SELF-CARE & VICARIOUS TRAUMA A WORKSHOP

By Mirjam Klann Thullesen

INTRODUCTION

Mirjam Klann Thullesen •  Psychotherapist and psychologist, trainer expert

witness, consultant.

•  I have worked in the refugee sector in the UK since 2006, with a particular interest in trafficking and torture.

•  I am now completing doctoral research looking

specifically at the impact of work with refugees.

OBJECTIVES OF THE WORKSHOP

•  Explore how you are impacted by your work

•  Understand vicarious trauma

•  Risk factors for developing vicarious trauma

•  Self-care strategies and positive boundaries

•  Develop a personal self-care plan

•  This is an interactive workshop – be ready to have a

conversation about how you are impacted.

EXERCISE

•  Discuss in pairs what motivates you to support

refugee and asylum seekers in the way you do.

•  What drives you?

•  Take about 3 minutes each to discuss your values

and drives.

IMPACT ON WORKERS

‘The expectation that we can be immersed in

suffering and loss and not be touched by it is as unrealistic as expecting to walk through water without getting wet’

Kitchen Table Wisdom: Stories That Heal, Rachel Remen (1996)

REFUGEE TRAUMA

•  Practical instability: Lack of safety, housing, security. •  Health problems: Chronic pain, Injuries. •  Psycho-emotional difficulties: Depression, Post

Traumatic Stress Disorder. •  Manifesting in: Fear, reliving trauma, flashbacks,

nightmares, dissociation, forgetfulness, avoidance.

IMPACT & VICARIOUS TRAUMA

•  Definition of vicarious trauma: •  ‘The cumulative transformative effect on the helper

of working with survivors of traumatic life events.’ (Bloom 2003 p.459)

•  This is a helpful definition as it accepts the impact of

the work as having both ‘positive’ and ‘negative’ impact – it transforms.

SYMPTOMS OF VICARIOUS TRAUMA

•  Feeling overwhelmed, exhausted, isolated, low. •  Feeling disillusioned, despairing and hopeless. •  Disconnection from loved ones/social withdrawal. •  Cynicism. •  Denial of refugee’s trauma. •  Fight or flight response/heightened arousal. •  Intrusive imagery, dissociation, depersonalisation. •  Feelings of anger, sadness, rage. •  Bystander guilt. •  Questions of competence/self-worth. •  Increased sensitivity to violence. •  Changes in world view / spirituality.

EXERCISE

•  What symptoms of vicarious trauma do you recognise in yourself. •  How are you impacted generally. •  You can write this down on your notepad or ask

your partner to take notes while you talk. •  Discuss in pairs - take 5 minutes each.

RISK FACTORS FOR VICARIOUS TRAUMA

•  Bearing witness to the pain of clients •  Overworking •  Ignoring boundaries •  Taking on too much work •  Not taking breaks •  Lack of workplace support •  Professional isolation •  Poor time management •  Systemic barriers that impede helping the client;

such as the asylum process.

RISK FACTORS CONTINUED…..

•  Lack of professional supervision •  Not enough reflection space •  Low levels of training and experience •  Unaddressed personal trauma history •  High levels of personal stress •  Unrealistic expectations around outcome for clients •  Excessive time in job •  Feeling of responsibility towards others •  Strong desire / ability to help others

SELF-CARE

• The better we can take care of ourselves and maintain healthy boundaries, the more we will be in a position to be truly empathic, helpful and compassionate towards others.

SELF-CARE PLAN

•  Look in your pack for the self-care plan. •  Take 5 minutes on your own to fill in some of the

ways you look after yourself. •  Discussion with group.

PERSONAL SELF-CARE STRATEGIES

 Physically: •  Exercise •  Regular sleep – 7-8 hours a night •  Eating regularly and healthily •  Learning to recognise your physical symptoms of

stress / vicarious trauma •  Going for a walk after difficult client interaction •  Breathing exercise to calm self if difficult situations

occur. •  Ensure personal safety.

SELF-CARE STRATEGIES Psycho-emotionally: • Asking for help when you need it •  Feeling able to say no to requests for help • Recognising that others struggle with similar

difficulties to you • Being open to feedback from others •  Taking time for self-reflection • Counselling / Therapy

SELF-CARE STRATEGIES

Socially •  Spending time with friends and family •  Time in nature / the arts / theatre / concerts •  Reaching out and letting loved ones know when

you are struggling •  Regularly assess your work - life balance •  Limit ‘heavy’ content in reading, films, activities, etc.

when outside of work •  Keeping a balance between spending time with

others and alone

SELF-CARE STRATEGIES

Organisationally/collegially:  • Reaching out to colleagues / Staff • Regular debriefing with colleagues • Regular peer or clinical supervision to

support you in how you feel about the work • Ensure you’re not taking on too much work •  Set effective boundaries • Plan fun events with colleagues • Managers to promote culture of staff well-

being in their teams • Recognise when colleagues are struggling • Celebrate the successes

FOUR STEPS TO SELF-CARE

•  Supervision & Collegial Support •  Implement your self-care strategies

•  Vicarious Trauma & Self-Care Training

•  Understanding Refugee Trauma Training

QUESTIONS & REFLECTIONS

•  Feel free to contact me on:

Mirjam Klann Thullesen mirjamthullesen@gmail.com 07722732799