Trauma-Informed Leadership for Helping Professionals: How to Sustain the Heroes Among Us

For all doctors, nurses, health, mental health, police, fire, paramedics, emergency management and emergency operations centres, education, child and family services workers, government leaders, and all support staff in these systems and others.

Note: This is the second of a SERIES of NACTATR™ Communications that will be released as circumstance warrants. As indicated in the work of VTRA™, “The better the data, the better the assessment and the better the assessment, the better the intervention.” As professionals from multiple disciplines across the continent are sharing their expertise and new experiences, we are also learning that the current pandemic has generated unique dynamics that need to be addressed. Most modern traumatic circumstances throughout North America were single incident tragedies. Tragedies, that while painful in the aftermath, were able to be contained because there was no ongoing threat (e.g. the aftermath of a shooting where within hours the gunman is in custody and there is no further threat, etc.) However, the pandemic before us is currently an ongoing threat which means we are delivering crisis response services while we are still under attack. Many are being required to do some regular tasks differently; not according to established protocol or tasks completely new to them. This generates additional anxiety and the higher the anxiety, the greater the symptom development. Hyperarousal and hypervigilance are common trauma symptoms even among the helpers and so is anxiety, fear and flight. Therefore, we need to help the helper while continuing to lead across the nation.

Purpose of this E-Alert
There are human systems dynamics (organizational) that will play a part in determining if our staff flee from the weight of the workplace or stay the course during this current crisis. Most of these dynamics are more about feeling supported and understood by leadership than about a desire not to work or even about a paralyzing fear of contracting the virus. We are seeing already that “Naturally Open” leaders are endearing their staff to them for the collective societal cause while “Naturally Closed” leaders are draining the energy from their already tired teams. “Trauma-Informed Leadership” will stay the course and still the waters in the workplaces and professions that we clearly need in order to move forward.

Context
We are seeing in our communications with government, emergency response and other organizational leaders that some helping professionals, essential to our support and recovery, are starting to waver and some have already distanced from the workplace not because of social distancing but because of a lack of emotional safety and understanding within their professional organizations. As well, support staff who have been in the background in the past, are now on the frontlines of emergency services without the benefit of our years of practical experience.

Although this is not at a critical point, some regions, departments, programs and services are seeing staff go on leave, refuse to work or simply bow under the pressure. This Alert is not speaking to a single incident as no two cases are the same; it is speaking generically to dynamics that we have the power to influence! Some leaders have already stated they could “predict” who was not going to “stay the course” at work yet the same leaders fail to see the connection when they admit as a supervisor they had never had a meaningful conversation with that staff member for at least the past five years. In another case a leader may have worked compassionately to support a staff member but because of their personal health, family circumstance, etc. they also knew that staff member would likely not be able to remain in their role during this pandemic. Both of these examples can be addressed for the good (See “Open Leadership: How it Looks”).

For example, some of what we are hearing is: “It’s not my job!” “This is above my pay grade!” “I didn’t sign up for this!” “Why should I put myself at risk!” are frequently thought or uttered by professionals and support staff who do not feel emotionally safe, valued, cared for or understood by leadership. In the midst of this crisis is the wrong time for a leader to be saying: “Just do your job!” “Well that’s what we pay you for!” “If you don’t like it leave!"

As noted in our first E-Alert, we teach in the Traumatic Events Systems (TES™) Model of Crisis and Trauma Response that, “High-Profile trauma does not necessarily generate new symptoms in human systems but instead intensifies already existing symptoms”. That means that leaders and organizations that were healthy and functional prior to this pandemic will be able to bear more anxiety than emotionally closed systems. In truly open systems, team members stay the course knowing how important they are to the workplace and how important the workplace is to them. Most of us in the helping professions feel privileged to serve others and understand the importance of our roles. But in closed systems, the team members wonder “why should I go the extra mile and sacrifice more for an organization that does not care about or value me.”

An Aside: Read “Trauma in Human Systems: A Brief Introduction”
In 2001 Dr. Marleen Wong requested I write and present an academic paper for Los Angeles Unified School District and partners on my pioneering work on the impact of trauma on human systems. I did so and a month following the 9/11 terrorist attacks the article was released. Although the paper is school-focused, all the types of human systems and related dynamics are generalizable to all worksites.

Trauma in Human Systems: A Brief Introduction

Assessment of Current Dynamics
A dominant emotion experienced by many people, even if only sporadically, is fear. Fear of having loved ones or ourselves contract the virus; fear of job loss; fear of the uncertainty the future brings, etc. Yet in the professional workplace, and under the current circumstance, we are seeing fear of being inadequate and not up to the challenge; fear of breaking down under the pressure and fear of not being supported by leaders if momentary human weakness is exhibited. But we are also seeing closed system dynamics where staff have not felt supported in the past and their lack of healthy connection to the workplace has made it easier to walk away from responsibilities. In these cases, their organizational fears may be warranted. Yet the same professional currently in a closed system would not walk away under open leadership, therefore open leadership is the key.

Open Leadership: How it Looks
a) First principle of crisis response: model calmness. Open leaders can do this in a genuine way. They can also be strategically truthful, when necessary, and admit that they are worried too but know “we can make it through this because you are the most compassionate and skilled team I have ever had the privilege to stand beside!” Pretending you are not impacted at all sets a bar too high for most to reach. “Being human but hopeful is power in leadership!”

b) Understand the circularity between micro and macro dynamics. Micro dynamics refer to individual functioning, family functioning and often workplace dynamics that are interacting all the time (whether you knew it or not.) Macro dynamics are the broader community, region, country and now world that we live in. During times of high-profile crisis staff should avoid saturating themselves in the macro-system and strategically maintain their focus on the micro-system. For example, some health care professionals are being crushed under the weight of the media stories from Italy and other acutely hit regions. Then their own hospital setting becomes traumatic stimuli for what feels like inevitable loss rather than a setting to bring comfort and recovery. High level leaders trained in VTRA and the TES Models need to be aware of the macro-system and its implication for those on the ground, but those on the ground need to make their world small and controllable. Watching video clips and media interviews with grieving families and hearing the detailed stories of their losses drains even the best of us of our emotional energy. It is a standard that the more a person can “identify with the story” that they are watching Online or in the news, the more it will increase their own symptom development. “Denial gets a bad wrap sometimes.” We can “consciously” place ourselves in a state of denial by, for a time, staying in our lane locally and let the rest of the world do the same. *Personal Note: In all my years of leading in the aftermath of high-profile crises, I have never looked at media coverage, searched videos on my iPhone or Googled what people were saying about what we are doing on the ground because I didn’t care! I never allowed my energies to be drained by the macro-system so that I could be completely present for the people I was there to serve.

c) Our bodies have become weaponized. Although mostly in a subconscious way, most people (young and old) can feel that their bodies are or could be weaponized! That has elevated the anxiety dramatically as loved ones both fear being infected by those they care about and also fear being the cause of someone else’s illness. It is also being intentionally used by high risk for violence and emotionally acting out individuals where they have been spitting on others or touching people telling them they have the virus and “Now you do too!” As noted earlier, “many are being required to do some regular tasks differently; not according to established protocol or tasks completely new to them.” (E.g. Because our bodies have become weaponized, a pandemic places health officials, fire and paramedics at the forefront where in the past police would normally secure a scene before fire and paramedics proceed but now there are circumstances where they need to secure a scene before police can proceed.) This is where pre-trauma functioning is so important because if the relationship between Police, Fire, and Paramedics is open, respectful and collaborative they will adjust to this temporary procedural change with relative ease. Communities that have advanced their VTRA protocol are able to easily transition and transfer their relationships in traumatic events like a pandemic. If the pre-trauma functioning was closed or impaired then leaders will need to step up, acknowledge we should not have let our relationship deteriorate to this point and then commit to work together now and repair later any unresolved historical issues that led to the divide in the first place. We can all walk up to this task.

d) Treat the big things big and the little things little. This is big! Open leaders do not depersonalize their staff around them but instead see their teams as real people, where life is happening to everyone. This means that a more open leader who realizes they have avoided a necessary but courageous conversation with a staff member may decide, when the timing is right, to sit down with that person, acknowledge the conversation should have occurred sooner and then use the opportunity to clear the air. Get personal and say I know you are a “single parent,” “your parent just passed away,” etc. and the weight that must be on you and then let them know how important to the team they are and how important to you they are. Open leaders also understand that how they treat one staff member is seen by other staff: it is a culture of caring and respect that draws the best out of people. For instance, the staff member who has a child with a disability or a family member in critical care because of an unrelated illness may simply not be able to work. In that circumstance, open leaders work to appease the guilt of a team member feeling like they are abandoning their team. Wisdom dictates that an open leader finds the positive including, “it is a blessing in disguise that you are not going to be here because as the team gets tired we will need you to help carry the load a bit for us when you return."

e) Make good use of unused human resources. There are some staff who have knowledge and skills that transcends the current job they are doing. Closed leaders tend to be so rigid they fail to take advantage of the willingness of staff to take on a task they are uniquely skilled for if it is outside their typical job description. Be creative and allow staff to be creative under the current circumstance. Closed leaders worry that “if I allow this now, it will set a precedent for the future.” Truly open leaders are not so absorbed with power and control that they are worried about three months from now. Open leaders seek creativity and ways to grow the skill of their team, not supress it at a time when we need to think and breathe freely the most. Quite simply, sometimes we need to just get out of the way and let our teams thrive.

f) Over-functioners/Under-functioners and Natural leaders. Every organization has staff who are “rule-governed” (e.g. the staff member who is a stereotypical first-born child from their own family of origin.) They understand leadership and as such stay in their lane unless asked by those above them to do so: they respect the hierarchy. For that particular staff member, it is not resistance, it is reticence in someone waiting to be asked to lead. We need to rely on natural leaders who are currently under-functioning and free them to lead by example, mentorship, or emotional support for younger or less experienced staff. There are also over-functioners who because of circumstance from their own past experiences or just due to their personality traits and characteristics are more emotionally in tune than others. For the leader who struggles with the emotional part of human functioning, these types of staff can provide an intellectually open leader with amazing insights. They are providing emotional support to some staff anyways: better if it is support with a leaders’ blessing than support required because of the lack compassion and understanding of a leader.

g) Apologize. The body knows if we work in an open or a closed system. It can be understood with one simple jingle: “the more closed a human system is, the more emotional energy it takes for us to function within it.” When unresolved conflicts between leaders and staff occur, it can contaminate all or part of the system (the same applies to unresolved conflicts between staff as well.) Many work places simply form alliances to accommodate the unspoken issues, but with the heightened anxiety of a pandemic those issues will be exacerbated whether we are speaking openly about them or not. Open leaders share leadership, including their humanity. If a leader knows there are important matters unresolved then they can apologize for not addressing them earlier. If they know they may have hurt someone’s feelings they can use this Alert as the springboard to say: I received this communication regarding trauma-informed leadership and I realize (explain). We have learned that a genuine apology, even in the workplace, can repair a damaged team and infuse it with the energy to move forward. We should not need to rely on our families to support us to get through the day at work. Instead, our workplace should be so supportive that when we go home we have the energy we need to care for them!

h) See Self-Care Strategies in Appendix 1

To All the Frontline Staff: The Heroes Among Us
Everything contained in this document is about every professional (frontline, support staff, others) and is applicable to staff to staff dynamics as well. There are multiple levels to organizational structure and natural informal leadership roles that form because of seniority and personality. As such, there are untold opportunities for all to make a concerted difference in the performance of our new task to circumvent the greater effects of this pandemic. Therefore, open professionals will be aware of:

a) First principle of crisis response: model calmness.
b) Understand the circularity between micro and macro dynamics.
c) Our bodies have become weaponized.
d) Treat the big things big and the little things little.
e) Make good use of unused human resources.
f) Over-functioners/Under-functioners and Natural leaders.
g) Apologize.
h) Self-Care Strategies in Appendix 1

Most have worked in a setting where a leader was struggling. Sometimes because of personal issues the leader may have been emotionally unavailable and other times they lack the skill or experience to do the job they were hired to do. Sometimes a staff member may realize they are simply more mature than their supervisor. In this situation, the frontline staff needs to over function and support the overall system in spite of the leadership deficit. We can address those other issues when the dust settles.

We have become global citizens bound together in a common experience that transcends culture and geopolitical boundaries but our work is here at home! To a certain degree, this crisis will define us as to who we are as individuals and as a people. Those who lead with purpose, even within the walls of their own homes, will fair far better, when we move beyond this moment in time. But those who did little when they were capable of doing more will feel the weight of that choice as the rising generation asks, “where were you when COVID-19 made the world stand still?”

Special Note to my Colleagues Across North America
As you become aware of trends and insights you feel we at NACTATR™ can support through these E-Alerts, videos and upcoming Podcasts please let us know. The work of VTRA™ and TES™ has grown because of our collective learning and ongoing collaboration.

APPENDIX 1
Self-Care Strategies

ONLINE RESOURCES

http://www.socialworkcommunity.com/2017/07/21-free-self-care-activities/
https://positivepsychology.com/positive-psychology-exercises/
https://www.socialwork.career/2013/05/how-to-practice-self-care.html
https://jamiehartsfield.com/2018/07/14/self-care-menu/
LEADERSHIP TIPS:

1. Set up a CULTURE OF SELF CARE BY ROLE MODELLING.
In times of crisis, natural open leaders understand deeply that not everyone will respond to a crisis in the same way. Open leaders quickly establish a safe and non-judgmental narrative that is not only stated but observed - “be kind to yourself and each day take some time to integrate wellness.”

2. Set some time aside to do “check-ins” with your staff.
Experienced professionals are conditioned to taking care of themselves during the day to day stresses of their work. We are reminded however of the uniqueness of this pandemic and that the boundaries and actions are continuously fluid leaving those who are serving with a sense of loss of control. Open leaders, establish formal and informal processes for staff to check in. For example, morning meetings can be started with “emotional check-ins’” with a quick, “On a scale of 1-10 on how are you feeling?”

3. Establish a buddy system on your team.
As a leader you may be called to numerous meetings to navigate through the crisis. Establish buddy systems on your team so that the team is checking in with each other. It’s a great way to establish a culture of self-care within the team.

4. Have the CONVERSATION if you need to.

You all know that there are times when our staff are running on little to no energy. You may have one staff member who is a natural leader, but so tired, they are now unintentionally draining energy from the team. It’s simple, pull that staff member aside privately, tell them they are a hero to the team and then tell them, “your done for the night.” Maybe even send them home early. Put a boundary on that time away from work and remind them how valuable they will be when they come back rested.

Bless your hearts!
J. Kevin Cameron, M.Sc., R.S.W., B.C.E.T.S., B.C.S.C.R.
Board Certified Expert in Traumatic Stress
Diplomate, American Academy of Experts in Traumatic Stress
Executive Director, North American Center for Threat Assessment and Trauma Response

Special Thanks to Pat Rivard and the rest of NACTATR Team for your help in the development of this and our forthcoming Alerts.