Psychological Support during SBTF Crisis Mapping Deployments

[This is a guest blog post by Maggie Jarmolowski, our dedicated SBTF Counselor]

“The most beautiful people we have known are those who have known defeat, known suffering, known struggle, known loss, and have found their way out of the depths. These persons have an appreciation, sensitivity, and an understanding of life that fills them with compassion, gentleness, and a deep loving concern. Beautiful people do not just happen.”

— Elisabeth Kübler-Ross

Hello! My name is Maggie Jarmolowski and Iʼm excited and honored to be part of this outstanding & important network of volunteers. As a therapist who specializes in working with people who have been affected by violence, the compelling and important nature of crisis mapping first became clear to me in the aftermath of the earthquake in Haiti when I was involved both as a volunteer mapper and mental health consultant on the Ushahidi-Haiti Crisis Mapping project. Not only did crisis mapping provide near real-time data that located trapped and wounded people and linked those with vital medical supplies and rations to those without, but it also provided hope…hope in that the survivors were being heard, that they had a voice, that they were not lost. Haiti provided a potential for the future of humanitarian response and the purpose of the SBTF is to help fulfill that potential.

Despite this amazing work, which yields both concrete and intangible benefits, crisis mapping volunteers can a times also “witness” trauma. In many cultures, it is commonly accepted that those who experience man-made or natural disasters will experience psychological affects. I could talk about the why: related mirror neurons and and the resonances of our nervous system (in fact, I would be glad to at another time); but the simple fact is that being affected by our own or otherʼs suffering lies at the core of what it is to be human, why we want to help, the reason why when we witness something in another it resonates deeply with us.

To be sure, most helpers emphasize the positive effects of their work—increased empathy, gratitude, compassion and a sense of purpose, being able to effect change and the experience of an increase sense of control. Helpers and witnesses often experience many of the same symptoms as those who have experienced a traumatic event themselves. This is frequently seen in the humanitarian community where those returning from the field experience intrusive memories, nightmares, increased substance use/dependance, memory and concentration impairments, feeling numb and disconnected, depressed and difficulties in key relationships. These and other symptoms are often referred to as vicarious traumatization and can be thought of as a common reaction to witnessing and engaging with other peopleʼs suffering and need.

However, this asks the question, what about the volunteer crisis mapper who is perhaps thousands of miles away, not directly witnessing the suffering or destruction of survivors or helpers on the ground? What are the effects? As you might imagine, there are many protective factors that volunteers experience because they may usually manage to keep some of their daily routine, social supports and are not themselves subject to worries of safety or resource deprivation in the field. However, because of these elements, many volunteers are unaware of their unique vulnerabilities and need for self-care during and after times of service.

Firstly, one of the main strengths of crisis mapping means that volunteers are often forced to take in the violence or suffering of an even at multiple levels. While helpers on the ground are affected because of their close and intimate contact with survivors. In order to do their job well, mappers may switch back and forth, looking at an event from a micro to a macro level and back. They are concerned about the message they just received from a family trapped on a single street and go back to the map or list that gives the full view scope of the crisis. This demonstrates the strength of the process for an active agent for aid and change, but can psychologically be overwhelming. Every dot caries with it a message, a plea, a face.

Secondly, crisis mapping volunteers do not have access to some of the psychological protective factors of those on the ground. As stated before, it is a given that many people do this work because they care, they want to help, they are effected by others. They know that human connection is essential to healing. Helpers in the field both see first hand the horrors AND the beauty—the success when someone is found or healed, the dancing in the makeshift churches days after a disaster, the singing of the women gathered to share tell their stories of survivors of sexual violence. They experience first hand the effects of their labor and how it helps (and to be sure, more acutely how they are unable to help). They are able to, witness those directly affected by the crisis as people in need but who maintain their dignity and fullness. It helps both helpers and survivors to put traumas in a context of the larger story of a human life. “This thing happened to me, I survived it, but it isn’t all of me.” It is tremendously healing and hopeful to bear witness to this. It is both true that there are stories of hope shared in the crisis mapping  community community and many aid workers in the field are not able to have a personal relationship with each survivor they encounter. However, the knowledge of the vastness of suffering stripped from the protective relational context presents a unique experience for volunteers to digest.

For volunteers, identifying how you are being affected by your work as a crisis mapper and taking care of yourself is important to your long term longevity with this important work. It is responsible and healthy to observe if and how you have changed during and after a crisis and to make things like engaging your social support and maintaining most of your normal routine a priority.

Below you will find a list of common reactions to experiencing and “witnessing” trauma. You may identify with some or many of the items. It is also important to remember that being affected by witnessing and helping with a traumatic event is NOT pathological and cause for immediate worry or alarm. It is important to know that what you are experiencing is normative, that you aren’t the only one and that taking care of yourself and perhaps seeking support would be a good next step.

With this in mind, Patrick Meier of the SBTF Core Team has asked me to assist volunteers in answering questions about how they are being emotionally (and/or physically and spiritually) effected by their work in crisis mapping and provide short term support via Skype. Many worry that this would be “entering therapy”. It is not. It is just an opportunity to check in with someone who understands the work and its psychological affects. My aim would be to lend support, help problem solve and build on volunteerʼs own resiliency.

A bit about me. Im a Licensed Independent Clinical Social Worker living and working in Cambridge, Massachusetts. I am an alumna of Georgetown University with a BSLA in French, German and Government and the University of Michigan where I earned my MSW in Interpersonal Practice with Adults. I completed 3 years of post-graduate training at the Victims of Violence Program under Judith Herman, MD in association with Harvard Medical School. I currently divide my time between my private practice, the Victims of Violence Program, The Suffolk County House of Corrections and teaching at Lesley University. I have also spent time working in Haiti.

I’m eager to get to know some of you through this process. Please feel free to contact me with questions or to set up a time to meet over Skype at and here is my profile on the SBTF Ning platform. In the meantime, thank you very much for all your efforts with the SBTF, you are truly an inspiring network of volunteers and I am honored to join you in our quest to make the world a better place.

Feel feel to peruse the resources below (which have also been uploaded to the dedicated SBTF Ning platform).

Resources:

Common Reactions to Trauma

Changes in emotions, mood and behaviors are considered natural and inevitable reactions being affected by a traumatic event.

Each person may have one or more of these reactions (please note people may experience other reactions that are not listed below as well):

Cognitive

Memory loss
Difficulty making decisions
Difficulty concentrating
Confusion
Losing track of time
Flashbacks
Intrusive memories
Replaying the trauma
Suicidal thoughts
Trouble focusing on previously enjoyed activities Difficulty dealing with “normal life”
Preoccupation with work or thoughts related to the crisis

Psychological

Feeling helpless/powerless Grief
Fear of safety Numbness/shock
Increased sense of vulnerability Nightmares

Overwhelming feelings Anger/rage
sadness
Increased anxiety/nervousness

Difficulty feeling joy and happiness
Self-blame
Depressed mood
Decreased frustration tolerance
Diminished sense of purpose
Catastrophising- assuming the worst-case scenario

Physical

Fatigue
Difficulty falling or staying asleep
Change in eating or appetite
Nausea, diarrhea, stomach pains
Sweating, rapid heartbeat, chest-pains
Being easily startled
Neck/back pain
Headaches
Vulnerability to illness, worsening of chronic medical problems

Behavioral

Angry outbursts
Avoiding contact with reminders of trauma
Tearfulness
Failure to engage in exercise, diet, safe sex, regular health care Excess smoking, alcohol drugs, food
Increased risk-taking
Problems managing the boundaries between yourself and others

Relational

Withdrawing from or clinging to others
Alienation from friends and family
False or distorted view of others
Breakdown in trust
Changes in sexual activity
Doubts about relationships
Feeling of being misunderstood by friends and family
Alternating between demanding, distant or unconcerned with others Irritability
Increased fighting
Ending relationships
Blaming others

Spiritual

Increased questioning of faith Withdrawal from religious practice Increased doubt
Loss of faith or sense of meaning
Despair
Change in world view
Loss of sense of safety in the world

Positive

Increased sense of:

gratitude
compassion
empathy
concerned for others connection
purpose
change in world view

Coping with Common Reactions

Different strategies work for different people. In the aftermath of violence and trauma, it is important to establish a self-care routine, even if it is temporary or it differs from your usual one.

Diet: Eat regularly and healthily as much as possible. People are drawn to sugar and caffeine in a crisis but these substances can increase stress levels, so it is important that they are limited. Sometimes people under extreme stress use more alcohol than usual. Alcohol and other drugs may postpone feelings or reactions but, in the long run, they actually make them worse. Use common sense about what you put into your body at this particularly stressful time.

Rest and Relaxation: It is important to maintain a regular schedule that let you get enough sleep and includes relaxing, stress-reducing activities. If you know any formal relaxation techniques, such as meditation or deep breathing exercises, use them. Otherwise, use whatever strategies usually help you relax; listen to music, read, or play with pets or children. Maintain some activities that you usually enjoy- playing sports, journaling, engaging creatively. Escape (with a book, time off a movie), play

Physical Activity: Exercise is one of the best ways of reducing stress. Although it may be difficult to find the time, try to work it into your day. If you usually exercise, try working it back to your schedule.

Social Contacts: Keep in contact with family, friends. Alone-time is necessary and healthy but maintain connections as much as possible. It is common to feel (and it may be true) that they simply wonʼt understand, and it can be tempting not to reach out to them. Lack of good social support puts helpers at increased risk for vicarious trauma.

Support Systems: Talk about your reactions to the trauma or working with traumatized populations. It is important that you chose people who listen to how you feel. Supportive listeners may be friends, family, clergy, teachers or self-help groups. They may also be professional counselors. If you have a spiritual practice, engaging in prayer or religious services can be connecting and healing.

Minimize: junk food, alcohol, drugs, caffeine, exposure to traumatic media (news, violent movies).

Sources: National Center for Posttraumatic Stress Disorder, Victims of Violence Pamphlet: Common Reactions to Trauma

Helpful websites:

  • The Headington Institute: psychological and spiritual support for humanitarian relief and development workers. Vicarious Traumatization Training Module, 
  • National Center for PTSD, 
  • Reentry Trauma: The Shock of Returning Home By Gwen Vogel, PsyD, Justin Stiebel, JD, MA, and Rachele Vogel, MA

 

 

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2 Comments

  1. Posted January 23 at 7:10 pm | Permalink

    Thanks so much for posting this Maggie. It was the Haiti EQ that moved me into motion in the crisis mapping field, working 24/7 for weeks on end to do whatever I could to help. At the time, many of us wondered if the crazy emotions we were experiencing were signs of some form of PTSD, but the concept of digital volunteers was so new, that there really hadn’t been any thought given to it. It seemed almost unbelievable that we could be experiencing trauma this way, and many of us even felt guilty for having these emotions, given what the Haitians and the responders on the ground were going through. So we just pushed it all aside and kept on working. Now, 2 years later, we know better. We know that people can get overwhelmed by what they are experiencing, and having someone to turn to to offer support is HUGE. Thank you so much for joining the team. We’re honoured to have you on board.

    Best,
    Melissa

  2. Posted January 24 at 6:00 pm | Permalink

    I really like your writing style, great info, regards for posting . “God save me from my friends. I can protect myself from my enemies.” by Claude Louis Hector de Villars.

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