Yet, what are the nebulous costs that result from absenteeism, lack of employee focus, increased usage of insurance as a result of medical conditions, and even issues related to sabotage instigated by unhappy employees, simply due to an emotionally unhealthy work environment?

What is an emotionally hazardous work environment?

For this definition, it is a workplace lead by a manager who believes in demonstrating power and control over employees, dominates others through intimidation, conveys no compassion or understanding for the individual needs and issues of employees, and who may frequently take credit for the work of his or her subordinates. In other words - a workplace lead by a narcissistic manager.

Narcissistic people frequently demonstrate "God Complex," behaviors: They think that others in the world believe exactly what they believe. They see themselves as omnipotent, untouchable, and feel that rules don't apply to them. They are frequently arrogant and conceited and have a sense of entitlement about them.

Yet the worst part of their behavior is that they do not see others as equal human beings - employees may as well be robots or machines as humans, for these narcissistic leaders do not comprehend that others have feelings, needs, and thoughts … thus, the reason they are incapable of empathy or compassion in their dealings with "underlings". A vision of Scrooge comes to mind, constantly harping at Bob Cratchett to work longer, harder, and for less, and pouting like a child or having a temper tantrum when Bob asked to have Christmas Day off.

Despite his (or her) apparent lack of emotion when it comes to others, when the tables are turned it is quite another matter. When the narcissistic boss gets his (or her) feelings hurt, perceives he has been slighted in any way, or is threatened that an employee's abilities might be better than his own, he will overreact with a rage that leaves terror in his wake. Everyone knows when the boss is having a temper tantrum and all do whatever possible to stay out of the path of the hurricane. Unfortunately for some, they will always be stuck in the eye of the storm and will suffer from the emotional abuse that ensues.

In these days of extreme competition in business, it is quite common for corporate leaders to hire managers with vastly competitive personalities, who will work themselves, and their teams, like crazy to make it to the top. And yet we have seen in recent years, how those same go-getters are sometimes oblivious of who they walk over on the way, until it's too late.

Take Enron for example. Top leaders of the once powerful corporation became so obsessed with their power, control, and omnipotence, they were blindsided to the devastating end result they were creating. In their "Godlike" vision, how could anything possibly go wrong?

Not all narcissistic bosses are as obvious as the infamous Mr. Scrooge. The more insidious, "stealth" type narcissists can still create an emotional hell for those around them. Name calling, talking down to employees, sexual harassment, dishing out the "silent treatment" to those who have slighted or mis-stepped around the boss, establishing multiple and/or unrealistic rules, prohibiting personal objects in the workplace (photos of family, etc.), and dishing out unrealistic job expectations are just some examples of the subtle brainwashing/ controlling techniques that gradually but consistently erode a normal workplace into one that is downright cancerous. And just as with cancer in the body that can spread its malignancy throughout, thus an entire corporation can become victim to this "disease."

In addition to narcissistic managers, narcissistic employees can make their coworkers equally crazy. While these people may not have the title to go with their grandiose fantasies of power and importance, they seem to act the role anyway. Those in the crossfire can still suffer the same effects as if working for a boss of the same behaviors. Bullying, employing the "silent treatment," not carrying their share of the workload, filing false accusations, persistent teasing, name-calling, threatening, and attempting to control others in a variety of ways, these power mongers can still leave the victims in their path, exhausted, drained, and looking for work elsewhere.

So how do these abusive monsters gain access to a position within a corporation to begin with if they're so terrible?

One of the greatest abilities of narcissists are their great acting ability. They win the Academy Award for Best Actor or Actress, and can worm their way into any variety of positions. They know just how to be the perfect employee, manager, or partner for as long as it takes to become well entrenched in the system … then once they have a foothold, their "real" personality eventually surfaces. Rather like the famous Dr. Jekyll and Mr. Hyde. Yet, by then it's usually too late for human resources to notice. The probationary period is up. And to terminate the employee now becomes a tricky legal walk.

Worse yet is the narcissistic boss who continues to look like the ideal employee to those he reports to, yet who unleashes his terror on his underlings. When his employees go to complain to upper management, they are not believed, since the middle manager has convinced upper management of his excellent, role-model behavior and talents.

So what is the hidden cost of employing narcissistic individuals in your work place? Is it high turnover? High absenteeism? Employees on Prozac? Or just the fact that people hate coming to work and thus give you a halfway job?

In the grand scheme of things, working in an emotionally hazardous environment can be compared to living in a war zone: the instability of the situation that can change without notice, the constant strain of living under high tension, the ongoing worry of being "under the gun," the desire to stay out of the line of fire, for fear of being attacked. This is indeed how many employees feel working for narcissistic managers.

If you were living in a real war zone, what symptoms might you see? Depression, anxiety, chronic fatigue, anger, inability to concentrate, gastro-intestinal symptoms, blood pressure changes, headache, backache, changes in appetite, agitation, hysteria, Post Traumatic Stress symptoms, and so on.

So what is the real cost? If we could put it in dollars and cents would we be more careful who we hire to lead our teams of valuable employees, as well as members of the team?

Instead of a huge percentage of our populace being drugged with antidepressants as a means to cover up the root of the problem, let's start asking pertinent questions about what's going on in their lives - not only at home, but in the work environment as well.

Mary Jo Fay, RN, MSN is a columnist, speaker, and author of "When Your Perfect Partner Goes Perfectly Wrong - Loving or Leaving the Narcissist in Your Life." She is founder of the Narcissism Survivor Network (www.helpfromsurvivors.com) and can be reached in the US at 303-841-7691. She writes and speaks extensively about helping victims of Narcissism Victim Syndrome.