Fiona is a senior accredited BACP psychotherapist, supervisor and trainer. She currently works as a private consultant but has previously worked for InterHealth, the British National Health Service (NHS) and Transport for London. In her consultancy work, she supports various NGOs and many emergency first responders including the British police and The London Fire Brigade. Fiona has recently published a book entitled: Psychosocial Support for Humanitarian Aid Workers.
Resilience is often described as the ability to not just ‘bounce back’ and recover from stress or abnormal conditions, but also to ‘bounce forward’ and come back stronger than before. This applies to organisations as well as individuals. There are many common reasons why people may experience high stress levels in the workplace, but for aid workers in particular, the nature of their work and the risk of exposure to traumatic material or experiences can leave staff vulnerable to burnout, cumulative stress and vicarious trauma.
Resilience is of fundamental importance for staff well-being. A lack of resilience can also have serious security implications as highly stressed aid workers have been known to adopt risk-taking behaviour as a coping mechanism, thereby endangering themselves, their colleagues and their organisation as a whole. High levels of stress can lead to dysfunctional teams and affect people’s decision-making abilities; it can particularly cause individuals to escalate rather than defuse incidents and problems.
To support security managers and aid workers in building personal resilience (and, therefore, organisational resilience), I have developed the RESPECT resilience toolkit as part of the book I published in 2018 entitled: Psychosocial Support for Humanitarian Aid Workers. In the following blog I summarise some of the key areas that the toolkit presents as ways to promote personal resilience: Relaxation, Education, Social, Physical, Exercise, Creativity and Thinking.
Calming the system when we are traumatised or feel acute stress is essential, and the first step in stabilisation. To achieve this, simple breathing exercises, mindfulness activities, sleep, prayer, or anchors (such as photographs or jewellery) have proved to be effective. Take the example of Yasmin. She is an aid worker, living and working in Lebanon. Reflecting on how chaotic her life has been in recent years, she told me, ‘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.
I often refer to the statement ‘Facts Fight Fear’. Focusing on facts enables the mind to think logically, thus reducing anxiety levels. Tim, a logistics manager, arrived for a counselling session just after experiencing a flashback. He said, ‘I don’t know what happened – it just came out of the blue. It started at the gas station around the corner.’ 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. It is important to understand how physiology is impacted by trauma and acute stress, and what personal triggers can cause visual images of past trauma to resurface.
Although attachment begins in infancy, the need for attachment relationships continues throughout our life. A key aspect of improving personal resilience is developing and maintaining positive relationships with family, friends and colleagues. Team building before a traumatic incident and peer support after the incident are both valuable methods of increasing resilience and promoting an effective recovery. Abdul was driving three doctors to a hospital in Kabul when the vehicle in front drove over an improvised explosion device (IED). He witnessed his colleague suffer severe injuries and tried to help in any way he could. Back in the compound, he stated: ‘We all keep a close eye on each other. If someone seems “zoned out” we check in with them and give them space to talk if they need to. You don’t feel alone and there is no authoritative pressure as your colleagues have been through the same thing and they understand. They do not judge you.’
So much is written about trauma and stress being held in the body. There are multiple ways to release this stress, including Emotional Freedom Technique. This means actually ‘shaking it off’, massage, adopting a balanced diet, interacting with nature and using relaxing scents, such as lavender, rose and lemongrass.
When under stress, the human body releases ‘stress hormones’, such as adrenaline, noradrenaline and cortisol. However, when we exercise we release ‘feel good hormones’, such as serotonin and endorphins and it not only helps to keep us fit but also keep our minds alert. Martial arts and yoga, in particular, are well known for promoting impulse and emotional control through careful body movements and associated breathing. Alternatively, exercising with weights can be effective for building confidence but be mindful that the adrenaline pumping nature of this type of activity can become addictive.
Creativity can soothe the traumatised parts of the brain, creating a distraction as well as healing qualities. Art and writing are both effective ways of activating the creative part of the brain and techniques such as the Tree of Life Therapy and Narrative Exposure Therapy are an effective means of grounding yourself. Music has also been widely used as a healer but be aware that adrenaline pumping music can make you hyperalert and anxious.
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. Such negative thoughts are often caused due to exposure to certain stimuli that heighten stress levels. To address this, you should monitor your stress levels and perhaps avoid certain subjects for a period of time. When negative thoughts do surface, it can be useful to consider what you might say to a friend in a similar situation as we are often more kind to others than we are to ourselves.
Some of the techniques discussed here will be more effective for some than others but over the years many of the aid workers I have worked with have found one or more of them to be beneficial. I encourage you to share this toolkit with your colleagues and remember that any time spent prioritising our own well-being will increase our resilience and benefit those around us.
For more detailed information on the techniques described here, please visit my blog. If you would like to learn more about resilience, trauma and critical incident care, I also invite you to explore the book I published recently on Psychosocial Support for Humanitarian Aid Workers.
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