P. PTSD - Post Traumatic Stress Disorder.

This post is for the letter P in my series on workplace bullying for the 2011 A-Z Blogging Challenge. This is a repost of the original.

PTSD (Post Traumatic Stress Disorder) can be described as:

an invisible injury occurring as a result of major traumatic experiences, including violence, harassment, assault, rape, accident, fire, explosion, disaster, or witnessing such events.
(from bullyonline) 

PTSD is a natural emotional reaction to a shocking and disturbing experience which has overwhelmed one's ability to cope. It causes significant impairment in social, occupational or other important areas of functioning.

There is growing awareness and acceptance that PTSD can also result from an accumulation of many small, individually non-life-threatening incidents such as being exposed to prolonged and relentlessly abusive bullying. To differentiate, the term "Complex PTSD" is generally used.

The feelings and emotions resulting from serial bullying which are similar to those of PTSD include:

• Avoid discussing or thinking about the events
• Avoid going places that remind the person of the trauma
• Chronic gloominess
• Concentration is shot, often confused
• Catatonic. Some people experience an inability to get out of bed (this is very different to laziness)
• Distress at being asked to recall the events or being around people discussing bullying
• Detached, as if watching others from behind a screen
• Exhaustion which is not relieved by sleep
• Flashbacks may be common, with frequent distressing recollections of the events
• Flight or fight response is on constant alert
• General disinterest in life
• Guilty for being weak
• Hyper-vigilant
• Irritable
• Loss of libido
• Nervy
• Pacing the house at all hours of the night
• Recurrent nightmares - adds to sleep deprivation 
• Snappy
• Startles easily and frequently
• Sleep is disrupted constantly, may have trouble falling asleep and staying asleep
• Unable to find meaning or fun in life
• Vomiting or nausea at mention or discussion of the event

East side Gallery. Berlin. 2009.

Here's some information about stress and Recovery from Bullying - learning new patterns of behaviour after having been bullied and Another Step in recovery from bullying, The Making of Happiness (more tips to assist recovery from bullying).

Here tomorrow: Q. Qualities we instill in our children (which make it easier for them to be bullied)

There are many outstanding resources on line. A couple I find useful are Bullying. No way! an Australian resource for teachers and students, and a UK site Bully On Line. 

Minding the Workplace by David Yamada is regularly updated with interesting and useful articles and research, and eBossWatch on facebook links to articles about workplace bullying from around the world.

This is in no way an exhaustive list, and each country will no doubt have equally good or more relevant websites. If you're being bullied please seek advice from a professional health care practitioner experienced in this area. 

Over at jumpingaground I'm spending the month Drabbling using alliteration, often with an environmental theme.

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A tiny amount of effort can make the world of difference.

Imagine for a moment that you're in a workplace, and there have been a few veiled comments that someone you know, but aren't particularly close to is being bullied. Let's for the moment call her Sheila, but it could as easily be Chip, Ahn, Stephan, Narasimha or Lee.

What's it to you? After all Sheila has friends, you've seen them going for a walk, chatting over lunch and you know they sometimes go out for a drink after work some Fridays.

But Sheila looks dreadful, she seems weighed down and no longer makes witty quips to her friends. The spring has gone from her step and you've heard she no longer goes out for lunchtime walks or to the Pub after work. She has become hesitant, nervous, wary and on edge, sometimes snapping for no apparent reason.

What comes as a surprise to many people is that whilst they know the target of a bully needs support it's rare for that person to be receiving the level of support they desperately need. I'm not referring to assistance from HR or legal options. I'm talking about the little everyday things that help make life bearable, so that the target doesn't feel so dreadfully, painfully alone.

Clearly, something is wrong with Sheila. Perhaps it's more than a temporarily grumpy boss, and she is being systematically hounded, harassed, mobbed or bullied.

But
a) you don't know what to do
b) you think someone else is helping/supporting - she's got lots of friends, right?
c) you think that what you have to offer is too minimal to make a difference

It's so easy to assume that someone else is helping. But there are all sorts of reasons this may not happen: One person may be struggling with their own issues and not notice, another may be concerned that if they're seen to support they will become the next target, and many others think "Surely her closer friends are helping. I'm not really that important to her." (More on this here)

Time and time again, I've had people say to me: "I felt so alone, it's like no-one noticed or cared."

My request to you is to show you care. Never assume the target has allies. The bully regularly has cronies, they can be powerful, nasty, vicious and unrelenting in their subtle and not so subtle undermining ways. The target rarely has the same level of support.

The simplest of things can make all the difference and let the target know they're not alone. In all sorts of unobtrusive ways you can show you care. A "thinking of you" text or email. A stick-it note with a smiley face or amateurish sketch of a bunch of flowers or clown. A kind word. An offer to have a coffee together. An email with a beautiful/inspiring/amusing photo attached. You don't really need to say much or commit to deep involvement. A variety of support is important, and your role may not need to be more than this.

Tactful support is mostly welcome; ask if you're unsure. Remember, you may be the only person to show you care. 

Here's a link to a post describing a situation I've witnessed far too many times - the tell tale signs of abuse and the debilitating suffering and legacy of unrelenting bullying.

Examples of artistic creativity might give the target hope
and remind them there is beauty in the world.

There's more information that could support the target here, here and here, and a book review on "Working with Mean Girls" by Meredith Fuller (which is equally relevant to men!)

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A path to Happiness - Meditation

At the recent Happiness and its Causes conference in Brisbane, the former scientist, now Buddhist monk, Matthieu Ricard (who is often described as the happiest man in the world), spoke about how the mind can be transformed from being agitated and anxious to a state of focused calmness, if we train it systematically. (Wiki bio here) Anxiety will be reduced, loving kindness and compassion will be increased and life is worth living because we find more meaning in it.

The unfocused, agitated mind can be trained in focused attention
We are unable to control the outer world, but we can train our mind by sitting quietly and focused, to decrease stress and improve our sense of well-being and fulfillment.

“It was only in 1998 that neuroscientists discovered that new neurons are continually being generated in the adult brain” the term that is being used is brain plasticity – great news for those of us who had believed that we were on a downhill trajectory after the age of about 25.

But it also means that just because you've been stressed, hypersensitive, or lived with ADD or ADHD all your life, it doesn't mean it has to stay that way for ever - you can start today to create positive change.

Using brain imaging and behavioural tests it’s possible to look at the inner workings of a meditator’s brain, using Western research techniques, to begin to understand the beneficial mental states achieved through meditation.

Photo of Matthieu Ricard by Waisman
Brain Imaging Lab,
University of Wisconsin - Borrowed from here

Put simply, it means that scientists can point to the parts in the brain to show that meditation works to create a happier person.

Happiness
Genuine happiness results from the deep fulfillment that arises from a healthy mind; it enables us to deal with whatever comes our way. We hear of people who appear to live in paradise, but are miserable - we know that what happens outside us doesn’t necessarily make us happy.  By adopting a few achievable techniques from the 'super meditators' like Matthieu Ricard, we learn to become less vulnerable to the vagaries of negative life events.

Highly regarded doctors, psychologists, scientists and others have been systematically gathering evidence for many years that practicing techniques such as Mindfulness Meditation, can have profound effects on our psychological health, general wellbeing and overall happiness.

Throughout the conference it was emphasized that successful meditation rests on discipline, not wishful thinking. But, most encouragingly, it is completely unnecessary to trade in your day job to become a Buddhist, or indeed any kind of monk. Just a few minutes of sustained voluntary attention each day as you pause from your regular chores is powerfully beneficial. That’s great news for those of us for whom meditation seems awkward and somewhat alien.

Interesting article about Matthieu Ricard and meditation here
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Reality TV meets the science of Positive Psychology

Making Australia Happy

Doctor Anthony Grant, one of the three presenters of the TV series, Making Australia Happy (2010) spoke at the recent Happiness and its Causes conference in Brisbane.

I wrote briefly about the series here (link). The excellent web site for the show is here (link)

The goal of the series was not to make the participants happy, but to introduce them to a number of interventions including Positive Psychology. It was hoped these would improve their levels of happiness over an eight week period. “The overarching aim of the series was to introduce positive psychology concepts to the general Australia public in order to encourage the use of scientifically validated approaches to the enhancement of wellbeing on an individual and community level.” says Dr Grant.

Participants were chosen so that the general public could identify with them; essentially they were 'the person next door'.

How happiness was measured
Dr Grant and his peers devised a happiness test, which incorporated a number of well-validated measures; this became known as the “Happy 100 Index”. (You can take the test here.) However, because the professionals wanted to go beyond a self-reported assessment, a range of physiological tests were also included, including blood pressure, stress, and sleep. Brain activity was measured before, during and after the programme.

The programme was holistic and acknowledged that diet and sleep can affect wellbeing significantly. As such, physical exercise levels, sleep patterns and diet were all examined. The participants were given feedback about the results, and sleep, exercise and dietary changes were encouraged as needed.

There was not a ‘one size fits all’ approach, but an acknowledgement that different interventions would suit different individuals.

The interventions included
     1. Eulogy. Write your own funeral speech including what you hope to be remembered for. It helps us focus on the goals and values that are most important to us.

     2. Random acts of Kindness or altruism. It’s known that doing something good for another has a positive effect on wellbeing. Participants were encouraged to engage in some form of meaningful activity for others.

     3. Mindfulness activities, exercises and training. Participants were introduced to ACT (Acceptance and Commitment Therapy) by Dr Russ Harris who also spoke at the conference. (More on this another time).

     4. Gratitude. Participants were encouraged to express appreciation and praise of others.

     5. Forgiveness. This tends to be the aspect many of us avoid addressing in our lives, and can be scary to confront. We harbour resentments, and these can be like a cancer of the soul.

     6. Reflection, review, renew. Participants were encouraged to pause and look at what was working or not.

The results
Dr Grant openly acknowledged that while he has expected some improvement in self-reported wellbeing, he had not expected the substantial improvements in the biological markers of well-being.

Participants with high blood pressure and cholesterol experienced a substantial drop in readings; levels of immunity increased as did measures of resilience.

Most interestingly, the brain scans showed less activity, participants were calmer, and as Dr Grant said in the presentation “a quiet brain is a happy brain”. A calm, happy brain is less agitated, with its owner more at ease with themselves and others.

The participants reported an increase in satisfaction with life, and this affect remained at the 6 month follow-up after filming was over. That's excellent news about things we can all adopt relatively easily.

There was no single overall most effective intervention, and although Positive Psychology sounds like it focuses only on pleasant emotions, participants were encouraged to embrace the full range of human experience – not to avoid or shy away from more challenging emotions such as sadness, grief or anger, but to build a full, rich and meaningful life accepting these emotions as part of that richness.

One of the beauties of the series that the viewer was able to relate to the participants, there was no embarrassment, cringe-worthy moments or feeling superior. I would describe it as supportive, and encouraging. These were real people trying to improve their lives. No winners, no losers, just people very much like you and me.

So if you’re feeling a bit down, a couple of things you can do RIGHT NOW (yes really) are check out your diet, turn off the electronic devices when you go to bed (all of them!) and right now, stand up, and do some gentle exercise.

If you're interested, you can do many of the exercises presented in the programme using the materials on the web site.  Here it is again!

I'm going to head off now and do 2 sets of step-ups before I begin getting dinner then I'll complete the Happiness questionairre. I wonder if I'll be game to share my score?

*If you're think you could be depressed please seek professional support - if you don't know where to start, try Beyond Blue (here), Lifeline (here) or your local GP (General Medical Practitioner).
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Breathe with awareness

I've been dipping into "The Happiness Trap" by Dr Russ Harris, and I'd like to share a couple of paragraphs about the importance of breathing. It sounds odd doesn't it; but as I said the other day, breathing with awareness can assist beneficially in all sorts of difficult situations.

Russ is talking about a client whose husband and child died in a car crash and how waves of sadness wash over her which trigger a strong desire to drink heavily. She eventually finds that remembering to take even one deep breath can make a difference. "It gave her a few precious seconds to realise what was happening. Then she could make a conscious choice as to whether or not she would act on that urge."

Sometimes she still chose to drink heavily, but over time, she found that by remembering to be aware of her breathing, she was able to make more decisions to drink less (which she knew wasn't helping her recover). Eventually the desire had less control over her, and she felt more in control of her life. She was still extremely sad, but not overwhelmed and out of control with heavy drinking.

Further on he talks about what to do when you're in a crisis.

"No matter how bad the situation you're in, no matter how much pain you may be suffering, start by taking a few deep breaths. If you're breathing, you know you're alive. And as long as you're alive, there's hope. Taking a few breaths in the midst of a crisis gives you valuable time to get present, to notice what's happening and how you're responding and to think about what effective action you can take. Sometimes there is no immediate action to take. In this case, being present and accepting what you are feeling is the most effective action."

I suspect that many people who are suffering from PTSD can relate to the situation above. I really like the last two sentences; "Sometimes there is no immediate action to take. In this case, being present and accepting what you are feeling is the most effective action." It sounds simple, but it may not be easy.

Tidal River. Wilsons Promontory. Victoria.

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Another step. Recovering from bullying.

Last month I looked different aspects of bullying; I’ve now moved on to looking at the recovery process. If you’ve been the target of serial bullying, you’ll understand the challenges involved in coming to terms with what’s happened and learning to live and breathe freely again.

Not long ago someone said to me, that even after having been out of the bullying environment for over a year, it seems almost impossible not to get caught up in thoughts like “If only…” “What if…” “Why didn’t I…” “How did it come to this?” “What did I do wrong?” and other similar comments, even though it is clearly evident they’re serving no useful purpose at all.

What seems to regularly happen, is that after becoming aware of this destructive rehashing, the target begins berating themselves with negative comments along the lines of “You’re useless, you know this isn’t helping”, “Why are you being so mean to yourself, why don’t you go for a walk…it’s because you’re not only useless, but lazy” on and on. As I said the other day, it’s a real double whammy.

This person’s mind is so used to following the well-worn unhappy paths, that it takes committed and conscious discipline not to fall into this self destructive habit. You're learning to nip it in the bud as soon as you become aware of it happening.

The path to the familiar story of the past can be easy to take. It’s a well worn track, and while you’re busy doing something mundane, you suddenly become aware that the old hurts and painful episodes are playing out again, and again, and again.

Sometimes I think of it like a virulent ‘earworm’. You know, one of those ghastly songs that as soon as you hear the title or melody, you can’t escape it, and it plays for days and days ‘till you all but scream “Get out of my head and leave me in peace.”

But much worse.

Is it helping?

If yes, read no further!

If not, are you able to pause for a moment as soon as you become aware of what’s happening?

A bit like we talked about the other day. Just pause. That’s all for the moment.

The next bit seems to be tricky. It’s just letting all the crap and hurt just be there without putting a value judgement on it, without the shoulds and oughts kicking in automatically. Can you make space for it, give the prickliness of it a little room?

The idea is to begin breaking the old familiar habit and take one tiny step in the long process of choosing and consolidating a new habit. I don’t pretend it’s easy. In a sense it’s a bit like forging a new track through uncharted territory where there appears to be impenetrable jungle full of all sorts of tricky obstacles. Our brains seem to skitter towards the familiar path, even if it’s hurtful.

What’s happening is that when you’re fighting the painful, intrusive thoughts constantly, and pushing them away fearfully, (because they hurt so much) the pathway to them seems to get stronger.

This old path is clear and direct. It’s so well worn from the countless times it’s been travelled that the sides are up high, way over your head and it’s difficult to see over them to what is around outside. To choose to deviate involves conscious effort, slipping and sliding, clutching at the steep sides, scrabbling up and over, but then and only then is it possible to see that being on this track was preventing you from seeing other options.

And so, one step.

Just one.

When the painful thoughts intrude; pause; breathe deeply, three times if possible, stretch tall.

That’s it.

I wonder how many times each day you can do this. 5, 10, 50 or more? Does it help?

There's a bit more on the recovery process here.

Recovery from bullying - learning new patterns

If you’re on the healing journey after surviving serial bullying one thing you can be sure of, the road could well be rocky.

You’re possibly feeling vulnerable and nervous about rejoining the workforce. You may be thinking, “If it’s happened before, it can happen again”, you may be annoyed with yourself for being "weak" in not standing up to the bully (there's some information on how we can bully ourselves here), and feel fearful. For some there will have been the workplace bullying AND self bullying – as if one alone wasn’t enough, you’re contending with a double whammy.

Basically you’re a nice person who got stung badly. You’ll remain a nice person but ideally learn a few skills to help prevent it happening again. Your character will remain attractive to the bullies in the world, simply because you have qualities they fear/envy/or whatever their motivation is. (Information about what bullies look for in Why me?)

What I'm offering here is not a one size fits all suggestion, but one tool to add to your toolkit that might be useful in some instances.

One of the things that many people have said to me is that they have an automatic "Yes" that kicks in when they’re being asked to do something at work.

From childhood we’ve been taught to be accommodating, helpful, to defer to those in authority, to be kind and help people out when they ask. We have NOT been taught to be alert for bullying behaviour or even to know what it is.

If you’re unsure what bullying behaviour is, have a look at The Angst and Anguish of workplace bullying (A in the A-Z Challenge) or How to Recognize Bullying Behaviour at Work (B in the A-Z Challenge) It’s good to read widely and be aware of what constitutes bullying.

The following is adapted from a post I wrote back in November last year.

Many of us regularly find ourselves getting overloaded at work and may have fallen into the habit of agreeing to all and sundry requests, even if they go against our better instincts for self-preservation. Sometimes however, the power imbalance between us and the boss is such that we feel pressured into agreeing - it's a subtle kind of bullying, and can have some negative long term ramifications if not nipped in the bud.

One client found herself habitually saying 'yes' to any request her boss put to her, even if it meant missing both morning tea and lunch breaks, and working unpaid overtime and consistent 'graveyard' shifts. Her health was clearly suffering and she was burnt out and miserable by the time she came to me. It had got to the stage where her boss had come to rely on her compliance and the situation needed a gentle shakeup.

Firstly, stop and think.

That's all.

It sounds very simple, but many people find this first step overwhelming. Remember you may have been trained from childhood to be a “nice”, helpful person.  Learning a new pattern of behaviour goes against the grain, and that may bring a sense of discomfort.

Many of us like to feel needed, and being asked to do things can also make us feel important (and there's nothing at all wrong with that - in moderation). In addition, some of us have grown up in cultures that encourage us to put our own needs down, possibly to keep the peace in our family, for religious reasons, and sometimes because one gender is seen to be more powerful (and deserving) than the other.

Some people describe a sinking feeling in the stomach when they pause to assess the situation, and believe they’ll be fired on the spot. It’s ok – pausing may be new and unfamiliar, it gets easier with practice! So, don't be hard on yourself if it's tough to pause before agreeing.

Secondly, ask a few questions. Is it urgent that you drop everything to, for instance, see this client immediately? Will the world fall apart if you use your lunch break to eat and digest your sandwich in peace? Does the patient need urgent assistance that only you can provide causing you to lose your 15 minute afternoon break? Who else is on the scene who could assist?

If you're being asked to take on an additional project unexpectedly it may be appropriate to say "Can I get back to you about that tomorrow morning?" It's a question that comes out as a statement - you may need to rehearse this one.

But please remember, this isn't a 'one size fits all' suggestion, and your response needs to be suitable, thoughtful and respectful, taking into account your personal situation.

Some bosses have developed the knack of catastrophising even the slightest mishap into a drama of world proportions. I worked with a manager like this some years ago, and the department was in a constant state of nervous anticipation waiting for the next 'catastrophe' to fall. It was draining, and led to increased staff 'mental health day' breaks simply to counteract the emotional exhaustion of dealing with the unreasonable and unnecessary demand for immediate action. Need I say, we weren't dealing with life and death situations, but routine, predictable everyday events.

By asking a couple of questions, your boss will quickly see that the pattern is changing. In the best scenarios, this leads to an increased level of professionalism and mutual respect. Interestingly, my clients who've begun using this technique state that their view of themselves begins to change from being a bit of a pushover to more confident and assured. Workplaces haven't fallen into anarchy, and in fact, the workplace culture has often improved.

Thirdly, if the request is reasonable, of course you'll agree graciously. You may choose to drop what you're doing and fulfil the request. In the process however, you'll have regained a sense of control, and a pattern that may have outlived its usefulness will begin to crumble.

If possible, find a trusted person to practice this with. There are times when rehearsing in your head is fine, this isn’t one of them. You need to hear your own voice and find the right words. To begin with, it's awkward and unfamiliar, and hearing yourself saying these new things can be quite unsettling.

There's more on recovering from bullying here.
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The Making of Happiness

In my last post, I mentioned a television series called Making Australia Happy, and promised that I’d introduce you to the ideas behind the show. This link leads to the web site attached to the show, as well as to a self assessment Happiness Test. You'll also find suggested guidelines for worksheets, links to the episodes, and the research behind the show.  If you're think you could be depressed please seek professional support - if you don't know where to start, try Beyond Blue (link), Lifeline (link) or your local GP (General Medical Practitioner).

Whilst I found the format of the show a bit gimmicky in that it mirrored the games show format of ‘The Biggest Loser’ etc. I stuck with it because of the calibre of the presenters and quality research behind the programme. Normally I’d turn this kind of show off because I’d be very critical of, and skeptical about the validity of the content.

Eight people were selected from a miserable inner city suburb near Sydney. The promotional blurb states “Hoping to find greater fulfillment and meaning in their lives, they’ve signed up to an eight-week happiness program ... they discover that the road to happiness is tough, but that the rewards can be immense…”

They found that happiness changed their biology and the functioning of their brains in a very positive way.

Three professionals from different walks of life explained how their particular intervention would work and how it interlinked with the other two. It is known that each alone is beneficial, but the idea was to encourage each volunteer to adopt all three because of the positive gains when they’re used in combination.

Three strategies 

1. Mindfulness was introduced by Dr Russ Harris. When I realized he was one of the presenters I was confident the show would be reputable. Russ trained me in the Mindfulness technique called ACT (Acceptance Commitment Therapy). I found him to be honest, trustworthy and he acts with integrity. I figured that if he was on board, the quality of the other techniques presented would be equally as good.

Dr Russ Harris taught the eight volunteers some simple, evidence-based techniques for cultivating mindfulness. These were taken from a model called ACT which teaches mindfulness skills through quick, simple exercises rather than the more traditional method of meditation.

The promotional material goes on to say that Mindfulness means paying attention with openness, curiosity and flexibility. The technique (along with other meditation techniques) is gaining the attention of leading medical researchers, psychologists and neuroscientists who are studying the long term benefits for stressed people.

2.  Positive Psychology focuses on the value of positive emotions, character traits and environments.  The ideas behind Positive Psychology were pioneered by Dr Martin Seligman, and are based on a model of wellness and positive human functioning. A lot of research has been done which supports the benefits of this model. Dr Tony Grant introduces this section.

3. Physical health. A huge amount of research has also been done into the importance of improved physical health to support happiness. A physiotherapist, Anna-Louise Bouvier worked with the participants to look after their bodies, sleep patterns, diet and exercise. As the blurb says “in order to get the most out of their mental training, it was vital for the volunteers to be in good physical shape".

Check out the links, take the test if you want, and have a look at the show if you have time. There's a huge amount of good information and things to do.

Next I'll have a look at other strategies to support those recovering from bullying. I'll revisit ACT and mindfulness later on.
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