UNDERSTANDING STRESS

Stress Made Easy
For most we are lucky enough not to experience real major traumatic events in our lives, this is not to say that we do not routinely experience stress. Stress can be considered as a reaction to stimuli that threatens our psychological or physical well being. This stimulus can be an event, situation or object that we perceive as a threat to our own equilibrium, and this varies from person to person.

We have three components in how we perceive stress.

Behavioural Response. This is termed by our coping ability, be it our ability to address how we think of stress and change this thinking pattern, or by coping with stress by trying to avoid the stressors in our lives or just asking for help in changing the stressful situation. We can also look at the emotions around stress and take part in breathing exercises adapting our way of life to include exercise and healthy living and engaging in activities that bring about pleasure in our lives. It should be noted that coping works when we have control over a situation.

Physiological Responses. Our physical responses to stress are more or less the same. The initial phase as most will know is the fight or flight phase in which our bodies prepare for conflict by increasing our heart rate which leads to sweating, quickened breathing, perspiration and our pupils dilate. All of which prepares us to fight or run from the perceived stress. The second stage is when the stress continues, in this phase we adapt to the prolonged stress reaction, however the physiological responses are still high, if we can not get past this we then reach exhaustion which heightens are risk of disease and illness. Our bodies are susceptible to such conditions and our ability to fight new stressors is depleted.

Emotional Responses. We can experience many emotions during times of stress which need to be brought into perspective and control. Frustration can lead to anger, this can be seen in working situation were one can become frustrated with for example a colleague which may lead to anger. Stress from such life changes can lead to Anxiety and Fear.

Stress related illness is all too common in our lives today. We are bombarded by stressors each day, we work longer hours, are more pressured by technology such as mobile phones that bring pressure straight to us wherever we happen to be. It is therefore vital that we understand the issue of stress in order to be more aware of it and to allow us to take appropriate measures to ensure against it or to reduce it from our lives.


By
Mark Reddy

Am I in a “High- Risk” Job?

By Dr Jo Clarke and Dr. Michael Carroll

Introduction

There are some jobs which, of their very nature, leave individuals open to danger. Often called “critical occupations”, these jobs are unique in that professionals can encounter traumatic events which may, under certain circumstances, exert critical impact on their psychological well-being. It’s not difficult for most of us to name the kinds of jobs we are talking about. Emergency service personnel and disaster responders are two clear examples where front-line workers face acute risk owing to the nature of their work. Body recovery after natural disasters, removal of victims from vehicle crashes, attending scenes of terrorist activity can all be readily identified as situations likely to challenge any individual’s psychological equilibrium. Drawing up an inclusive list of ‘critical occupations’ would be a considerable challenge, but no doubt Garda would feature high on the list.

An organisational strategy to enhance the well-being of staff working with the most difficult, disruptive and damaged prisoners held in High Security prison discrete units in England has been devised. Much of what is now in place is very applicable to organisations and individuals in other environments e.g., police, fire brigade.

Traumatic Events and Well Being

A traumatic event is one that is outside of the range of usual human experience and that would be markedly distressing to almost anyone. Examples given of such events include threat to life or physical integrity or seeing another person being seriously injured or killed. Clearly, front line emergency responders (like the Garda) face such events frequently.

From research and from reviewing backgrounds to help outline and implement the well being strategy above a number of factors has merged:

• It’s not just the events that can traumatise. How individuals react to events is vitally important (there will be individual differences here). Age, gender, length or service and previous history of trauma are all factors in how stressful an event can be.

• Interestingly, organisational practices will also impact e.g., For example, organisations characterised by high levels of bureaucracy, internal conflicts regarding responsibility, persistent use of established procedures (even in novel situations), and a strong motivation to protect the organisation from blame or criticism, have all been found to increase the risk of poor post-trauma outcome Conversely, positive organisational practices, such as adoption of autonomous response systems, consultative leadership styles, training to develop adaptive capacity, and tolerance of procedural flexibility, can all enhance the likelihood of positive outcomes

• Finally, events removed from the work context, but significant to the individual, also need to be understood if risk potential is to be managed. For example, in a study of prison and community-based sex offender treatment providers, respondents who had experienced a non-work related adverse event in the previous six months, also reported significantly higher levels of dissatisfaction with their organisations. Such events included illness, relationship breakdown, house moves and so on.

An engaged workforce is identified by high levels of resilience, characterised in turn by the ability to bounce back from negative emotional experiences despite threats to the individual. This is illustrated by staff who are competent, autonomous, understand the difference they can make to their work place and have personal values and beliefs that fit the needs of the role they undertake. Consequently, an engaged and resilient workforce is one that has low rates of turnover, low levels of sick absence and high levels of performance. The development and maintenance of such should arguably then be the number one priority for both individuals and organisations in the critical occupations business. How can we ensure such a workforce exists?

Interventions

Our well-being model included three sets of interventions: primary, secondary and tertiary. The first two aim to prevent stress occurring in the first place. Tertiary interventions are those put in place to support individuals if distress is experienced.

Primary interventions are concerned with the individual. They cover issues of selection, training and preparation of the individual to undertake a critical role. In addition to skills and competencies to do the job, self-care skills also need to be considered (psychological self-maintenance). The aim here is not to deselect staff who have yet to acquire the requisite skills, competencies or values to stay psychologically well and perform highly, but to generate a profile that enables the individual and organisation to work together to achieve such a position if potential is shown to do the job.

Further interventions concerns the job itself, and relate to the workplace, the work force and the work people do. Here, consideration needs to be given to the environment, organisational policies and procedures, on-the-job support, frequency of exposure to traumatic events, recognition of distress and so on. However, recognition and understanding of the impact that dynamic factors can have on well-being enables appropriate responses at both the individual and organisational level. Disclosure by a worker of difficult family circumstances, for example, can enable a manager to initiate different support options; understanding the impact on the team of a new manager can allow apposite preparation and so on. Intervention here would be an example of secondary prevention. Tertiary responses might include referral to a mental health professional or counsellor, adjustment of work demands, retraining and so on.

Consultation

With the support of the prison’s senior managers (essential to the perception of meaningful intervention), a five stage process was initiated. This included:
1. Focus groups with frontline staff to identify their perceptions of barriers to well-being and high performance.
2. Examination of which of these (if any) could be removed or changed.
3. Use of training in how to manage the demands of work that cannot be adjusted.
4. Consideration of best methods to support managers.
5. Consideration of new ways of working to encourage resilience.


Practical Strategies

A number of practical interventions were proposed. To aid the management of physical energy, regular formalised breaks were introduced. Five to 10 minutes in every 90 was recommended, with team members physically leaving their work stations for that period of time. Some team members additionally opted to undertake a lunchtime exercise programme to augment their physical energy. To assist with the renewal of emotional energy, formal debriefs were recommended to provide team members with an opportunity to off-load the issues at the end of each day. Voluntary sessions with a mental health professional or counsellor were also offered on an ‘as needed’ basis. To help staff remain mentally engaged, a rotation system was recommended, whereby team members moved between the tasks needing to be undertaken. In addition to the above, preparedness training was also advised. Training in psychological self-maintenance skills, emotion management and the nature of psychological distress can enable staff to feel equipped and empowered to manage their emotional reaction as it arises, rather than feel overwhelmed or baffled by it.

Training focused on the development of psychological self-maintenance skills. As most practitioners in high risk jobs would probably affirm, training in the skills to do ones job is often comprehensive, but in the skills to look after oneself, non-existent. Based on the principles of emotional detachment, the programme describes the behavioural and psychological process of stressful responding. Attendees generate their own risk profile and then practice methods for managing risky elements and enhancing protective ones. An empirical evaluation of the programme when used with police officers demonstrated significant increases in job satisfaction and reduced absenteeism.

Well-being in critical occupations

Clearly, organisations have a duty of care to their employees to generate working environments that are as safe as possible. Individuals also have a duty of care to themselves to ensure they avail themselves of all opportunities to stay psychological well in the work context. These responsibilities are likely to be most effectively executed where there is a genuine desire to enhance performance and well-being through consultation and collaboration. Organisations that impose support structures from the top down are unlikely to reap the benefits of their intentions. It should not be surprising that many of the interventions included in our Well-being strategy, were also recommended by frontline staff –testament to staff’s wisdom, experience and intuition for what works in enhancing their well-being.

Many thanks to both Dr Jo Clarke and Dr. Michael Carroll for allowing me to publish their article.

"Recession and its Impact" (Garda Review)

Recession and its impact

Published in the Garda Review March 2009

Mark Reddy writes on the impact of recession on our mental welfare.

Ireland has been dealt a blow from which we will not fully recover for many years; it impacts us financially, but to a much greater extent mentally.

Life involved working long hours, spending money and getting on the property ladder. We dialled a phone to have our dinner delivered. Those that delivered our meals drove bigger cars than us. Our TVs are flat, our floors wooden and our homes expensive; we were unconcerned taking loans and banks offered us credit beyond the norm; the most frugal of us living beyond our means, and why not? Sure weren’t we all in the same boat.

But then the unimaginable happened. We have at least one friend on the dole, you can’t pick up a paper without reading of cutbacks, a failing housing market, increased levies and pending strikes and disputes. Everyone has an opinion but few a long term solution.

Faced with decreased salaries and a high cost of living, some invested in a second home and now have this added burden, others involved family in guaranteeing loans, plans for retirement may now be completely halted. The impact of this on our sense of worth and social status brings pressure on ourselves and our families, bringing despair.

We might find ourselves completely exhausted, overrun by stress and in fear for the future. This change in our circumstances impacts on our sense of security to adapt and meet these new challenges. Some are able to cope and adapt but others are not and these are the people we need to support. Failure to adapt will impact on our abilities to see anything positive in life. Blinded by our inability to cope and adapt results in helplessness and this sense of insecurity, worry and stress will, if not treated lead the vulnerable to the onset of other psychiatric illnesses.
We may comfort seek unhealthy behaviours such as alcohol and drug abuse, overeating or other addictive behaviours, all of which will add to our difficulties.

Untreated, the long term negative impacts of anxiety can lead to depression and a sense of hopelessness. Hopelessness can be a predictor to suicide and needs addressing. Depression can impact on health and ability to fend off illness. Hopelessness will increase the risk of those we place most demands on; they risk deterioration in their own health and mental well being. The impact of not addressing our issues will have a greater impact on our loved ones.

When we are aware of the facts we are better able to adapt and change our behaviours and outlooks in order to be better able to deal with the issues at hand. It’s imperative to know that firstly that none of us are alone in this.

If you find yourself in this position seek help. Don’t overcomplicate by imaging others don’t want to know. An ability to express fears and concerns will give the opening to others to do the same. Look to family for support; ask yourself would you give help to someone in need, if so then you can bet that others will do the same for you. Deal first with stresses that are impacting on you and your health.

Deal with the practical worries in a practical way, gardaí have several agencies they can approach, primarily the garda Employee Assistance Service. Outside of this there are many services established to provide professional care and advice.

Don’t be afraid to seek advice and support and believe in yourself that you have the strength to get through this and learn some valuable lesson while doing so. We are at a time when we have to assess what is valuable to us. Some things are more important than others.

Many thanks to Neil Ward Editor of the Garda Review for his kindness and support.