Building resiliency in yourself and others following disasters
Mental health professionals have spent a long time studying post-traumatic stress disorder (PDF) as a response to disaster. But more recently they have focused on resiliency (PDF), defined professionally as “the ability to spring back from and successfully adapt to adversity,” and by a 15 year-old high school student as, "Bouncing back from problems and stuff with more power and more smarts." Resiliency is also sometimes referred to as psychological hardiness (PDF), wellness (PDF), and positive psychology (PDF). Regardless of the name we give it, resiliency and the ability to “bounce back from (disasters) with more power and more smarts” is an important goal of mental health, and mental health providers can do a lot to facilitate resiliency in those we accompany.
Each of us has a built-in capacity for resiliency, "a self-righting tendency" (PDF) that operates best when we cultivate and practice it.
Here are some suggestions for building resiliency, excerpted and modified from a very comprehensive American Psychological Association website (PDF).
10 Ways to Build Resilience in yourself and others:
- Make connections. Good relationships with close family members, friends, colleagues, or others are important (PDF), especially following disasters. Accepting help and support from those who care about you and will listen to you strengthens resilience. Some people find that being active in civic groups, faith-based organizations, or other local groups provides social support and can help with reclaiming hope. Assisting others in their time of need also can benefit the helper.
- Avoid seeing crises as insurmountable problems. You can't change the fact that disasters events happen, but you can change how you interpret and respond to these events. Try looking beyond the present to how future circumstances may be a little better. Note any subtle ways in which you might already feel somewhat better as you deal with difficult situations. Punctuate time: write for publication or keep a journal to remind yourself that time is passing.
- Accept that change is a part of living. Acceptance of the fact of trauma (PDF) is an important element of resiliency. Certain ways of being human, for you and for those you work with, may no longer be attainable as a result of the circumstances around the disaster. Accepting circumstances that cannot be changed can help you and your consumers or clients focus on circumstances that you can alter.
- Move toward small and tangible goals. Develop some realistic goals. Do something regularly -- even if it seems like a small accomplishment -- that enables you to move toward your goals. Instead of focusing on large and abstract tasks, ask yourself, "What's one thing I know I can accomplish today that helps me move in the direction I want to go?" What Bertrand Russell termed “tranquilization by the trivial” is certainly relevant in disaster resiliency.
- Take decisive actions. Emerging ecological models of trauma recovery (PDF) emphasize the need for action and empowerment. Act on the adverse situations associated with the disaster as much as possible. Take decisive actions, rather than detaching completely from problems and stresses and wishing they would just go away. And encourage those with whom you work to do the same.
- Look for opportunities for self-discovery. There is some interesting work on the role of insight in trauma and disaster resiliency (PDF). Focus on what we can learn about ourselves, and how we have grown in response to loss, as an important feature of resiliency. Many people who have experienced tragedies and hardship have reported better relationships, greater sense of strength even while feeling vulnerable, increased sense of self-worth, a more developed spirituality, and heightened appreciation for life.
- Nurture a positive view of yourself. Developing confidence in your ability to solve problems (PDF) and trusting your instincts helps build resilience.
- Keep things in perspective. One of the effects of trauma is to shrink our perspective on time and space. It is helpful to nurture in ourselves and our clients and consumers the ability to keep the disaster in perspective. Try to consider it in a broader context and keep a long-term perspective.
- Maintain a hopeful outlook. (PDF) An optimistic outlook enables you and those you work with to expect that good things will happen in your life. Try visualizing what you want, rather than worrying about what you fear.
- Take care of yourself and encourage self-care in your clients or consumers. Pay attention to your own needs and feelings. Engage in activities that you enjoy and find relaxing. Exercise regularly. Taking care of yourself helps to keep your mind and body primed to deal with situations that require resilience.
The key is to identify ways that are likely to work well for you, and for your clients and consumers, as part of your own personal strategy for fostering resilience.
Web Links
This pamphlet by the American Psychological Association, titled “Road to Resilience,” is a great guide that introduces resiliency, how it is developed, and strategies for developing it. (PDF)
This website on resiliency has a Resiliency Quiz that presents the principles behind resiliency, assesses individual factors that contribute to resiliency, and gives tips on building resiliency. The site also has literature that can be ordered and a resources page with links to relevant outside articles. (PDF)
This is an article reporting the findings of research conducted at the Illinois Bell Telephone company in relation to resiliency of people who work in highly stressful work conditions. The study found that certain individuals are able to thrive despite adversity, leading to the understanding of the set of principles that operate behind resiliency, or “hardiness.” (PDF)
Returning home from a disaster assignment
Disaster work can be a unique and very rewarding experience as disaster response workers feel part of a family and all work toward a common goal. There is a sense of adventure as we face the unique problems of each disaster setting, a sense of shared pride as we ease the suffering of survivors, and a sense of personal satisfaction in our ability to help.
But we also experience things that most people -- including our families, friends, and co-workers -- could not begin to understand or appreciate, things far apart in time, space, and power from our everyday lives. One of my practicum students spoke of an “airlock” between the hospital entrance and the psychiatric inpatient ward, in which he experienced the distance between that space and the space in which he ordinarily lived, both going into and coming out of that space. Here are some suggestions, excerpted and elaborated from this document (PDF), on how to ease the airlock transition from the disaster place to your home place.
Return is a Process, Not an Event. I think in my own work about the process of atmospheric reentry (PDF): too direct an approach to returning home and you burn up, too indirect and you bounce off. Try to get it just right. Be patient with yourself.
Rest. Often, you may not get enough rest while working on a disaster, and when you return home you will feel exhausted. It may take several days to catch up, and both family members and employers need to understand that you need time to yourself before beginning a full schedule of normal activities.
Pace. On a disaster relief operation, you perform your job as fast as possible to provide the greatest amount of assistance in the shortest possible time. It may take time to return to the more relaxed pace of your co-workers and family members.
Sharing. You will want to talk to family members and co-workers about your experiences, and they will be eager to tell you about theirs. What you were doing may seem much more exciting and significant, but remember that their experiences are as important to them as yours are to you. If they seem to accuse you of being away when the washer overflowed, or the kids threw up, it’s only their way of saying, “We missed you.”
Emotions. When you return home, some feelings or emotional swings associated with disaster-related stress may surprise or frighten you. If you anticipate some of these emotions, you can manage them better.
Disappointment. You may find that others are not interested in hearing about your experiences, or that your reunion with your family and co-workers does not live up to your expectations. You may expect they will be happy to have you home and be surprised to find they are angry at your absence. Anticipating this response will help you in managing it.
Frustration and conflict. Your needs may not match those of family or colleagues. Although you may want nothing more than a good home-cooked meal, your family may be looking forward to going out to eat. Try to be kind in expressing your needs and frustrations.
Anger. Problems presented by your family, friends, or co-workers may seem very trivial compared to those facing the disaster victims you just left. Try to remember that the folks at home feel that their problems are just as important to them right now. Appreciate how your own anger and grief affect your ability to see the relativity of life events.
Survivor identification. The actions or characteristics of people at home may remind you of your experience with disaster victims. You may experience emotional reactions that can surprise and confuse not only you, but also them. Try to make others understand the reasons behind your reactions.
Daydreaming. This is a part of response to trauma, and is healthy dissociation and part of your own response to trauma. You may find yourself wishing you could return to the disaster you just left, or be sent out again right away. Remember you are more important to the folks at home than you can imagine; they may just express their appreciation differently.
Mood swings. These are normal after returning home, as they one of the ways to resolve conflicting feelings you have experienced on the operation. You may change from happy to sad, tense to relaxed, or outgoing to quiet without much warning. When you have time to put your disaster work into perspective, noticeable alterations in mood will pass.
Children. It can be hard to explain to children why you must be away. If you tell them why you are leaving, and call home while you are away, it will help calm their fears. When you return home, try not to frighten them with stories about what you have seen and done. Tell them about the disaster in a way that is appropriate to their level of development, and involve them in preparedness efforts for your family. This will help them feel as if they are part of what you have been doing and reduce their fears about similar disasters at home.
Your participation in disaster relief work is a gift to the world. Practicing self-care and developing resiliency during the process of your return will allow you to continue giving your gifts.
Web Links
This is a PDF version of the fact sheet “Coping with Disaster: Returning Home from a Disaster Assignment.” It addresses much of the topics found above. (PDF)
This is an article from the British Medical Journal, titled “Selection, Training, and Support of Relief Workers: An Occupational Health Issue,” that cites research findings on the mental health implications for relief workers during and after disasters. It addresses a need for and encourages increased training and awareness in stress management, self-care, and resiliency. (PDF)
National Consensus Statement on Mental Health Recovery
Our approach to mental health recovery is consistent with the U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration (SAMHSA) which has developed the following guidelines:
The 10 Fundamental Components of Recovery
Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential.
Self-Direction: Consumers lead, control, exercise choice over, and determine their own path of recovery by optimizing autonomy, independence, and control of resources to achieve a self-determined life. By definition, the recovery process must be self-directed by the individual, who defines his or her own life goals and designs a unique path towards those goals.
Individualized and Person-Centered: There are multiple pathways to recovery based on an individual’s unique strengths and resiliencies as well as his or her needs, preferences, experiences (including past trauma), and cultural background in all of its diverse representations. Individuals also identify recovery as being an ongoing journey and an end result as well as an overall paradigm for achieving wellness and optimal mental health.
Empowerment: Consumers have the authority to choose from a range of options and to participate in all decisions—including the allocation of resources—that will affect their lives, and are educated and supported in so doing. They have the ability to join with other consumers to collectively and effectively speak for themselves about their needs, wants, desires, and aspirations. Through empowerment, an individual gains control of his or her own destiny and influences the organizational and societal structures in his or her life.
Holistic: Recovery encompasses an individual’s whole life, including mind, body, spirit, and community. Recovery embraces all aspects of life, including housing, employment, education, mental health and healthcare treatment and services, complementary and naturalistic services, addictions treatment, spirituality, creativity, social networks, community participation, and family supports as determined by the person. Families, providers, organizations, systems, communities, and society play crucial roles in creating and maintaining meaningful opportunities for consumer access to these supports.
Non-Linear: Recovery is not a step-bystep process but one based on continual growth, occasional setbacks, and learning from experience. Recovery begins with an initial stage of awareness in which a person recognizes that positive change is possible. This awareness enables the consumer to move on to fully engage in the work of recovery.
Strengths-Based: Recovery focuses on valuing and building on the multiple capacities, resiliencies, talents, coping abilities, and inherent worth of individuals. By building on these strengths, consumers leave stymied life roles behind and engage in new life roles (e.g., partner, caregiver, friend, student, employee). Th e process of recovery moves forward through interaction with others in supportive, trust-based relationships.
Peer Support: Mutual support—including the sharing of experiential knowledge and skills and social learning—plays an invaluable role in recovery. Consumers encourage and engage other consumers in recovery and provide each other with a sense of belonging, supportive relationships, valued roles, and community.
Respect: Community, systems, and societal acceptance and appreciation of consumers —including protecting their rights and eliminating discrimination and stigma—are crucial in achieving recovery. Self-acceptance and regaining belief in one’s self are particularly vital. Respect ensures the inclusion and full participation of consumers in all aspects of their lives.
Responsibility: Consumers have a personal responsibility for their own self-care and journeys of recovery. Taking steps towards their goals may require great courage. Consumers must strive to understand and give meaning to their experiences and identify coping strategies and healing processes to promote their own wellness.
Hope: Recovery provides the essential and motivating message of a better future— that people can and do overcome the barriers and obstacles that confront them. Hope is internalized; but can be fostered by peers, families, friends, providers, and others. Hope is the catalyst of the recovery process. Mental health recovery not only benefi ts individuals with mental health disabilities by focusing on their abilities to live, work, learn, and fully participate in our society, but also enriches the texture of American community life. America reaps the benefi ts of the contributions individuals with mental disabilities can make, ultimately becoming a stronger and healthier Nation.
Resources
www.samhsa.gov
National Mental Health Information Center
1-800-789-2647, 1-866-889-2647 (TDD)
Original Link