I’ve built a toolkit that helps my clients increase their resilience to acute stress and trauma. So far in my three part series on the subject, I’ve covered relaxation, education, social, and physical tools. This week, in my third and final post, I'd like to talk about exercise, creativity, and thinking. Exercise really does release hormones that make you feel yourself again. And coupled with basing your thoughts in reality, these tools will enable you to stay much more resilient to stress and trauma. The resilience toolkit (Dunkley, 2018) 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, ready to use when needed. What can exercise do to help us stay relaxed? The stress response releases hormones such as adrenaline, nor-adrenaline and cortisol. When we exercise we release feel good hormones, such as serotonin and endorphins. Exercise – Being active not only helps us to keep fit, but research has shown that it also helps keep our minds alert. Yoga, Thai Chi, Qi Gong and Martial Arts – These forms of exercise have been described as enhancing a spiritual or universal connection. The movements are performed in relationship with the breath, which encourages emotional regulation, with research also showing a reduction in heart rate variations (HRV). This enables control over our impulses and emotions, reduces anxiety and depression, and also the risk of physical illness (Sack et al, 2004). Van der Kolk and colleagues evidenced how ten weeks of yoga markedly reduced PTSD symptoms (Van de Kolk et al, 2014). Building physical strength – Building physical strength by exercising with weights has been shown to increase confidence. However, due to its adrenalin pumping nature this type of exercise can become addictive; so if this technique is your preferred resource, make sure you balance it with resources from the other categories. Core strength exercises such as Pilates can also encourage an inner confidence and strength. Some stress busting creative tools… Creativity can soothe the traumatised parts of the brain, creating distraction as well as healing qualities. Art – Painting or drawing is a great way to activate the creative part of the brain. This type of resource involves focus, and is therefore a good distraction that keeps us grounded in the present. The Tree of Life therapy, founded by Ncazelo Ncube and David Denborough (Denborough, 2008) involves clients drawing a tree as a metaphor to represent different aspects of their lives. Music – Music has often been used as a healer, connecting deeply to our emotions and offering comfort. Notice the music you are drawn to, and why. If you are listening to adrenalin pumping music and you feel hyperalert and anxious, you may want to listen to calming music for a while. Writing – It can be helpful to just allow words to form on paper, with no judgement or pressure to ‘get it right’, but just using writing as a means to ‘get it out there’. Narrative Exposure Therapy (Schauer, Neuner & Elbert, 2005) focuses predominantly on the client writing a detailed narrative timeline of all the traumatic events experienced. Safe place - Another exercise you can do to help relax your body and reassure yourself that you are safe is to do the ‘safe place’ exercise. This was originally used in hypnosis for reducing traumatic stress (Napier, 1996). Imagine a time when you were totally relaxed and happy. Become aware of all your senses as you recall this event: what did you see, feel, hear, taste, touch and smell? How did you feel at the time and where do you notice that feeling in your body? Using sensory information you can bring the memory alive, and recall it as a calming resource to use when you start to feel anxious. Experience the rational rather than the emotional. The emotional brain, rather than the rational brain, dominates the mind when we are stressed. Therefore we can be consumed with thoughts of ‘not being good enough’, ‘not having done enough’, or feeling ‘we are to blame’. These thoughts might ‘feel’ true, but they are often not based on reality. Challenging negative thoughts –Consider what you might say to a friend who had experienced a similar event. Write down these supportive statements, and try saying them to yourself. Affirmations/Mantras – Write a couple of affirmations (supportive statements about yourself) and keep them nearby, to refer to regularly. Avoid stimuli – Material on social media or TV can be triggering. Monitor what you are watching and your arousal levels. It may be that you need to spend a period of time avoiding certain subjects. A final word on RESPECT. If we can learn to ‘RESPECT’ ourselves more, listen to our bodies and prioritise our own well-being we can role-model good self-care to support ourselves and our staff/clients. Recently, a colleague who recovered from burnout and vicarious trauma shared, ‘I eventually became comfortable with my reinvented self-image. I had to reassess my work commitments and how much I was willing to do. Instead of talking a good “work/life balance” I had to hunt it down. Being outside, exercise, making time for people, smiling, being present, not pursuing a grand plan but finding great comfort in predictable stability, and understanding my own psychological make-up were all critical coping mechanisms.’ 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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