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‘SHATTERED ASSUMPTIONS….. BROKEN LIVES’. UNDERSTANDING AND MANAGING TRAUMA. by. Andrew Davies. Aims…. To facilitate a greater understanding of Trauma and it’s impact on individuals and organisations

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Shattered assumptions broken lives

‘SHATTERED ASSUMPTIONS…..

BROKEN LIVES’

UNDERSTANDING AND MANAGING TRAUMA

by

Andrew Davies


Shattered assumptions broken lives

Aims….

  • To facilitate a greater understanding of Trauma and it’s impact on individuals and organisations

  • To facilitate a greater understanding of how individuals and organisations can manage and recover from the trauma of critical incidents

  • To emphasize that traumas cannot always be prevented but can be contained and managed once they have occurred if efficient and effective policies and practices are adopted.


Shattered assumptions broken lives

Our Context

(Living and working in an unsafe world)

“Every day in Africa an impala wakes up. It must run faster than the fastest lion or it will be killed.

Every morning a lion wakes up and knows it must outrun the slowest impala or it will starve to death.

It doesn’t matter whether you are a lion or an impala… when the sun comes up you had better start running.”

Anonymous


Shattered assumptions broken lives

Our Context….

  • South African life has been characterized by violence and crime both before and after the revocation of the apartheid system.

  • In some ways, trauma (whether realized or anticipated) has become “part and parcel” of the South African psyche.

  • The burden of overwhelming trauma and its consequences has been experienced by South African trauma counsellors for many years.


Shattered assumptions broken lives

Our Context…

(The trauma of everyday life)

  • Amongst the highest violent crime rates in the world (including murder, car-jacking, and violence in schools). Homicide accounts for 44.5% of deaths.

  • The highest rates of rape, child abuse, and family violence in the world.

  • Rampant HIV/AIDS infection rate.

  • Large disparity between rich and poor.

  • Limited and inadequate community resources.

  • SA employees are at risk for exposure to incidents of traumatic stress.


Shattered assumptions broken lives

Definition of Trauma….

  • “A sudden, unexpected (unprepared for) event that

    • is outside the range of normal human experience

    • involves actual or threatened death or serious injury or a threat to the physical integrity of self or others

    • and would be markedly distressing to anyone”

  • The event is so unpleasant and shocking that the human mind and body react in an autonomic defensive manner.

  • The traumatisation is caused by the event, not because of some failing or weakness in the person.


Shattered assumptions broken lives

Critical Incident Defined….

“A critical incident is an event that causes disruption to an organisation, creates significant danger or risk and traumatically affects individuals within the organisation”

  • These are events with circumstances that are unusual or distressing and typically produce immediate and/or delayed emotional reactions that surpass the individual’s normal coping mechanisms and have the potential to interfere with usual functioning

  • Examples include: explosions, accidents, civil unrest, assaults, fire, terror attacks, etc.


Shattered assumptions broken lives

The Psychological Impact of Trauma

Stress is a reaction to an event or situation that places pressure upon a person. When demands become extremely threatening, overwhelming, or severe, they provide a heightened state of physical, cognitive, behavioural and emotional arousal commonly called “traumatic stress”

Stress

Traumatic Stress


Shattered assumptions broken lives

Shattered Assumptions (Janoff-Bullman)

  • The experience of trauma shatters two basic assumptions about the self and the world:

    • The belief in personal invulnerability or immortality

    • The belief that the world is a meaningful and orderly place, and that events happen for a reason

  • Violence, shatters a third belief: the trust that other human beings are fundamentally benign.

  • These 3 assumptions (or illusions) allow people to function effectively & to relate to others. After trauma, individuals are left feeling vulnerable, helpless and out of control in a world that is no longer predictable.


Shattered assumptions broken lives

The Psychological Impact of Trauma

OVERWHELMED

OUTCRY

Fear, sadness, rage

PANIC OR

EXHAUSTION

DENIAL

Refusing to face

memory of incident

EXTREME

AVOIDANCE

INTRUSION

Unbidden thoughts of

the event

FLOODED STATES

WORKING THROUGH

Facing the reality of

what has happened

PTSD

COMPLETION

Going on with life

PHASES IN THE REACTIONS TO TRAUMA


Shattered assumptions broken lives

The signs & symptoms of PTSD

People often respond to a stressful or traumatic experience with very strong feelings. They start saying, feeling and doing things that they did not do before

The following reactions commonly occur in response to trauma (the response involves intense fear, helplessness or horror):

  • Re-experiencing the trauma (recollections, physical reactivity)

  • Avoidance or numbing (detachment, estrangement, forgetting)

  • Increased arousal (startle response, irritability, sleep problems)

  • Other symptoms (depression, guilt, cognitive problems)


Shattered assumptions broken lives

Rescue & recovery personnel (fire, police ambulance etc)

Third level

Grieving relatives, friends and colleagues of first level individuals

Second level

Individuals directly experiencing the event who may or may not be physically injured

First level

4th level casualties

The community/organisation as a whole

The Ripple Effect


Shattered assumptions broken lives

Definitions:

Vicarious traumatization: The transmission of traumatic stress by observation and/or bearing witness to the stories of traumatic events.

Secondary traumatization: The overwhelming traumatic effect resulting from exposure to the trauma of the victim.

Continuous traumatic stress:A term used in place of PTS when trauma is so pervasive and unremitting that it falls within the range of normal human experience.

Burnout: A state of physical, emotional, and mental exhaustion caused by a depletion of ability to cope.


Shattered assumptions broken lives

A Duty of Care……

  • Creating and maintaining an effective, well-tested Critical Incident Management Plan is perhaps the surest way to limit damages and hasten recovery while keeping the individual functional and the company operational.

  • A planned and structured model of crisis management will not only enhance an organisation ability to recover from financial losses and return more efficiently to full productivity, but will also assist the company to fulfil its moral responsibility to protect employees.

  • Responding to the needs of employees in a compassionate, sensitive and helpful manner in the event of trauma affirms the value of employees to the company.


Shattered assumptions broken lives

Guidelines for Responding to Trauma Victims

Trauma defusing and debriefing services are vital in assisting individuals to process the traumatic experience through an integrated, appropriate and effective method of intervention

These services also facilitate the normalisation of personal experience


Shattered assumptions broken lives

A Note on Caring……

“…. relieving the emotional suffering of clients automatically includes absorbing information that is about suffering….

Often it includes absorbing that suffering as well”

(Figley, 1995)


Shattered assumptions broken lives

Defusing

Defusing is the ventilation of thoughts and emotions associated with the crisis event, and should be provided as soon as possible after the initial impact of the critical event to mitigate the effects of the trauma and promote recovery

  • PHASES

  • Introductory Phase

  • Exploration Phase

  • Information Phase

  • Do’s & don’ts

  • Cross cultural considerations


Shattered assumptions broken lives

Debriefing

Psychological debriefing is an established multi-phase group crisis intervention process to help individuals work through their thoughts, reactions, & symptoms followed by training in coping techniques.It is not therapy but Involves:

  • Education about stress reactions

  • Emotional ventilation

  • The promotion of cognitive reassurance that the stress response .is controllable and that recovery is likely

  • Mobilisation of resources within & outside the individual or group

  • Preparation for future

  • Intervention to assist in recovery from traumatic stress

  • Screening for people who need additional support


Shattered assumptions broken lives

“Healers must understand that caring does not only mean caring for others; it also means caring for oneself. We must be aware of our limits and know when it is necessary to nurture ourselves… No one can heal without being healed”

(Elizabeth Kubler-Ross)


Shattered assumptions broken lives

“We are not invulnerable, but if we maintain a strong sense of community among ourselves, we can be resilient”

(Catherall, 2001)


Shattered assumptions broken lives

Thank you


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