Rejection sensitive dysphoria - AIBU

[Lipido]

name changed and will have to leave this a bit vague

A member of staff has returned from sick leave (workplace stress, extended 6 months - came back the day before flipping to half pay).

Occy health have sent a recommendation that based on the self diagnosed rejection sensitive dysphoria a number of reasonable adjustments are put in place.

One of the adjustments is that emails shouldn’t include bold text or underlining as this triggers the above, not just emails from me, emails from any senior person in the organisation

My AIBU is NOT about the above diagnosis . It’s about the fact that an occupational health nurse can give this kind of recommendation (and others) based on a phone assessment for a self diagnosed issue. With absolutely no understanding of how this will play out in the real world? I cannot monitor or screen emails to this person. I cannot ensure they are never given feedback they might not like. I essentially cannot manage them at all!

Just fyi,

the remit of occupational health is to protect and promote the physical and mental wellbeing of employees by preventing ill-health related to work.

This includes providing impartial advice to both employees and employers, developing health and safety policies

RSD isn't a diagnosis. It's more like a presentation.

My psychiatrist outlined a lot of areas where RSD was relevant in my autism diagnosis, but said it isn't a diagnosis in and of itself. Much like not being able to cope with the feeling of brushed velvet isn't a diagnosis, it is just an inhibiting part of a wider disability.

Occupational Therapy has been absolutely invaluable to me though with identifying RSD and being able to realise that what I perceive as criticisms aren't always negative, and it is OK not to be a perfect person.

I think a better recommendation from OH would be for the member of staff to either enquire about it's availability on the NHS or whether their employer can partially or fully fund some occupational therapy to address this as some employers will. It may also be something funding can be applied for through access to work, though I don't know for certain as I didn't have to go this route.

I agree with you. I think all the OP can do to cover themselves is say that they've tried but ultimately the accommodations are not practical or sustainable. Its like saying that you someone can't receive emails with the colour red because it triggers their PTSD. This employee needs to go off sick and get help for their mental health.

Exactly this.

I would advise that you talk to them about how this will work. You will ask senior colleagues to follow the recommendations when emailing this particular person but stress you have no power over external emails.

Maybe if they then get an email they find difficult, they can forward it straight to you and the two of you can work together to address the actual content of the email rather than the bold and underlined sections that trigger them.

As they have acknowledged they have RSD, you should be able to have open discussions with regard to feedback they are reacting badly to and whether this is because of the actual feedback or their condition.

I'm also ND myself so come off it thinking the world owes everyone a favour. HTH.

We simply can't go on indulging everyone with "reasonable adjustments" for self diagnosed conditions, it's making the work place unnecessarily stressful for everyone and people are running out of patience which will adversely affect those with genuine conditions who requests for adjustments are entirely reasonable. It's just not possible to meet everyone's demands because the accomodation for one person might upset another and it's really unreasonable to expect all staff to remember everyone's requirements without ever making a mistake.

Do you send bold and underlined missives? If you do pack it in, it’s irritating and passive aggressive. Also never ever say occy health, it’s giving heavy David Brent vibes.

Yes I know. I was pointing out that they can’t concur that someone has something they’ve diagnosed themselves with. They are not able to diagnose people.

I’d reply to Occy health and cc HR, saying thank you for this. I didn’t realise we apply adjustments to this extent for self diagnosis so ccing hr to confirm. In any case, these aren’t adjustments I can implement - I have no authority to screen emails from everyone else in our company to ensure they don’t have bold text nor to monitor every interaction to ensure it doesn’t include any unwelcome feedback. You will probably need to take this up with the head of people or perhaps the ceo, I’m sorry I don’t know who would be responsible for this kind of firm wide messaging?

Separately regarding what is in my remit, I have concerns as to how this impacts my performance reviews for my team, at a surface reading your email says I can now only give positive feedback, how will this work in practice? @hr hoping you can give me some guidance here on how to do my job well and fairly for my whole team.

kidn regards, pissed off manager.

We put bold text into our board papers for clear reading so….

In my work, occupational health employees refer to themselves as occy health. It’s fine for people to say occy health if that’s what they’re used to saying.

we use bold font for subheadings for a vision impaired colleague to find the key points more easily

We put key phrases in board reports in bold at my global company.

To add, I can ensure you nobody at all is being passive aggressive to our board.

This is absolutely not true. I don’t get the leap from I didn’t get a service so others shouldn’t…this was ‘race to the bottom’ encapsulated in a post …you don’t know this person and to be off 6 months she won’t be self diagnosed

As a manager I'd feel I was underperforming sending an email like that.

Yes, we can make adjustments for self-diagnosis - they are supposed to be used where there is a possibility of impairment. But OH don't call the shots. They suggest the adjustment, and it's part of the manager's role to determine whether it's reasonable. So she can now do that - there's no need for all the criticism of OH once she is performing her own role. HR in my place would not be pleased to be cc-ed on an e-mail like that either. They wouldn't appreciate a paper trail suggesting I was acting on anything other than business needs. And it's perfectly possible to refuse adjustments on business needs.

🙄 We once had a trainee announce that she would not be receiving feedback on her course exams or be sitting in when the answers were given out as that would be too upsetting for her. Since the job was a law enforcement adjacent role that got very swiftly refused.

Me too the poor attitude is glaringly obvious

Didn’t you read the OP? It is self-diagnosed. And hence the point of this thread and the issue being debated.

FWIW - Its not a ‘race to the bottom’. I do know a teensy bit about this, having an actual diagnosed severe mental health disability, and also working in a senior position in mental health services, and also being a Senior Occupational Therapist myself.

But sure, discount my contribution as a race to the bottom. 😒

Its exactly this sort of utter nonsense that makes me so glad Im retired 😉

Err this. They need to get back in their lane

Personally I hate endless text in emails and ideally want them all in bullet points. Funnily enough due to an actual formally diagnosed thing. But l appreciate it's not all about me and other people feel differently

I use bold all the time in my emails - especially if they’re long and I’m asking people to do something. I also use a tl;dr sentence at the top sometimes. And to be honest, I don’t think I would stop doing this on generic team/unit wide emails because the type of job I do means that this way of communicating is more effective. One person’s need in this case doesn’t weigh up against the whole business need. That’s said, I think I would almost never use bold or underlining with an individual so if that’s happened or you are doing that then I’d stop quickly.

I do actually have RSD, and it plays out more in individual interactions. Eg if my boss sends a message asking for a quick chat, then if I’m not given any context I’ll spend the time between now and the meeting assuming I’m being sacked. I also don’t respond well to messages that appear to be demanding or negative and I interpret any vaguely non positive comment as horrifically negative. I’m working on this. This week I’m a bit put out because I’ve had a minor medical procedure and have stated that I will wfh next week because of a combination of wound care and high strength abx making me feel ill, and he’s left me on ‘read’.

I think maybe you need to work with this person gently to understand the actual problem.

Ah.... RSD is NOT a diagnosis, it is a collection of symptoms which can have different causes, most likely based on previous experiences, exacerbated by ND if it is present. In the same manner I could request adjustments based on difficult childhood experiences, which are more likely to lead to a clinical diagnosis btw.

My question would be what is the organisational culture - and perhaps what triggered workplace stress for this person - and adjusting that on their return. Is there a lot of absence sickness? Are others complaining about the tone of emails?

Following

So, you think you are qualified and able to diagnose conditions remotely, from a single forum post, without having assessed the individual, in person?

What are your qualifications? Which professional body regulates your profession?

So this is why it’s causing an issue:

Organisations work on processes. Once they get modified for individuals then you are more likely for mistakes to happen.

However, Individuals want personalisation.

At its foundation personalisation and process are at cross purposes. So there is initial friction. ( Sometimes this is good because the process needed a nudge to change). But it’s there.

It only works imo when the inclusive accommodation is something the person does themselves to help them join in with the process. Or when the process is changed across the whole organisation so it’s a functional, foundational change.

So in this case - a directive to the whole organisation that no bold/underline be used in email (I think this would be unreasonable really but is an example of process change).

IT finds some way to screen persons emails and remove bold and italic before they read them.

Or team member, has therapy to deal with the part of their brain that gets overstimulated by a message - this could be something like cbt.

The important thing about about accommodations is that is to help the person to join in with what is hard for them.

Somewhere that has been lost when professionals are recommending things that just facilitate avoidance which is ultimately unhelpful.