Working within the field of trauma is deeply moving. I have been doing so for over 17 years, and in my view it is completely unacceptable to continue to hear stories of carers who have fallen through the net of care.
The neuroscience and research of trauma has developed at a great pace over the last two decades. But still, stories of individuals suffering with trauma symptoms continue to rise. Recently, as I was speaking to a group of security managers at a humanitarian forum, I became aware that trauma awareness training seemed to be a luxury, due to ‘lack of resources’.
Over 20 years ago, around the time that I suffered from Post-Traumatic Stress Disorder (PTSD), there was very little understanding of the impact of trauma and there was no trauma specialist therapy available to me, but not understanding my symptoms was the most disturbing ailment. I often experience clients feeling the same way:
not knowing anything about trauma symptoms or PTSD, I thought I was having a nervous breakdown and this was a major mental health collapse. I couldn’t see how this would get better, that this was something that could be recovered from, I just thought, this is finally it; I’m losing it for good. (Omar, Jordan)
Aid workers are mostly driven by the belief that the humanitarian imperative comes first and the right to receive humanitarian assistance is a fundamental humanitarian principle, which should be enjoyed by all citizens of all countries. The prime motivation of responses to disaster is to alleviate human suffering amongst those least able to withstand the stress caused by disaster.
When humanitarians give aid it is not a partisan or political act. But, as humanitarian responses have become more prolific and protracted, and humanitarian and development agendas have become more closely linked, aid workers have also started to advocate for equality, justice and empowerment.
Humanitarian work is inherently stressful, with long working hours, away from family and friends, frequent transitions, security constraints, managing emergencies and making life-saving decisions. Not to mention a plethora of other stress inducers too numerous to list here.
Humanitarian aid workers can often overlook their own self-care, in the name of the greater cause. Steve Ryan, a security consultant, describes the reasons he experienced cumulative stress:
years of travelling, often at short notice, to dangerous places; the unforgettable smell of a mass grave in a Lebanese summer; constantly juggling social and work life; hearing the crack of a bullet overhead in Yemen; talking about risk across grand tables in HQ, or plastic picnic tables in the field; a close call in Syria, and guilt-inducing missed calls on my ever-present work phone had all taken its toll.
All of these experiences are compounded by the lack of support individuals receive from their organisations at the time. This needs to change.
Self-care, resilience and mindfulness are some of the buzzwords referring to wellbeing and well mental health.
Our aim should be to strengthen our own self-care and resilience, and that of the organisation. A resilient organisation encourages resilient staff, and vice versa. Aid workers have often said to me that they feel guilty asking for support and instead reach out to unhealthy coping mechanisms to drown out the uncomfortable feelings, such as alcohol, caffeine, nicotine or recreational drugs.
‘I felt guilty if I informed anyone I was suffering. How could I complain, when I was faced with such despair in my work, and others were suffering from so much more?’ (John, Norway).
Ben Porter, the founder of the Recreation Project, Uganda, and a staff care and psycho- social consultant, refers to a break-down truck to highlight the importance of self-care: Whilst jogging down a red-dirt road in the Ugandan countryside, I came across a stranded tow-truck (a breakdown as they call them).
My friend looked at me and laughed. What happens when the breakdown breaks down? Double trouble, I replied. The situation just got much worse. Ben notes that ‘staff who are employed to assist those in need can end up breaking down and requiring assistance’. If we don’t take care of the carers first and foremost, we will not be strong or resilient enough to care for others.
I repeatedly hear from aid workers that stigma is one of the main reasons why individuals do not reach out for support. Individuals suffering mental health issues often worry that they will be perceived as ‘weak’ and, in fact, psychiatrist Tim Cantopher, who wrote the book Depressive Illness: The Curse of the Strong (Cantopher, 2012), describes individuals suffering from cumulative stress as resilient and strong.
It is the very fact that they are conscientious, dedicated and hard-working that puts them at risk of becoming ill. The aid workers who shared their stories with me were not weak; I met strong, passionate, inspiring and resilient individuals.
They also represent the ‘change makers’ who, at times, are willing to be the lone courageous voice advocating for colleagues who are also struggling, sometimes confronted with a wall of denial and a risk of being scapegoated.
These individuals should be embraced as an asset to any organisation and not shamed into resignation.