Assertive vs. Aggressive Nurses can stand up for their rights and address negative behavior in the workplace.

Kathleen A. Zeiler, MEd, RN

Vol. 9 Issue 26 Page 4 The Learning Scope This offering expires in 2 years: Dec. 8, 2010 The goal of this continuing education offering is to educate nurses about assertiveness, passive aggressiveness and aggressiveness. After reading this article, you will be able to: 1. Describe the differences between assertive, aggressive and passive-aggressive behavior. 2. Discuss the consequences of assertive, aggressive and passive-aggressive behavior. 3. Identify the visual, physical and verbal characteristics of assertive behavior. You can earn 1 contact hour of continuing education credit in three ways: 1) For immediate results and certificate, go to www.advanceweb.com/nurses. Grade and certificate are available immediately after taking the online test. 2) Send this answer sheet (or a photocopy) along with the $8 fee (check or credit card) to ADVANCE for Nurses, Learning Scope, 2900 Horizon Drive, King of Prussia, PA 19406. 3) Fax the answer sheet to 610-278-1426. If faxing or mailing, allow 30 days to receive certificate or notice of failure. A certificate of credit will be awarded to participants who achieve a passing grade of 70 percent or better. Merion Publications Inc. is an approved provider of continuing nursing education by the Pennsylvania State Nurses Association (No. 008-0-07), an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation. Merion Publications Inc. is also approved as a provider by the California Board of Registered Nursing (No. 13230) and by the Florida Board of Nursing (No. 3298). Do not go gentle into that good night, Old age should burn and rave at close of day; Rage, rage against the dying of the light. - Dylan Thomas

Self-assertion is both a simple concept and an important communication tool. Assertiveness is an interpersonal communication skill that can be learned and practiced each day. Assertiveness is appropriate and direct, and is an effective way of expressing one's feelings, beliefs and opinions. Assertiveness opens the way for honest communication and dialogue about one's legitimate rights.1Assertive people express opinions, thoughts and feelings clearly and openly in a nondefensive manner. Being assertive means being able to both make requests and refuse unacceptable requests.2On the other hand, aggressive or passiveaggressive behavior can have negative results among family, friends and colleagues. Aggressive behavior is standing up for one's rights in a negative manner that violates the rights of others. Tension and anger are the hallmarks of aggression. The recipient of aggressive behavior feels dominated, humiliated and embarrassed. Using aggression, the aggressive person blocks the formation of good relationships. Passive-aggressive behavior asserts the underlying belief that one's feelings aren't important. Passive-aggressive behavior appears weak. Passive behavior expresses negative feelings in an indirect and frequently obstructive way. Passive people appear willing to comply with a request and may even appear enthusiastic, but they don't perform the task in a timely manner or don't fulfill the request at all. An example would be a patient who agrees to a medication or diet regimen but is noncompliant. Passive-aggressiveness is anger expressed in a nonverbal way. There often are psychological ramifications for this type of behavior. A long-term consequence of aggressive and passive-aggressive behavior is depression. Other psychological effects of mismanaged aggression include anger, compulsions, self-hate and anxiety.3Conversely, a long-term consequence of assertive behavior is increased selfconfidence and self-esteem. The difference between assertive, aggressive and passiveaggressive behavior is the goal and the approach. Aggression Aggression is "any form of behavior directed toward the goal of harming or injuring another living being who is motivated to avoid such treatment."4Some aggression is overt; some is covert. Aggressive style is characterized by accusations, angry tones, belligerence, intolerance and a focus on "I win, you lose."5How do aggressive people survive and find their targets? They learn young, around third grade, that not everyone can be bullied. They hone their skill and target specific people to prey on.6Aggressive behavior stands up for its rights, but in the process violates the rights of others. Aggressive people dominate, belittle, try to get even and hurt others. Aggressive people use phrases like "you're crazy," "do it my way" and "that's just about enough out of you!" Aggressors put down your feelings, make choices for you, and become hostile and defensive. Passive-Aggression Waiting for what you want only happens in fairy tales. Was Cinderella passiveaggressive?7Why didn't she walk out on that nasty stepmother? Why did she wait for the Prince to ask her to dance at the ball? Why didn't she just take the other glass slipper to the castle? Passive-aggressive behavior is a pattern of expressing your feelings in an indirect and often obstructive way, instead of openly expressing them.8People who are passive-aggressive do

not deal with situations head-on. They may act out through gossip, back-biting, foot-dragging and sarcasm. Passive behaviors include timidity, deference, inhibition, fear of rejection and fear of offending. Hostile-passive people hold a deep, simmering resentment. How about the husband who never says anything nice, or the person who acts so flustered that people are constantly trying to help? Are they really clueless or helpless? What about you? Do you radiate vulnerability? Are you unable to assert and defend yourself? Do you think people generally rescue a passive/helpless person from an aggressor? Usually not; they feel uncomfortable. Bullies prey on passive people. Passive-aggressive behavior denies one's feelings and opinions, allows others to choose for you, and operates from guilt and anger. Assertiveness So, are you a Queen Bee or a Wannabe? Assertive people stand up for themselves in a nonaggressive way. People who are assertive can stand on their own two feet while not stepping on anyone else's feet. They do not have to be rude, boorish or unpleasant to make their needs known. Assertive people know what they want. Assertive people don't blame others. They offer suggestions and ideas, not advice. They distinguish fact from fiction and are able to give and receive feedback. Gender Differences Assertive women experience more harassment than their demure counterparts. Particularly in male-dominated industries, men may harass women who have masculine traits to keep the sexes unequal. Studies of differences in aggressiveness and violence in men and women don't show a clear distinction as to which gender is more violent. Women's violence is more subtle, indirect or verbal, while men use more active and direct violence. Other studies found, on average, men were somewhat more aggressive than women, but sex differences were inconsistent across studies.9 Leadership & Assertiveness Authoritarian-style parents or a tough boss often leave scars that hold us back from being assertive. People who climb the corporate ladder often use their affiliate and collaborative styles to manage. As they climb higher, leaders may become uncomfortable with the authoritative role their position requires. Being directive and using your authority does not have to be aggressive and negative. A caring approach works well with about 50 percent of people. The other 50 percent work well with a logic-focused approach, seek challenges and want to be respected for their output.10b> Assertive leaders and subordinates demonstrate self-confidence and self-respect. "This is who I am," "this is what I want" and "this is why I want it" are assertive statements. Communicating in an assertive manner reduces disagreeable encounters and helps individuals avoid being taken advantage of. Assertive leaders, subordinates and friends seek a "win-win."

Authoritarians say, "Do it now because I said so." Assertive people say, "Come with me; this is how we will do it." A leader who has difficulty being assertive takes on more work than he can handle and allows employees to work in a subpar capacity because he doesn't want to criticize their performance. However, the reverse of this can be true. A subordinate who is not assertive can be taken advantage of by the leader/manager. Personality Theories Theorists disagree on whether aggression is rooted in environment or biology. In motivational theory, blocked needs are seen as the cause of aggression. This theory draws on Abraham Maslow's hierarchy of needs, often represented as a pyramid, with the more primitive needs at the bottom.11The lowest-level needs - physiological needs - such as breathing, eating and drinking must be met before a person can move on to eventual selfactualization. Aggression may occur in individuals who do not achieve the physiological, safety, love/belonging or esteem needs necessary to reach self-actualization. Higher-level needs, i.e., self-actualization, only come into play after the lower needs in the pyramid are met. Behaviorism theory and behavior analysis are thriving in the 21st century. Behaviorists view aggression as a learned response. Others suggest aggression is learned from personal experiences and role models, i.e., environmental influences such as socioeconomics and television. Cognitive theory states aggression is learned but acknowledges the existence of some biological factors. Cognitive theory also states learning occurs vicariously by observing modeling influences and its consequences. Social learning theory examines behavior patterns across a lifetime and demonstrates, in addition to sociocultural influences, background fortuitous events often exert an important influence on the course of human behavior. Keys to Assertiveness Assertive body language includes appearing interested and alert (not angry), possibly leaning forward to show interest, maintaining everyone's personal space and conversational gestures. Use a nonemotional voice. Timing is important when you want to practice being assertive. Assertive responses are characterized by "I" instead of "you." Assertive responses run a low risk of hurting a relationship; they do not attack people's self-esteem or put them on the defensive. The decision to be assertive improves your self-respect. Assertiveness is standing up for your rights. Assertive people say, "I deserve to make my needs known." Assertiveness is catchy. People admire and respect people who stand up for themselves and try to replicate that behavior. Your relationships with friends and family benefit from your assertiveness. No one will say, "I never know what you really think," or "I wish I could really know how you feel." Assertive people interact appropriately with aggressive, hostile, attacking and otherwise unreceptive people. Assertive people protect their rights while respecting the rights of others.

Assertiveness is developed over time. Like a good physical workout, the results of being assertive are cumulative. Your body feels better and your sense of self-value improves. Can you: See your needs as important as the needs of others? Speak up about things that bother you? See yourself as direct and honest? Speak up when you have a different opinion? Accept that others may have a better idea? Accept new ideas and criticism? Communication is the key to assertive behavior. Communication includes a sender, a message and a receiver. The sender must put out a clear message. If the message is clear and assertive, the receiver will have an easier time responding in a similar manner. Assertiveness is enriching. It allows you to show genuine concern for others' rights because your own have been met. n References 1. Villanova University. (2007). Assertiveness. Retrieved Oct. 4, 2008 from the World Wide Web: http://www.villanova.edu/studentlife/counselingcenter/infosheets/psych_topics.htm?page=ass ertiveness.htm 2. Farrington, J. (2008, July 27). How to become truly assertive. Retrieved Oct. 4, 2008 from the World Wide Web: http://www.leadershipturn.com/how-to-become-truly-assertive 3. Bach, G.R., & Goldberg, H. (1974). Creative aggression (pp. 182-185). New York: Doubleday & Co. 4. Conflict Research Consortium Staff. (2000). Article summary of "Aggression and violence" by Susan Opotow. Retrieved Sept. 25, 2008 from the World Wide Web: http://www.beyondintractability.org/articlesummary/10429/?nid=5725 5. Raudsepp, E. (2007, Feb. 1).Areyou properly assertive? Retrieved Nov. 26, 2008 from the World Wide Web: http://www.allbusiness.com/human-resources/employeedevelopment/4051770-1.html 6. Marano, H.E. (2004, Feb. 12). Assertiveness, not aggressiveness. Retrieved Sept. 7, 2008 from the World Wide Web: http://www.psychologytoday.com/articles/pto-20040212000002.html 7. Lucia, A. (2005). Cinderella is no go-getter. Retrieved Oct. 4, 2008 from the World Wide Web: http://www.adlassociates.com/pages/newsletter_archive/oct2505.htm

8. Hall-Flavin, D., et al. (2007, Mar. 9). Passive-aggressive behavior: How can I recognize it? Retrieved Nov. 26, 2008 from the World Wide Web: http://www.mayoclinic.com/health/passive-aggressive-behavior/AN01563 9. Ray, J. (1981). Authoritarianism, dominance and assertiveness. Journal of Personality Assessment, 45(4), 390-397. 10. Kennett, M. (2008, Feb. 1). First-class coach. Retrieved Nov. 26, 2008 from the World Wide Web: http://www.managementtoday.co.uk/search/article/781027/first-class-coach 11. Maslow hierarchy of needs. (2007). Retrieved Nov. 26, 2008 from the World Wide Web: http://www.abraham-maslow.com/m_motivation/Hierarchy_of_Needs.asp 12. Improving assertive behavior. Retrieved Oct. 4, 2008 from the World Wide Web: http://www.coping.org/relations/assert.htm Kathleen A. Zeiler is a retired hospital administrator and currently on the nursing faculty at Louisa County High School, Mineral, VA. Assertive, Aggressive & Passive Behaviors Assertive power: Personal power, standing up for oneself Aggressive power: Dominance power, power for the aggressor Passive power: Lack of power to stand up for oneself Assertive behavior: Characterized by openness Aggressive behavior: Characterized by threatening Passive behavior: Characterized by timidity and deference to others Assertive behavior: Uses direct eye contact Aggressive behavior: Glares and stares Passive behavior: Uses minimal eye contact Assertive behavior: Speaks often, clearly and openly Aggressive behavior: Speaks loudly Passive behavior: Fears speaking up, fears their thoughts don't have value Assertive behavior: Uses a normal tone of voice Aggressive behavior: Talks over and interrupts Passive behavior: Speaks softly

Assertive behavior: Uses good body posture Aggressive behavior: Uses the body to threaten Passive-aggressive behavior: Uses poor body posture Assertive behavior: Speaks politely but firmly Aggressive behavior: Speaks rudely, threatening Passive behavior: "Shrinking violet" Assertive behavior: Sticks to the point Aggressive behavior: Rages Passive behavior: Doesn't get to the point Assertive behavior: Expresses negative feelings in an open, direct way Aggressive behavior: Demands rather than asks Passive-aggressive behavior: Expresses negative feelings in an indirect and often obstructive way Assertive behavior: Gets right down to the task Aggressive behavior: Rages against the task Passive-aggressive behavior: Acquiesces to the task, but procrastinates and simmers with resentment Assertive behavior: Is fair Aggressive behavior: Is one-sided, angry and belligerent Passive behavior: Appears to be fair Assertive behavior: Wants to get their needs met Aggressive behavior: Tends to be defensive, has a chip on shoulder Passive-aggressive behavior: Can be "hostile-passive," appear satisfied, then sabotage projects and spread malicious gossip to undermine others What Gets in the Way of Assertiveness? Common Obstructive Thoughts I'll hurt someone's feelings

 They won't like me They will be angry with me I'll be responsible for myself I'll feel devastated They will think I'm selfish I might look stupid I'll look like I don't care I won't appear modest about myself It is my obligation to take care of others Practice Being Assertive Ask a friend for a favor Say "no" when a request is unreasonable Keep your opinions on the front burner, stick to them Accept compliments Questions things that don't make sense Insist on being respected Strategies Find ways to succeed (e.g., academics, appearance, friendships, career, athletics, physical ability) Learn to communicate Make your needs and desires known Express yourself without threatening others Identify clearly what you want Copyright 2013 Merion Matters 2900 Horizon Drive, King of Prussia, PA 19406 800-355-5627 Publishers of ADVANCE Newsmagazines www.advanceweb.com