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Stress creates walking wounded
25 Jan 2002
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Colliard: "There has to be time to rest"
Website: http://www.humanitarian-psy.org
Claire Colliard is founder and executive director of the Center for Humanitarian Psychology, a Geneva-based NGO offering psychological support to humanitarian staff. As a former clinical psychologist, she argues that agencies have the responsibility to do what they can to prevent staff being overwhelmed by stress and overwork, through providing good access to information and communications channels. Supporting aid workers for the past eight years of increasingly difficult and dangerous work has made it obvious that the classical concept of stress is a gross understatement of what happens to humanitarian staff. Most of humanitarian personnel I have seen, especially those whose international work is their career and have been on mission after mission, are polytraumatised people – some we could even call the walking wounded.In the humanitarian world, stress factors are very different from those at home and often overwhelming. First, there are practical issues, such as another climate with new languages, new foods and tropical diseases. In work, there will be long hours, security fears or active danger, culture shocks of a new environment, and limited support from the organisation.Away from work, a humanitarian worker may be separated from their partner, family and friends, living in the emotional isolation of round-the-clock group life or literally isolated in remote operations. There are the fundamentals of witnessing inhumanity and tragedy for months or years when it is all but impossible to meet others’ high expectations.For stress to resolve itself, there has to be time to rest, the chance to express problems, and a secure environment. With little of this in the field, cumulative stress can set in rapidly, after just weeks in certain situations. It may bring behaviour changes, emotional dysfunction, loss of initiative, negative attitudes, an inability to rest, anger towards managers, and even psychosomatic symptoms (research shows back or skin problems as the most common).If support is not offered, others may be affected within the team, which can trigger personnel turnover, clique formation, conflicts between groups and scapegoat mentality, while undermining communication between the local office and headquarters. This can become the "headless chicken" syndrome: people running around, believing they are achieving a lot but really getting nothing done, with catastrophic effects on programme implementation.If the individual is aware of what’s happening, they may keep it a secret for fear of losing their job. Or they may not be conscious of the effects, and the silent stress become distress and then denial - a well known defence mechanism to deal with overwhelming conditions - or a clinical disorder. In these late stages, leaving humanitarian work may mean even more problems, painfully trying to readapt to their home life or an ordinary job.But there is much that agencies and their staff can do. Two factors are vital: one is information, the other is expressing difficulties through communication and sharing. These should be part of any humanitarian psychological and/or peer support programme.Human resources staff should be trained in stress matters and critical incident management to pass on the necessary information to their staff. Humanitarian workers should know what could happen to them and how to handle critical events before going on a mission, especially those in conflict zones, such as through "first mission" workshops.As well as compulsory time off, agencies should create a support structure to help troubled field staff, and have a mandatory personal, professional and psychological debriefing when the person comes home, with further professional counselling if necessary. Agencies could also give "coming home" workshops for personnel who want to leave.Those points are at the core of the psychological and peer support programme that the Center for Humanitarian Psychology offers to human resources departments which want to implement this system inside their organisation, tailored to their specific needs and structure, together with training for staff members and human resources departments.The waning of the cowboy attitude in relief missions is encouraging. However, quite a few expatriates find it hard to drop the hero act and they can descend into stress, trauma and grief without any tools to help themselves. At CHP we believe that each agency has the responsibility to give their staff both professional information and support in order to lessen psychological casualties and help programme implementation.This article originally appeared in
People In Aid's newsletter for January 2002
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