For mediators and ombuds working in traumatized communities, it is critical to have an approach that is trauma sensitive and trauma informed. Trauma is extremely complex and multi-layered. For our purposes we will address only a few essential aspects. These include:
- Basic understanding of the nature and effects of trauma
- Basic understanding of vicarious or secondary trauma
- Basic practices for self care
Trauma can be understood as the injury resulting from an experience that overwhelms one’s ability to protect oneself and stay safe. The injury can be physical, developmental, emotional, relational and/or spiritual. Sometimes people heal from the injury and recover healthy functioning. Sometimes functioning is altered in a manner that persists. Whether and how recovery of healthy functioning occurs depends on many factors including severity of the experience, age, innate characteristics, support within the environment, previous traumatic experience etc.
For our purposes, the persisting consequences of severe traumatization, beyond the physical injuries, can best be understood as alterations in the stress response systems which allow us to keep ourselves safe. These changes take place across all domains including in perception, processing, reactivity, cognition and self regulation. Traumatized individuals may literally perceive threat where no threat is intended from cues which are absolutely neutral to others. Threat, actual or perceived, alters how we process auditory and visual clues.
When faced with danger our systems prepare for “fight, flight or freeze”. In fight or flight we undergo all the physiologic changes that prepare us to protect ourselves or escape – increased heart rate, respiration, etc. When we can neither defend ourselves nor escape, we freeze – our body prepares for injury. These two paths are described as hyperarousal and dissociation:
- Hyperarousal is pretty easy to recognize – it shows up as agitation, difficulty with focus, concentration and memory, high reactivity, anger and aggression.
- Dissociation may be harder to recognize in that it is inherently a form of withdrawal in which we are physically present but mentally disengaged. It is successful to the degree that one doesn’t draw attention to oneself. Individuals who defend themselves by dissociating don’t confront or antagonize and may be very passive and compliant but they are also not truly present.
When discussing developmental trauma it is said that “States become traits”. In childhood, the brain is organizing in response to experience and adapting for the world in which it finds itself. Persistent high levels of threat and activation of “fight, flight or freeze” will result in a brain which organizes for that environment. The hyper vigilance and/or dissociation will become persistent traits rather than transient states.
Our goal is to “First, do no harm”. Then, of course, we want to work in ways which are actually effective and useful. This means deliberately establishing and maintaining an environment of essential safety. Some key elements;
- Because we experience the novel and unfamiliar as potentially threatening systematically incorporating the “safe and familiar” from the very beginning can be very helpful. How to go about this in Rwanda can be determined collaboratively with our partners.
- The physical environment matters. For traumatized individuals an unobstructed path to the door is necessary. Enough room so that one’s personal space is intact – our partners can guide us in terms of what this means in the countries and communities where we work.
- Shared agreements regarding how to deal with getting triggered – again, developed in collaboration with our partners.
- As a general principle, avoidance of retraumatization means awareness of and respect for personal boundaries. Any disclosure of personal information takes place at the discretion of the individual. Being pressured to tell the story of your trauma is not the same as being able to “tell your story” in your own way, at your own time.
- When working with others we have an ethical responsibility to be aware of what we, as individuals with our own personal histories may be bringing into the relationships. Our own trauma, unrecognized and unmanaged, can easily be activated and alter the dynamic in very significant ways.
Secondary or Vicarious Trauma
Those who bear witness to the suffering of others and are empathically engaged with victims of trauma may become traumatized themselves. Common signs that one is experiencing secondary trauma include changes in sleep and appetite, intrusive or repetitive disturbing thoughts and images, increased difficulty managing emotional states, emotional numbing, difficulty maintaining healthy boundaries, confusion, cynicism and feelings of hopelessness and loss of meaning.
The critical elements in managing vicarious trauma are awareness, balance and connection. Knowing the risks and recognizing the signs allow us to anticipate and cope with secondary trauma. Self care involves balancing the work with adequate rest, play, escape, exercise and proper nutrition. Caring for one another within the conflict management team is supported by developing practices that systematically sustain focus and awareness and attunement. These include regular check-ins , doing “body scans”, breathing and other somatic practices which help with managing stress, scheduled debriefing and “decompression” times. It can be helpful to ritualize these activities so that they precede as well as follow interaction with traumatized individuals and groups.
We need to remember that while we do know, in a general sense, about the history and current conflict and trauma environments of the countries and communities where we are working, we do not know much at all about the individuals with whom we interact. It is crucial that we do not make assumptions, that we hold “Beginners Mind” as we engage with individuals and groups. The most important component of Beginners Mind is as it relates to ourselves. Self awareness is the necessary first step as we seek to “”do no harm”.