Stress and the World Relief Staff

Stress and the World Relief StaffMaintaining Your Well-Being

Stress: a demand or change that the human system is required to meet and respond to.

Three types:Critical incident (acute, traumatic)Vicarious traumaCumulativeStress cannot be avoided - in fact it can be used as a motivator in life. The trick is to accept stress as a daily part of life, but learn how to control and dissipate it.Critical IncidentReaction that occurs as result of traumatic event during which an individual is seriously threatened by harm or deathDemands of event exceed available coping resources and results in severe stressIntense fear + helplessness + loss of controlMost workers in field will experience at least one seriously disturbing/frightening incidentApprox. 25% of workers will undergo life threatening event (Headington Institution)Vicarious TraumaOccurs in response to witnessing or hearing about traumatic events that happen to othersSigns and symptoms of stress usually less intense that critical incidentRelief workers (RW) hear all types of stories so cannot avoid but need to learn how to prepare for it and deal with itMore than 90% of RW surveyed had witnessed or heard about traumatic event during their current assignment (Headington Institute)Less traumatic, more gradual but most problematicUsually related to low intensity but more chronic stressors that pile-upExamples are:Chaotic/reactive work environmentInadequate preparation and briefingAsked to complete tasks outside of area of training/competenceFeeling overwhelmed with unmet needsCommunication problems (work, cultural, personal)Facing moral and ethical dilemmasPersonal/family problemsChronic sleep deprivationCumulative StressWhich of the three types of stressors have you experienced?Which of the three seem to be the most problematic for you personally?In your own life can you identify with any of the characteristics of a relief worker?Do you think much about the stress in your life? If so, what do you do about it?

Cultural IssuesWhen thinking about stress you need to identify what it looks like in your own personal context and culture.How is stress conceptualized in this culture?Is there an individual concept of stress or mainly understood through family and group process?What are typical indicators of stress in this culture (experienced physically, emotionally, mentally, relationally, spiritually, or through behavior)?What have people in this culture traditionally done to deal with stress? What is the role of the individual or community in managing stress?What mechanisms are typically used to deal with stress (social, culture oral, and behavioral)?What do you believe are the most common stressors among your staff?What are the most common stressors of the people that you serve?

Questions to Think AboutFight or flight 1,500 biochemicals releasedEpinephrine & norepinephrine HR BP Blood flow changes to brain, heart, muscles, stomach Sharp thinking, auditory, and visual senses Readiness of muscles to contract Ability to act in present and sense potential danger Readies you for fight or flightSigns of StressCortisol Counteracts pain & inflammation Important when need to focus on solving problem or get to safetyEndorphins production increased Identical to morphine chemical makeup Potent painkiller Creates sense of well-being, even euphoria approaching carelessness Cannot produce at high levels for extended length of time Can lead to aid junkie

Signs of Stress(cont)Women produce more oxytocin Tend-and-befriend, counteracts fight-or-flight Encourages women to care for children Want to be close proximity to other women and when this occurs oxytocin increases again reinforcing the effects

Men produce more testosterone Enhances the fight-or-flight

Signs of Stress(cont)Can sensitize your amygdale of brain and send into high alert easilyCan cause cells in the hippocampus of brain to shrink compromise brains ability to retain new memoriesIncreased chance of stroke and/or heart diseaseIncreases blood clottingImpairs effectiveness of immune systemIncreased level of stomach acid productionChronically depleted endorphin levelsIncreased incidents of vivid dreamingGet sick more easily and stay sick longerFeel tired, drained, and worn outMay start to feel anxious, cynical, hopelessRelationships sufferMay use drugs, alcohol or engage in risky behaviorEmotional and spiritual effectsEffects of Prolonged StressWhat symptoms are you or do you normally experience?Feeling of low statusUnhappy marriage/relationshipsQuarreling with peopleDebts/money problemsHealth problemsUnsatisfactory living conditionsLack of social supportBoredomUnrealistic goalsWork problems

Risk Factors: Increase our vulnerability to stressIntense drive to advance oneself or ones causeAdversarial and competitive manner opinionated, often rigid, talks at othersEasily irritated, intolerant of imperfections in othersTaking on too much and will not give anything upQuick pace in walking, eating, speaking, gesturing hurry-up diseasePhysical and mental alertness habitually tense and poised for actionImpatient, dislikes waitingInability to relax feel guilty when doRisk Factors: PersonalityTends to be more of a risk taker and likes stressNature and intensity of traumatic events experiences in the pastNature and intensity of work that may trigger a current reactionNumber of stressors experiencingLength of exposure to stressful situationWork organizational factorsHistory of previous psychiatric illnessPronounced introversionNegative and pessimism may feel never have done enoughMay feel do not have enough resources to meet needsMay face moral dilemmasStruggle to find balance between demands of work and own well-beingRisk Factors: Relief WorkersProtective FactorsDecreasing & Dissipating StressPhysical ActivityRest

Decreasing & Dissipating StressHealthy EatingWater

Decreasing & Dissipating StressOptimism Curious

Decreasing & Dissipating StressKnow your strengths and weaknessesAppreciate how God has made youBe aware of strengths and accentuateRecognize weaknessesWork on being adaptableBe flexibleLook for meaning in eventsGain aptitude in areas where you may be called to work

Manage Your EmotionsIs what you worrying about really going to make a diffenceBe aware of resentment over the past and anger in the presentCannot change the pastNot everyone is going to agree with youYou are going to make mistakes

Decreasing & Dissipating StressSocial Support

People with low social support:4 times more likely to experience trauma2.5 times more likely to experience some form of physical illnessGreater risk for heart diseaseDecreasing & Dissipating StressLaughterThankful

Decreasing & Dissipating StressTake Time Away/DistractionsNeed a breather and chance to step back on regular basisIdeally time off every weekNeed to do something fun and relaxingNeeds to be on your calendar

Decreasing & Dissipating StressStorytellingA way to express changes and cope with eventsTalk with friends, counselors, stories, poetry, painting, etcWriting appears to be most effective way detailed accounts of stressful events that links facts with feelings found to have positive impact on health

Decreasing & Dissipating StressBe HardyCommitment: purpose to life and involvement gives meaningControl: Perceive we have control over stressor or choice of how we react to itChallenge: Seeing difficulties as a challenge rather than a threat and accepting only thing in constant in life is change

Decreasing & Dissipating StressSpirituality/FaithBuilds hardiness and resilienceHelps maintain perspectiveActs as a compass and anchorSense of what is important in lifeSource of strength and hope

Decreasing & Dissipating StressDecompressReview past events

Rehearse upcoming events

Relax deep breaths

Decreasing & Dissipating StressRelaxationRepetitive activities such as quilting, weaving, knitting, walking)Techniques such as diaphragmatic breathing, muscle relaxation, reflective prayer)

Using Protective FactorsPlace a + by a by the protective factors that are most commonly used in your culture.Place a by protective factors that you personally use on a regular basis.List one or two new protective factors that you are willing to start using.

Live as normal a life as possible, and do things that make you feel goodKeep away from mind-altering substancesExercise regularly and eat a healthy dietBe honest about your feelings write them down or tell them to a trusted friendDo not isolate yourself, but do take time to sleep, relax, and to be aloneRefrain from blaming others Do not make major decisions; will need to make some decisions and will help regain confidenceLet go of feelings of guilt and self-blameOpen up to others and spend time with them

Behavior if Exposed to Traumatic EventsPan American Health OrganizationBehavior if Exposed to Traumatic EventsMaintain a sense of humor even if you feel terribleLend a helping hand to others, but do not overextend yourselfUtterances fuelled by anger or ignorance are best left unsaidTend to be more accident proneStructure your time and keep busyThink realistic and positiveRealize that your reactions are neither unique or abnormalAccept your limitations and those of othersSeek professional help if necessaryStrive for inner peace

Pan American Health Organization What Not to DoDont believe that you have to care for your coworker or someone else if you feel mentally unable to do so you wont be able to.Dont believe that you cant say what you are feeling you need to.Dont attempt to reassure yourself or others that everything is okay it is not.Dont try to impose your explanation for what happened on others it is just your opinion.Dont blame yourself for what happened this is not the time for accusing anyone.Dont tell other people that you know how they are feeling you dont.Dont say to the other person to simply forget about it it isnt that simple.Dont feel pressured to respond when someone else is talking to you just be there and listening is what matters most to that person.Dont be afraid to ask someone else how they are doing your concern may be very uplifting to them.Dont try to talk someone else out of their feelings even if you dont understand their reactions to an incident just listen.

Pan American Health Organization Care International Safety and Security Handbook (200). Retrieved August 1, 2008 from: http://ngosecurity.googlepages.com/English_CARE_International_Safety_and_Security_Handbook.pdfTraits David Baldwins Trauma Information Page. Emotional Health Issues for Families of Disaster Workers by the American Red Cross. Retrieved July 10, 2008 from:http://www.trauma-pages.com/h/arcwkfm.phpFawcett, J. (Ed.) (2003). Stress and Trauma Handbook. Monrovia, CA: World VisionHeadington Institute (2007). Online Training Modules. Retrieved July 6, 2008 from: http://www.headington-institute.org/Default.aspx?tabid=2258Manning, G., Curtis, K. & McMillen, S. (1999). Stress Living and Working in a Changing World. Duluth, MN: Whole Person Associates.Pan American Health Organization (2001). Insights into the Concepts of Stress. Retrieved August 1, 2008 from: http://www.paho.org/english/ped/stressin.htmPan American Health Organization (2001). Stress Management in Disasters. Retrieved August 1, 2008 from: http://www.paho.org/english/ped/stressmgn.htm

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