What causes stress in aid and development work? And what can be done about it? Thrive’s LOTTIE SHIPP has been digging deep into our data to look for trends among the people we support. Our Psychosocial Director GRAHAM FAWCETT has been quizzing her on what she’s discovered.
Graham: Tell us about your research, Lottie.
Lottie: Well we know that working in aid and development often means working in physically and psychologically challenging conditions. People can face direct and indirect stressors on a daily basis. For some, this takes a toll on their mental health, and they seek counselling with Thrive. After a counselling session, our psychologists write up their clinical notes. These notes are anonymous. They simply summarise what occurred in the session, and highlight next steps. I’ve been looking at some of the main themes that occur in these notes.
Graham: And what did you find out?
Lottie: I found three main stressors faced by aid workers. The first are traumatic stressors: first-hand or indirect experience of life-threatening situations such as physical or sexual assault, bombings, death caused by malnutrition. The second are chronic stressors, which are ongoing challenges like a lack of privacy, movement, or medical care. And thirdly, organisational stressors: issues with management or team members, such as overwhelming workload or under-resourcing. Many also reported worrying about their personal safety, as they were located in volatile places. This leads to hypervigilance and anxiety.
Graham: Yes, this concern about personal safety is common. It shows the reality of working in such places, but it also tells us something important about the support that these people feel they should receive. This is not necessarily support in the form of counselling or therapy, but more a desire for their managers to understand what they’re going through, and to express solidarity with them in a thoughtful way. It also shows the necessity for camaraderie in a team, and to find mutual support in that way. What else did you find out?
Lottie: I noticed a recurrent theme of issues during one’s own childhood – like trauma, neglect, or feeling they had to ‘grow up too fast’ and take on too much responsibility at a young age. It seemed as though the nature of the work can cause previous traumas like this to come to the surface. I also noticed a pressure to be perfect, which is often accompanied by self-criticism and rumination.
Graham: This perfectionism is a growing phenomenon over the last 10 to 15 years. It seems to be because more people are applying for each job, and so the standards become higher. The result tends to be that more people with perfectionist tendencies are doing aid work. And people like this find it challenging to manage the inevitable failures and compromises involved in frontline humanitarian work. Recent work by Gemma Houldey talks about this.
Lottie: I also noticed that often people feel like they have to carry the weight of the world – they put the needs of others in front of their own. Linked to this is a feeling of being let down by organisations, which manifests itself as frustration with the aid sector as a whole, and difficulties communicating needs to their managers. Issues with current relationships were common too, often taking the burden of the problems of other family members’ problems or recent bereavements that were difficult to process.
Graham: Yes, relationship issues are strikingly common for aid workers, both with the pressures of problematic colleagues or leaders, but also problematic family or friendships. Why do you think this research is important, Lottie?
Lottie: I think that to be able to support someone, you need to understand where they are coming from, the problems they face, and their experiences of the world. To get a rounded picture, it can be helpful to look at the experiences of a group of people, and identify the themes and individualities within their stories. This is particularly important for psychologists and counsellors, who need a deep understanding of the people that they serve in order to best meet their needs.
Graham: Yes, and it reminds me of how Psychology professionals involved in this area often debate how to get the right balance between serving the individual client or patient and keeping everything confidential, alongside the need to give feedback to the organisation or industry as a whole if there is a problematic dynamic, individual or circumstance, which is giving rise to distress in the first place.
Lottie: Yes and this research aims to help contribute to that conversation. We want to better understand the groups of people who have counselling with Thrive. In particular, we want to know whether their struggles generally fit into the same few boxes, or if they seek counselling for more diverse reasons.
Graham: What surprised you about what you found out?
Lottie: I thought it was going to be difficult to identify common themes, given that we work with a diverse group of people from all walks of life. And so I was surprised to find similar threads running through patient notes. I was also surprised that most people place the needs of others before their own, forgetting that they could only take care of those around them if they took care of themselves first.
Graham: It’s great that you’ve done this research, Lottie. These results are important to help us orient existing therapies, and to think about potential new ones. It’s also useful in feeding back to the wider industry about potential solutions around the management of mental health and wellbeing in a team or organisation as a whole, not just of the individual level.
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