Employee Assistance of the Pacific

by Vali Hawkins-Mitchell

A three-part series published as a guest blogger for the Risk and Resilience HUB

April 27,  May 23, and June 23, 2019

This is a three-part series on human concerns in disaster recovery:

Part 1 What: What are Human Concerns

Part 2 So What: The Risks

Part 3 Now What: The Applications

Part 1 -- What: What are Human Concerns

What is a Disaster?

Disaster: a sudden, extreme event creating damage, loss, and destruction to life and property. What can be missed entirely is the “disaster inside” the disaster:

• The employee who was in the middle of a divorce procedure who now must postpone it.

• The parent who is now hesitant to leave children alone after realizing how short life can be.

• The boss who showed cowardice during the event now trying to lead the team.

• The supervisor who has lost good producers.

• The previously traumatized employee who now is re-traumatized.

• The individual who now blames responders and responses to cope with their feelings.

• The company that disavows the time some people take to recover with gung-ho messages.

All of us manage countless challenges at home and work. Some days are easy and others not so much. And challenges can range between zero (an easy nothing) and a ten (the difficult or worst). Everyone has a ten. If your biggest difficulty so far in life was a hangnail, that was your ten. For someone else a ten might be the death of a loved one. It isn’t a contest. One person’s two may be someone else’s ten. Regularly manageable ones and twos can become tens during and after a disaster. For example, managing pets routinely may be a one but during a disaster can turn into a ten. Human Concerns for risk and recovery means there is no one-size-fits-all strategy. Recovery and risk planning should be as equally unique and dynamic as each specific incident and individual’s experience; the full spectrum of human responses possible.

The definition of a disaster, often stated in terms of destruction, economics, and casualties, doesn’t begin to accurately determine what happens to humans. What is devastating to one person may be a mere annoyance to someone else. It is essential to not just listen, but to hear humans in duress and to ask them to clarify the specifics of their unique experience without judgment or assumptions. I have found this step missing in “lessons learned” briefings. When the incident is “over” for some, it has only begun for others.

What are Human Concerns?

Human Concerns are those problems and issues that influence the emotional, spiritual, mental, physical, and relational aspects of life. Problems are acute and issues are chronic. For example: A flat tire is a problem, whereas poverty, that makes getting a new tire impossible, is an issue. A problem may be temporary and fixable, where an issue may only be manageable over time.

What comes first? Job one is Extreme Self-Care.

My introduction to emergency services was on a Tsunami Management Team. New to the field and eager to learn from the pros, I entertained images of rapid and compassionate response teams, cool equipment, maps, graphs, and high-tech gear. However, the very first item of business was:

Ok, reminder for the new people: You hear the sirens and get out of harm’s way. We’ll all meet on __________ Hill Ridge with our families and gear. Locals will head upland and away from the coast, the *&@% tourists will flock in to watch and take photos. When it’s all over we’ll go clean up the mess.

I was stunned. How could professional responders think about themselves first? But that message became a mantra of “put on your own oxygen mask first or you’re no good to anyone.” And no matter how trite that expression may seem, the wisdom remains: Extreme Self-Care is job one.

What is Extreme Self-Care?

Extreme Self-Care means doing more than the basics of your regular regimen of physical, emotional, mental and spiritual activities. Extreme self-care demands you evolve your practices in case you need more when under duress. It’s your Self-Care Go Bag you can turn to during hurricane season, pandemics, wildfires, tsunami, earthquakes, hazmat events, tornadoes, terrorism, active shooters, or space alien zombie invasions. Consider deepening your regimen by expanding these three foundations:

1. Mindfulness
2. Well-being
3. Resiliency

What is Mindfulness?

Mindfulness means paying attention to where you are and what is going on for you in the moment. Although now a multi-billion-dollar industry, the basics of mindfulness simply include:

1. Being aware.
2. Focusing on the present moment, while calmly and non-judgmentally noting feelings, thoughts, and physical sensations.
3. Being present with whatever the experience may be.
4. Paying attention with intention.

Bodies and brains change during emergencies. Mindfulness provides another option to reactions of fight, flight, or freeze: becoming creative in the moment based on that specific moment. A unique moment may necessitate a unique response that has presented itself. If one is aware, options open up. Many survivors of disaster report that it was a quick decision they made in the moment, during critical seconds, that saved them. Practicing mindfulness can help you function better during drills, planning, and actual events.

What is Well-Being?

Well-Being initiatives refer to supporting the large, whole-life, holistic, and complete human experience. Unlike the Wellness movement, now a $3.7 trillion market, Well-Being does not limit itself to physical fitness, health, nutrition, cosmetics, and disease prevention. Dartmouth College, an Ivy League school, suggests Well-Being includes intellectual, emotional, physical, social, spiritual, environmental, and financial attributes. Gallup, the organization that delivers “analytics and advice to help leaders and organization solve their most pressing problems with a global reach,” promotes five essential elements for Well-Being: Career, Social, Financial, Physical, and Community.

Many companies provide Wellness or Well-Being programs. Extreme Self-Care practices include using and evolving such resources available for your benefit before you need intervention.

What is Resiliency?

Resilience is a learned set of behaviors, thoughts, and actions that provide a defense against stress, challenge, and setbacks. Resilience the core of your extreme self-care and well-being practices that becomes your reservoir of resources if the well goes dry. Resiliency doesn’t mean you “bounce back” to your old original shape after a crisis or challenge. There is no bounce backwards. The past is past. Resiliency means moving forward into the new NOW with new meaning. Resiliency isn’t a contest or a magical thing that happens to some special people. It is learnable, a choice, and a personal life-practice. Resiliency doesn’t mean you don’t feel pain, grief or anguish. It means feeling your emotions or feelings, but not dragging victimhood along like paper stuck on your shoe. Resiliency isn’t a false happiness but can direct you forward to a return to joy after duress.

The more Mindful you are of your own self-care processes and what throws you off-track, the more you build your Well-Being, and the more Resilient you become, the more sensitive you will be to the Human Concerns that arise in a disaster. Mindfulness, Well-Being, and Resiliency are accessible processes to find meaning, clarity, and a sense of presence before, during, and after a challenge. And isn’t that what recovery is?

Stay tuned for the next blog – So What: The Risks. What is your why?

References:

https://globalwellnessinstitute.org/press-room/statistics-and-facts/

https://students.dartmouth.edu/wellness-center/wellness-mindfulness/roots-wellness

https://www.gallup.com/press/176624/wellbeing-five-essential-elements.aspx

Part 2 -- So What: The Risks. What is your why?

A. There Is Nothing New About the Idea That Disasters Are Stressful On Humans.

It is common knowledge that a disaster produces collective stress that can exceed the ability of the affected population to cope with the physical, emotional, and financial burdens that result.

There are many common symptoms of post-disaster trauma, where feelings become intense and sometimes unpredictable. Irritability, mood swings, anxiety, flashbacks, physical reactions, confusion, inability to make decisions, sleep/eating problems, addictions, headaches, nausea, chest pain, change in relationship skills, conflict, withdrawal, avoidance, anger, work loss, depression, and even suicide are reported manifestations of post-disaster responses.

• After the Northern California firestorm in October 2017, for example, the number of people seeking mental health resources in Sonoma County nearly doubled.
• In 2010, researchers found that approximately one-third of Hurricane Katrina survivors who had been displaced to Houston, Texas had increased their tobacco, alcohol, or marijuana use after the storm.
• Six months after Hurricane Sandy, a brief telephone screening found 14.5 percent of surveyed adults were suffering from Post-Traumatic Stress Disorder (PTSD).

B. Finding Meaning Can Ameliorate Post Disaster Stress

Catastrophe. We survive…then what?

Research has revealed cultures that technically survive catastrophe but no longer thrive, having lost their meaning, rituals, languages, and customs. Occupied and colonized indigenous people know this. Without deep “meaning” people do not thrive. Human factor aspects in recovery practices should include asking: “Why should you care about recovering eventually? What would it mean to eventually recover? What is your meaning, what is your why?”

Transforming powerlessness into meaning is an incredible service to recovery. On a personal level, meaningful activities can include remembering, memorializing, journaling, photographic recording, talking story, supporting others, claiming significance, developing a new service mission, strengthening an existing belief system, providing new perspective, enhancing belonging, and sustaining values practices such as forgiveness and gratitude. At the community level, meaning can translate into actions that enhance respect for history, future, traditions, rituals, customs, collective collaborations, and shared values. In the workplace, meaning can be expressed by the employee who just wants to get back-to-work because “I need a paycheck” or the more esoteric “this work is my life mission.”

C. So What About Meaning?

“When we are no longer able to change a situation, we are challenged to change ourselves.”

“Everything can be taken from a man but one thing: the last of the human freedoms—to choose one’s attitude in any given set of circumstances, to choose one’s own way.”
Viktor E. Frankl

According to Viktor Frankl’s seminal work, following his experiences in Nazi death camps, meaning is found

• by creating a work or doing a deed
• by experiencing something or encountering someone
• by the attitude we take toward unavoidable suffering

The philosopher Sartre stated that meaning is something truly unique to each person; separate, independent and not given…it must be achieved.

According to Kierkegaard, another legendary philosopher, meaning is a lived experience — a quest to find one’s values, beliefs, and purpose.

Meaning determines why someone wants to not only survive, but thrive after a disaster. Meaning is the glue of civilization. Finding meaning creates buy-on to the complex magnitude of legitimate recovery. Putting a Band-Aid^® on someone may be good enough for a boo-boo. Reattaching meaning after a catastrophe requires not only heart and soul, but near surgical precision with critical attention to details. It takes more than a brief crisis intervention.

When recovery plans go beyond the cleanup kits, cash, food, water, business continuity protocols, critical incident interventions, teddy bears, and candles, it bridges the time between what was, what is, and what may be that forms a psychological and neurological connection. It takes more than well-intended “thoughts and prayers” to move through the what, so what, and now what process of recovery. There is a beginning, a middle and an end to the disaster. The earthquake ends. Then what? “What is your why?” helps move people from “I’m powerless” to “I’m reclaiming or have found new meaning.”

Meaning can be found in gardening, parenting, pets, art, exercise, faith, community service, people, places, philosophies, theologies, and more. Meaning is personal. Because meaning isn’t tangible it might be temporarily misplaced, but still exists. Meanings are the anchors and shelters we use before, during, and after disaster. If meaning disappears, it needs to be restored along with the buildings and electrical systems. Most professionals know there is nothing more off track than preaching your meaning or saying “everything happens for a reason” to someone reeling in grief. However, gently introducing the concept of meaningfulness is an essential “Part” of the process of recovery and a significant addition to long term healing.

D. From Survive to Thrive

Q: How can you recognize recovery?

A: People are continuing, connecting, contributing, and finding meaning.

I suggest several two-month follow-ups to establish “how everyone is really doing.” Like being exposed to a contagious disease that you believe you are immune to, after a massive exposure you might “come down with the bug” anyway. Stress can work like that also. Most people recover, find meaning, get on with life, adapt, cope and have resilience. If not, the symptoms might start showing after a few weeks or months. My clients are advised to seek help if they aren’t starting to have some good minutes, hours, or even days after a couple of months. They may still feel bad, upset, sad, mad, or at lost ends most of the time, but recovery is a non-linear process. This means they should ALSO start having some better feeling periods with more distance from the event. This does not mean forgetting, glossing over, replacing the experience with some false sense of happy-meaning, or “getting over it.” Some things can never be “gotten over” entirely. Nor should they be. However, the initial bottomless abyss, still as deep, should eventually take up a little less time and devastating emotional real estate. The survivor can still go there in a heartbeat but hopefully won’t move their furniture in with a U-Haul^® truck. Meaning provides a bungee cord to visit and then exit the grief. Encourage them to visit and feel the feelings, and keep looking for new meaning. Some survivors will thrive by turning the disaster into their own mission of service. As long as it isn’t just a way to continue emotional self-harm this meaning can be a powerful new contribution. Individuals and communities heal when they discover the meanings of their disasters…especially with catastrophic disasters that seem absolutely meaningless.

References

Brian Stafford et al, The Emotional Impact of Disasters on Children and Families, American Academy of Pediatrics. https://www.aap.org/en-us/Documents/disasters_dpac_PEDsModule9.pdf

Susanne Babbel, The Trauma That Arises from Natural Disasters, Psychology Today, 2010. https://www.psychologytoday.com/us/blog/somatic-psychology/201004/the-trauma-arises-natural-disasters

Knvul Sheikh, Natural Disasters Take a Toll on Mental Health, BrainFacts, 2018. http://www.brainfacts.org/diseases-and-disorders/mental-health/2018/natural-disasters-take-a-toll-on-mental-health-062818

Viktor E. Frankl, Man’s Search for Meaning, Beacon Press, 2006

Part 3 -- Now What: Applications for Meaning and Resiliency

Resiliency doesn’t mean you “bounce back” to your old original shape after a crisis or challenge. There is no bounce backwards. The past is past. Resiliency means moving forward in order to reclaim balance with new meaning. Balance can be lost if focus is only on one aspect of life – physical, emotional, spiritual or mental. The return to “balance” after a major disaster is the essence of recovery work. Body, Mind, Spirit, and Emotions need daily care and maintenance to stay in balance, remain stable, and support sustainable and healthy responses to challenge. These prior Self-Care practices enhance resiliency to meet life’s challenges when they arrive.

One aspect I have discovered as significant in my private practice and personal life is to continue seeking meaning. I was first introduced to the concept of “meaningfulness” through the works of the great psychologist Viktor Frankl. His groundbreaking work on finding meaning, discovered while a victim of the Holocaust, provided a framework for resiliency that retains its value today. The capacity to seek and find meaning unites the physical, emotional, spiritual and mental faculties, which in turn creates a balance that is more capable of sustainability than for someone out of balance.

Contemporary research continues to affirm that resilient people have learned, or are willing to learn, how to adapt in order to manage sudden change, chaos and ambiguity. They will connect their resources to their challenges, understand the differences between past, present and future, and cope with the apparent incomprehensible nature of events that initially appear totally incomprehensible. They have practiced what helps them return to balance. They also have a personal sense of meaningfulness.

Sense of meaningfulness: If people have a high sense of meaningfulness, they will be motivated to engage in problems and demands posed by life. They will perceive life events as meaningful either in an emotional or cognitive sense, and they are therefore seen as worth investing energy in. People with a high sense of meaningfulness are determined or committed to regain meaning and stability in their lives. (http://reflectd.co/2014/01/29/resilience/)

Sustainable recovery demands focused attention until balance has returned from the “upset.” Medically, this is called a return to homeostasis.

Homeostasis: the tendency of a system, especially the physiological system of higher animals, to maintain internal stability, owing to the coordinated response of its parts to any situation or stimulus that would tend to disturb its normal condition or function. (http://dictionary.com)

Metaphorically, think how during an earthquake everything is in chaotic temporary motion. Not the best time to try to make a cup of tea. However, after everything has stopped shaking and after evaluation, assessment and damage control, that cup of tea sounds pretty good. Taking stock after an incident is usually the first order of business. Recognizing that the shaking is over is a good first step. Then applying all the mental, physical, spiritual and emotional tools at hand, one begins to re-establish a new order and meaning based on the current conditions. This is why first responders run and practice drills all the time. They evaluate, triage and take care of business faster than anyone and return to their collective resiliency quickly. And if not, they know where to get support; peers, Employee Assistance or other appropriate professionals. They generally recover quickly because their meaning is woven into their mission.

What is your meaning that creates the fabric and texture of your life? Do you know your purpose, your value directions, your personal mission? What do you need in order to create an extreme self-care resiliency practice? Here’s a place to start:

1. Mindfulness

Mindfulness is simply a full awareness of yourself in the present moment. What is going on with you right now? What are your observations about your environment, emotions, body, mind, energies and spirit? Pay attention for 10 seconds while you take a deep breath or two.

2. Choices

Resiliency isn’t a contest or a magical thing that happens to some special people. It is a choice and a personal life-practice. Victims have no choices. Before, during and after a catastrophic incident, there are choices to be made. Survivors access those choices to their best capacity.

3. Personal Practice

Create a personal, custom designed, extreme self-care practice. What do you require spiritually, emotionally, mentally and physically today? After you answer that, what else would you need in the event of a disaster?

4. Add 1% Effort to Goal

It doesn’t take a 100% effort to change anything. Adding an additional 1% to any project over time moves things forward. Like I have often suggested to people creating their first emergency go-bags, do a little extra shopping each grocery trip, and over time you will be well stocked. The same goes for resiliency. Add a bit of meaning, choice, and personal practice over time and you will continue to strengthen your personal infrastructure to increase your capacity to sustain your custom-designed resiliency. What is 1% you can add in order to increase your resiliency?

5. Check the List

The list below is a compilation of attributes that research shows enhance resiliency. I suggest you confidentially grade yourself from zero-to-10 (zero means none, and 10 means great) to see where you may need to add your 1% work toward resiliency.

Score Yourself	0 to 10
Cope well with changes/challenges brought about by the realities of life?
Are you healthy and vital?
Do you bounce back easily?
Do you overcome challenges quickly?
Can you change in a new direction with a new situation?
Are you elastic and flexible (instead of rigid and fixed)?
Do you value transformation from adversity to positive outcomes?
Do you react well to unexpected events and learn valuable lessons?
Can you rebound from setbacks?
Can negatives become positives?
Can challenges become lessons?
Are you self-reliant but not islolated?

6. Research and Custom Design

These attributes contribute to resiliency. More is better. Less is riskier. Mindfulness means you know yourself well. On the same 0-10 scale, rate your levels of:

Awareness	Initiative
Balance	Insight
Caring	Integrity
Caution	Justice
Civic Responsibility	Kindness
Connection	Leadership
Courage	Love
Creativity	Loyalty
Curiosity	Meaningfulness
Decisiveness	Morality
Discipline	Optimism
Drive	Perseverance
Empathy	Playfulness
Fairness	Self-reliance
Faith	Social Intelligence
Forgiveness	Spiritual foundation
Generosity	Teamwork
Gratitude	Tenacity
Honesty	Uniqueness
Hope	Use of knowledge
Humanity	Vitality
Humility	Will
Humor	Wisdom
Independence

7. Do you know your resources?

Do you know just the basics, or have you developed a full and extensive list of what would help you under duress? Do you see the ads for emergency preparation and think “I’ve got a flashlight, so I’m good!” and stop there? In today’s world, your list of resources needs to be comprehensive. Start here:

Community resources

Employee Assistance Providers

On-line Resources/phone lists

Faith-related resources

Emergency go-bags/Family plans

Emergency medical or mental health resources

We don’t know if, when, how or where a next disaster will occur. The statistics suggest it is not “if” but “when.” Extreme self-care and resiliency preparation should be part of what gives your life meaning. Preparation is not paranoia; it’s just good thinking. Continue to invest an extra 1% energy to your personal physical, mental, emotional and spiritual practices over time. Then go about your meaningful life.

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Dr. Vali Hawkins-Mitchell is a licensed mental health counselor, trauma and resiliency specialist, business consultant, well published author, award winning artist, and coach. Currently she is the co-owner of the largest employee assistance program and physician assistance program in the state of Hawaii and a leading international authority on the role of emotions in the workplace. She holds a PhD in health education, a master’s degree in psychology, and another master’s degree in art therapy. www.valihawkinsmitchell.com   www.eapacific.com