in his nonviolent communication. He identified what he called Jackal language and Giraffe language, and used two puppets in his workshops to help people see the differences. He picked Giraffe because it had the largest heart of the land mammals.

So basically he saw Jackal language as focused on right and wrong, while giraffe language focused on needs and requests. Basically we all have needs, and needs are not connected to a specific person, but we can make requests to specific people to meet our needs.

And it actually can seem scary, how do you ask for something without making the other person wrong if they don't want to comply. And so people end up more passive than they should, and then only speak out when gross transgressions occur, and then they can't separate their needs from the other person's behavior they don't like, so blame and criticism come out despite all efforts to avoid it.

This article talks about it, with four stages: 1. Observing, 2. Feeling, 3. Needing, 4. Requesting.
----------- Example from needs
...If you cannot express your needs, it is difficult for someone to fulfill them. That is obvious now, but the heat of conflict can burn your positive intent to follow the NVC process. You now know to express your needs – and follow other stages of NVC – but it is easy to blame, criticize, and avoid the techniques when anger gets the better of you.

In conflict, you feel attacked and mirror someone’s anger. This is not peaceful communication. You probably reason to yourself that if people change, then you would not become angry – that is reactive, blame-filled living.

There is an amazing thought that has worked for me to overcome this problem. It is something I use everyday to separate myself from people’s below-average behavior. The technique keeps my head above the water in difficult conversations as it prevents me from being dragged into the depths of someone’s anger, rudeness, and poor communication.

KEVIN said...

Thank you so much for writing this. I've always suspected this to be the case, but never heard it stated so well. Looking back, I remember grouchy grade school teachers who I felt hindered my academics and patient, inspiring ones who helped.

Anonymous said...

Seems to me that one of the greatest sources of rudeness in America today is the way married women talk to their husbands. You can observe this in public places and private gatherings: many wives speak to and of their husbands in tones of barely concealed (and sometimes not concealed at all) contempt. This seems to be a white middle-class and upper-middle-class thing; I haven't observed this behavior very often among other races or working-class white people, and I have only infrequently observed it the other way around (husband public rudeness to wife). I don't know what % of wives act this way, but among the white middle class & up demographic it feels pretty high.

The consequences of this sort of female behavior on the health, happiness, and productivity of the male population has to be pretty significant.

Stuart Schneiderman said...

Great observation and great analysis.