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10 April 2009
Relief Workers Might Suffer from Undiagnosed Trauma
Aid workers must help themselves in order to better help others
Washington — Relief workers draw admiration as they help communities recover from natural disasters and violence, but beneath the surface of charitable work are stress and trauma that afflict workers as they experience tragic situations, confront their own limitations and then disengage when their mission ends.
Long hours of dedicated work can cause relief workers to ignore signs that they need to address their own problems, but caring for themselves is a key component of effective relief work, according to Nancy Good Sider, associate professor of trauma and conflict studies at Eastern Mennonite University in Harrisonburg, Virginia.
Good Sider recently visited relief workers in countries affected by the December 26, 2004, tsunami to promote staff wellness, with an eye on the end of relief efforts in 2010.
“If you want to help other people, you need to first help yourself,” she told America.gov. To illustrate this point, she asked relief workers to describe the tools they use in their jobs that need to be kept in good shape. Responses ranged from computers to hammers and other tools. “Nobody in the workshop ever said themselves. They are the main instrument,” she said.
AID WORKERS SUBJECT TO “SECONDARY TRAUMA”
Exposed to disasters, relief workers sometimes fall victim to what Good Sider calls “secondary trauma,” which can cause depression, stress and other symptoms. “The more empathic and caring we are, the more susceptible we are to possible symptoms of burnout and secondary trauma,” she explained. “Relief staff responds to the need,” but the positive differences they are making often get subsumed by the tendency to focus on inconveniences, criticisms and limitations.
There is a need to “come to terms with doing the best you can and be OK when things aren’t perfect,” she said. “And stress is a normal part of relief work. … The time is short with so much disaster, sometimes in the midst of a violent conflict. It can lead to depression, nightmares, and get turned inward to yourself as anger, or projected to those close to you.” Acknowledging the need to step back “doesn’t mean that they’re weak, selfish or crazy. … You need to give to yourself so you can give to others.”
Good Sider’s work ties into other trauma-healing programs offered at EMU’s Center for Justice and Peacebuilding. (See “University Offers New Approach to Trauma Healing.”)
She tells relief workers there are three parts to managing stress and building staff wellness: “Nancy’s ABCs” of awareness, balance and choice.
Awareness means recognizing the symptoms that show you are suffering from stress or trauma. For example, Good Sider said, she has learned to recognize muscular tension at the back of her neck as an alarm sign.
Balance involves recognizing the burdens stress imposes. Good Sider said she will hold up a mug of coffee and ask the relief workers at different times of the day how much they think it weighs. The idea of carrying it around, she said, is “not so much if I have stress, but what I’m doing with it, noticing how it weighs me down over time. And it’s also the reality that I’m not just holding this coffee but I’m also picking this up, and carrying this, and something else is cluttering on. And that’s how we go.”
Additionally, part of seeing balance is appreciating the post-traumatic growth that people experience, such as newfound strengths and discoveries about themselves, factors that can offset some of the negative effects of trauma.
Choice involves a conscious decision to deal with stress, to avoid going down a destructive track. “The stress needs to be engaged, released and worked through, rather than something that is ignored.”
She gathers workers together and asks them to complete the sentence: “I could take care of myself, but …” and explain their rationale. This helps them to identify the barriers that hinder everyday self care. The next question asks for a description of one strategy they currently use to stay resilient.
ENDINGS CAN CAUSE STAFF ANXIETY
Because many tsunami relief efforts will be ending in 2010, Good Sider encouraged leaders to start talking and planning for the upcoming changes. “Any change creates stress, and an ending particularly,” she said. It is more than losing close relationships. “You know what you’re saying goodbye to but you don’t know what’s out there that you’re moving toward, and it’s very uncomfortable. It really kicks up everybody’s anxiety.” The workers need not only to know it is coming, but the range of feelings they can expect. Endings and transitions stir up the entire organization’s stress, and it’s helpful to know that this is entirely “normal and natural” and to make some healthy care choices.
Relief workers are often people “who feel quite called” to the job. “They really want to make a difference,” she said. But they need to be better prepared for what awaits them in the field.
Firefighters are not sent into a burning building with only advice on how to use their equipment. They receive plenty of training and information on the ways to do their job and not get injured or fatigued. But that is not the case for those being sent to conflict and disaster areas, Good Sider said.
“I don’t think we’re doing our jobs if we’re sending people out to do this really important work and are only training them on things like how to work with building houses and acquiring clean water and sanitation. We need to alert workers to a basic knowledge and skills for stress management, trauma healing and resilience,” she said.
