WW52 January 31, 2018: Helping the Helpers not to Harm… The Origins of Human Service Response™, Part II

Wednesday Wisdom Series: Helping the Helpers not to Harm…
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Here is your bi-monthly Wednesday Wisdom series from the Family Assistance
Foundation, reminding you that a fully-integrated approach for assisting survivors of
traumatic loss involves a balance of head and heart. Wednesday Wisdom is written
and copyrighted by Carolyn V. Coarsey, Ph.D., and distributed by the Family
Assistance Education & Research Foundation Inc., fafonline.org. Reprint is available
with written permission from the Foundation. 

Helping the Helpers not to Harm… 
The Origins of Human Service Response™, Part II
Wednesday Wisdom Heart 

"Victims are members of society whose problems represent the memory of
suffering, rage, and pain in a world that longs to forget.

                                                                                  -Bessel van der Kolk, MD,
                                                                                  American Psychiatrist, and Post-
                                                                                  Traumatic Stress Researcher

Part I of The Origins of Human Services Response™ highlighted how important it is
for an organization to respond to a traumatic event in the workplace with maximum
support for all
in harm's way including those who appear to be uninjured. Part I
featured survivors of aviation disasters, while
Part II involves an example from the
cruise line industry. In addition to illustrating the power that employee responders on
site during a traumatic event have in helping or harming survivors, it also illustrates
that the death of one person is
a disaster for that family.
                          
Secondary traumatization refers to behavior and attitudes of employee responders
that are insensitive and result in re-traumatizing an already victimized person. The
traumatizing event (crisis) includes not only the objective view of the event, i.e.,
accident, crash, crime, death, etc., but also their subjective experience—i.e., the
survivor’s perception of the crisis including all that happens when they are helpless
and dependent. Untrained employees can cause a second, third, and multiple
assaults on the survivor. While the harm done is not intentional, for a survivor who is
in a regressed emotional state—it is difficult to process the lack of empathy and
compassion that often results during secondary traumatization.
 
Now you will read the story of a man whose wife died on board a cruise ship which
provides a clear example of secondary traumatization.
The man’s wife died in her
sleep of apparent natural causes.
The man was not able to leave the ship for several
hours due to the distance to port at the time the death was discovered.


The most terrible moment of my life was when the doctor coldly told me without an
ounce of empathy that my wife was dead. The next few hours were some of the
worst I have ever spent on earth. My first caretaker was extremely nice; she held my
hand and cried with me. But when the shift changed, I received a woman who was
not coached in grief and could not console me in the least. She simply stared at me
uncomfortable with my despair and told me to stop crying every time I started. In a
moment when your entire world is crashing around you, and you feel like you have
nothing left to live for, being told to stop crying felt like another stab to the heart. 
Not
only was the love of my life gone, but I was repeatedly told that I wasn't being
allowed to feel what I was feeling. I was alone with no one.


As the day went on, I heard a TV playing in a waiting room. I thought to myself that
some distraction might be helpful so I sat and watched the TV. An employee
eventually told me that people would be coming in soon and I couldn't sit there for the
last 30 minutes of hell left on the cruise. I was guided to a room and forced to sit in
the dark with a TV that did not work. I went up to the deck and called my family. I
don't doubt that anything would have made that day okay for me. But I do know that
I felt much worse because of the staff on your ship. 


While this company has a well-trained and highly qualified Care Team, this example
makes the point previously discussed in Part I of this two-part series. Organizations
are better served by training all employee responders at every point of contact with
survivors. The underlying theoretical model for HSR™ is based on the teachings of
psychiatrist Gerald Caplan, regarded by many as the father of crisis theory. In 1974,
in his own words, Dr. Caplan stated: The biggest problem in preventive psychiatry
today is to help caretaking people who are on the spot at the time of a crisis exert
their pressure to tip the balance over to the side of emotional health.
Dr. Caplan
further taught that what happens during the crisis is more predictive of how the
survivor turns out psychologically than other factors about the
survivor’s circumstances.

 
Wednesday Wisdom Head

"In fact, the most powerful influence in overcoming the impact of
psychological trauma seems to be the availability of a caregiver who can be
blindly trusted when one’s own resources are inadequate.

                                                                                            -Bessel van der Kolk, MD,
                                                                                            American Psychiatrist, and Post-
                                                                                            Traumatic Stress Researcher

My dissertation, Psychological Aftermath of Air Disaster: What can be learned
for Training
? published in 1992, traces the history of what was known at the time
about the psychological effects of survivors of technological tragedies, which was
very little. In 1974, the US had passed the Disaster Relief Act calling for a systematic,
organized approach to dealing with the emotional and psychological effects of
natural
disaster. In 1978, the US Federal government held a meeting with all major
stakeholders in the aviation industry to discuss how survivors of aviation accidents
should be supported. Despite the recognition of the need for supporting survivors of
aviation disasters, no other action resulted at that time.


With no formal research on the psychological/emotional effects of a technological
crisis on survivors, the official responders to psychological needs of survivors from
the seventies up through the nineties were counselors and mental health workers.
The scientific study in my doctoral dissertation showed clearly that while these
professionals were often considered to be helpful to survivors, the group of
responders who had the greatest impact on them was the employees who worked
for the company who used their organization’s resources to provide practical
support including transportation, lodging, food, and basic needs, and most
importantly, re-connecting them with their own family and friends as quickly as
possible, while showing empathy and respect for the survivors.


Government and other leaders in the academic and psychiatric groups in the past
believed that the best psychological support for survivors of all crises were
 those
with mental health and clinical backgrounds. However, today, research is showing
the need for a multi-disciplinary approach for assisting survivors in crises, starting
with the organization's employees themselves. The
Foundation’s on-going interviews
with survivors from all types of workplace disasters continue to underscore the value
of well-trained employee responders—and the greatest area of need is in training
those who are “on the spot” at the time of the crisis.
                                                                   
© 2018 Higher Resources, Inc./Aviem International, Inc.
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