‘I find working with trauma inspiring, not only because of witnessing the human spirit to survive, but also because of the privilege to travel such difficult terrain with an individual who is suffering to a path of greater resilience, self-compassion and traumatic growth.’ (Dunkley, 2018) The nature of the human spirit is resilient and strong; we thrive for survival against all odds. Trauma impacts our mind, body and spirit; it invades our internal and external world. Critical incidents, whether man-made or natural disasters, are becoming more prevalent and assiduous. Traumatic experiences can unite us or tear us apart, depending on how they are managed, and the support individuals receive. Having supported emergency first responders after the Grenfell Tower Fire (2017), where 71 people lost their lives, the healing power of community was evident. The community came together to support one another, people opened their doors, community centers offered support to families, religious centers offered all faith services, and there was an overwhelming amount of donations given by the local community and local businesses. A tribute wall was created, which represents a real expression of how people were feeling. The statement ‘bonds formed are difficult to break, our community will stand together’ highlighted the power of people wanting to come together and support each another during adversity. Those that have experienced trauma often describe themselves as broken, as if parts of them have shattered and become fragmented. Specialist trauma care unites the fragmented parts within an individual, so they start to feel ‘whole’ again. As much as an individual is fragmented by trauma, so can an organisation and community be. As much as healing from trauma is about uniting broken parts within an individual, so it is about uniting community, locally and globally. Coronavirus is teaching us that we need to work collaboratively and unite as one human family to combat this virus. The core principles of humanity, neutrality, impartiality, and independence are more necessary than ever. To heal from trauma we need a supportive trauma informed community. As Martin Luther King reflects, ‘we are caught in an inescapable network of mutuality… whatever affects one directly, affects all indirectly.’ (Ramalingham, 2013). I strongly believe healing communities and countries suffering from trauma will lead to a more cohesive, inclusive and peaceful world. At FD Consultants we are training organisations and communities to become trauma-informed. We are also training peers to become psychological first aiders/focal points to create a resilient organisational culture. During a training on vicarious trauma awareness, which I facilitated in Nairobi I referred to the word, ‘Ubuntu’ (a Nguni word and Southern African philosophy) – ‘I am, because we are’. Healing from trauma can’t be done individually; we need support from trauma informed organisations, communities, teams, and families, to truly heal from trauma. Van Der Kolk, a psychiatrist renowned for his work on trauma, also refers to the word Ubuntu: ‘my most profound experience with healing from collective trauma was witnessing the work of the South African Truth and Reconciliation Commission, which was based on the central and guiding principle of Ubuntu…. that denotes sharing what you have, as in “my humanity is inextricably bound up in yours.” Ubuntu recognises that true healing is impossible without recognition of our common humanity and our common destiny.’ (Van Der Kolk, 2014, p. 349). Ubuntu underlines the importance of working collaboratively and respectfully, working with local communities, and encouraging community engagement. Dalia Lama wrote some words of wisdom about the Coronavirus ‘For the Call to Unite’ (May, 2020). ‘We need to reach out to each other with compassion. As human beings we are all the same, we experience the same fears, the same hopes, the same uncertainties… This crisis and its consequences serve as a warning that only by coming together in a coordinated global response will we meet the unprecedented magnitude of the challenges we face. I pray we all heed the call to unite.” Find a way to connect to your local community; watch out for colleagues that may be struggling in the workplace; join a specific group supporting the vulnerable, so as to really embrace the healing power of community. For organisations looking for employee psychological support, FD Consultants are the trauma specialists and well-being service who will best deliver a reliable, quick, and bespoke support system in the workplace. FD Consultant’s team of accredited specialists will offer ongoing support to help manage stress, prevent burnout and provide specialist trauma care where required, enabling your staff with the tools to cope, and recover more quickly. Get in touch with us today
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‘Post-traumatic growth suggests that individuals who survive trauma often become stronger and more resilient. Some individuals who carry the scars of psychological trauma want to use their experiences to make a difference and help others, this results in numerous acts of kindness’ (Dunkley, 2018). In adversity we are adaptable and resilient. One thing Coronavirus has taught us is the importance of staying connected. The road I live on has setup a WhatsApp group. Even though I have lived on this road for seven years there are so many people I had never met before. I have now built relationships with them remotely. This has created a local community where we are all looking out for each other, including baking, shopping, collecting prescriptions, sharing artwork, knitting rainbows and hearts for the NHS, and delivering supplies to food banks. We even have a karaoke singer who sings in his front garden every Saturday, where we can request songs. I have witnessed so many acts of kindness over the last few months, from looking after the most vulnerable to providing support to the key workers. It has warmed my heart and highlighted the generous spirit of the human race. We are going to have periods when we feel emotional, and days where we may not want to speak to anyone, and at the same time, we know that acts of kindness are available to receive and to give. Research has highlighted that acts of kindness build our confidence and sense of purpose; they make us feel good. Acts of kindness allow us to see the bigger picture, a different perspective we may not have been aware of before; they help us to connect and develop as human beings. This month we are focusing on acts of kindness. We share what FD Consultants have offered over the last few months. Our aim is taking care of the carers. If we can help the carers of our world remain resilient during a crisis, they can continue to carry out the amazing work they do, leading to more healing and further acts of kindness. FD Consultants have been providing supplies to food banks, have delivered pamper packages to individuals who need a pick up, have offered free information and guide sheets, have developed staff wellbeing plans for organisations, and have supported communities around the world to develop new skills during a time of crisis. FD Consultants are offering a package of care for organisations to support their staffs’ psychological wellbeing. This package of care includes the following three, half-day, workshops:
Additionally, we are specialists in offering traumatic grief counselling for individuals and psychological debriefs/process groups for teams. Our workshops promote self-care and enable individuals to feel confident in supporting others’ psychological wellbeing. Now more than ever role-modelling good self-care and offering kindness to others matters. Not only can it help people stay connected, but also the way people are made to feel during a traumatic event has a fundamental impact on their recovery after the event. William Boyd wrote in his book Sweet Caress, ‘However long your stay on this small planet lasts, and whatever happens during it, the most important thing is that, from time to time, you feel life’s sweet caress’ (Boyd, 2016). For organisations looking for employee psychological support, FD Consultants are the trauma specialists and well-being service who will best deliver a reliable, quick, and bespoke support system in the workplace. FD Consultant’s team of accredited specialists will offer ongoing support to help manage stress, prevent burnout and provide specialist trauma care where required, enabling your staff with the tools to cope, and recover more quickly. Get in touch with us today As part of the Coronavirus humanitarian response, FD Consultants have been carrying out consultations with humanitarian aid staff preparing to deploy. Having supported humanitarian staff prior to, during, as well as following deployments for many years and, in consideration of the unique and unprecedented circumstances of Coronavirus deployments, we have consolidated some reflections and considerations. Coronavirus Deployments The humanitarian sector recognises how Coronavirus responses will draw parallels to other familiar humanitarian scenes. In terms of deployments this might mean political violence or civil unrest, movement restrictions, curfews, being separated from loved ones with often unreliable internet and little time to communicate name a few. As well as, of course, the variety of related difficulties common to epidemic response, including stigmatization by the local population, managing PPE shortages and, carrying the responsibility for others’ lives. These are understood as a ‘part of the work’. Circumstances specific to Coronavirus deployments, on the other hand, are an evolving reality. Humanitarians are being asked to manage additional concerns. For example, as deployed staff you might be the vector of the virus to the vulnerable groups you are supporting. You may also be carrying concern for loved ones back home with you into a deployment aimed at addressing the same ‘danger’. Or, having to accept being ‘stuck’ for a period in your deployment country because of travel restrictions. Furthermore, as one staff member put it, “we’re very much on borrowed time.” And yet, there is the 14-day mandatory isolation upon arrival, which might include remaining isolated from fellow colleagues staying in the same location. Where, from the relative comfort of your accommodation, you will be supporting ‘remotely’ the crisis work going on within close proximity to you, knowing that local and other colleagues are ‘in the thick of it’. Possibly resulting in experiencing feelings of loneliness, guilt or frustration. With all this in mind, it is understandable, if not normal, to imagine that even the most well seasoned humanitarian will feel tested in ways their prior deployments have not. Coping strategies and resilience in Coronavirus deployments “You don’t know how long it’s going to take, how long you will have to be there to be sure things are up and running. You have to accept that before you go and let go of the ‘need to know”. This is how a humanitarian explained the way they manage some of the uncertainties faced in emergency deployments. At the time it struck me that this ‘letting go of the need to know’ was somehow both practical as well as self-compassionate. Coronavirus deployments not only carry the inherent stresses of emergency deployments but also unique personal and professional dimensions. Both practicality and self-compassion could go a long way towards encouraging resilience in such circumstances. As described by a number of staff, resilience is the ability to balance being highly adaptive to a fast-changing situation and set of needs with maintaining personal and professional boundaries so as not to burnout. Similarly, it is the ability to know when to say ‘I am out for now. I have to sleep, or rest, or be alone’, so you can remove yourself before you explode or make an unnecessary mistake. This inner voice that is letting you know it is time to take a break, however brief or inopportune, cannot be ignored. It is also about appreciating how teamwork is at the root of any successful deployment, as was repeated by all staff. This involves trusting, relying on, as well as supporting your team. Finding ways to communicate what you need to, at the same time letting go of moments of hostility or rudeness ‘till after deployment’. Coping, psychological wellbeing and, perceived sense of control When we are stressed it is often a product of overwhelm, of feeling out of control. In emergency deployments, particularly at present, where certain variables are entirely unknown, supporting our ‘perceived sense of control’ is key. Research into stress related coping styles has shown that ‘Engaging’ coping styles support our ‘perceived sense of control‘ and, in turn, our psychological wellbeing. Active confronting, for example, refers to directly and consciously facing the stressor, in a “hands on” way. Reassuring thoughts allow us to put things in perspective and to look for ways to acknowledge that, “it's not the end of the world.” Unsupportive coping styles, on the other hand, involve what are called disengagement strategies. When passively react, for example, we “wallow” in negativity, not really addressing the stressor. When we have a palliative reaction we disassociate from the stressor by letting the stressful event numb you. When avoiding we don’t address the problem directly but instead disengage from the situation and avert attention from it through escapism, wishful thinking, self-isolation, undue emotional restraint, and/or using drugs or alcohol. Sometimes we will shout at a colleague, which might be a sign we haven’t listened to the ‘switch’ telling us its time to take a break. All of these reactions are natural, even healthy, within limits. When they become the norm is when we need to reassess. How can FD Consultants support staff? FD Consultants, through their pre-deployment resilience consultations, psychological evaluations, mid and post deployment consultations, as well as trauma assessments and follow up trauma counselling, are well placed to support staff through all phases and experiences on deployment. Mid and post deployment consultations, as a means to ‘checking in’ on staff wellbeing, are recommended now, more so than ever, given the particularly intense and unprecedented circumstances in which staff are deploying. These provide an opportunity to talk through some of the deployment specific circumstances they may be facing, and how they can best cope. Get in touch with us today Author: Arianna Rondos (Associate, FD Consultants) Throughout the coronavirus (Covid-19) crisis much emphasis has been placed on factors that might make individuals physically ‘high risk’ should they contract the virus. NHS UK has published guidelines to help identify and advise people within this category - including, for example, cancer patients, transplant recipients, and those with heart, lung, or kidney conditions – on how to ‘shield’ and prevent themselves from coming into contact with the virus. The reason is that their compromised physical health means a heightened level of vulnerability and the likelihood of becoming gravely ill. What we may have heard less about over recent weeks are factors that might lead those with mental health difficulties to be at higher risk during this crisis. Whilst an individual’s mental health history may not necessarily heighten or reduce their risk of physically contracting coronavirus (Covid-19), or directly influence how seriously they would be affected if they were to fall ill, it can have a profound impact on how they cope with the current situation. It seems universally recognised that the coronavirus (Covid-19) pandemic, and all the measures that have been put in place to halt its spread, are affecting people’s mental health[1]. Who might warrant additional care and consideration from a psychological perspective, though? Here, I present several different categories of mental health difficulty and explore how people living with them may be affected at the current time. Anxiety, Panic Attacks & OCD It’s an anxious and worrying time for most people right now as we wonder, without clear-cut answers, how long the virus will be prevalent for, whether we and the people we love will remain safe, when restrictions to our daily lives will lift, and how our individual and collective livelihoods will be affected longer term. For anyone with anxiety, for whom intense levels of worry and fear are a general and restrictive feature of everyday life, such concerns are likely to be amplified at present. This may lead to feelings of being overwhelmed. Some sufferers of anxiety may also be noticing an increase in panic attacks (intense periods of fear, sometimes accompanied by shortness of breath and shaking), and those with obsessive compulsive disorder (OCD) may find themselves drawn towards compulsive behaviours such as handwashing and cleaning – particularly now these behaviours are being promoted as ways of protecting against the virus. Finding a trusted person to talk to is likely to help anyone experiencing these types of conditions, as struggling with worries and compulsions alone can feel isolating and also lead to anxiety spiralling as it goes unchecked. Limiting one’s exposure to the news and social media can also be a helpful strategy for dealing with anxiety at this time, as is sticking to reputable sources of news that can be relied upon to be factual rather than sensationalist. Whilst there is a lot about the current situation that none of us can control, anyone with anxiety may benefit from reminding themselves of the things they still can control at the present time – for example, planning how they spend their day and creating a routine that promotes self-care and overall well-being. Bereavement & Loss Anyone who experiences the death of someone close to them during this period, be it due to coronavirus (Covid-19) or any other reason, is likely to have a particularly challenging bereavement. It may be that they were unable to see the person in their life who died due to social distancing, and that they can’t reach out to friends and family after the loss in the way that they usually would. Funerals currently have to be much smaller, scaled-down events than families might wish for, and this can also feel very upsetting. Similarly, anyone who has experienced a bereavement in the past may find that difficult memories of this are stirred up through the constant reminders of death and suffering that we are encountering in the news right now. It is important to remember that grief (the progression and range of emotions we go through as we adjust to losing someone close to us), is a natural process and not something to necessarily be pathologized or viewed as a mental health ‘problem’ – even though it can feel very difficult at the time. If anyone you know is bereaved at this time, then gently acknowledging their loss and offering what support you can over the phone or through video-chat will likely be helpful. Do not push a bereaved person to ‘open up’ or share deeper feelings right now, though. They will be in the early stages of their loss and, given the uncertain and unusual circumstances we’re currently all experiencing, they may not feel safe to connect with more complex emotions for a little while. Depression In its mildest form depression can mean feeling low in mood and finding it hard to muster up the energy to engage in day to day life and the things you once enjoyed. More serious depression can manifest in feeling unable to perform the most basic aspects of self-care, such as eating, bathing and dressing, and can result in sufferers feeling hopeless and sometimes suicidal. Many aspects of the current coronavirus situation might compound the difficulties of a person suffering with depression. Social distancing, for example, might draw a depressed person living alone further into isolation, and working from home might reduce a depressed person’s motivation to get up each day and maintain a reasonable routine. Worries about the future and bleak news stories may particularly impact on someone who is already depressed. Therefore, if someone you know may be experiencing depression at this time, do check in on them to provide social and practical support. If their depression seems more severe (particularly if they have spoken of feeling suicidal or at risk of harming themselves), encourage them to speak to a mental health professional – who should still be able to offer them a consultation remotely. Telephone helplines such as the Samaritans (and other national helplines listed through Befrienders International) can also offer valuable support to anyone in crisis. Trauma Anyone who has directly experienced or witnessed trauma in their past may have a nervous system that’s particularly sensitive to stress. In worrying or uncertain situations, trauma survivors may experience strong physical and psychological reactions such as shaking, sweating and unwanted ‘flashbacks’. They may also feel very ‘activated’ and easily launched back into the ‘fight or flight’ mode we associate with responding to danger. It’s easy to see how the current coronavirus crisis might feel very ‘triggering’ for someone with a history of psychological trauma, and how some of their responses might feel distressing or overwhelming. However, such responses are usually very normal – what we might call a ‘normal reaction to an abnormal situation’. Trauma-informed counselling (which can be delivered remotely) can help individuals in this situation to make sense of their reactions and to learn how to manage them – for example, through learning relaxation and grounding techniques. Summary Those with current or historic mental health difficulties are likely to be at a higher risk of struggling during the coronavirus outbreak - even if their physical health remains unchanged - due to increased levels of worry and a heightening of certain symptoms, as detailed above. ‘Shielding’ and supporting these individuals may not be as straightforward as is the case for those with physical vulnerabilities. Employers, colleagues, friends and family members of those living with mental health difficulties will do well right now to sensitively check in with them and encourage them to seek further professional support if this seems necessary. Below are details of some relevant sources of online information. However, it is worth remembering that GP surgeries and community mental health teams (CMHTs) are still available and able to offer support and guidance at this time in the UK, albeit remotely. The same should be applicable for emergency mental health services overseas. Therefore, if managing staff abroad, now may be the time to check relevant details and make your team aware of how such services can be accessed if needed.
Author: Felicity Runchman, Associate, FD Consultants Date: May 2020 References [1] Roxby, P. Coronavirus: ‘Profound’ Mental Health Impact Prompts Calls For Urgent Research. BBC News [Internet]. 2020 April 16 [cited 2020 May 1]. Available from https://www.bbc.co.uk/news/health-52295894. |
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