Coping with stress and personal crises during

during international operations. Stress affects decision making, judgement, performance and the ... it is important to deal with stress and crisis rea...

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Coping with stress and personal crises during international operations

Stress affects decision making, judgement, performance and the ability to cooperate. As field staff on international operations you will encounter difficulties that can cause severe stress. Stress affects your health by directly affecting your bodily functions and by weakening your immune defence, which makes you more susceptible to illness. Research and experience have shown that it is important to deal with stress and crisis reactions to prevent ill-health and so that one feels well and has the energy to do one’s job as required. This brochure will increase your knowledge about how you can cope with stress when on an operation and what to do in situations that result in crisis reactions. At the end of the brochure you find some breathing exercises for relaxation.

What causes stress? The causes of stress are called stressors. Here are some examples of stressors you could experience when on an operation: •

Powerlessness – As a result of seeing all the misery, suffering, oppression, and poverty without being able to do anything; especially difficult when children are suffering.



Information – Lack of or incorrect information



Unfamiliar culture – Language difficulties. Unfamiliar food, manners and customs.



Climate – High or low temperatures and/or extreme humidity



Equipment – Lack of equipment, shortage of equipment, defective equipment



Organisation – Bureaucracy, inadequate leadership, lack of resources



Health – Anxiety about getting sick, diseases, lack of medical care, poor hygiene conditions



Animal life – Spiders, snakes, insects and other unfamiliar animals



Isolation – Far away from home and help, home sickness



Work situation – Too much or too little to do



Security state – Threats, restrictions, landmines



Secondment – Alienation, loneliness



Cooperation – Conflict on various levels, e.g. between individuals or within a group. Lack of respect for differences.



Self-perception – Own demands on performance. Fear of not being good enough.



Inactivity – Waiting for decisions or materiel, bureaucracy, obstacles because of the weather.



Home situation – Powerlessness when various types of problem occur at home.

What is stress? Stress reactions are the body’s way of preparing for an increase in performance. Originally, stress was the body’s way of coping with threats to survival where fight or flight was required. Then it was a case of being as strong and as quick as possible. Short term stress is necessary and harmless, on the condition that the body is then given the chance to calm down and recover. It is during long term stress with little chance for peace and quiet that stress becomes harmful. The body’s polarization becomes too high. It is extremely strenuous for the body to keep getting signals about life threatening threats. If the polarization remains high for a long time the body becomes fatigued and vital functions can be completely knocked out – then the body “burns out”. Low polarization results from the body being given time for recovery, rest and relaxation.

HIGH polarization = •

Bodily stiffness



Poor sleep



Stomach problems



Irritation



Depression



Breathing difficulties



Restlessness



High blood pressure



Headaches



Forgetfulness



Clumsiness



Shoulder pains



Concentration difficulties



Infections

LOW polarization = •

Patience & tolerance



Buffer against stress



Body moves easily



Even tempered



Increased capacity



Good sleep



Relaxed shoulders



Better concentration



Stronger immune defence •

Lots of energy

Good physical condition is a good foundation for being able to cope with stress and to reduce high polarization. This is based on: •

A balanced diet



Good fluid balance



Regular exercise



Regular sleeping habits



Maintaining a good bodily weight



Balance between work and time off



Limited intake of nicotine, caffeine, alcohol, and other stimulants

You can also reduce polarization by activating the body’s “peace & quiet system”. You can do this via: •

Social interaction



Cultural events



Experiencing nature



Contact with animals



Humour



Massage



Music



Yoga, qigong, tai chi



Relaxation exercises

What can you do when you’re stressed? It is important that you know yourself what you can do to reduce the effects of different stressors. Ask yourself: •

How can I keep in good physical condition when mobility is restricted, the temperate high, and time limited?

• What options have I got for recovery and relaxation?



Am I drinking enough water?



Have I got a balanced diet?



How can I mentally prepare myself for various situations?

Practice identifying how you feel and recognising stress signals. •

Have you got a headache and pains in your shoulders and neck?



Have you got back pains?



Have you got a digestion problem?



Can you feel/hear your heart beating while resting?



Do you have difficulties sleeping?



Do you wake up early in the morning and feel tired?



Do you find it hard to concentrate?



Do you have difficulties finding time for everything?



Do you feel angry or irritated?

Coping • Avoid or remove that which is causing stress If possible, avoid that which is stressing you. If this means that you’re only postponing the problem then it’s better to deal with it, for example, by analysing it and breaking it down into more manageable parts. You can list what needs to be done and prioritise items, and then make a plan for when everything should be completed. And it’s important to get going and to do what you’ve decided to do.

• Reduce your stress level You can reduce your stress level through various relaxation techniques.You can do this using various forms of breathing and by muscle relaxation. Other ways can be via meditation, yoga, tai chi, or qigong.

• Change the way you think “It’s not how it is, it’s how you deal with it” is one way of

describing how to deal with reality as it is, without enlarging problems and starting to think pessimistically. Negative thoughts can make the feeling of stress greater and reduce the capacity for action. Instead, try to see opportunities for yourself and in the situation.

• Ventilate stress Talk with someone about how things are for you. If you like writing you can keep a diary or write letters. You can also do things you like doing and which relax you. Exercise is another way to ventilate stress. Stress reactions in the body create unrelieved physical and mental energy, which then require the body to move.

Catabolic stress Catabolic stress arises as a result of not enough food, water or sleep, and can lead to a fatigue reaction. This is primarily a risk on intensive operations where the need for humanitarian aid is great. The risk for a rapid fatigue reaction increases if polarization is already high prior to the operation.

Symptoms of a fatigue reaction can be: •

Intense tiredness, often in conjunction with tiring hyper activity



Sadness, resignation, guilt, hopelessness



Inability to acknowledge mental fatigue and the denial of lost energy



Physical symptoms, such as, headaches, back and stomach pains

Coping It isn’t always easy to accept that you need to do something about your stress when you’re right in the middle of an intensive operation. Make it a habit of stopping during the day and reflecting over how you feel. In the event of catabolic stress you might need a temporary break from your duties, preferably with the option to leave the operational

area for rest, recovery and possibly a defusion session Because it can be difficult to realise that one needs to do something about one’s stress, it can be a good idea within the group to keep an eye on your operational colleagues as a matter of routine. If everyone thinks like that then you’ll know that someone is keeping an eye on you. The head of mission has a responsibility to plan for periods of recovery and relief. When you return to work you might need to take various fatigue reactions into account. Shifts can be made shorter and you need to be extra careful with sleep, food and drink.

Crisis reaction and trauma reaction Experiencing an individual serious event can result in a crisis reaction, or if the stressor is very strong, a traumatic reaction. If you don’t get help to work through the traumatic reaction there is a risk of suffering from post traumatic stress disorder (PTSD), which requires specialist treatment. If you have a high polarization and/or have other unresolved events behind you then the crisis reaction can be worse.

Examples of serious events: •

witnessing violence, epidemics, disasters, famine



being the victim of violence or the threat of violence



witnessing bombings



witnessing the results of large-scale materiel destruction



being present when a colleague is injured or killed



being involved in accidents and serious emergencies

Coping If you suffer shock then you may need help from others. Shock can last from a few minutes to a few days. During shock psychological first aid is administered and you can apply this yourself when you need to support someone else.

Examples of psychological first aid that you can apply to others: •

Give signals of safety, support and care



Top up on nourishment by giving them food and drink. Don’t give them any alcohol



Talk as little as possible but listen even more



Don’t leave the person alone

Dialogue sessions as support When the shock has passed one needs to talk to somebody. There are different session methods that can be used as support when dealing with personal crises. The aim of such sessions is stress relief and the processing of events for the limitation and counteracting of psychological after-effects. People have different levels of resistance and capacities for recovery. Processing sessions are appropriate if there is proof of strong remaining reactions approximately 3 weeks after an event.

Various forms of session: • Colleague support session (held with colleagues) Belonging to a work team and together with colleagues being able to discuss events jointly experienced is a very good aid for reducing stress reactions. The aim is to create order in chaotic impressions and thoughts. This makes stress relief and the recovery process easier.

• Defusion session (led by the head of mission or a session leader) Defusion sessions are structured sessions for individuals or groups to air their feelings, to vent their stress, and should be held as soon as possible after the event, after any shock reactions have passed. Sessions follow a simple format whereby the group/ individual talks through the chain of events and a discussion is held on the thoughts and feelings that arose because of the events. Defusion sessions are recommended as a matter of routine after every event that has involved severe stresses and strains.

• Processing session (led by a session leader) If after approximately 3 weeks there are still some strong reactions remaining, then between 2 and 6 processing sessions are held. If further treatment is required after that then trauma therapy might be needed.

Stress reactions after an operation Even if stress levels were experienced as low and no crisis events occurred during an operation psychological after-effects can still arise. These can for example be: •

Sleep problems



Restlessness



Anxiety



Flashbacks of events



Feelings of emptiness



Irritation



Blaming oneself, feelings of guilt



Aggression, hate



Concentration problems



Physical reactions

Coping • • • • •

Understand that reactions are normal. Be patient. It can take time to adjust both physically and mentally. Speak about your experiences with your operational colleagues. Make time for recovery. Time might be needed on a daily basis in seclusion to reflect over and think through over what happened. Seek help if required. Stress reactions after an operation are not an illness, but if the reactions don’t go away then they can lead to mental and physical ill-health.

Breathing exercises Basic breathing 1. Sit or stand in a relaxed position. 2. Slowly inhale through your nose, counting to five in your head. 3. Exhale from your mouth, counting to eight in your head as it leaves your lungs. 4. Repeat several times. That’s it!

Tips: •

As you breathe, let your abdomen expand outward, rather than raising your shoulders. This is a more relaxed and natural way to breathe, and helps your lungs fill more fully with fresh air, while releasing more “old” air.



You can do this just a few times to release tension, or for several minutes as a form of meditation.



If you like, you can make your throat a little tighter as you exhale so the air comes out like a whisper. This type of breathing is used in some forms of yoga and can add additional tension relief

Breathing and visualization •

Close your eyes and relax. Let your breathing become slower and deeper.



Breathe from your diaphragm or belly instead of from your shoulders or chest. Don’t force it, but let your breathing become natural and relaxed.

Visualize... •

As you breathe in, imagine that ’relaxation’ is coming into your body and flowing through your limbs, reaching every part of you. As you breathe out, imagine that all the stress from your body is being released. After a few minutes, you should feel more ’full’ of peace, and the stress in your body should be reduced.

Or... •

As you breathe, imagine that your hands and feet are getting warmer. With practice, this can further reverse your stress response and actually warm your extremities, relaxing your body in the process.

Another Idea... •

Imagine that, with each breath, your body is becoming looser. With each exhalation, your limbs are a little more like spaghetti, your face a little more relaxed, your body a still pool of water.

Keep breathing. •

Continuing this exercise for between five and twenty minutes can relieve stress and help you return to your activities (and stressors) with a renewed sense of strength and serenity.

Tips: •

If you are really tired and fear that this will put you to sleep, keep your practice to about 5 minutes, or set an alarm.



Conversely, if you’re having trouble sleeping, this exercise may prove very helpful.

Notes

ADVANT PRODUKTIONSBYRÅ

Swedish Civil Contingencies Agency 651 80 Karlstad, Sweden Telephone +46 771 240 240 www.msb.se Publ.nr MSB0155-10