Preparing for and Responding to Threatening / Stressful Events: A Self-help Guide for Employees

1. Purpose of the Employees' Self-Help e-Guide

This self-help guide is designed to help employees take an active role to:

• Strengthen their resilience to threatening/stressful events. Preparation and knowledge enhances our innate resilience, drive to survive and live fully again after traumatic or potentially traumatic events;
  
  
• Strengthen knowledge about what to do after threathening/stressful events. There are things that you can do in the aftermath to mitigate your short term and long term reactions to the event.

2. Before and during an event/ Building resilience

Resilience is the human ability to maintain a state of balance and healthy levels of psychological and physical functioning in the face of tragic events. The great majority of people exposed to traumatic and potentially traumatic events continue to have positive emotional experiences and show only minor, temporary disruptions in functioning.

2.1 Being aware of and improving your personal strengths, competencies and autonomy

There are multiple personnal tools that can be used to maintain its balance and strengthen resilience to extremely aversive events. Because of their key roles, it's important to be aware of them and improve them when possible.

1. Hardiness:
   Being committed to finding meaning and purpose in life, believing that you can influence the "outcome" of an event and believing that you can learn and grow from both positive and negative experiences will help you gain a sense of control.
   
   
2. Self-enhancement:
   Positive self-esteem, looking out for personal needs in the face of personally threatening events and maintaining active social networks will help strengthen your resilience.
   
   
3. Emotional control:
   In the midst of threatening events a certain amount of emotional repression and denial can be helpful. In the long term, however, it is not helpful to bury distressing thoughts, feelings and memories. It is better to find someone you feel comfortable speaking with.
   
   
4. Positive emotion and laughter:
   Positive emotions (gratitude, interest, love, etc) and laughter are protective ways to cope with adversity.
   
   
5. Engaging in goal directed activities:
   Being engaged in activities, however small, to improve things for yourself and others is extremely strengthening and hope inducing. Taking action is a powerful way to gain triumph over the meaninglessness of trauma and other adverse circumstances.

(Bonanno; Janoff-Bulman; Lightsey)

2.2 Maintaining emotionally supportive relationships at home and at work

Humans are social by nature and connections with significant others provide an important centering function that helps us to bounce back from excessive stress and trauma and help us find meaning out of disaster and tragedy.

It has been found that the workplace offers a significant amount of emotional support. Being involved with your co-workers and supervisor in planning and developing an Emergency Response Plan is one way to prepare for traumatic events that may occur in the workplace.

Staying connected with others can make you feel less alone when an event occurs and can help you sort out reactions to the events. Think of the people in your social network at present that are most significant in your life. Include family, friends, partner, co-workers and/or professionals such as family doctor. Make sure you have their phone numbers both at home and in the workplace. Assess what you are doing to maintain a social network and whether you need to reach out more to others in your life.

If you have children spend more time with them. Ask them about their reactions to the event. Sudden changes in family routines, as well as fears and anxieties resulting from their own disaster experience can change the way children and teens behave. Involve them in recovery activities. Small children, in particular, need more physical care, holding and reassurance. For more information on  Helping Children and Adolescents Cope visit the  Public Health Agency of Canada's Office of Emergency Services web site.

2.3 Being informed about what is happening in your environment

Being as well informed as you can of the disaster or traumatic event, having an emergency response plan (including knowing your workplace Emergency Response Plan as well as creating your own personal and family Emergency Response Plan), and knowing about available resources within yourself and in your community and workplace, all combined to give you more of a sense of control, strength and resilience. After an event has occurred, finding out what has happened may be the key to recovery. Sharing with others what you witnessed can also help you better assess what has happened and it's implications to you and others.

2.4 Being informed about typical emotional, bodily and behavioural reactions to trauma and knowing your personal stress reactions

"Trauma" means wound. Like any purely physical wound, trauma can take its toll on the "bodymind". It can create emotional wounds that are painful and can take some time to heal. Recovery then requires patience to feel, to express your reactions and to relate with others who can support you and receive your support. With the support of family and friends, most people recover without further problems in a short period of time.

In fact, most experience temporary disruptions following a highly disruptive event and many do not undergo significantly long term wounding, and return to normal functioning fairly quickly.

That being said, whenever we feel that our lives are threatened, our inborn survival instincts automatically kick in. Our body and mind gear up and take over to fight the danger or to flee from it. Here is a list of typical reactions triggered whenever we go into fight or flight response mode:

• a. Reactions in your body: Initially you may have:
  
  
  • rapid heartbeat and breathing;
  • sweating and cold, clammy hands;
  • upset stomach and diarrhea;
  • dry mouth, stomach in a knot, uncontrollable shaking; and
  • muscle tension and aches and an inability to relax.
    
    
• b. Reactions in your thinking process:
  
  
  • Confusion, disorganization, inability to concentrate;
  • Denial, disbelief, sense of unreality, dissociation;
  • Heightened awareness of certain details;
  • Illusion that we are at the center of events; and
  • Dazed, bewildered.

Days or weeks after the event, you may find it hard to stop thinking about the event, find it hard to remember day to day things, and feel disorganized at work and at home. You may have recurrent flashback of event and find that you have great difficulty making decisions.

• c. Reactions in how you feel:
  
  
  • fear, anxiety, shock;
  • powerlessness, helplessness;
  • horror, terror, anger;
  • numbness;
  • sense of loss; and
  • sense of frailty and vulnerability, sense of abandonment.

Days or weeks after the event, you may fear that a similar event may reoccur. If there have been deaths or injuries you may feel guilt for being alive, anger at the senselessness and injustice of the event as well as sadness for the losses and anxiety about the future. You may feel unable to laugh or feel pleasure or feel constantly worried, nervous or upset. You may feel hopeless about the future and detached and unconcerned about others.

• d. Reactions in your behavior: Initially you may:
  
  
  • attempts to confirm danger, seek cover or attempt to escape;
  • look for someone who will help/advise;
  • protect/rescue family and/or co-workers; and
  • freeze, faint, cry, scream, or do the same thing over and over again.

• After awhile you may:
  
  
  • isolate yourself from family and friends;
  • fail to engage in exercise, healthy diet, safe sex and regular health care; and
  • depend on tobacco, alcohol or food to cope.

For more information on how to deal with your stress contact your Employee Assistance Program (EAP).

2.5 Practicing healthy living and good self-care before tragedy strikes

There are a number of potentially prolonged situations where government employees may be working in a capacity of response to a crisis. As part of their work federal employees may need to provide a wide range of community services. In those cases, having a self-care plan for high intensity work will be particularly important.

A lifestyle that sustains and supports emotional and physical health requires you to be aware of key ingredients that help to maintain and refuel your energy. Develop a self-care plan tailored to your unique needs, identify ways to improve and maintain your energy level and your ability to cope and name the main resources that you will need in order to take care of yourself during times of disaster or threatening events. Important elements to include in your preparation are:

1. Maintaining Lifestyle Routines
   
   Daily routine tasks and habits are often performed without much thought. These routines are important contributions to sustain emotional and physical well being. Assess whether you need to reprioritize your daily activities and maintain whatever healthy routines are possible during times you are involved in a high intensity work period or excessive stress and trauma.
   
   
2. Maintaining Physical Fitness and Planning For Fun
   
   Physical fitness and times for fun are renewing to our bodies and our minds. Think of the physical activities that you currently engage in as part of your self-care routine and assess whether you need to do more of these. If you are not a regular exerciser, think of some ideas about how to increase your physical activity on a daily basis (i.e., walking to and from work, to the bus or subway station). For more information, see  Canada's Physical Activity Guide.
   
   
3. Maintaining Healthy Diet/Nutrition
   
   Healthy fuel is required when our bodies and minds are performing beyond our usual expectations. Times of heightened stress are when we are most vulnerable to neglect healthy foods and routines as well as succumb to junk food. We are also at risk for over-using our favorite stimulants/relaxants during high stressful periods.
   
   Eat healthy, balanced meals during times of excessive stress. Eating small to moderate size meals along with frequent snacking is known to help the body's processing of food and provides for brief breaks from your work. Remember to keep yourself well hydrated by drinking plenty of water and fruit juices. For more information visit Canada's Food Guide.
   
   
4. Maintaining Effective Work Habits
   
   Some work habits and routines are more effective during a sustained period of high intensity work. For example, alternate high intensity tasks with low intensity tasks; analyze the task and break it down into manageable parts; when you cannot see a solution, take a break or debrief with a colleague or manager.
   
   Realize that there are only so many hours in a day, and there is only so much that you can realistically do in that time. Be mindful of what you can realistically accomplish within a given time and how overextension can deplete your energy, focus and productivity.

2.6 Having Emergency Response Plans

1. Family/Significant Others Care Plan (Family Emergency Response Plan):
   Develop an Emergency Response Plan so that if something were to happen while you were at work, your loved ones would know how to protect themselves. Having a family emergency response plan will lessen your worries about their well being. Include family planning for disasters requiring evacuation such as natural disasters, terrorism, bioterrorism or pandemic threats. Involve the entire family in the plan. Also identify the key family responsibilities that are normally expected of you and plan for alternative arrangements. (i.e. optional care providers). Here are essential elements to include:
   
   
   • Health: Have extra supply of medical and health supplies. Discuss plans for medical needs before a disaster with adult children away from home and elderly family members. Be prepared for special circumstances of quarantine or caring for influenza infected persons at home;
   • A ready-to-go kit: extra water, bottled beverages, favorite nonperishable and energy foods, flashlights and batteries, first-aid kit, radio, medications, evacuation destination with alternate route, maps, contact numbers; and
   • Knowing where your family is or how to locate them is critical for reducing anxiety.
     
     
2. Work Emergency Response Plan:
   A well thought out emergency response plan will help you and your co-workers to respond quickly and effectively. Find out if your unit has an emergency plan. If there is an Emergency Response Plan under your responsibility remain as informed as possible of potentiel risks and their implications on your safety. If not, speak with your manager about the importance of having one. Your manager may want to refer to Preparing for and Responding to Workplace Trauma: A Manager's Handbook (and Preparing for and Responding to Workplace Trauma: A Manager's eGuide for suggestions. You will also find a  " Workplace Safety Toolkit" that may be helpful to you.