Horizontal Hostility: Drama Triangles

The term horizontal hostility was coined to discuss a mental health phenomena that plagues the
nursing profession. Horizontal hostility is the subtlety of behaviors that rub off between groups of
co-workers, family, or peers. Communication does not entitle an abuse of power, but in circumstances
of stress (like those in hospitals) there is a noticeable shift of negative emotion transferred from one
person to another. I am reminded of a time spent in the country where the peacocks would get chased
by the dog. In retaliation, the birds began to chase the cats. The emotional abuse that nursing
professionals experience with 'burn-out' resembles the peacock chase.

Abusive relationships have an imbalance of power, whether or not the relationship is personal, or
professional. Horizontal hostility occurs because there is a lack of awareness in the bully's reactions.
The peacocks have forgotten their victimization. They have taken the role of bully with regard to the
cats. Grounding awareness in the current moment, takes practice. New behaviors of assertiveness can
feel impossible when there is an entrenched depletion of self-worth. The simple behavior of awareness
deadens the effects of horizontal violence. Contemplation provides the capacity to elevate thoughts
away from the fight or flight survival framework.

Horizontal hostility defines a victim role; someone who is oppressed. The drama triangle is the
combined roles of the perpetrator (bully), victim, and a rescuer. These three roles are interchangeable.
The rescuer is a common role, in which helping professionals identify. Although, often victims will
believe that they are a portraying the rescuer role. A hostile reaction to any perceived threat blinds the perpetrator into behaving as if in the victim role. The result being a revolving drama triangle. Examples of the emotional effects of horizontal hostility are anger, irritability, decreased self-esteem, self-doubt, and feelings of being unable to meet
expectations. Some cases of horizontal hostility depress immune function, a direct consequence of
bullying that is physically demonstrable. A perpetrator will perceive themselves as the victim, but in reflection, adjust their perspective, and witness their behavior as that of an undercover bully.

The bullying in our social interactions leads to strained relationships with partners and friends.
Depression and stress from simply witnessing verbal abuse brings consequences both physical and
mental. Physical and psychological responses to peer to peer hostility include substance abuse, or
over-eating. Drama triangle behavior is perpetuated by low interpersonal/emotional support, or lack
of interdiction by witnesses. This spiral of negative behavior can be blocked by actions that sponsor
direct communication about negative behaviors.

It is simply this awareness which allows the victim to take responsibility, to assert against both negative body language and verbal abuse. The freeze and leave method (as it is part of the victim's framework of survival) serves only to free oneself from the drama triangle. It is the reflection, the contemplative moment that allows each of us to renegotiate
our experience. With contemplation, we are able to communicate succinctly our true feelings.

The larger picture of happiness and respect is a choice. Could focusing inward, using contemplative
practice to break the drama triangle help redefine our relationships? Are we all victims? At some
point, we have all witnessed an interaction that made our psyche cringe. Maybe it was a visual image
in a magazine, or something we witnessed in our community. More than likely it was on the
television, which sponsors a fear-based mentality. Allow for a brief moment, your mind to wander off

How much of our day is spent in conscious consideration of how the expectations of others feed our own choices? Classically, we know hostile communication has relevance in the protection of basic needs, safety, and the need for attention. Consider that the fight or flight response is the starting point for anyone ever having experienced emotional abuse (horizontal hostility). Horizontal hostility appears as a shifting freeze and deny behavior. A victim freezes and brings the abuse inside. Turning the assault onto their senses as stability. It becomes the framework for our cognitive agenda. Horizontal hostility adds an option to our survival tools of fight, flight; the possibility of freeze and leave.

The people who are caring for us in times of weakness deserve the luxury of healing, progressive work environments. Recognition of emotional abuse as a real physical threat to health, especially in the nursing professions. The use of overt and covert tactics to intimidate, blame, or criticize are not a social norm. There is a remedy to horizontal hostility.

Hostile adults communicate their problems without covert tactics like a refusal to participate, whining, or fabricating
offenses. The immediate response to identify and end this type of reaction must be established by either a participant, a witness, or the person in charge. What would our health care system include to foster innovative, and precise mental health treatments? Confident sponsors that protect themselves and others from negatively impacting participation in community.