Category: Work

feature-_-af5-470x260-fe5510d0d275a89fd87a25acc8b8aee46014c652

Trauma Exposure Linked to PTSD in 911 Dispatchers

00Featured news, Health, Post-Traumatic Stress Disorder, Therapy, Trauma, Work September, 17

Source: Public Domain at flickr

In February 2016, Gail—a 911 dispatcher with Toronto Paramedic Services—found herself in tears at work. She had just received a call about Wallace Passos, a three-year-old boy from Toronto, who fell from a 17-story apartment building to his death.

At age 57, Gail has been working as an Emergency Medical Dispatcher for 15 years. Taking calls from around the city, she dispatches the closest ambulance. All dispatchers are expected to work 12-hour shifts, at times with only one colleague on duty.

This past year, Gail’s job became especially difficult for her when she was diagnosed with Post Traumatic Stress Disorder (PTSD). Gail recently spoke with the Trauma and Mental Health Report to discuss the experience that led to the diagnosis:

“I’m still haunted by the sounds of the family crying on the phone after the three-year-old fell off the building. I imagine the boy in pain, and it’s just awful.”

Gail is not the first emergency dispatcher to experience PTSD symptoms. A study conducted by researchers at Northern Illinois University described how 911 dispatchers are exposed to duty-related trauma, which is defined as an indirect exposure to someone else’s traumatic experience. Duty-related trauma puts dispatchers at risk for developing PTSD. Participants in the study reported experiencing fear, helplessness, and horror in reaction to various calls they received.

Along with the stress of being on the receiving end of difficult calls, emergency dispatchers also deal with the pressure and demand of following protocol, despite variability in situations.

Toronto Paramedic Services follows specific protocols set by The National Academy of Dispatch. The system was developed at Salt Lake City, Utah in 1988 and incorporates a set of 33 protocols for those answering 911 emergency phone calls. On a call, everyone is treated equally and is asked the same basic investigative questions. These questions are then used to give priority to life-threatening situations and provide guidance to first responders like firefighters, paramedics, and police officers on the scene.

While the protocols can be useful for guiding dispatchers through stressful situations, in other circumstances, they can cause pain and discomfort when a dispatcher can tell that a situation is hopeless. Dispatchers are not trained to deal with each unique case differently; they are expected to follow through with the routine questions regardless of circumstances.

In the case of Wallace Passos, Gail had to give instructions for CPR despite knowing that the child was already dead.

“It’s not just that the little boy died, but I feel that I traumatized the people that were trying to help him because I was required, in my position as a dispatcher, to tell them what to do to try and save him. And I knew from their description that he was dead. But we have to follow the procedure; we have to try.”

This predicament is further compounded by the blame placed on dispatchers for negative outcomes. Gail explains:

“People curse us and call us names just because we’re doing our jobs.”

Before her diagnosis, Gail often found herself crying at work without reason; she would take a call regarding a minor injury and become emotional. Her supervisor eventually gave her permission to take a leave of absence.

Over the past few months she has had disruptive sleep, nightmares, headaches, and unexplainable muscle spasms:

“I am hyper-vigilant, especially when I hear sirens. And it doesn’t have to be an ambulance; it could be a police car or fire truck. I hear the sirens and I start tensing up and looking all around me.”

Gail has been on a year-long search for proper psychological support for her PTSD. Unfortunately, there are few mental health benefits offered to dispatchers. Gail sought help from doctors, counselors, and social workers, most of whom referred her to other mental healthcare workers without providing much support.

But there is reason to be optimistic. The Ontario government passed legislation in February 2016 for better mental health support and benefits for first responders with PTSD, including 911 dispatchers.

“It made me sad that no one was stepping up and taking care of us. I want my peers to understand what it’s like to have PTSD after doing this job because I felt so alone when it happened to me. But this new legislation is huge. I think it’s very important because it’s raising awareness around this concern.”

–Afifa Mahboob, Contributing Writer

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report.

Copyright Robert T. Muller.

This article was originally published on Psychology Today

12345_0-d29ea5d70cd84b7c8e71928344a1a0595fe087f1

Police “Blue Wall of Silence”; Facilitates Domestic Assault

00Anger, Conformity, Domestic Violence, Featured news, Health, Relationships, Work April, 17

Source: Stefan Guido-Maria Krikl on flickr

In January 1999, Pierre Daviault, a 24-year veteran constable of the Aylmer Police Services in Quebec, was arrested on 10 criminal charges for allegedly assaulting and drugging three ex-girlfriends between 1984 and 1999. Daviault resigned from the police force a few days later, but he was only sentenced to three years’ probation, no jail time.

In their 2015 book Police Wife: The Secret Epidemic of Police Domestic Violence authors Susanna Hope (pseudonym) and Alex Roslin describe instances of police spousal abuse within the U.S. and Canada, reporting that at least 40 percent of U.S. police-officer families experience domestic violence, compared to 10 percent of families in the general population.

Some officers are speaking up. Lila C. (name changed), a Canadian corrections officer (CO), was interviewed by the Trauma and Mental Health Report to discuss the growing issue of spousal abuse in Canadian law enforcement. Lila’s former colleague, Stephanie (name changed), was a victim of abuse. Awareness of Stephanie’s predicament, and the inability to do anything about it, affected Lila’s mental health more than anything else on the job.

Lila explained:

“Steph and I bonded very quickly and we were very open with each other, which is normal when two COs work together so often. But she never actually told me about the abuse she was taking at home. I noticed bruises on her neck myself.”

Stephanie’s perpetrator was her husband—a long-time police officer of the Peel Regional Police in Ontario. He was a man Lila knew well, and considered a friend:

“At first I didn’t want to believe what I was seeing and I kept quiet for the first few hours of our shift that day. But eventually, I asked ‘what’s that on your neck, what’s going on?’ And then came the breakdown period and she told me everything.”

Upon opening up to Lila, Stephanie revealed that she was frequently abused by her husband at home, both physically and verbally.

“My first gut response was ‘you need to leave him and tell someone’. I mean, how could he continue to work in law enforcement, deal with these types of cases on the job, and then go home and abuse his wife off the job? But Steph wouldn’t do it—she wouldn’t leave him. She felt that she wouldn’t be able to have him arrested. If she called the police to report him, who would believe her?”

In Police Wife, authors Hope and Roslin argue that one factor perpetuating abuse is that many officers think they can get away with it.

Carleton professor George Rigakos explains in an interview with Hope and Roslin: “A major influence in the use of domestic violence is a lack of deterrence. If there is no sanction, then it’s obvious the offence goes on.”

Referred to as the “blue wall of silence”—an unwritten code to protect fellow officers from investigation—officers learn early on to cover for each other, to extend “professional courtesy.”

And when a woman works up the nerve to file a complaint, police and justice systems often continue to victimize her. She must take on a culture of fear and the blue wall of silence, while simultaneously facing allegations of being difficult, manipulative, and deceptive.

Lila explains:

“I mean, I saw her almost every day and it was a huge elephant in the room. We didn’t bring it up again. And though I didn’t see her husband often, when I did see him, it was weird. He had no idea that I knew—I just couldn’t be around him, knowing what he was doing. But there was no getting away from the constant reminder of this unspoken and undealt-with abuse.”

Knowing both the victim and the perpetrator, knowing that the abuse was not being addressed on a systemic level, and feeling powerless to do anything about it herself affected Lila’s mental health and enthusiasm about the work she was doing:

“About two months in, I started having panic attacks on my way to work and even during my shift. I vaguely remember nights where I had bad dreams. It’s weird, I wasn’t even the one being abused, but I felt unsafe. I knew that I couldn’t say anything, because it would probably make things worse. I feared for Steph’s life, but in some strange way, I also feared for my own.”

Many officers face ostracism, harassment, and the frightening prospect of not receiving support when they do not abide by the blue wall of silence. Believing she would not be taken seriously if she decided to come forward (because of her gender) only amplified Lila’s sense of powerlessness and anxiety.

“I know that the system is unjust towards women, and that makes this situation even more hopeless to confront.”

Stephanie eventually left the corrections facility where she and Lila worked, and they gradually lost touch. Lila doesn’t know if Stephanie is still with her husband, and looking back she partly wishes she had said something about it.

Hope and Roslin explain in Police Wife that we are often reluctant and afraid to intervene if we think a friend or family member may be in a violent or abusive relationship. They encourage bystanders to acknowledge the courage it takes to reach out.

–Veerpal Bambrah, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

Feature2-470x260_0-4f3635d761f37275c701a0f564a0160311f114d1

Fast Food Industry Demands ‘Emotional Labour’ from Employees

00Burnout, Depression, Emotion Regulation, Featured news, Health, Stress, Work October, 16

Source: Steffi Reichert on Flickr

Donna Abbott (name changed), a long-time employee at McDonald’s, does more than serve Happy Meals. She smiles politely and greets every single customer. It’s part of the job. She’s even expected to ask the customer about their day. That way, the customer can walk away feeling satisfied.

Emotional labour—strict emotional control and outward enthusiasm—may be a way of earning tips. But in some sectors, including North America’s growing low-wage service industry, emotional labour is a fundamental part of the job. Displaying concern for a customer’s needs, smiling, and making eye contact is critical to a customer’s perception of service quality.

Cheerful presence can be essential to profitability of service providers, particularly in the fast-food industry. But emotional labour may be doing more harm than good to employee emotional and mental wellbeing.

A recent research review by Alicia Grandey and colleagues at Penn State University examined the benefits and costs of emotional labour practices, including those used in fast-food services. According to the study, the self-control and regulation needed to convey a sense of artificial happiness for an extended period of time is taxing, depleting energy and resources that could be dedicated to other tasks.

In an interview with the Trauma and Mental Health Report, Donna said:

“The energy that I spend being overtly happy could be used elsewhere—I know that I’d be able to take orders faster and prepare meals quicker if I didn’t have to take that extra and, in my opinion, forced step to be emotionally friendly with customers that I don’t know.”

Emotional fatigue that detracts from the ability to do other work isn’t the only problem. Unless the employee is naturally a positive person, the act of suppressing true feelings and generating insincere ones leads to what psychologists call dissonance—a tense and uncomfortable state that can lead to high levels of stress, job dissatisfaction, and burnout.

“It’s just stressful and really frustrating,” says Donna. “It creates this push and pull within you that you really want to—but often can’t—resolve. And in trying to cope with these fake feelings, I’ve turned to things I’m not proud of and don’t admit to everyone.”

Donna reports excessive use of cigarettes and marijuana, particularly after a long and emotionally draining 10-hour shift; addictions that are not uncommon among employees in the fast-food industry. According to the Substance Abuse and Mental Health Services Association’s National Survey on Drug Use and Health, food service has the highest rate of drug use, with an estimated 17.4% of workers abusing substances.

Individuals vary in their ability to deal with inauthentic emotional expressions. This means that the effects of emotional labour on emotional and mental wellbeing do not apply to all fast-food employees. Some workers may be able to identify with the organization’s values of positive emotional communication, making them better prepared to express appropriate emotions. And people who are generally more cheerful and pleasant may be able to turn off negative emotions more easily than others.

Donna is one of the less cheerful employees:

“When I started working at McDonald’s I would say that I was happy, but still not at the level of putting a smile on randomly for just anyone. I’m not a naturally happy person. And after being there for a long time, I wouldn’t say that I’m the most pleasant employee. I’ve had my fair share of negative attitude and customer complaints, which make it very hard to pretend to be happy or care about the customer—especially since it’s not technically in my job description to do that.”

In their research, Grandey and colleagues note that there are some jobs where emotional labour may be a core requirement. Childcare workers or people who care for those who are mentally or physically ill are a common example. But, the dissonance that a fast-food employee feels is probably more than workers experience in other sectors, like care providers, who typically see the act of helping as part of their identity.

Emotional labour comes at an emotional cost. And employers who require emotional labour should do so in a supportive rather than controlling climate. By training employees to recognize mistreatment, offering down-time to help workers re-charge, and giving employees opportunities to engage in honest interaction, employers might find a positive attitude that comes about on its own.

–Veerpal Bambrah, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

Feature-12-470x260_0-e15732e4a8b608b3ea40e8b6e86c607f6cf7984c

Mental Healthcare Lacking for Small Business Owners

00Anxiety, Burnout, Depression, Featured news, Health, Stress, Work July, 16

Source: Gary Suaer-Thompson on Flickr

Being your own boss, doing something you love, having control over your own schedule. These are only a few reasons why people choose to start their own business.

But the reality many small business owners face is far less appealing. Financial stress, professional isolation, long hours, and blurred boundaries between work and family life can take a toll on mental health.

Although there is a growing focus on mental health in the workplace, programs often target large companies with thousands of employees, providing fewer options for those running small businesses.

Jeffrey Markus, entrepreneur and founder of Daddyo’s Pasta and Salads restaurant in Toronto, knows firsthand the psychological impact of running a small business. When his restaurant was struggling, he took it personally:

“I was a go-getter and an entrepreneur. But as business slowed I was more and more affected. I couldn’t separate myself from my business. It was the worst experience of my life. It put a strain on my marriage and I missed out on seeing my daughter grow up, which was very difficult for me.”

In Markus’ opinion, small business owners are overlooked when it comes to providing support for people in the workplace.

And he may well be right. While employees in larger organizations often have access to human resource support or programs, business owners and entrepreneurs are left to deal with stress on their own.

Associate professor Angela Martin of the Tasmanian School of Business and Economics in Australia, conducts research on the mental health of small business owners. She believes that while there is some evidence of a growing awareness for providing mentally healthy workplaces among larger businesses, it may not be helping entrepreneurs:

“Small business owners need access to support, but the current workplace mental health programs are missing all of these people. These models don’t work in small business as they do in a larger organization. They don’t translate to a single person.”

Martin’s research has been used to develop a set of preventative guidelines that help small and medium business owners recognize the signs and symptoms of mental health issues in themselves and their employees. But she is working in an under-investigated field:

“There is no big systematically collected data, so we don’t know how many people are affected and what impact it is having on small and medium business.”

Another issue is that while small businesses are often seen as one type of industry, they are actually quite diverse—ranging from building contractors and health professionals to artists and online retailers. These differences mean that the time and cost constraints faced by individual business owners are also different.

In Jeffrey Markus’ experience, the number of small business owners in distress is alarmingly high. But after facing his own share of crises, he has learned to care for himself as well as his business:

“People are borrowing against their homes which can cause marital issues. Many marriages break down when husbands and wives clash within a family business. But I had to reframe my thinking and approach to things. I had to get the entrepreneur life to work for me, not against me.”

Markus has learned a few simple things that go a long way, such as saying no to the prospect of expanding his restaurant to multiple locations, remembering to leave time for relaxation and self-care, and being more present within the lives of his family and close friends.

In considering his experience, he notes that community and peer support were key in helping him get through tough times.

Rebekah Lambert, a good friend of Markus, is an entrepreneur working to help other small business owners connect with each other and find support. Her company, The Freelance Jungle, is an Australian initiative providing community support and helping people manage the stress of running a business:

“I found a lot of people are having a hard time. I saw a lot of them spending money on being a businessperson, but not on getting proper support.”

Markus agrees that small business owners need to support each other due to the absence of government programs. This is particularly important since business owners’ poor mental health will affect not only their lives but also the mental health of their employees.

Potential solutions being examined by Lambert and other entrepreneurs are online associations and support networks, local meetup groups, and mentorship programs. With a current lack of formal mental health programs, it is important that business owners learn to look after themselves in the meantime.

– Veerpal Bambrah, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

Underage Models Need Federal Protection and Regulation

Underage Models Need Federal Protection and Regulation

00Environment, Ethics and Morality, Featured news, Gender, Law and Crime, Post-Traumatic Stress Disorder, Stress, Work October, 15

Source: Anna Fischer/Flickr

When Jennifer Sky launched her career at age fourteen, she imagined a glamorous lifestyle, fame, and designer clothes.  Flash forward to seventeen:  Her experiences turned out to be very different.

For Jennifer and many other young models, the fashion world includes foreign locations and a cascade of highly sexualized situations with little supervision, grueling twelve-hour days with few breaks, and high-stress photo-shoots.

In a recent interview with the Trauma & Mental Health Report, Jennifer shared her experiences as a young model abroad, and discussed the repercussions she’s now facing.

Jennifer: In Japan I was molested several times on the subway.  In France, I stood in hypothermic-temperature waters every day for a week.  In Mexico, I was given drugs and coerced into going topless at age sixteen.  The human trafficking elements of fashion were all around me.  

It was during this time that Jennifer began experiencing symptoms of what was later diagnosed as Post-Traumatic Stress Disorder (PTSD). In her latest book, Queen of the Tokyo Ballroom, and herYouTube video that went viral earlier this year, Jennifer describes how her normally gregarious personality started to change.  She became withdrawn, easily startled, and feared new places.  Eventually, she felt so timid she barely spoke.

Although the symptoms began in the 1990s, Jennifer did not seek treatment until 2010 when she moved back to New York City.

Jennifer: I moved back to finish college and the symptoms returned with such a force that I could no longer ignore them.

Jennifer experienced panic attacks during stressful events, which were sometimes followed by dissociative episodes where she would lose, in her words, “whole swaths of time.” These overwhelming symptoms led her to visit her university’s clinic where she was formally diagnosed.

Almost twenty years since modeling, through anti-anxiety medication and psychotherapy, Jennifer is managing her symptoms and is now a graduate student and activist.

Jennifer: I’m working toward transforming a problematic and corrupt industry into a positive one. Fashion can be fun.  It can be a rewarding opportunity.  It can also be abusive, opportunistic, corrupt, and traumatizing.

So what is currently being done to make youth modeling a safer profession?

In the Fall of 2013, New York State passed the Child Model Law, which ensures protection for individuals under eighteen, who work in the fashion industry.  The law requires tutors and chaperones, and that 15% of the model’s earnings be held in financial trust.  It also requires that all working children and adolescents be in possession of a permit while on set, and limits the amount of time they are allowed to be there.

The changes to labour laws in New York State saw instant successat the 2014 New York Fashion week, where only three underage models obtained permits, and were able to work the fashion shows.  Previously, as many as 60% of the models were under eighteen.

As promising as these changes are, the new labour laws are not federal – they only protect models that are working in the state of New York. In general, models still face a working world devoid of adequate labour regulation or protection.

Jennifer still questions whether the modeling industry is the right environment for children. But, by raising awareness and promoting models’ rights, Jennifer hopes to convince the U.S. federal government to change laws on underage modeling.

Jennifer: When we are talking about the protection of children, there really should be no debate.

– Magdelena Belanger, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright: Robert T. Muller

This article was originally published on Psychology Today

Trauma Workers At Risk for Compassion Fatigue

Trauma Workers At Risk for Compassion Fatigue

00Burnout, Empathy, Featured news, Health, Resilience, Self-Help, Trauma, Work July, 15

Source: Brian Walker/Flickr

The expectation of unending compassion for others is unrealistic. For trauma workers, hearing devastating stories can take its toll. This can be seen in detrimental effects to physical and emotional health; that is, a specific type of burnout called compassion fatigue.

The Trauma & Mental Health Report recently spoke with compassion fatigue specialist and director of Compassion Fatigue Solutions in Kingston, Ontario, Françoise Mathieu, to discuss the symptoms of the condition and how trauma workers can protect themselves from it.

Q: What is compassion fatigue?

A: It is a gradual shift and decline in an individual’s ability to feel empathy and compassion towards others. It is not an illness or disorder. Often, the term compassion fatigue is used interchangeably with vicarious trauma or secondary traumatic stress (STS), but there is a distinction.

STS refers to a traumatic, stressful experience without direct exposure to the trauma. STS results from hearing traumatic stories, like hearing witness testimonies or stories of torture. Over time, those stories can shift your view of the world to a tainted and jaded one, to the point where you lose the ability to experience joy. For example, people who work with victims of sexual trauma may have a hard time trusting babysitters or coaches. Vicarious trauma is the result of the accumulation of several STS experiences.

Q: Who is susceptible to compassion fatigue, vicarious trauma, and STS?

A: Helping professionals are the most susceptible. This typically includes physicians, nurses, mental health care workers, allied health professionals, therapists, clergy, law enforcement, teachers, long term care workers, and personal support workers.

The public can also start internalizing trauma from continuous exposure to graphic images portrayed by the media. Overexposure of the September 11th, 2001 terrorist attacks created a heightened sense of danger and paranoia. The difference is that the relationship helping professionals form with their clients is very unique: You become deeply vulnerable. When you’re opening your heart and listening to someone’s pain, it can be very intense.

Q: Are there any signs and symptoms of compassion fatigue?

A: A major warning sign is workaholism. Many helping professionals are so dedicated to their jobs that they don’t have a balance between their work and home lives. The more caring you are, the more vulnerable you are. We call it a “normal consequence” of doing a good job. Helping professionals may experience a decline in empathy, reduced collegiality, dreading client appointments, and belittling their stories.

Or, someone might be doing a great job at work, but they have nothing left to give at home. Warning signs are irritability, social isolation, emotional and physical exhaustion, or self-medicating with drugs, alcohol, or even excessive shopping.

Q: What can protect trauma workers?

A: With increased budget cuts, many trauma workers do not have adequate training, so Trauma Informed Training can be highly protective. Richard Harrison and Marvin Westwood, researchers from the University of British Columbia (UBC), studied experienced trauma therapists and found that those who connected spiritually or creatively with something outside their work and felt supported by their families and communities managed well with the stress of their jobs.

Establishing a deep therapeutic alliance characterized by a meaningful relationship with clients, based on presence and heartfelt concern, also provided professional satisfaction.

Q: What can a person with compassion fatigue do to alleviate symptoms?

A: We can’t prevent compassion fatigue, but there are strategies and tools for professionals to be able to feel grounded, present in the moment, and well trained. Ask yourself these questions:

–Do I work somewhere where I have control? Control over your schedule can reduce compassion fatigue. Small changes can make a big difference.

–Do I have a debriefing process that might relieve some of the emotional strain?

–Do I have access to supportive people whom I can consult with, when I hear difficult stories?

–Am I trained in trauma-related concepts, so that I have a better understanding of the side effects?

–Do I have a transition ritual, a way to leave work behind and transition into my home life? (e.g., yoga, exercise)

Last, research shows that the most effective strategy is Mindfulness-Based Stress Reduction, which recommends relaxation techniques to reduce stress and improve self-compassion.

Mathieu adds that even if you have your own past history of trauma, it doesn’t mean that you shouldn’t be a helping professional. In this case, it’s important to identify your triggers, ensure you have a support system, and that your caseload doesn’t remind you of your personal trauma.

Mathieu cautions the trauma worker to “pay equal attention to the needs of your client, and yourself.”

– By Shira Yufe, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today