In this blog I’m pleased to share with you a second short clip of my presentation from the BACP Conference, focussing on vicarious trauma. Vicarious trauma, also known as secondary trauma, can be described as indirect exposure to a traumatic event through first-hand account or narrative of that event. People in the helping professions, counsellors and therapists, humanitarian aid workers, emergency first responders, journalists, police officers, doctors, and lawyers, may be at risk of vicarious traumatisation. Any person who has a significant relationship with a survivor of trauma may also come to experience vicarious trauma. Therapists and other helpers often hear stories of traumatic experiences in the course of their work. At times, hearing these stories may overwhelm them and lead them to experience, to a lesser extent, the same symptoms faced by the trauma survivors in their care. Vicarious trauma typically involves a shift in the world view of the helper. The helper’s beliefs about the world may be altered by repeated exposure to traumatic material. Compassion fatigue and burnout are related concepts that share some similarities with vicarious trauma, and a person might find themselves experiencing one or more of these states at the same time. Compassion fatigue is the condition of emotional and physical fatigue that results in the carer cutting off from their empathy to protect themselves from the impact of the work. It is often evidenced in carers that have been in the role for long periods of time. It becomes a way of their body protecting themselves. Individuals often have symptoms of feeling shut off, numb and detached. Burnout is a term sometimes used interchangeably with vicarious trauma, but this condition does not necessarily involve a traumatic element. People can experience burnout when they have a toxic work environment or when they feel themselves to be doing tedious or otherwise trying work without getting enough time for rest or appropriate self-care. Watch the presentation here (please note this is a very short section from a longer presentation):
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I had the honour to present at a recent BACP Conference in relation to caring for the carer and discussing support methods for those who are impacted by trauma, either first hand or vicariously. 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 and Thinking.
I hope you enjoy the presentation (please note this is a very short section from a longer presentation). 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. Its not often you get a book review that is so glowing you get a sense of pride swell up inside you, but this is one review Fiona is very proud to share with everyone. Written by Tobias Denskus who is a researcher and teacher, this review comes from someone within the industry and with vast experience in the humanitarian aid sector. He is a Senior Lecturer in Communication for Development in the School of Arts and Communication at Malmö University in Sweden. Tobias declares himself as a citizen of Aidland, having worked, lived, listened to people and experiencing international peacebuilding in Nepal, humanitarian work in Kabul, Afghanistan and research on German peacebuilding projects in Macedonia. Tobias completed his PhD at the Institute of Development Studies (IDS) at the University of Sussex and the wonders of transnational aid communities never cease to surprise him. Tobias writes… As it often happens with my books reviews for the blog there is an element of chance and surprise involved when discovering a great book for review. Fiona Dunkley’s Psychosocial Support for Humanitarian Aid Workers: A Roadmap of Trauma and Critical Incident Care is no exception-it probably popped up in my Twitter feed or in a post in the 50 Shades of Aid Facebook group. In light of the #AidToo developments and longer-term discussion in the industry about staff care, well-being and psychological support this is obviously an important and timely book. As a researcher and teacher I am always a bit skeptical when authors or endorsements promise a book with relevance ‘for everybody in the industry’, but Psychological Support delivers on that front: There are parts written with a self-help framework in mind, but most importantly, as the subtitle suggest, it is a self-mapping book. It provides a roadmap for individuals about how to prevent trauma or get help and at the same time provides a professional framework for those who provide or manage care, have humanitarian aid worker family and friends or have a research or pedagogical interest in models around such support. Dunkley’s vignettes, based on extensive work in- and outside the humanitarian industry, are powerful, tough stories and the theoretical framework around psychology and cognitive science helps the reader not to feel overwhelmed while at the same time being reminded compassionately that psychosocial support is not a simple ‘toolbox’ or ‘guideline’ that should be buried inside your computer. Another important reminder in her book is that with the expansion of the aid industry trauma is not just limited to front line staff: Journalists, therapists, aid workers, medical staff, social workers and care workers can all be exposed to vicarious trauma. Likewise, office staff can be exposed vicariously to trauma. This was highlighted in the Ebola response. Aid workers that were exposed to stories remotely started to experience trauma symptoms and requested psychological support (p.14). And while Dunkley’s book is certainly on a difficult subject, it is neither a discouraging let alone defeatist read. Cultural relevance as a key to good aid work, healthy aid workers and resilient communities There is such a lot of useful, practical material in the book, but one final aspects I would like to highlight is the chapter on Cultural relevance of psychosocial support. Many of the aspects are important reminder that apply to all good aid work. As I wrote in a recent post about some trends in aid industry employment, looking after those who provide aid is going to be an area of growth that deserves highest professional standards. Returning to where my review started, Psychological Support for Humanitarian Aid Workers is an excellent resource that creates an important road map from knowing about trauma, building resilience, managing emergencies and creating a comprehensive ‘grab bag’ in a professional, culturally appropriate way. To read the full review, and others, please visit Tobias’s blog here: click here Get a copy of the book Fiona's book, Psychosocial Support for Humanitarian Aid Workers, is available from Amazon. |
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