This is the second post of three in my series about building resilience to acute stress and trauma. This week, I'd like to talk about social and physical tools. I’ll look at using human attachments to curb our stress levels, and some of the physical ways we can release tension. Work demands and mental health risks to carers are ever increasing, so I have created a resilience toolkit acronym using the word RESPECT. I recommend accumulating a good balance of resources that cover the following areas: Relaxation Education Social Physical Exercise Creativity Thinking I suggest you try out some of the techniques in order to create your own personal resilience toolkit (Dunkley, 2018), ready to use when needed. How do Social factors play a role in helping ease acute stress and trauma? Socialising and connecting oneself with people can provide an invaluable source for stress busting. Here are a few of the things that I have found helpful.
If teams haven’t been supported well or offered good supervision after a traumatic event they can experience ‘trauma splitting.’ This can lead to a breakdown in team dynamics, becoming detrimental to staff wellbeing and, at times, resulting in grievances and scapegoating.
Reducing acute stress and trauma with Physical activities We know a lot about trauma and stress being held in a physical sense, so this has formed a very important part of my toolkit.
And finally. In my next, and last post in the series, I’ll cover building resilience to acute stress and trauma by using exercise, creativity and thought tools. Can exercise really release the sort of hormones that make you feel yourself again? And how can basing your thoughts in reality help you overcome workplace trauma? You can also find an in-depth look at the entire toolkit in my book, Psychosocial Support for Humanitarian Aid Workers, available from Amazon. In the meantime, feel free to comment with any questions or thoughts. Edited by John Kirkham
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In this series of blog posts I’ll cover some of the techniques that I use to build resilience to acute stress and trauma. I use this bank of resources both personally and with clients, and have seen first-hand the positive effect that using a mixture of these techniques can yield. I will, wherever possible, relate tools in the kit back to real life cases, although names have been altered and permission to use these real life stories granted. Maintaining resilience at work Work demands and mental health risks to carers are ever increasing. Research has shown that people in caring roles are at risk of vicarious trauma, cumulative stress, burnout, and compassion fatigue. So how do individuals in caring roles remain resilient and continue to be able to work in environments where they are at risk of being exposed to traumatic material, directly or indirectly? The resilience toolkit (Dunkley, 2018) Building resilience is about learning to respect and take care of yourself. I have created a resilience toolkit acronym using the word RESPECT. I recommend accumulating a good balance of resources that cover the following areas: Relaxation Education Social Physical Exercise Creativity Thinking I suggest you try out some of the techniques in order to create your own personal resilience toolkit, ready to use when needed. Each post in the series will cover a mix of tools from this toolkit. In this post, I cover relaxation and education. The first step towards stabilisation is relaxation Calming the system when we are traumatised or feel acute stress is essential, and the first step in stabilisation.
A simple breathing exercise is to take a deep breath in, hold for a couple of seconds and make the ‘out breath’ longer than the ‘in breath’. This activates the parasympathetic nervous system, avoids hyperventilation, and allows our mind and body to relax.
Yasmin is an aid worker, living and working in Lebanon. Reflecting on how chaotic her life has been in recent years, she says, I’ve been rushing from one thing to another. I feel like I haven’t breathed properly for a long time.’ After a great deal of resistance she finally started using breathing and mindfulness exercises. She no longer suffers from acute stress, and uses her practices daily whilst at work.
This philosophy is similar to Hebbian’s theory that ‘neurons that fire together, wire together.’ (Hebb, 1949). Newberg found that when studying individuals, of various faiths, during prayer, their frontal lobes lit up (linked to positive mood), but the pariental lobes (linked to sense of self) went dark. Individuals described this ‘as a sense of oneness with the universe’.
Becoming more aware through education I often refer to the statement ‘Facts Fight Fear’ as focusing on facts enables the prefrontal-cortex part of the brain to stay on line, thus reducing anxiety levels.
Tim, a logistics manager, arrived for his trauma counselling in a panic, clearly having just experienced a flashback. ‘I don’t know what happened – it just came out of the blue. It started at the gas station around the corner, as I was filling up my car with petrol.’ As we explored this further it became apparent that the smell of petrol had triggered his flashback of an explosion in Juba, where one of his colleagues had died.
In my next post... In my next post, I’ll cover building resilience to acute stress and trauma by using social and physical tools. We’ll look at using human attachments to curb our stress levels, and some of the physical ways to release tension. You can also find an in depth look at the entire toolkit in my book, Psychosocial Support for Humanitarian Aid Workers, available from Amazon. In the meantime, feel free to comment with any questions or thoughts. Edited by John Kirkham In this excellent podcast interview Trauma Therapist Fiona Dunkley is interviewed by the Arukah Network and shares her knowledge of some of the keys to trauma recovery. Fiona has worked with communities hit by terrorism, citizens in post-conflict countries, firefighters and sexual assault survivors. In this interview she discusses the role that community can play in helping people overcome their trauma. We hope you enjoy listening! A Roadmap of Trauma and Critical Incident Care from author and trauma specialist Fiona Dunkley. Humanitarian aid workers are trying to make a difference in an increasingly dangerous world. Psychosocial Support for Humanitarian Aid Workers: A Roadmap of Trauma and Critical Incident Care highlights the risks of such work, educates professionals responsible for their duty of care, and brings together current thinking to promote collaborative working to support the carers of our world. From the humanitarian aid worker trying to organise support amongst chaos, to the professional offering a safe place for recovery, all of these individuals are at risk of suffering trauma, burnout or cumulative stress. Therefore, it is vital that we recognise the psychological risks on these individuals, and that they recognise how they can support themselves, so they can continue to function in the work that they do. This book can be used as a trauma and mental health awareness guide for all staff whose work exposes them – directly or indirectly – to trauma, and therefore becomes a risk to their physical or mental wellbeing. Psychosocial Support for Humanitarian Aid Workers will appeal to all those working in the field of humanitarian aid, counsellors and psychotherapists, emergency first responders, as well as those who are looking to support themselves after surviving trauma. Philip Goodwin, Chief Executive, VSO International commented "Raising standards in psychosocial support for those working on humanitarian response to crises and disaster is only just being recognised by those organisations working in the field. This book is an essential and timely contribution to understanding the need for such support as well as providing a practical guide to establishing systems and approaches. I would urge all those responsible for humanitarian aid workers and indeed, for those responsible for staff or volunteers working in development organisations, to read this book as a matter of urgency and to take on board its recommendations" . The book covers topics including the roadmap of psychological risk, the physiology of trauma, treating trauma, the resilience toolkit and provides real self-help tools for anyone working in trauma support or wanting to learn more about easing the effects of burnout. Fiona Dunkley commented, “think of this book as a workshop on trauma awareness in the palm of your hand. My passion is to help care for those that care for others and if this book can provide that support then I have achieved my goal.” The book is available from Routledge – get your copy today: click here About Fiona Dunkley Fiona Dunkley is a BACP senior accredited psychotherapist, supervisor and trainer, is also a member of EMDR, UKRCP and ESTSS. Fiona founded FD Consultants, offering psychosocial support and trauma specialist services for humanitarian aid organisations. Fiona worked within the NHS, with emergency first responders and was the lead counsellor at Transport for London. She helped develop a critical incident plan after the 7/7 bombings. She has presented on ‘Good Morning Britain’ as a trauma expert, has published several articles and has been asked to speak at various international conferences. So much has happened recently that feels like progress when it comes to ensuring the right of people to live free from abuse. Millions of people across the world have harnessed the power of social media to demand an end to sexual violence and harassment against individuals using hashtags such as #MeToo, #AidToo, #TimesUp, #YouOkSis, #SayHerName, #MosqueMeToo, #23Days, #OneBillionRising and #EverydaySexism. Powerful figures, from Hollywood film producers to senior politicians and humanitarian aid bosses, have been named and shamed for crimes such as sexual misconduct, assault and child abuse. In the United States, more than US$20 million has been raised to establish a Time’s Up legal defence fund for lower-income women seeking justice for workplace sexual harassment and assault. This year should finally see the first steps towards the implementation of an international legal standard to help prevent, identify and remedy violence in the workplace, with a strong focus on the gender. But what is Gender Based Violence (GBV)? This is defined as any harmful act against an individual due to their gender, male or female, often motivated by power or control, all forms of sexual abuse, sexual harassment, domestic violence, honour killings, forced marriage, genital mutilation etc. The majority of perpetrators are male; although research shows male survivors are much less likely to report these crimes. Those who speak out against the physical, sexual, psychological and economic harm they endure often pay a terrible price. Victims face slurs, shame, can be ostracised from the community and education, experience a loss of income, more violence and even loss of life. For every woman or man that has shared her/his story on social media, there are thousands more for whom silence was the only option. In England I have witnessed and supported individuals at the Crown Court, but the percentage of cases that even make it this far is so miniscule we are just seeing the tip of the iceberg. So why is this happening? Any sector which supports vulnerable individuals can become a breeding ground for GBV due to several factors such as an imbalance of power (gender, beneficiaries), an inbred macho culture (risk behaviours - running on adrenaline), and being in confined environments. What can we do to stop GBV? Megan Norbert is at the forefront of creating change. She has recently been presented with the @InterActionOrg's Humanitarian Award for her work to end silence on sexual violence against aid workers. She's a gender-based violence in emergencies specialist with CARE. Megan shared her story with me for my recently published book, Psychosocial Support for Humanitarian Aid Workers: A Roadmap of Trauma and Critical Incident Care, buy your copy today click here One point I make in the book is if you don’t know how to support a colleague who may have just experienced a sexual violent crime you need further training. It is essential for preventing retraumatising individuals, and there is an urgency with much of the support due to timelines of forensic data collection. It is important individuals are well informed as it can make a huge difference to someone’s recovery. The initial stages of support are often the most crucial in someone’s recovery. Organisations need to create a culture of accountability and ensure follow up on reports and care to the trauma survivor is given in a timely and suitable fashion. In-country teams need to receive full training to know how to support each other and the care-givers in their teams. How can we empower people to speak out safely? What do organisations need to do? The only way we are going to change systematic ignorance of GBV is to ensure organisations, companies and NGOs have transparency, working collaboratively so perpetrators cannot be moved from one agency to another; this obviously ties into more stringent vetting and recruitment procedures. All organisations need to ensure they have whistleblowing policies in place, that they are promoted internally and a culture of sharing feelings and cases of GBV so that they are not swept under the carpet. FD consultants are working collaboratively with Care International by offering individual and group support sessions - lets hope more organisations follow their lead. This ties in with continually reviewing safeguarding policies and making them a priority within the organisation. Sadly, I have worked with many organisations where safeguarding is seen as a low priority (RtA found that only 16% of 92 organisations reviewed mentioned sexual violence in their duty of care policies). Organisations need to be aware of local protocols and laws; as well as consider if the survivor needs to be relocated for better care. I am often shocked at how little information organisations have about areas where they are deploying staff. Better support for Survivors Fundamentally our care and support for survivors of GBV needs to improve. Organisations need to have clear policies in place that are implemented as soon as a case of GBV is reported, with immediate medical care for the survivor, as well as providing access to counselling services. After the initial support organisations should offer legal support and follow up with the survivor to ensure they are not retraumatised and are receiving the care they require and have every right to. Here at FD Consultants we are passionate about training the carers and NGOs and have developed a Sexual violence awareness course to enable participants to better protect themselves against the threat of sexual violence and be better placed to respond in the event of an incident occurring. We strive to define sexual violence, challenge myths and build skills to support a colleague after a sexual violent crime. The true power of the #MeToo moment will lie in our ability to harness this rare, sustained global attention on the issue of gender-based violence to support the work of the grassroots activists, community-based organisations, journalists, academics, trade unions, NGOs and social movements who were doing this work well before the hashtags started trending and will continue doing it long after they stop. Their work needs to be well-funded and widely supported but it also requires the proper legal framework. That’s why the proposed International Labour Organization (ILO) instrument on Violence and Harassment against Women and Men in the World of Work is so important. There are currently 189 ILO conventions setting out basic principles and rights at work; not one of them focuses on gender-based violence. It is time to create a culture of zero tolerance, it is time for change. References
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