Understanding Trauma and Post-Traumatic Stress

In the previous post, I addressed the need for trauma-sensitive mindfulness.  One of the observations of David Treleaven mentioned in the post, was the need for meditation teachers to develop an awareness of, and sensitivity to, the presence of people who are experiencing, or have experienced, trauma.  Failure to do this could lead to mindfulness activity that generates trauma stimuli leading to re-traumitisation.  Being trauma-sensitive means understanding the signs of post-traumatic stress as well as having the presence of mind to modify mindfulness practices to take account of people’s needs in this condition.

Recognising the signs of post-traumatic stress

Trauma results where a person experiences an overwhelming amount of stress that exceeds their ability to cope and deal with the emotional fallout from that experience.  The effects vary with each individual and the nature of the traumatic event. Traumatic events can include the loss of a sibling or parent through death, separation from a parent at a young age, a life-threatening car accident or terrorist event, separation and divorce, a house fire, physical or sexual abuse or a natural disaster.

This variability in the nature and impact of traumatic events, and the individual’s reluctance to disclose through shame or the need to comply with an authority figure, means that it is often very difficult to ascertain whether a person has suffered from trauma and is experiencing post-traumatic stress disorder (PTSD).  According to several reports, up to 20% of people who experience a traumatic event together will experience post-traumatic stress disorder.

Trauma can impact a person’s thoughts, emotions, perceptions, level of arousal/reactivity and mood.  It can be reflected in behavioural change such as avoidance of a person or location, inability to sleep or sleeping too much, reliving the trauma through nightmares or flashbacks or withdrawal from social contacts or work colleagues.  The attendant emotions could be depression, anxiety and feeling unsafe.  Thoughts of suicide can also be one of the signs of post-traumatic stress disorder.

The role of memory and embodiment

Peter Levine, in an interview with Serge Prengel, discussed the role of memory in trauma and post-traumatic stress disorder.  Peter is the author of the book, Trauma and Memory: Brain and Body in Search of the Past – A Practical Guide for Working With Traumatic Memory.  His book is ground-breaking in that he highlighted the role of “implicit memory” and showed how to treat trauma sufferers by accessing the “complex interplay of past and present, mind and body”.  He termed his methodology, “somatic experiencing”.

In the interview, Peter stressed that we have several different forms of memory and the ones that are particularly relevant to trauma are episodic or autobiographical memories, emotional memories and procedural or body memories.  Episodic memory, also termed “defining moments” by Serge the interviewer, though low in emotive content are nonetheless impactful. For example, Peter describes a teacher who acted as a mentor to him and instead of blaming him for poor judgement encouraged him to learn and explore his curiosity.  Other mentors in his life as he progressed through his studies modelled similar behaviour.  This, in turn, led him to a career choice as a professional mentor – so the episodic memory acted as a “trajectory” for his progress in life. 

Emotional memories, on the other hand, “though further out of the realm of awareness” are “very powerful and compelling” and shape how we behave in our life.  Some interaction from the past is encoded with a very strong emotion such as sadness, anger or fear.   The emotional memory can interfere with a current relationship when something or somebody acts as a reminder of the past interaction so that we can be overwhelmed with either a very strong negative or positive emotion. 

While emotional memories operate at a deep level, body memories are deeper still.  At one level, they have to do with the acquisition of motor learning and skills, e.g. riding a bike.  At another level, they are determinants of our approach or avoidance behaviour.  Peter gives the illustration of coming across a former classmate more than 30 years after their schooling and finding that he had a strong desire to approach and reconnect with him.  The classmate had been his protector at school when other children tried to bully him – hence his approach behaviour.  An example of avoidance behaviour conditioned by body memory is when someone who has previously experienced sexual abuse actually freezes when touched by a loving partner.

David Treleaven reinforced the relationship between trauma and body memory when he stated in his video presentation that “the respiratory system is intimately connected to our sympathetic nervous system which is totally tied to traumatic stress”.  He pointed to two books by Babette Rothschild that highlighted the close connection between trauma and body memory, The Body Remembers and Revolutionizing Trauma Treatment.   David also explained further why meditation exercises such as mindful breathing can activate trauma stimuli.  He drew on the differentiation between exteroception (body’s perception of external stimuli received through the senses) and interoception (sensing conditions within the body such as deep breathing or tightness of the chest).  Normally exteroceptors and interoceptors integrate (e.g. the external sensation of viewing a sunrise is matched with the internal sensation of a warm feeling in your chest and a sense of looseness in your hands and legs); with trauma sufferers, “the relationship between interoceptors and exteroceptors can go awry”.

Peter Levine emphasised the need to recognise that we have a “fluid identity” – while our identity is shaped by the past, and the interplay of multiple events and interactions, it is possible to gently, but surely, release the embodied memories and progressively unearth the richness, power and sense of connection of an identity not locked into painful memories.  He has dedicated his lifework to training individuals and professionals in understanding the role of the different memories and in learning to use his trauma treatment methodology, somatic experiencing.  Other professionals, through an understanding of the mind-body connection, employ somatic meditation to assist trauma sufferers.

Reflection

We can grow in mindfulness as we develop an awareness of the role that memory plays in our own thoughts, emotions, moods and behaviour and learn to recognise the signs of post-traumatic stress in others.  As we develop this heightened awareness, we can make appropriate modifications to our meditation teaching and deepen our own meditation practice and reflection.

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Image – Sunrise over the water, Wynnum, Brisbane

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Depression and the Loss of Connection To Meaningful Work

Johann Hari, author of Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions, was concerned about the extraordinary rise in the use of antidepressant drugs in America and the associated total focus on biological causes of depression.  He set about doing worldwide research on the social factors contributing to depression.  He was particularly interested in precursor events or situations that led to a person experiencing depression.  His research led him to identify nine social factors that were contributing to the alarming rise in the incidence of depression and suicide.  As the title of his book indicates, each of these social factors related to a “lost connection.”  He describes the first of these causal factors as “disconnection from meaningful work”.

Loss of connection to meaningful work

Johann’s research (and that of his colleagues) covered a range of people engaged in different kinds of work, usually at lower levels in organisations.  They found that certain job characteristics contributed to a loss of meaning for the worker.  This disconnection with meaningful work resonates with the Job Characteristics Model developed by Hackman and Oldham in the 1970s as a basis for the design of jobs that generated positive psychological states such as the experience of meaningfulness and personal responsibility.

Johann, drawing on his own research and that of his colleagues, identified several job characteristics in different contexts that contributed to the loss of connection to meaningful work and resulted in people experiencing depression:

  • Lack of control over work – research into the high incidence of suicide amongst staff investigating tax returns in the Taxation Office in Britain found that a key contributing factor was the lack of control over their work.  No matter how hard they worked, the pile of work kept growing and they could never get on top of it.  The ability to control the work environment and how work is done, known as “agency”, has been the subject of much research into what constitutes a psychologically healthy work environment.
  • Lack of feedback – in the previous research, another factor identified as contributing to psychological illness was the lack of feedback about performance of the job.  No matter how well or how poorly the work was done, there was no feedback received from supervisors or managers.  This led to a sense of the work and the worker being devalued.  The disconnection between effort and “reward” in terms of positive feedback contributed to people feeling “irrelevant” – they felt that they were not important or relevant to what the organisation valued.
  • Lack of discretion – research into the experience of depression amongst typists in a typing pool demonstrated that a causal factor of depression was the lack of the ability to make decisions affecting the work and the typists’ output.  The typists were totally disempowered because work was given to them with instructions on how it was to be done by people they did not know; they lacked understanding of what the documents involved or meant; demand was endless; and they were unable to speak to each other.  The work was thus experienced as meaningless and “soul-destroying”.  This research, along with other studies, highlighted the fact that people lower in organisations experience greater stress than those at higher levels who have a lot of responsibility because the latter have more discretion over what they do and how they do it.
  • Lack of ability to make a difference – the example given by Johann related to a worker in a paint shop who spent all day adding tint to base paint and using a machine to mix the contents to provide paint with the colour requested by a customer.  The repetitious nature of this task and the associated boredom contributed to the worker experiencing a lack of meaning because he did not make a real difference in people’s lives.  Hackman and Oldham had previously identified “significance” of a job as a key element for a psychologically satisfying job.  Associated with that was the degree to which a job provided what they termed “task variety” and “skill variety”.  Work without variation and with no perceived impact, can be experienced as mind-numbing and deadening and lead to depression.

The loss of connection to meaningful work can be addressed at two levels.  Organisations can develop greater awareness about what constitutes unhealthy work design and remedy deficiencies in the design of jobs.  Action learning interventions can be helpful in this regard and, in the process, build employee’s self-awareness and sense of agency.

Workers, too, can develop inner awareness about what in their work is impacting their mental health and causing depression. They can explore this awareness through meditation and reflection and identify ways to remedy the situation.  As they grow in mindfulness, they may be able to identify why they are procrastinating and not removing themselves from a harmful work situation.  Johann found, for example, that the worker in the paint shop really wanted to change jobs and had already identified what job would give more meaning and joy for him.  However, he was held back by his perceived need to achieve the external rewards of life – better income and a good car.  Through meditation and reflection, it is possible to become more acutely aware of the cost of “staying’ versus changing and to be able to cope with the vulnerability involved in changing jobs.

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Image by Gerd Altmann from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Recognition of the Signs of Mental Illness and How to Intervene

In the previous post, I discussed being mindful of mental health in the workplace.  This involves not only awareness and being present to staff and colleagues, but also being able to recognise the early warning signs of mental illness and having the courage and competence to intervene.

The early warning signs of mental illness in the workplace

Recognition of the early warning signs of mental illness enables early intervention to prevent deterioration in a person’s mental health.  Without such an intervention, issues can build up for the individual, making it more difficult for them to manage their stress and/or stressors.

The Mentally Healthy Workplaces Toolkit introduced in the earlier post provides a list of possible early warning signs of mental illness and lists them under five categories:

  1. Physical – such as constant tiredness, continuous ill health, major changes in appearance and/or weight, complaints about ongoing health concerns
  2. Emotional – such as irritability, loss of a sense of humour or of confidence, increased cynicism, nervousness, overly sensitive to perceived or real criticism
  3. Cognitive – overall performance decline through lots of mistakes, lack of concentration and/or inability to make decisions (constant procrastinating)
  4. Behavioural – behaving out of character by becoming more introverted or extroverted, withdrawing from group activities, lateness to work, not taking scheduled breaks (such as lunches) but taking unofficial time off
  5. In the business – inability to meet deadlines, declining motivation, frequent absences, working long hours unproductively.

There may be multiple causes for one or more of these early signs to occur.  So, it becomes important to check in with the person involved as to how they are going and whether you can be of assistance.

Checking in – having the conversation

Often managers and colleagues are reluctant to say anything to the person showing early sings of mental illness and the person involved is often unwilling to raise the issue for fear of being seen as “not coping” or “being weak”.  Part of the problem is that they really need support and care and genuine concern for their welfare.  They can be experiencing a strong sense of isolation, lack of support and associated depression.  Extending a helping hand can often work wonders.   But how do you start the conversation?

People in the workplace are very ready to ask someone about a physical injury such as a broken wrist but when it comes to a mental illness they are often fearful or uncertain – yet the person with the early signs really needs someone to show care and concern.  So, we can have a situation where the two parties – the manager/colleague and the person experiencing mental illness – are compounding the problem by not engaging in the conversation- a form of mutual withdrawal.

The recognised format for the initial conversation where someone is displaying the early signs of mental illness is called AYOK – “Are you okay?” The Mentally Healthy Workplaces Toolkit offers four steps for starting the conversation:

  1. Ask R U OK?
  2. Listen without judgment
  3. Encourage action
  4. Check in

It is useful to preface this conversation with the observation, “I have noticed that…and I am concerned for your welfare.”  In other words, communicate what you have observed (shows you are interested in the person) and express care and concern.

The person involved may be unwilling to talk initially but it is important to undertake the occasional check-in.  An experienced practitioner at the 19th International Mental Health Conference mentioned that on one occasion he had the initial AYOK conversation and the person involved said they were okay…and yet, some months later they came up to the practitioner and said, “I’m not okay, my daughter committed suicide three months ago – can you help me?”  Having had the initial conversation opened the way for the subsequent voluntary disclosure.  To avoid the conversation compounds the sense of isolation of the individual involved – they feel that they can’t help themselves and that no one else is willing to help them.

It is important to prepare for the conversation beforehand – know what you are going to say, allow time for the interaction and choose an appropriate time and place.  You need to ensure that you are prepared to listen and be mindful during the conversation.

You can provide support by suggesting they use the Employee Assistance Program, visit their doctor (who can initiate a formal Mental Health Care Plan) or discuss options for making reasonable adjustments to their work situation.  The important thing is that you take compassionate action, not letting the situation deteriorate.

It is vitally important to maintain confidentiality about any information disclosed to protect the privacy of the person involved.  You will need the explicit consent of the individual to disclose the information to co-workers, for example.  The information conveyed to you can only be used for the purpose intended by the disclosure – e.g. to enable a reasonable adjustment to their workload or pattern of work.

The exception would be where the person discloses that they are experiencing suicidal thoughts or feelings.  In this case, you will need to seek professional support.  Beyond Blue has some very sound and detailed guidelines for the conversation in these situations, including what language to use.  ConNetica, in their blog post Chats for life APP, also provides an App (with practical conversation tips) which has been designed by young people for young people experiencing mental health problems, and possibly suicidal thoughts and feelings.

As we grow in mindfulness through meditation and reflection, we can become more aware of the early signs of mental illness, have the courage and confidence to have the AYOK conversation and a willingness to take compassionate action.

 

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Image source: courtesy of geralt on Pixabay

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Why Kids Need Mindfulness

In her interview with Tami Simon, Goldie Hawn explained in depth why children need mindfulness training and what led her to develop and conduct MindUP™.

At one level, it concerned Goldie that American children rarely smiled – a stark contrast to children in Third World countries who smiled a lot despite experiencing incredible deprivations.

Goldie was also concerned about school-age children needing psychological help to deal with anxiety and stress.

School-age children have their own direct sources of anxiety – such as performance expectations of parents and teachers, peer acceptance and sibling rivalry.  Performance expectations can relate to academic performance, achievement in a sporting arena or meeting career expectations.

Self-generated anxiety in children can be compounded by parental anxiety and stress – generated by economic downturn and associated job losses, the threat of terrorism and career stresses.

Anxiety in parents is contagious and can contaminate  the emotional life of children.  They, in turn, carry their accumulated anxiety and stress to school and bring home anxieties from school experiences, including bullying.

The recent suicide death of 14 year old, Dolly Everett, because of online bullying, highlights the pressures that kids are under from peers.  Dolly was a bright, happy and caring child who was subjected to cruel, cyber bullying.

This form of devastating peer presure carried out via mobile phones and social media, is one of the many stresses that school children today have to deal with.

What Goldie has done through her MindUP™ program is expose children to brain science and enable them to understand their own emotions and reactions.  She has also given them a common language to express themselves via metaphors, e.g  the amygdala as a “dog barking”.

Another key feature of the program is “mind breaks” – a simple process focused on breathing that enables the children to learn how to calm themselves.  As they grow in mindfulness through mindful practice, they are able to attain calmness and clarity and better manage their lives at home and school.

As Goldie points out, she is giving  school children the tools to be positive and caring leaders of the future:

They are going to be able to manage their emotional construct, their reactivity, to become better listeners, ideate better, problem solve better, and have some dignity, some level of humanity that they have learned through their early education.

Children need mindfulness to equip them to better manage the stresses of day-to-day living and to have the resilience to handle bullying behaviour.

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Image source: Courtesy of GoranH on Pixabay

 

Mental Illness in the Workplace

There are two compounding trends that, in concert, are beginning to increase the issues associated with mental illness in the workplace.  They are the incidence of narcissistic managers and the growth in the number of people in the workforce who have a mental illness.  I will deal with each of these trends in turn and link the issues to the offsetting influence of mindfulness.

The Incidence of Narcissistic Managers

Many significant publications such as Psychology Today, Harvard Business Review, Inc.com, Health.com and Time.com, have recently discussed the incidence of narcissistic bosses and ways to self-manage in the workplace to protect yourself from psychological damage caused by these bosses.  It is suggested that most people will encounter at least one narcissistic manager in their working life – I have experienced three that I can recall.

What are the characteristics of narcissistic managers that contribute to mental illness in the workplace?  Well the characteristics of these managers have been summarised by the underlying philosophy of “me, myself, I” – that is  I “first and foremost”.

Characteristics of Narcissistic Managers

There are many characteristics of narcissistic managers described in the articles and in research. Some of the more common traits described (and confirmed by my own experience) are:

  • Self-aggrandisement – believe they are more capable, competent or efficient than they actually are (believe they create high performance teams when the reverse is true)
  • Obsession with self advancement – their careers come before anything or anybody else
  • Over-concern with visibility and being seen in a good light
  • Blame others when mistakes occur (to deflect blame from themselves) – always looking for a “scapegoat”
  • Will lie to save their projected image
  • Take credit for other’s work if it advances their own positive visibility
  • Insensitive to the needs of others, especially their own staff
  • Will constantly change priorities depending on what advantages them, without regard for the impact of such constant change on others
  • Will have an in-group, but any member can become part of the out-group at anytime if they cause embarrassment
  • Create unrealistic time pressures for staff to try to show that their area is highly productive
  • Will publically criticise their own managers in front of the manager’s own staff
  •  Will micromanage to try to ensure that mistakes do not occur and that what they want to occur will actually happen.

The Impact of Narcissistic Managers on Mental Health

The reality is that these managers do not achieve control. In fact, their situation becomes progressively out of control  and they experience high levels of stress as a result, on top of their self-induced stress caused by self-obsession.  They may gain compliance through fear, but lose commitment because people physically or psychologically withdraw to protect themselves – no longer caring about the work, unwilling to offer suggestions for improvement, avoiding contact with the manager or engaging in covert sabotage (to get back at the narcissistic manager). They also lose confidence and begin to question their own competence.

The narcissistic manager, then, not only creates an environment conducive to the development of mental illness in staff, they also potentially aggravate  the condition of staff who already have a mental illness before joining the narcissistic manager’s workgroup.  The compounding issue is that the narcissistic manager lacks the insight to see how they contribute to the conditions creating, or aggravating, mental illness; nor are they overly concerned about the individuals negatively impacted by the highly stressful workplaces they create.

People in the Workplace with a Mental Illness

Beyond Blue, an organisation dedicated to improving the mental health of all Australians, estimates that there are 3 million people in Australia suffering from anxiety or depression and eight people die each day from suicide.  This suggests that anxiety and depression are an issue in the workplace.  Beyond Blue funds an extensive research program covering anxiety and suicide for all categories, including young people, women, men, aged people and the LGBT community.

The Black  Dog Institute also supports the development of mental health in the community.   They draw extensively on research to support their role.  From this research, they are able to maintain that:

Mental illness is very common. One in five (20%) Australians age 16-65 experience a mental illness in any year.  The most common mental illnesses are depressive, anxiety and substance  use disorders.

What is particularly concerning is that they report that suicide “is the leading cause of death for Australians aged 25-44 and second leading cause of death for young people aged 15-24”.

This means that suicide is potentially prevalent among people who are in early-career or mid-career as well as those entering or about to enter the workforce.

The role of Mindfulness 

The narcissistic manager exhibits the characteristics that are the opposite of the mindful manager.  They particularly lack self-awareness and hence self-management. They are by nature lacking in empathy and compassion and are unable to communicate with insight as they are blinded by their own emotions and selfish-obsession.  Their only motivation is to advance themselves – they have no source of motivation beyond themselves and  are thus unable to engage committed individuals.

As we mentioned in recent posts, emotional intelligence skills can be learned through mindfulness.  The challenge is finding ways to engage narcissistic managers in mindfulness training when they have a “keep busy” mindset.  Offering mindfulness training as a means of stress reduction may provide the motivation for them to be involved – because it focuses on “where they are hurting”.

Hence, mindfulness has the potential to help narcissistic managers to manage their stress levels, change their management style and assist other individuals experiencing mental illness.

Jon Kabat-Zinn has demonstrated over more than 30 years that his Mindfulness Based Stress Reduction (MBSR) training has very substantial benefits for people suffering different levels of stress and forms of mental illness.  His findings through his practice have been confirmed by neuroscience research.

As individuals in either group grow in mindfulness, they will experience the benefits, and contribute to the development of a more humane workplace.

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Image source: courtesy of Maialisa on Pixabay