English Translation Understanding and Coping With Traumatic Stress Final

8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final

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Understandingandcopingwithtraumaticstress

OnlineTrainingModule


byLisaMcKay

SELFSTUDYMODULE1


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Headington Institute 20071

HeadingtonInstitute

200EastDelMarBlvd

Suite119

Pasadena,CA91105

USA

Phone:6262299336

www.headingtoninstitute.org

Theinformationcontainedinthesemodulesisprovidedsolelyforeducationalpur

poses.Theselfexaminationexercisesandscalesonthiswebsitearenotintendedto

beused

as

diagnostic

or

treatment

tools.

Any

concerns

you

might

have

about

men

talhealthissuesshouldbediscussedwithaqualifiedmentalhealthprofessional.If

anyofthematerialinthismoduleraisesconcernsforyou,pleasecontacttheHead

ingtonInstitutestafforotherappropriatelyqualifiedmentalhealthprofessionals.


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TABLEOFCONTENTS

Introduction

Stressandhumanitarianwork3

3

Study text

Howcan

humanitarian

work

be

stressful?

Keyconceptsregardingtraumaticstress

Culturalissues

Signsofstress

Riskandprotectivefactors

Burnout

Examiningyourownwellbeing

Combatingstressandburnout

6

6

8

12

13

16

20

23

24

Quiz

Testmyknowledge

29

References

Resources

33


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Introduction:StressandhumanitarianworkForsevenyearsIlivedamongthosewhoseliveshadbeentorninpiecesbyrockets,

mines,executions,rape,torture,andanunspeakableclimateoffearthatcouldshat

terthesanityofanyhumanmind.AsIworkedinthewarsandpostwarsituationsin

Afghanistan,theBalkans,Cambodia,andtheDemocraticRepublicofCongo,Ifound

myselfinenvironmentsforwhichnohumanbeingisprepared.Theseareextreme

situations,invokingoursurvivalinstincts,expectingustotapintoourultimateca

pacitiesofstrengthandcourageWhenyouseetheimmensesufferingofthoseyou

areattemptingtohelp,youaremorallyandemotionallycompelledtoputasideyour

ownfears.Temporarily.Youfunctionunderpressureinthepresentbypostponing

yourrelieftothefuture.Thatkindofpressuredlivingandworkingbuildstensions

withinthatwillhavetoreleasedatsomepoint

YasminSherifonherworkwiththeUnitedNations

(quotedinDanieli,2002,p.62)

Humanitarianworkerscomeinmanyshapesandsizes.Theyworkinonsiterecovery

andreliefmissions,education,healthtraining,agriculturalassistance,communitymo

bilization,economicdevelopment,waterandsanitation,conflictresolution,andadvo

cacy.The

common

thread

across

these

diverse

roles

is

aservice

orientation

in

the

face

ofsufferingandneed.Everyonewhoworksforahumanitarianorganizationisahelper

insomecapacity.

Thetraditionalimageofhelpersisthattheyareselflessandtireless.They,themselves,

tendtoexpectthatbecausetheirworkisforanoblecause,theywillsomehowbeim

munetopressure.However,humanitarianworkersareimpactedbytheirwork.Theyoftenleaveattheendofthedayfeelingthattheyhavenotdoneenoughbecausethe

scopeoftheneedissooverwhelming.Theycanbetroubledbywitnessingviolenceand

poverty,andbyhearingthestoriesofrefugeesanddisastersurvivors.Inaddition,in

todays

global

climate,

many

face

danger

during

the

course

of

their

work.

In

this

serviceorientedprofession,manyhumanitarianworkersstruggletofindahealthybalance

betweenthedemandsoftheworkandtheneedtopaysomeattentiontotheirown

physicalandemotionalwellbeing.

Toooften,humanitarianworkersconsistentlyfailtopayanyattentiontotheirownself


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careandwellbeing.Humanitarianworkcanbedemanding,bothphysicallyandemo

tionally,andthosewhoneglecttheirownneedseventuallyfindthemselvespayingthe

price.Theygetsickmoreeasily,andstaysicklonger.Theyfeeltired,drained,andworn

out.Theymaystarttofeelanxious,cynicalorhopeless.Relationshipssuffer.Theycan

starttoactinwaysthathurtthemselvesbyusingdrugs,alcohol,orengaginginrisky

behavior.Intheend,thosewhodecidedtodohumanitarianworktohelpotherscan

enduphurtingthemselvesandthosearoundthem.

Humanitarianworkerscanbesupportedinseveralwaysthatreducetheliklihoodof

developingstressrelatedproblems.Thefirsttypeofimportantsupportistoprovide

basicinformation

about

stress,

trauma,

normal

reactions

to

stressful

situations,

and

helpfulcopingstrategies.Everyhumanitarianworkershouldunderstandtraumatic

stressandknowhowtohelppreventoralleviatetraumaticstressreactions.Knowl

edgeaboutnormalreactionstostressfulsituations,andactionregardinghealthyself

carepractices,worktogethertoprotectphysicalandemotionalwellbeing.Enhanced

wellbeingmeansthathumanitarianworkersremainhappier,healthierandmoreef

fectiveintheirwork,longer.

ThisisthefirstinaseriesofonlinetrainingmodulesproducedbytheHeadingtonInsti

tutethatexplorevariousaspectsoftraumaticstressasitrelatestohumanitarianwork.

Thisintroductory

module

aims

to

help

humanitarian

workers:

1. Understandthedifferenttypesoftraumaticstressassociatedwiththeirwork

2. Recognizethesignsofstressandburnout

3. Learnselfcaretechniquestohelpalleviatestressreactions

Bytheendofthismoduleyouwillbetterunderstand:

Thenatureoftraumaticstress

Threecommontypesoftraumaticstressassociatedwithhumanitarianwork

criticalincidentstress,vicarioustrauma,andchronicstress

Theeffects

of

traumatic

stress

Whyitisimportantforhumanitarianworkerstoknowabouttheseeffects

Howtomonitoryourownwellbeing

Selfcaretechniquestohelpalleviatestressreactions

Wheretogetmoreinformationforcontinuedlearningorpersonalassistance.


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Ofcourse,thisstudymoduleisnotacomprehensivetreatmentofthesubjectofhu

manitarianworkandstressandtrauma.Instead,thismoduleprovidesanoverviewof

criticalincidentstress,vicarioustrauma,andchronicstress.Itprovidesaframeworkfor

astudyprogramthatcanhelpthoseinterestedinthesubjectlearnaboutitattheir

ownpaceandenhancetheirunderstandingwithadditionalresources.Thisintroduc

torymodulefocusesprimarilyonchronicstress,burnout,andselfcarestrategies.Ad

ditionalonlinemodulesinthisseriesfocusmorespecificallyon:

Traumaandcriticalincidentcare

Reentryissuesandworklifebalance

Copingwith

vicarious

trauma

Humanitarianwork,traumaticstressandspirituality

Asyouworkthroughthestudysectionsinthismodule,taketheopportunitytoreflect

onhowtheinformationpresentedisrelevanttoyourworkandlife.Personalreflection

questionshavebeenprovidedattheendofeachstudysectiontohelpyouthroughthis

process.Youmayfinditparticularlyhelpfultowritedownyouranswerstotheseques

tions.

Whenyouhavegonethroughallthelessonsinthismodule,trytestingyourcompre

hensionby

taking

the

online

quiz.


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PartOne:Howcanhumanitarianworkbestressful?

Humanitarianworkcanbeamongthemostexciting,enriching,andimportantworkin

theworld.Ithas:

Moralappeal:Itisusuallyserviceworkforworthycauses.

Personalappeal:Workinginternationallyandbeingexposedtodifferentcul

turesstretchesandchallengesindividualstogrow.

Adventurousappeal:Humanitarianworkersoftenserveinthemidstofextreme

and

challenging

situations.

Facingthechallengesofworkinginthehumanitarianfieldcanbestimulatingandrichly

rewarding,bothpersonallyandprofessionally.However,withrewardscancomesome

personalcoststhatresultfromlivingandworkinginthemidstofdisastrous,violent

situationsandfacingchallengesthatoftenseemoverwhelming.Someofthepressures

associatedwithhumanitarianworkinclude:

Threatandviolence:Whetheritistheresultofnaturaldisaster,civilconflict,or

increaseddomesticcrime,manyhumanitarianworkerswitnessviolenceandits

aftereffects,orareexposedtoupsettingstoriesofpersonaltragedy.

Socialdislocation:

Many

humanitarian

workers

experience

separation

from

theirsocialsupportnetworks,suchasfriendsandfamily.

Culturaldislocation:Livingandworkinginanothercountryoftenmeansthat

newrulesforcommunicatingpolitelyandeffectivelymustbelearned.

Spiritualdislocation:Separationfromfamiliarreligiousframeworks,exposure

toradicallydifferentviewsaboutspiritualityandreligion,andexposuretotrau

maticeventscanchallengeandalterahumanitarianworkersreligiousbeliefs.

Povertyanddeprivation:Humanitarianworkersoftenliveandworkinthe

midstofextremepovertyanditsassociatedsufferingwithoutenoughresources

availabletocombattheproblems.Thiscanleadtofeelingsofimpotenceand

beingoverwhelmed.

Moraldilemmas:Humanitarianworkmayinvolvefacingmoraldilemmassuch

asnegotiatingwithwarlords,concernthataidmaybeprolongingaconflict,or

witnessinghumanrightsviolationsbutbeingunabletorespondduetoopera

tionalconsiderations.

Theworkenvironment:Commonworkstressorsinclude:interpersonalandcul


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turallybasedconflictamongteammemberswhoareforcedintoprolonged

closenessandinterdependence;roleambiguity;lackofappropriateresources,

personnel,time,logisticalsupport,orskillstodothejobexpected;andheavy

workloadandlonghours.

Forpersonalreflection

Whatdoyoufindespeciallyrewardingaboutworkinginthehumanitarian

field?

Whatdoyoufindespeciallychallenging(physically,emotionally,mentally,

spirituallyand

relationally)

about

working

in

the

humanitarian

field?

Howdoyoufindyourselfreactingtosomeofthechallengesyouhave

listed?


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PartTwo:Keyconceptsregardingtraumaticstress

Stresscanbedefinedasanydemandorchangethatthehumansystem(mind,body,spirit)isrequiredtomeetandrespondto.Stressisthereforeapartofnormallife.

Withoutchallengesandphysicaldemands,lifewouldbeboring.Stress,however,be

comesdistress(ortraumaticstress)whenitlaststoolong,occurstoooften,oristoo

severe.Itisalsoimportanttonotethatwhatisdistressfulforonepersonmaynotnec

essarilybedistressfulforanother.Yourindividualperception(howthreatenedyoufeel

andhowmuchcontrolyouhaveoverthecircumstances)canaffectthedegreeofdis

tressyoupersonallyfeel.Traumaticstresscanthereforebedefinedasthereactionto

anychallenge,demand,threatorchangethatexceedsourcopingresourcesandresults

indistress.

Therearethreemaintypesoftraumaticstresstowhichhumanitarianworkersareex

posed:

Criticalincidentstressor acutestress

Definition:Thesearetwotermsusedtorefertotraumareactionsthatoccurasthere

sultofatraumaticeventduringwhichanindividualisseriouslythreatenedbyharmor

death.These

types

of

events

are

often

referred

to

as

criticalincidentsandareunusual

andintense.Examplesofcriticalincidentsthathumanitarianworkersmayexperience

includebeingassaulted,beinginsituationswheremanypeoplearedying,beingwithin

rangeofgunfire,orexperiencingcaraccidents,bombings,kidnappingsandcarjackings.

Reactions:Experiencingacutestressreactions(alsoreferredtoascriticalincidentstressreactions)afteracriticalincidentisanormalresponsetoanabnormalsituation.

Thetraumaticeventtriggersanintensefightorflightresponsethatresultsinaseries

ofapproximately1500biochemicalreactionsinthebody.Forexample,sharpincreases

inthelevelsofstresschemicalssuchasadrenalineandcortisolleadtoanincreased

heartrate

and

changes

in

blood

flow

as

you

prepare

to

deal

with

the

threat.

Whoisatrisk?Thistypeoftraumaticstresstendstobemoreproblematicforhumanitarianworkerswhoarepostedoutsidethedevelopedworld.Researchsuggeststhat

mostworkersinthefieldwillexperienceatleastoneseriouslydisturbingorfrighten

ingincidentduringthecourseoftheirwork.Approximately25%ofhumanitarianwork


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ersincomplexhumanitarianemergencysituations(e.g.,workingincountriessuchas

Iraq,AfghanistanandtheDemocraticRepublicoftheCongo)canexpecttoundergoa

lifethreateningexperience.

[Formoreondetailedinformationontraumaandcriticalincidentstressseeouronline

trainingmodule,Traumaandcriticalincidentcare]Vicarious trauma or secondary traumatization

Definition:Thesetermsrefertostressandtraumareactionsthatcanoccurinresponse

towitnessing

or

hearing

about

traumatic

events

that

have

happened

to

others.

In

thesecases,otherpeoplearethevictims,andyouseethemundergoingsuffering,or

hearabouttraumaticeventsthathavehappenedtothem.

Reactions:Vicarioustraumacantriggermanyofthesamereactionsthatoccurwhen

youpersonallyfaceacriticalincident.Signsandsymptomsaresimilar,althoughusually

lessintense,thanthosetriggeredbydirectexposuretotraumaticevents.However,in

somecasestheleveloftraumatizationcanbealmostasgreatinsecondaryvictimsas

inprimaryones.Whoisatrisk?Itisnowwidelyacceptedthatinteractionwithvictimsoftraumaticexposureplaceshelpersathighriskofexperiencingsomeformofsecondarytraumatic

stressresponse.Humanitarianworkersinallrolesregularlyheardistressingstories,

andfacetherealitiesofviolence,povertyanddisaster.Vicarioustraumaistherefore

inherenttohumanitarianworkandproblematicforbothfieldandhomestaff.Therele

vantissuebecomeslessabouthowtoavoidvicarioustrauma,andmoreabouthowto

prepareforanddealwithit.

[Formoreondetailedinformationonvicarioustraumaseeouronlinetrainingmodule,

Vicarioustrauma]Cumulative stress

Definition:Cumulativestressreactionsarealessdramatic,moregradualformofstressreaction.Theyareusuallyrelatedtolowintensitybutmorechronicstressorsthatper

vadeapersonslifeandpileup,oneontopoftheother.Somecommonsourcesof


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chronicstressforhumanitarianworkersinclude:

Achaoticandreactiveworkenvironment

Feelingoverwhelmedbyunmetneeds

Tightdeadlinesandstressedcoworkers

Communicationdifficultiesduetopersonalityandculturaldifferences

Inadequatepreparationandbriefing

Beingaskedtocompletetasksoutsideyourareaoftrainingandcompetence

Facingmoralandethicaldilemmas

Isolationfromyourfamiliarsocialsupportnetwork

Chronicsleep

deprivation

Traveldifficultiesanddelays

Reactions:Thenegativeeffectsofeverydaystressorsbuildupovertime.Chronicstressorstriggerenduringstressreactionsthatcangrowinintensityandbecomeprob

lematicovertime.Thepresenceofmultiplechronicstressorsisoftenabetterpredictor

ofhigherstresslevelsthantheoccurrenceoftheoccasionalcriticalincident.Ase

quenceofrelativelymildstressfuleventscanultimatelycreatehighstresslevelsifnot

dealtwitheffectivelyonanongoingbasis.

Whoisatrisk?Nearlyeveryoneexperiencesthistypeofstressreactionatsomepointduringtheirlives.However,regardlessoftheirparticularrole,mosthumanitarianworkersareexposedtoelevatedlevelsofoccupationrelatedchronicstressors.Inaddi

tiontotypicalchronicstressors(suchastrafficdelaysandjobevaluations),humanitar

ianworkersalsofacesomeofthechronicchallengesthatcomewithworkinginacrisis

culture.Howyoumanagetostriketherightbalancebetweentheurgencyofthework

andotherareasoflifeisthemostrelevantissue.Humanitarianworkerswhodonttake

chronicstressseriouslyandproactivelypreparetomeetthechallengesrunarealrisk

ofburningoutwithin3to5yearsofhighimpactwork.

Allthreetypesoftraumaticstresscanbeproblematicforhumanitarianworkers.How

ever,research

and

anecdotal

evidence

suggests

that

chronic

stress

reactions,

such

as

burnout,arelikelytobeproblematicforthegreatestnumberofhumanitarianworkers.

Therefore,theremainderofthismodulefocusesprimarilyonrecognizingandmanag

ingcumulativeandchronicstressreactions.


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Caseinpoint

Theperiodbeforedeploymentwasextremelystressful.Therewassomuchtodo

andmyexperiencemademefeelinadequatelyprepared.Myimmediatemedical

chainofcommandseemedtoofferlittleornosupportoradvice.InKosovoIspent

sevenextremelydemandingmonths.Ifeltcompletelyresponsibleforensuringthat

nothingwouldgowrong.IknewthatIwaspushingmyselftoohardandneglecting

myownpersonalneedsbutIwasntabletoletup.

CherylNetterfieldonherexperienceasamedicalofficerdeployedtoKosovo

(quotedinDanieli,2002,p.50)


Whichtypeoftraumaticstress(acute,vicarious,orcumulative)ismost

problematicortroublesomeforyou?


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PartThree:Culturalissues

Traumaticstressisnotjustaproblemforwesternhumanitarianworkerswhorelocate

(usuallytemporarily)todevelopingcountriesanddisasterzonesforthesakeoftheir

job.Infact,themajorityofhumanitarianworkersworldwidearefromnonwesterncul

turalbackgrounds,workingintheirhomecountry.Thesenationalhumanitarianwork

ersarenotexemptfromexperiencingtraumaticstress.

Physiologicalandemotionalresponsestodisasterarebroadlysimilaralloverthe

world.However,anindividualsinterpretationofstressandtraumaisshapedtosome

extentbyculture,socialcontext,andpersonalexperience.Itisimportanttoacknowl

edgethattherearedifferencesacrossculturesinhoweventsareexperiencedandhow

traumaticstressisexpressed.

Humanitarianworkersfromnonwesternbackgroundsreadingthismodulewillfindit

helpfultokeepthefollowingquestionsinmindastheyprogressthroughtherestof

thestudytext.Therearemanycommonalitiesacrossculturesinsignsandsymptomsof

stress,andeffectiveselfcaretechniques.However,therearesomeimportantdiffer

encestoo.Forexample,anindividualfromWestAfricamayexperienceandreadilydis

cussphysicalsignsofstressandtension,butfeelmuchlesscomfortablediscussing

emotionalreactions.

In

another

example,

seeking

solitude

may

be

avery

effective

self

caretechniqueforpeoplefromFinland.SomeonefromIndia,however,maynotfind

solitudehelpfulandenergizing,butstrangeanddiscomforting.Westernerslivingand

workinginternationallyshouldalsotakethetimetoconsiderstressandselfcarecon

ceptsinregardstotheirhostculture.

Whatconstitutesstressandtraumainthelifeofthisculture?Forexample,howisstressconceptualized?Isthereaconceptofindividualstressinthiscultureor

isitexperiencedandunderstoodmainlythroughfamilyandgroupprocesses?

Howisstresstypicallyexperiencedinthisculture?Whataretypicalindicatorsofstress?

Does

stress

tend

to

be

experienced

physically,

emotionally,

mentally,

relationally,spirituallyorthroughbehavior?Howisstressusuallyexpressedin

thisculture?

Whathavepeoplefromthisculturetraditionallydonetodealwithstress?Whatistheroleoftheindividualorthecommunityinmanagingstress?Whatindividual,socialandcultural,oralandbehavioralmechanismsaretypicallyusedto

dealwithstress?


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PartFour:Signsofstress

Signs of stress

Experiencesthatareperceivedasthreateningordemandingtriggeraseriesofapproxi

mately1,500biochemicalreactionswithinthebody.Stresschemicals(suchasadrena

lineandcortisol)aredumpedintothebloodstreamandtriggerthefightorflightre

sponse.

These

chemicals

prepare

us

to

deal

with

threatening

and

dangerous

events.

For

exam

ple,anelevatedheartratemeansthatmorebloodisbeingpumpedtoourmusclesand

brainsothatwecanassessthethreatandeitherfight,orrunawayfaster.However,

thefightorflightresponseisntgoodathelpingusdealwithmanyofthechronicstressorsthatweareexposedtoinlife.Formostpeople,fightingorrunningawayare

notrealisticoptionsfordealingwithstressorstheyencounteratworknotifthey

wanttokeeptheirjobs!

So,iffightingandrunningawayarentfeasibleoptions,howdowemanagethese

stressreactions?Agoodfirststepislearningtorecognizethesignsofstressthatmost

oftenappearinourlives.Reactionstostressarecomplexandtendtomanifestindifferentwaysfordifferent

people.Thecharacteristicsoftheperson(e.g.,theirphysicalandmentalhealth,levelofsocialsupport,andprevioushistoryoftrauma)interactwiththecharacteristicsoftheevent(e.g.,themagnitudeandtypeofstressfulevent,thepresenceofcumulativestressorsandotherlifeevents)toinfluencepeoplesexperiencesandreactions.

Stresschemicalscantriggerphysicalreactionsthatcanlingerfordays,weeks,orsome

timesmonths.Inadditiontotriggeringphysicalreactions,stresshormonesandchemi

calsaffectbrainchemistryandimpactthewaywethinkandfeel.Overtime,asour

bodies,emotions

and

minds

are

affected

by

stress,

this

has

implications

for

our

spiri

tualselvestoo.Spiritualityisacorecomponentofhumannature.Spiritualityshapes

andinformsoursenseofmeaningandpurpose,faithandhope.Whetherexperienced

asanexplicitbeliefinadeity,amorediffusesenseoftranscendenceorconnectedness

withnatureoralifeforce,orabeliefinhumannatureandsolidarity,mostpeoplebe

lievethattobefullyhumaninvolvesmorethansimplythephysicaldimensionsofexis


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tence.Overtimethetypesofchallengesthataidworkersfacecanimpacttheirworld

viewtheirconceptionsofGod,humanity,andwheretheyderivetheirsenseofmean

ing,purposeandhope.Finally,withthemixofphysical,emotional,mentalandspiritual

symptoms,itsnotsurprisingthatstressoftenshowsupinourbehavior.Thefollowing

aresomecommonsignsofcumulativestress.

Risktaking

(suchasdriv

ingrecklessly)

Overeatingor

undereating

Increased

smoking

Listlessness

Hyper

alertness

Aggression

andverbal

outbursts

Alcoholand/or

druguse

Compulsive

behavior(i.e.

nervoustics

andpacing)

Withdrawal/

isolation

Promiscuity

Physical Emotional Mental Spiritual Behavioral

Sleepdistur

bances

Changes

in

appetite

Stomachup

sets

Rapidheart

rate

Fatigue

Muscletrem

orsandten

sion

Backand

neckpain

Headaches

Inabilityto

relaxandrest

Beingeasily

startled

Moodswings

Feelingover

emotional

Irritability

Anger

Depression

Anxiety

Emotional

numbness

Poorconcen

tration

Confusion

and

disorganized

thoughts

Forgetfulness

Difficultymak

ingdecisions

Dreamsor

nightmares

Intrusive

thoughts

Feelingsof

emptiness

Loss

of

mean

ing

Discourage

mentandloss

ofhope

Cynicism

Doubt

AngeratGod

Alienationand

lossofsenseof

connection

Risktaking

(suchasdriv

ing

recklessly)

Overeatingor

undereating

Increased

smoking

Listlessness

Hyper

alertness

Aggression

andverbal

outbursts

Alcoholand/or

druguse

Compulsive

behavior(i.e.

nervoustics

andpacing)

Withdrawal/

isolation

Promiscuity


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Haveyounoticedanyofthesegeneralsignsofstresslately?

Whenyouareunderpressure,whichofthesesignsofstresstendtoappear

first? Followthislink(http://www.headingtoninstitute.org/Default.aspx?

tabid=1379)toaselfexaminationscaleifyouwouldlikeexplorewhether

youmightbedemonstratingsignsofstress.


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PartFive:Riskandprotectivefactors

Inadditiontolearningtorecognizeourownspecificearlywarningsignalssothatwe

canidentifywhenwereexperiencingunhealthylevelsofstress,itshelpfultoknow

whatriskandprotectivefactorswecarrywithus.Riskfactorsincreaseourvulnerability

toexperiencingtraumaticstressreactions.Protectivefactorsdecreaseourvulnerability

byincreasingourpersonalhardinessandresilienceandenablingustodealwithin

creasedlevelsofstresswithlessdistress.

Risk factors

Researchhasidentifiedseveralfactorsthatimpactthelikelihoodofexperiencingtrau

maticstressreactionswhenexposedtosufficientstressors.Theseare:

Thenatureandintensityoftraumaticeventsexperiencedinthepast:Thereis

noescapingourownpersonalhistoriescompletelywhenitcomestostressful

andtraumaticevents.Whileadesiretohelpothersinneedcanspringfromour

greatestpersonalwounds,itisimportanttorecognizethatconfrontingthe

traumaofotherscantriggerourownmemoriesofhurtandbetrayal.Thisisim

portanttokeepinmind,sincerecentresearchsuggeststhatatleastathirdof

humanitarianworkers

have

undergone

traumatic

events

prior

to

any

experi

encestheymayencounterinthefield.

Thenatureandintensityofthetraumaticorstressfuleventthattriggersthe

currentreaction:Thetypeofstressfuleventinfluencesthelikelihoodofexperi

encingstressandtraumareactions.Experiencingorwitnessingamanmadedis

asterinvolvinghumancruelty(suchasanarmedattack)isusuallymorestress

fulthanexperiencingorwitnessingnaturaldisasters.

Thenumberofstressorsexperienced:Thosewhoareexperiencingmultiplesig

nificantlifeeventsandchanges(suchasthedeathofaparentormovinginter

nationally)tendtobemorevulnerable.

Thelength

of

exposure

to

stressful

situations:Asexposurelengthens,riskincreases.

Organizationalfactors:Preliminaryresearchsuggeststhathumanitarianworkersidentifyorganizationalfactorssuchasteamrelationships,leadership,clarity

ofmissionobjectives,andagencystructure,astheirprimarycauseofchronic

stress.


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Historyofpreviouspsychiatricillness:Thosewithapriorhistoryofpsychiatric

illness,especiallythosewhohaveexperiencedacutestressdisorderorpost

traumaticstressdisorder,tendtobemorevulnerable.

Lackofsocialsupport:Socialsupportisveryimportantinprotectinghumans

fromtheeffectsofstressandtrauma.Recentresearchsuggeststhat,compared

tothosewithmediumtohighlevelsofsocialsupport,thosewithcompromised

socialsupportare4timesmorelikelytoexperiencetraumatizationand2.5

timesmorelikelytoexperiencesomeformofphysicalillness.Individualswith

outpartnersarealsoatgreaterrisk.

Pronouncedintroversion:Peoplewhoareintrovertedaretypicallymorevulner

able.

Negativityandpessimism:Habituallynegative,pessimisticindividualsaremore

vulnerabletostressrelateddysfunction.Inaddition,themorenegativetheir

appraisalofthemeaningfulnessoftheirhumanitarianmissionorworkassign

ment,themorevulnerabletheyare.

Protective factors

Incontrast,thefollowingfactorstendtohelppeoplethriveinthefaceofadversity.

Theybufferindividualsagainsttheeffectsofstressfulexperiences,andhelpthemcope

withthe

transitions

demanded

by

significant

life

events:

Socialsupport:Welldevelopedinterpersonalskills,extraversion,andtheabilitytosecureandmaintainagoodsocialnetworkarevitaltoemotionalhealthand

stability.Recentresearchsuggeststhatstrongrelationshipswithothersmaybe

evenmoreimportantthanpersonalcopingknowledgeandskills,andthebest

protectioninstressfulenvironments.

Optimismandhealthyselfesteem:Anoptimisticoutlook,regularexperiencesofpositiveemotions,ahealthyselfesteem,andfaithinselfaretraitsthatfos

terhardinessandresilience.

Spirituality:Spiritualityincorporatesanindividualsvisionofamoralorder

andsearchformeaningandpurpose,religiousbeliefs,andhopeforthefuture.

Ingeneral,spiritualityisaveryeffectiveprotectivefactor.Theexceptionsap

peartobewhenanindividualsspiritualityisnave(untestedand/ornot

thoughtfullyconstructed),orwhenindividualsareparticularlyrigidintheir

spiritualbeliefs.Intheseinstances,individualswhoarefacedwiththechal


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lengesofhumanitarianworkappeartobemorevulnerabletotheshatteringof

rigidworldviews,lossofsenseofmeaningandpurpose,negativeselfimages,

andotherattendantpsychologicaldifficulties.

Adaptability:Acertaindegreeofflexibilityinbeliefstructure,emotionalexperienceandworldviewisaprotectivefactor.

Tendencytofindmeaning:Anaturaltendencytofindmeaningandpurposeinevents,especiallystressfuleventsthatchallengeanindividual,isanotherpro

tectivefactor.

Curiosityandopennesstoexperience.Curiosityandopennesstonewexperi

encesarerelatedtoadaptability,hardinessandresilience.

Aptitude:Resourcefulness,intellectualmasteryandgeneralcapabilityareprotectivefactors.

Riskfactors ProtectiveFactors

Thenatureandintensityofanytraumatic

eventsexperiencedinthepast

Thenatureandintensityofthetraumatic

orstressfuleventsthattriggerthecurrent

reactions

Thenumber

of

stressors

experienced

Thelengthofexposuretostressfulsitua

tions

Organizationalfactors

Historyofpreviouspsychiatricillness

Lackofsocialsupport

Pronouncedintroversion

Negativityandpessimism

Socialsupport

Optimismandhealthyselfesteem

Spirituality

Adaptability

Tendencytofindmeaning

Curiosityand

openness

to

experi

ence

Aptitude


20/35




Whichoftheseriskandprotectivefactorscanyourecognizeinyourownlife

history,currentsituation,andpersonality?

Howdoyouseethesefactorsinteractingwiththestressyouexperience?


Whichoftheseriskandprotectivefactorscanyourecognizeinyourownlife

history,currentsituation,andpersonality?

Howdoyouseethesefactorsinteractingwiththestressyouexperience?


21/35


PartSix:Burnout

Asstressaccumulatesandstaysathighlevelsforextendedperiodsoftime,humanitar

ianworkersrunanincreasedriskofexperiencingburnout.Burnoutisaprocess,notan

event.Thistermreferstoatypeofcumulativestressreactionthatoccursafterpro

longedexposuretooccupationalstressors.Prolongedexposuretoemotionallyde

mandingsituationswithinadequatesupportgraduallydepletesanindividualsown

naturalresourcesfordealingwithstressandstrain.

Thefollowingareoccupationalsituationsthattypicallycontributetoburnout:

Conflictbetweenindividualvaluesandorganizationalgoalsanddemands

Lackofmanagerialand/orsocialsupport

Overloadofresponsibility

Roleconfusion

Senseofhavingnocontroloverqualityoroutcomeofwork

Littleemotionalorfinancialreward

Existenceofinequity,lackofrespect

Consistentexposuretotraumaticmaterial

Inthe

humanitarian

field,

the

road

to

burnout

is

often

paved

with

good

intentions.

Thosewhocomeintoajoboranoverseasassignmentthinkingthatitsgoingtobethe

solutiontoalltheirproblems,whohaveextremelyandunrealisticallyhighhopesand

expectationsaboutthechangetheywillmake,andwhowouldratherworkthando

anythingelse,areprimecandidatesforburnout.Thereisnothingwrongwithbeing

idealistic,ahardworkingperfectionist,oraselfmotivatingachiever.Theproblemlies

intherealityorunrealityoftheidealsandexpectations.Unrealistic,highlyidealisticjob

expectationsandaspirationsaredoomedtoleadtofailureandfrustration.

Aswithothertypesofstressreactions,peopletendtoexperienceburnoutindifferent

ways.

However,

normal

signs

of

burnout

do

tend

to

cluster

in

physical,

emotional,

mental,spiritualandbehavioraldomains.Thefollowingaresomecommonsignsof

burnout.


22/35



What is the best defense against burnout?

Thefirstandbestlineofdefenseagainstburnoutisprevention!Apartfromcultivating

acertainsenseofrealism,oneofthebestthingsyoucandotoavoidburnoutisto

createbalanceinyourlife.Investmoreinfamilyandotherpersonalrelationships,so

cialactivitiesandhobbies.Spreadyourselfoutsothatyourjobdoesnthavesuchan

overpoweringinfluenceonyourselfconceptandselfesteem.Asyoureadthroughthe

finalsectionsofthismodule,thoughtfullyexamineyourselfcarepractices.Theywill

helppreventordinarystressfrombecomingdistress,anddistressfrombecomingburn

out.

Physical Mental Emotional Spiritual Behavioral

Exhaustion

Headaches

Highblood

pressure

Insomnia

Dreams

Backpainand

otherchronic

tensionlinked

pain

Stomachcom

plaints

Selfdoubt

Blame

Negativity

Disillusionment

Reducedsense

ofaccomplish

mentandpur

pose

Feelingunappre

ciatedorbe

trayedbythe

organization

Foggythinking

Mentalapathy

Lackofinsight

intoreduced

capacitytofunc

tionwell

Emotionalex

haustionand

fragility

Feelingover

whelmed

Feelinghelp

less

Hopelessness

Mistrustof

colleaguesand

supervisors

Depression

Anxiety

Apathy

Inability

toengage

Wounded

ideals

Cynicism

Declineinper

formance

Apathy

Boredom

Interpersonal

difficulties

Irritability

Increasedad

dictionsor

de

pendencies

Recklessbe

havior

Neglecting

onesown

safetyand

physicalneeds


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Haveyounoticedanyofthesegeneralsignsofburnoutlately?

Followthislink(http://www.headingtoninstitute.org/Default.aspx?

tabid=1379)toanselfexaminationscaleifyouwouldliketoexplorewhetheryoumightbedemonstratingsignsofburnout.


24/35



PartSeven:Examiningyourownwell-being

Inthelongrun,takingcareofourownwellbeingisanessentialprerequisiteforeffec

tivelyhelpingothers.Itisoneofthebestwaystomaintainfitnesstocontinueinthat

helpingcapacity.

Thefirststeptotakingcareofyourwellbeinganddealingmoreeffectivelywithstress

andburnoutisunderstandingyourownselfcarestrengthsandneeds.Takingaper

sonalinventoryhelpsyouunderstandwhereyournaturalselfcarestrengthslie,and

whichselfcareareasneedextraattention.

Beforegoingontothefinalsectionofthismodule,pauseforamomentandtakein

ventoryofhowyouaredoing,andidentifywhichhelpfullifestylebalancestrategies

youuseregularly.Forpersonalreflection

Whataresomeofyourtypicalselfcareandcopingstrategies(bothnegative

andpositive)whenyouarestressed,fatigued,oranxious?

Whatsustainsyouinthiswork(i.e.,whatrefreshesyou,energizesyou,and

givesyouhope)? Whathelpfulselfcarestrategiesdoyouwishyouwereusingmoreregu

larly?


tabid=1379)toaselfexaminationscaleifyouwouldliketoexplorewhether


Whataresomeofyourtypicalselfcareandcopingstrategies(bothnegative

andpositive)whenyouarestressed,fatigued,oranxious?

Whatsustainsyouinthiswork(i.e.,whatrefreshesyou,energizesyou,and

givesyouhope)? Whathelpfulselfcarestrategiesdoyouwishyouwereusingmoreregu

larly?


tabid=1379)toaselfexaminationscaleifyouwouldliketoexplorewhether

youcurrentlyhavegoodselfcarestrategiesinplacetohelppreventburn

out.


25/35


PartEight:Increasingyourwell-being:Combatingstress

andburnoutthroughself-care

Dealingproactivelywithstressisalearnableskilloftensummedupbythephrase

stressmanagement.Theobjectiveofgoodstressmanagementisnotmerelytohelp

yousurviveyourcareer buttohelpyougrowandthriveasaresultofthestressful

challengesthatyoumightface.Inshort,itinvolvesrecognizingnaturalselfcare

strengthsalreadypresentinyourlifeandlearninghowtoapplythese,andadditional

helpfulstrategies,moreconsistently.

Youwillneverbecomesogoodattakingcareofyourselfthatyouleadastressfreelife.

However,thereismuchyoucandotomakesureyouretakingcareofyourselfprop

erly,toimproveyourwellbeing,andtohelpalleviatetraumaticstressreactionssuch

asburnout!Nosingletechniquewillrelieveallyourstress,butpayingattentiontothe

followingthreeareasofselfcarewillbuildupyourhardiness(yourabilitytohandlemorestresswithlessdistress)andyourresilience(yourabilitytobouncebackafterparticularlystressfulortraumaticevents).

Physical

Regularexercise:Exercisingatleastthreetimesaweekwithamixtureofaerobicexercise(e.g.,running,walking,swimming),exertion(e.g.,weights),and

stretching(e.g.,pilates)hasmultiplestressmanagementbenefits.Forexample,

ithelpsourbodiesprocessstressrelatedchemicals,reducesmuscletension,

releasesfeelgoodchemicalscalledendorphins,helpsusstaygenerallyfitter

andhealthier,andimprovesoursleep.Thisisoneofthesinglemosteffective

stressmanagementstrategies.

Sleep:Mostadultsneedbetweensevenandninehoursofsleepanighttofunctionattheirbest.

Healthyeating:Justasyourcarwouldnotrunwellonpoorqualityfuelornofuel

at

all,

our

bodies

and

brains

function

much

better

when

we

provide

them

withtherighttypeoffuel. Drinkingenoughwater:Bythetimeyoufeelthirstyyouvealreadylost2to3

percentofyourbodyfluid.Thislowersyourbloodvolume,makingyourheart

workhardertopumpbloodtoyourbrain.Stayinghydratedisoneoftheeasiest

waystohelpourselvesfunctionwell.


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Laughter:Laughterandpositiveemotionsreleasefeelgoodchemicalsthat

acttoundothecardiovasculareffectsofnegativeemotionsandhelpourbodies

relax.

Limitingyourconsumptionofalcohol:Alcoholnotonlylowersourinhibitionsandleadsustodothingswemaynotnormallydo,butitisadepressantand

depletesessentialvitaminsusefulinhelpingustodealwithstress(theBcom

plexvitamins).

Relaxationtechniques:Avarietyofrelaxationtechniques(suchasprogressivemusclerelaxation,diaphragmaticbreathing,visualizationandmeditation)can

beusedtoelicittherelaxationresponse.Thisactstoundothemuscularand

cardiovasculareffects

of

negative

emotions

and

help

our

bodies

relax.

Massage,whirlpool,sauna:Touchandwarmthareeffectivewaysofelicitingarelaxationresponseandcuingourbodiestorelax.

Repetitiveactivities:Repetitiveandabsorbingactivitiessuchascrossstitching,walking,quilting,drawingandcookingcanfunctionasaformofmoving

meditationthatissoothingandrelaxing.

Emotional and relational

Nurturingrelationships

Contactwith

home/friends

through

email,

phone,

tapes

Talking

Humor

Ongoingsupportgroup

Reflection:journaling,writing,meditating,poetry

Creativeactivitysuchasdrawing,sculpting,cooking,paintingandphotography

Movies,books,music

Havingbalancedpriorities

Understandingtraumaticstressandhaverealisticexpectations

Counseling

Therearethreemainthemesapparentintheseemotionalandrelationalselfcaretech

niques:

Interpersonalrelationships:Socialsupportfactorsplayamajorpartindeterminingstressreactionfactorsandvulnerability.Ourrelationshipswitheachother


27/35


aresoimportantthatrecentresearchsuggeststhatitmaybeourrelationships

thatsaveusratherthanourknowledgeandskills(Fawcett,2003,p.124).Ifyou

donthaveastrongsocialsupportnetwork,makeanefforttocreateone.The

mostprotectivesocialnetworksarentnecessarilylarge,buttheyareintercon

nected.Familiesandgroupsoffriendswhoknoweachotherwellareexamples

ofinterconnectednetworks.

Timeaway/distraction:Allowingyourselfabreatherandthechancetostepawayonaregularbasisisanothercrucialemotionalselfcaretechnique.Ideally

youshouldtakesometimeoffeveryweektodisengagefromworkandissues

thatdrainyou.Atleastsomeofthistimeshouldbespentdoingsomethingfun

andrelaxing.

It

is

especially

important

for

humanitarian

workers

to

be

aware

of

thesetypesofboundaries.Workinginthisfieldtendstosensitizeyoutointer

nationalissuesandtheimpactofdisaster,makingitdifficulttodisengageeven

whenyourenotattheoffice.

Storytelling:Beinginvolvedinhumanitarianworkchangespeople.Seekingtounderstandandexpressthesechangesisanimportantmethodfordealingwith

theimpactofthework.Storytellingcantakeseveralformstalkingwithfriends

orcounselors,journaling,andwritingletters,stories,poetry,orothermoreab

stractformsofcreativeactivitysuchaspainting.Writingappearstobeanespe

ciallyeffectivewayofdealingwiththeimpactoftraumaandstress.Writingde

tailedaccounts

of

stressful

events

in

away

that

links

facts

with

feelings

has

beenshowntohaveapositiveimpactonphysicalhealth.

Spiritual

Knowingyourvalues:Wheredoyoutendtofindmeaninginlife?

Participatinginacommunityofmeaningandpurpose

Regulartimesofprayer,reading,meditation

Spirituallymeaningfulconversations

Singingorlisteningtospiritualmusic

Contactwithreligiousleadersorinspiringindividuals

Timewithart,natureormusic

Solitude

Payingattentiontospirituality,justlikephysicalandemotionalselfcare,buildshardi

nessandresilience.Ithelpsyoumaintainperspective,andactsasacompassandan


28/35



anchorwhenyourefeelingoverwhelmed.Itisalmostimpossibletodohumanitarian

workwithoutitaffectingyourworldviewandspirituality,yoursenseofwhatsimpor

tanttoyouinlife,andyoursourceofstrengthandhope.Profoundchallengestospiri

tualityandworldviewaresomeofthemostsignificantchallengesthathumanitarian

workersfaceduringtheircareers.JohnFawcettputsitwell:

Therewillcomeatime,ifyoupursuethiscareerforlong,whenapro

foundlackofunderstandingwillthreatentosweepawayyouractions,

beliefs, achievements and even reason for being. Knowing this chal

lengewillcome,andensuringthatthereareclosefriendswhocanhear

yourquestions

without

harming

you,

is

an

essential

component

to

pre

ventativestressmanagement

(Fawcett,2003,p.154).

Sohowdowefeedourfaith?First,byunderstandingourpersonalvalues,whatwe

tendtofindmostmeaningfulinlife,andhowthisnurturesourspirituality.Second,by

seekingoutthingsthatareinlinewithourdeepestvaluesandwherewetendtofind

meaningthesearethingsthatmakeusfeelwhole,alive,joyful,andconnectedwith

somethingbeyondourselves.Soulfoodlikethistendstoshiftthewayweviewourlife

andthelifearoundus.Somecommonsourcesofsoulfoodareprayer,readingscrip

turaltexts,

religious

services,

meditation,

yoga,

deep

relationships,

nature,

art

and

mu

sic.


29/35



Whichoftheseselfcarestrategiesdoyouuseregularly? Whichdoyoufindmosthelpfultoyou? Whichstrategiesdoyouwishyouusedmoreregularly? Clickhere(http://www.headingtoninstitute.org/Portals/32/resources/

Effective%20self%20care.pdf)todownloadahandypocketcardwithself

careremindersonit.

Physical Emotionalandrelational Spiritual

Regularexercise

Sleep

Healthyeating

Drinkingwater

Laughter

Limitingconsumption

ofalcohol

Relaxationtechniques

Therapeuticmassage,

whirlpool,sauna

Repetitiveactivities

Nurturingrelationships

Contactwithhome/friends

throughemail,phone,

tapes

Talking

Ongoingsupportgroup

Reflection:journaling,

writing,meditating,poetry

Creativeactivities

Movies,books,music

Havingbalancedpriorities

Understandingtraumatic

stressandhavingrealistic

expectations

Counseling

Knowingyourvalues:

Wheredoyoutendtofind

meaninginlife?

Participatinginacommu

nityofmeaningandpur

pose

Regulartimesofprayer,

reading,meditation

Spirituallymeaningfulcon

versations

Singingorlisteningtospiri

tualmusic

Contactwithreligiouslead

ers

Timewithart,natureor

music

Solitude


30/35



Self-Quiz:Testyourknowledge

Choosethebestanswertoeachofthefollowingquestions.Thisquizismeanttotest

yourcomprehensionofthematerialinthemoduleyouhavejustread.Youranswers

willbeautomaticallytalliedattheendofthis20questionquiz.

1. Internationalhumanitarianworkerscommonlyexperiencestressfromwhichofthe

followingsources?

a. Violenceandthreat

b. Socialdislocation

c. Spiritualdislocation

d. Theworkenvironment

e. Alloftheabove

2. Stresscanbedefinedasanydemandorchangethatthehumansystem(mind,

body,spirit)isrequiredtomeetandrespondto.

a. True

b. False

3. Stressbecomesdistress,ortraumaticstress,whenitlaststoolong,occurstooof

ten,or

is

too

severe.

a. True

b. False

4. Somethingthatisverystressfulforonepersonisalwaysstressfulforothers.

a. True:Everyonefindsthesametypesofeventsstressfultothesameextent.

b. False:Yourindividualperception(howthreatenedyoufeelandhowmuch

controlyouhaveoverthecircumstances)caneffectthedegreeofdistress

youpersonallyfeel.

5.

Trauma

reactions

that

occur

as

the

result

of

a

critical

incident

(a

traumatic

event

duringwhichanindividualexperiencesthethreatofseriousharmofdeath)areof

tenreferredtoas:

a. CriticalIncidentStress

b. AcuteStressReactions

c. Bothofthetermsaboveareregularlyusedtorefertothistypeoftrauma


31/35


reaction.

6. Experiencingtraumaticstressreactionsafteracriticalincidentisanormalresponse

toanabnormalsituation.

a. True

b. False

7. Traumaticstressreactionsneveroccurinresponsetowitnessingand/orhearing

abouttraumaticeventsthathavehappenedtoothers.

a. True:Individualsmustbedirectlyinvolvedintraumaticeventstobeim

pactedby

them.

b. False:Interactionwithpeoplewhohaveexperiencedtraumaticevents

placeshelpersatriskofexperiencingsomeformofsecondarytraumatic

stressresponse.

8. Somecommonsourcesofchronicstressforhumanitarianworkersinclude:

a. Aconstantlychaoticandreactiveworkenvironment

b. Feelingoverwhelmedbytheapparentneed

c. Inadequatepreparationandbriefing

d. Beingaskedtocompletetasksoutsidetheirareaoftrainingandcompe

tencee. Alloftheabove

9. Overtime,thepresenceofmultiplechronicstressorsisusuallyabetterpredictorof

higherstresslevelsthantheoccurrenceoftheoccasionalcriticalincident.

a. True

b. False

10.Humanitarianworkersareatriskofexperiencingwhichofthefollowingtypesof

traumaticstress?

a. CriticalIncidentStress

b.

Vicarioustrauma

c. CumulativeStress

d. Alloftheabove

11.Peoplefromdifferentculturesexperienceandexpresstraumaticstressexactlythe

sameway.


32/35



a. True

b. False

12.Whichofthefollowingisnotafactorthatincreasestheriskthatyouwillexperi

encetraumaticstressreactions?

a. Natureandintensityofanypasttraumaticeventsexperienced

b. Thenumberofstressfuleventsexperienced

c. Goodsocialsupport

d. Organizationalfactors

e. Historyofpreviouspsychiatricillness

13.Whichofthefollowingisnotanormalsignofcumulativestress?

a. Sleepdisturbances

b. Seeingthingsthatarentthere

c. Fatigue

d. Poorconcentration

e. Eatingmorethannormal

14.Whichofthefollowingstatementsistrue?

a. Burnoutisaprocess,notanevent.Itisatermusedtorefertoatypeofcu

mulativestress

reaction

that

occurs

after

prolonged

exposure

to

occupa

tionalstressors.

b. Burnouthappenssuddenly.Itisanacutebreakdownofpersonalfunction

ingthattendstohappenwithfewwarningsigns.

15. Whichofthefollowingisahelpfulwayofpreventingoralleviatingburnout?

a. Cultivatingacertainsenseofrealismaboutyourjobanditsoutcomes.

b. Createbalanceinyourlife,investmoreinfamilyandotherpersonalrela

tionships,socialactivitiesandhobbies.

c. Bothoftheabovearehelpfulstrategiesinpreventingoralleviatingburnout.

16.When

trying

to

increase

your

hardiness

and

resilience,

it

is

important

to

pay

atten

tiontowhichofthefollowingselfcareareas?

a. Physical

b. Emotionalandrelational

c. Spiritual

d. Itisimportanttopayattentiontoalloftheseareas.


33/35


17.Whichofthefollowingisnotagoodphysicalselfcarestrategy?

a. Regularexercise

b. Gettingenoughsleep

c. Drinkingabottleofwineeverynight

d. Laughing

e. Practicingarelaxationtechnique

18.Whichofthefollowingisnotahelpfulemotionalorrelationalselfcarestrategy?

a. Talkingtoagoodfriend

b. Spendingallyourtimewithpeoplewhoonlyseethenegativesideofsitua

tions

c. Writinginajournal

d. Watchingafunnymovie

e. Understandingstressreactions

19.Profoundchallengestospiritualityandworldviewareusuallysomeofthemostsig

nificantteststhathumanitarianworkersfaceduringtheircareers:

a. True

b. False

20.Which

of

the

following

are

helpful

spiritual

self

care

strategies?

a. Participatinginacommunityofmeaningandpurpose

b. Regulartimesofprayer/reading/meditation

c. Spirituallymeaningfulconversations

d. Timewithart,natureormusic

e. Alloftheabove

Quiz:

(1) e

(2)

a(3) a

(4) b

(5) c

(6) a

(7) b

(8) e

(9) a

(10) d

(11) b

(12)c(13) b

(14) a

(15) c

(16) d

(17) c

(18) b

(19) a

(20) e


34/35



Resources

Thismoduleprovidesanintroductiontothephenomenonoftraumaticstress.Itisin

tendedtoprovideyouwithsomebasicinformationaboutstressandcopingandguide

youtowardsadditionalresourcesthatwillenhanceyourunderstandingofthistopic.

Helpfulwebsitesandbooksarelistedbelow.

PleasecontacttheHeadingtonInstituteatinfo@headingtoninstitute.org,orphone

(626)2299336ifyoudlikemoreinformation,wishtospeaktoamentalhealthprofes

sional,ordesireaprofessionalreferral.

On the internetPsychosocial.org:http://www.psychosocial.org/

MobileMemberCareTeamforMissionaries:http://www.mmct.org/resources.htm

InternationalSocietyforTraumaticStressStudies:http://www.istss.org/

BaldwinsTraumaInformationPages: http://www.traumapages.com/

TheSidran

Institute

for

Traumatic

Stress

Education

and

Advocacy:

http://

www.sidran.org/index.html

Risksassociatedwiththepsychologicaladjustmentofhumanitarianaidworkers:

http://www.massey.ac.nz/~trauma/issues/20041/mcfarlane.htm

BooksSharingthefrontlineandthebackhills:Peacekeepers,humanitarianaidworkersandthemediainthemidstofcrisis(2002).EditedbyYaelDanieli.PublishedbyBaywoodPublishingCompany,Inc.

Thehumanitariancompanion(2004).WrittenbyJohnEhrenreich.PublishedbyIDTGPublishing.

Stressandtraumahandbook:Strategiesforflourishingindemandingenvironments(2003).EditedbyJohnFawcett.PublishedbyWorldVisionInternational.
mailto:[email protected]:[email protected]:[email protected]://www.istss.org/http://www.istss.org/http://www.istss.org/mailto:[email protected]


35/35

StressManagementfordummies(1999).WrittenbyAllenElkin.PublishedbyWileyPublishing,Inc.

Documents

English Translation Understanding and Coping With Traumatic Stress Final