Preparing for Traumatic Exposure; Practical Strategies for Interpreter Self-Health

Ron Lybarger, Ph.D.SLS KC

Spring 2014

Discuss the nature of traumatic exposure

The nature of interpreting related stress-how do you cope?

Coping strategies-stress management training/resources

Professional Quality of Life Scales-Revised

Emphasize personal responsibility

Under stress (fight or flight) muscles tense and blood flow is restricted to the main body and reduced to the hands and feet

Warmer hands->more relaxed->less cortisol Colder hands->increased stress->more cortisol

There is significant variance between individuals-take time to find your set point

1987-met Deaf man-JCCC-KSD-Park University 1990-A.A.S.-Sign Language Interpreting-B.S. Addiction

Studies-MCDPDHHI>600 Deaf 1992 M.A.-Counseling Psychology 1995-UMKC-KSD-Private Practice 1996-caseload of interpreters 1999-Ph.D. Counseling Psychology 2006 Sorenson-2012-911 Project Hundreds of Workshops and Trauma Debriefings

The ability to grow and thrive in the face of life's challenges and bounce back from adversity

Increase self-awareness

Improve self-regulation

Enhance your ability to manage energy and emotion in a stressful situation

The natural consequent behaviors and emotions resulting from knowledge about and exposure to a traumatizing experience of a significant other (Figley, 1995)

Caring people sometimes experience pain as a direct result of exposure to others traumatic material….it is the natural, predictable, treatable, and preventable unwanted consequence of working with suffering people. (Figley, 1999)

Occupational hazards of interpreting can include extreme & chronic stress, exposure to direct trauma, secondary trauma, depression, and burnout

Denial can be a natural response to these conditions……

Your trauma history will impact your emotional processing and reactions

Unidentified, unresolved trauma is likely to be activated by similar reports of consumers

In order to be self-aware and professionally effective as possible, we need to become more aware of our own issues, identify resources, and seek the necessary support

Interpreters must have your own sources of support and resources or your work and personal lives will be affected

Physiological arousal Depression Anxiety Disrupted interpersonal relationships Increased sensitivity to violence Cynicism Social Withdrawal Sleep Problems Substance Abuse Eating disorders Feelings of hopelessness

Tardiness or absenteeism

Loss of motivation/energy

Increased procrastination

Social withdrawal

Cynicism

Resentment/indifference/defiance

Increased use of substances

Body, mind and spirit run out of resources

Mental, physical and emotional damage

Adrenals become depleted-blood sugar plummets-decreased stress tolerance

Progressive mental, physical and spiritual exhaustion-illness-collapse

Being depressed or having symptoms make you more vulnerable to the negative effects of stress

Depressed mood most of the day, nearly every day Diminished interest or pleasure in activities Appetite disturbance-weight gain or loss Insomnia or hypersomnia Fatigue or loss of energy Feelings of worthlessness or excessive or inappropriate guilt Difficulty with concentration/decision making Thoughts of death-suicidal ideation Family history increases vulnerability 2-4X Average of 8 years after symptoms appear that folks seek

professional assistance

Cardiovascular disease

Musculoskeletal disorders

Psycho-emotional disorders

Workplace injury

Suicide, cancer, ulcers and impaired immune function

Few people receive formal training on how to manage stress-I’m gonna provide you some!

Training and preparation is the best defense for effectively coping with stress

Individuals with good stress management skills are happier and more productive both personally and professionally

Exercise, meditat ion, and yoga all are beneficial in multiple ways

Prevention is the most effective stress management strategy

Fight or flight Muscle tension Increased heart rate Eyes dilate Breathing changes Stomach may clench Biologically/neurologically wired for survival When perception of stress subsides, body returns

to normal-homeostasis

Hypothalamus signals adrenals to produce cortisol Cortisol is a chemical messenger in the body-it causes

the liver to release energy Prolonged exposure=increased risk of long term damage Affects bodies ability to use insulin Cortisol-visceral fat Increases blood pressure De-stabilizes glycemic levels Can cause sugar/fat cravings Affects encoding of memory

High cortisol levels cause us to age more quickly and increase the risk of heart disease.

Leads to depletion of essential nutrients.

High cortisol levels increase your risk of infection because it weakens the immune system and increases the breakdown of muscle and tissue.

Overtime, the adrenal glands cannot meet the demands of continued stress and become fatigued.

Adrenal fatigue eventually results in lower cortisol because the glands cannot continue the elevated production.

Low cortisol levels due to adrenal fatigue causes many unpleasant symptoms and increases the risk of health conditions such as heart disease.

Eating is a mood altering experience Food choices effect our ability to cope with

stress-glycemic control Anxiety and stress cause the body and mind to

crave sweet, fatty foods These foods/substances suppress the chemical

stress response happening in our bodies….also release pain relieving hormones

Simple carbs>tryptophan>serotonin

Body’s response to long term stress

Ongoing secretion of hormones-corticosteroids

Increase in blood sugar levels

Increased blood pressure

Overuse of body’s reserves

Eventually leads to disease

Discussion of cognitive errors/distorted thinking and how it contributes to life/occupational stress

Emotion impedes rational thinking and sabotages effective decision making

Learn to identify emotions and thought patterns that contribute to changes in your

Understand how your emotions contribute to your behavior

Practice managing and modifying your emotions Reduce intensity and duration of painful emotions Identify and manage your emotional vulnerability

Automatic thoughts

Irrational thinking

Rational rebuttal

Learn to recognize and define what is stressful for you

Identify unhealthy behaviors you use to cope

Take decisive actions to create new more effective coping strategies-BABY STEPS

Learn to take care of yourself

Get support

Identify and manage sources of stress

Relaxation techniques

Thought management

Stress prevention

Exercise

Meditation

Yoga

Spiritual activity

Rest

Maintain a rational perspective

The mental and physical effects of exercise are far more profound and complex than we once thought

Regular exercise=neuroplasticity-neurogenesis Regular exercise improves your mood, decreases

anxiety, improves sleep, decreases physiological and psychological effects of stress and raises self-esteem

Proven antidote to stress and aging 1 hour of exercise + 2 hours of life expectancy

Hippocampus

The term meditation refers to a family of self-regulation practices that focus on training attention and awareness in order to bring mental processes under greater voluntary control and thereby foster mental well-being and development and/or specific capacities such as calm, clarity, and concentration. Walsh & Shapiro, American Psychologist 4/06

Goal is to aim for continuous focus primarily on one object such as the breath

“Meditation” is simply focusing on your breath

Clinical observations and initial research suggest that personal meditation can mediate the costs of professional stress including:

Burnout Depression Anxiety Job satisfaction Efficacy Interpersonal relationships

Walsh & Shapiro, American Psychologist 4/06

Personal meditation practice has shown effectiveness in:

Reducing stress Enhancing empathy Improving life satisfaction Increasing self-compassion

Walsh & Shapiro, American Psychologist 4/06

A growing body of scientific research supports the efficacy of a regular yoga practice for stress reduction/remediation

Yoga's emphasis on breathing and the mind/body/spirit connection yields strong psychological and emotional benefits

A short lived gas that tremendously affects your body’s function

Highest levels in the nasal pharynx Stimulating NO promotes wakefulness Not enough NO promotes aging of the skin Helps dilate arteries and enhances blood flow Has a calming effect on the nervous system Roizen & Ozz 2007

Treating yourself with the same kindness and care you’d treat a loved one or friend

Avoid harsh and irrational critiques or negative generalizations about yourself

Employing a gentle nonjudgmental approach with ourselves helps with resilience, stress management and enhances the ability to bounce back after struggles

Self-gratitude Give yourself a fist bump…really!

Compassion Satisfaction

Burnout

Compassion Fatigue/Secondary Trauma

Emerging research has shown that yoga: reduces stress improves sleep reduces cortisol levels lowers blood pressure lowers heart rate increases personal perception of well-being reduces overall anxiety and muscle tension increases strength and flexibility

Average: 37 (39 for terps)

Above 42-all right!

Below 33-can’t get no satisfaction…..

Average: 22 (20 for terps)

Above 27: Need to become more cool?

Below 18: Pretty cool…….

Average 13 (17 for terps)

Above 17-Are you all right?

Below 8-For now………

Positive psychological change experienced as a result of the struggle with highly challenging life circumstances.

Post-traumatic growth is not simply a return to baseline from a period of suffering; instead it is an experience of improvement that for some persons is deeply profound. Tedeshi, R.G., & Calhoun, L.G. (2004). Posttraumatic Growth: Conceptual Foundation and Empirical Evidence

Wherever there is life there is hope. Even in the depth of despair and the dark night of the soul, there is the potential for new beginnings and growth.

Debriefing

Social support

Minimize novelty

Increase familiarity

Avoid fight or flight triggers

Process grief

Not therapy, psychoeducational, facilitate recovery, reassurance, normalization of thoughts and emotions, post-trauma closure, assess any additional needs of participants

A debriefing should NEVER include judgment or operational critiques