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Understanding & Managing Trauma ‘SHATTERED ASSUMPTIONS….. BROKEN LIVES’ ‘SHATTERED ASSUMPTIONS….. BROKEN LIVES’ Andrew Davies byby UNDERSTANDING AND MANAGING.

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Presentation on theme: "Understanding & Managing Trauma ‘SHATTERED ASSUMPTIONS….. BROKEN LIVES’ ‘SHATTERED ASSUMPTIONS….. BROKEN LIVES’ Andrew Davies byby UNDERSTANDING AND MANAGING."— Presentation transcript:

1 Understanding & Managing Trauma ‘SHATTERED ASSUMPTIONS….. BROKEN LIVES’ ‘SHATTERED ASSUMPTIONS….. BROKEN LIVES’ Andrew Davies byby UNDERSTANDING AND MANAGING TRAUMA

2 Understanding & Managing Trauma Aims…. To facilitate a greater understanding of Trauma and it’s impact on individuals and organisationsTo 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 incidentsTo 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.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. To facilitate a greater understanding of Trauma and it’s impact on individuals and organisationsTo 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 incidentsTo 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.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.

3 Understanding & Managing Trauma “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. AnonymousAnonymous It doesn’t matter whether you are a lion or an impala… when the sun comes up you had better start running.” Our Context (Living and working in an unsafe world)

4 Understanding & Managing Trauma Our Context…. South African life has been characterized by violence and crime both before and after the revocation of the apartheid system.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.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.The burden of overwhelming trauma and its consequences has been experienced by South African trauma counsellors for many years. South African life has been characterized by violence and crime both before and after the revocation of the apartheid system.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.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.The burden of overwhelming trauma and its consequences has been experienced by South African trauma counsellors for many years.

5 Understanding & Managing Trauma 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.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.The highest rates of rape, child abuse, and family violence in the world. Rampant HIV/AIDS infection rate.Rampant HIV/AIDS infection rate. Large disparity between rich and poor.Large disparity between rich and poor. Limited and inadequate community resources.Limited and inadequate community resources. SA employees are at risk for exposure to incidents of traumatic stress.SA employees are at risk for exposure to incidents of traumatic stress. Amongst the highest violent crime rates in the world (including murder, car-jacking, and violence in schools). Homicide accounts for 44.5% of deaths.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.The highest rates of rape, child abuse, and family violence in the world. Rampant HIV/AIDS infection rate.Rampant HIV/AIDS infection rate. Large disparity between rich and poor.Large disparity between rich and poor. Limited and inadequate community resources.Limited and inadequate community resources. SA employees are at risk for exposure to incidents of traumatic stress.SA employees are at risk for exposure to incidents of traumatic stress.

6 Understanding & Managing Trauma Definition of Trauma…. “A sudden, unexpected (unprepared for) event that“A sudden, unexpected (unprepared for) event that is outside the range of normal human experienceis 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 othersinvolves 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”and would be markedly distressing to anyone” “A sudden, unexpected (unprepared for) event that“A sudden, unexpected (unprepared for) event that is outside the range of normal human experienceis 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 othersinvolves 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”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 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.The traumatisation is caused by the event, not because of some failing or weakness in the person.

7 Understanding & Managing Trauma 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 functioningThese 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.Examples include: explosions, accidents, civil unrest, assaults, fire, terror attacks, etc.

8 Understanding & Managing Trauma 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” StressStress Traumatic Stress

9 Understanding & Managing Trauma The experience of trauma shatters two basic assumptions about the self and the world: The belief in personal invulnerability or immortality 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 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.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. The experience of trauma shatters two basic assumptions about the self and the world: The belief in personal invulnerability or immortality 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 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.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 (Janoff-Bullman)

10 Understanding & Managing Trauma The Psychological Impact of Trauma OUTCRY Fear, sadness, rage OUTCRY Fear, sadness, rage DENIAL Refusing to face memory of incident DENIAL Refusing to face memory of incident INTRUSION Unbidden thoughts of the event INTRUSION Unbidden thoughts of the event WORKING THROUGH Facing the reality of what has happened WORKING THROUGH Facing the reality of what has happened COMPLETION Going on with life COMPLETION Going on with life PTSD OVERWHELMED FLOODED STATES EXTREME AVOIDANCE EXTREME AVOIDANCE PANIC OR EXHAUSTION PANIC OR EXHAUSTION PHASES IN THE REACTIONS TO TRAUMA

11 Understanding & Managing Trauma The following reactions commonly occur in response to trauma (the response involves intense fear, helplessness or horror): Re-experiencing the trauma (recollections, physical reactivity)Re-experiencing the trauma (recollections, physical reactivity) Avoidance or numbing (detachment, estrangement, forgetting)Avoidance or numbing (detachment, estrangement, forgetting) Increased arousal (startle response, irritability, sleep problems)Increased arousal (startle response, irritability, sleep problems) Other symptoms (depression, guilt, cognitive problems)Other symptoms (depression, guilt, cognitive problems) Re-experiencing the trauma (recollections, physical reactivity)Re-experiencing the trauma (recollections, physical reactivity) Avoidance or numbing (detachment, estrangement, forgetting)Avoidance or numbing (detachment, estrangement, forgetting) Increased arousal (startle response, irritability, sleep problems)Increased arousal (startle response, irritability, sleep problems) Other symptoms (depression, guilt, cognitive problems)Other symptoms (depression, guilt, cognitive problems) 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

12 Understanding & Managing Trauma Third level Second level First level Rescue & recovery personnel (fire, police ambulance etc) Grieving relatives, friends and colleagues of first level individuals Individuals directly experiencing the event who may or may not be physically injured 4 th level casualties The community/organisation as a whole 4 th level casualties The community/organisation as a whole The Ripple Effect

13 Understanding & Managing Trauma 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. Burnout: A state of physical, emotional, and mental exhaustion caused by a depletion of ability to cope. 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.

14 Understanding & Managing Trauma 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.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.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.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. 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.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.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.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. A Duty of Care……

15 Understanding & Managing Trauma These services also facilitate the normalisation of personal experience 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

16 Understanding & Managing Trauma “…. relieving the emotional suffering of clients automatically includes absorbing information that is about suffering…. Often it includes absorbing that suffering as well” “…. relieving the emotional suffering of clients automatically includes absorbing information that is about suffering…. Often it includes absorbing that suffering as well” (Figley, 1995) A Note on Caring……

17 Understanding & Managing Trauma 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 Defusing PHASES Introductory Phase Introductory Phase Exploration Phase Exploration Phase Information Phase Information Phase Do’s & don’ts Do’s & don’ts Cross cultural considerations Cross cultural considerationsPHASES Introductory Phase Introductory Phase Exploration Phase Exploration Phase Information Phase Information Phase Do’s & don’ts Do’s & don’ts Cross cultural considerations Cross cultural considerations

18 Understanding & Managing Trauma Education about stress reactions Education about stress reactions Emotional ventilation Emotional ventilation The promotion of cognitive reassurance that the stress response is controllable and that recovery is likely 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 Mobilisation of resources within & outside the individual or group Preparation for future Preparation for future Intervention to assist in recovery from traumatic stress Intervention to assist in recovery from traumatic stress Screening for people who need additional support Screening for people who need additional support Education about stress reactions Education about stress reactions Emotional ventilation Emotional ventilation The promotion of cognitive reassurance that the stress response is controllable and that recovery is likely 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 Mobilisation of resources within & outside the individual or group Preparation for future Preparation for future Intervention to assist in recovery from traumatic stress Intervention to assist in recovery from traumatic stress Screening for people who need additional support Screening for people who need additional support 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: Debriefing

19 Understanding & Managing Trauma “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)

20 Understanding & Managing Trauma “We are not invulnerable, but if we maintain a strong sense of community among ourselves, we can be resilient” (Catherall, 2001)

21 Understanding & Managing Trauma Thank you


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