Addressing Triggers in a Trauma Informed Workplace

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We're going to explore creating an environment of safety for employees as well as clients and by identifying and addressing physical, affective, cognitive, environmental, and relationship or interpersonal triggers and threats. Did you realize that more than 20% of the population has experienced sexual abuse? 1% has experienced significant physical abuse. 26% have experienced, either directly or indirectly, domestic violence. 2.6% of adults have been in foster care. 4.5% of adults have experienced stalking. Approximately 40% of children have experienced a sense of abandonment and have developed insecure attachment as a result. Now the other two, having an adult abandon an adult, there are no. There is no data on that. But it can be very traumatic. If you are in a marriage, for example, or a relationship, and all of a sudden one day your significant other just up and disappears. And we know that therapist abandonment or a therapist suddenly refusing to see a client can also be traumatic for people because when therapists develop relationships with people with clients, it is one that's built on trust. And when that therapist abandons the client, a lot of times it's a replay of prior relationships and it further traumatizes the client. Layoffs are another example of trauma. You know that when we think about work trauma, when an organization just abandons its staff and says, you know what, you got to go. And there isn't a lot of data on this because it depends on the profession. It also depends on what else is going on in the world. We know during the pandemic, a lot more people were experiencing layoffs than pre pandemic. Identity theft can be traumatic for people. If they get a call and all of a sudden they realize that, you know, all of their credit cards have been usurped by somebody else, and their reputation and their Credit score is crap. It can be threatening, it can be traumatic and involuntary commitment. And this is one of those things that unfortunately we don't have data on, and we really need data on it. But this is when people are committed to the hospital against their will because they are a threat to themselves or other people or because they. In some, in some states, people can be committed to a detox facility because they are endangering themselves because of their substance use. But we don't know the percentage on involuntary commitment. But think about how traumatic it would be if you went in somewhere to get help and they didn't let you go home. It's important to remember that behavior is communication. That's kind of why I have it in all caps here. I'm screaming as much as I can. Behavior is communication. When people act a certain way, they're either saying, I feel safe, I trust you, I feel empowered, or they're saying, I feel threatened. Trauma reactions in staff and clients have a whole range Health issues, including sleep problems, pain, general health. You know, they get sick easier, or they develop addictions. We can see these. When trauma is not addressed or when trauma is triggered within the organization, we may see an increase in these symptoms and in the staff person or the client, verbal or physical aggression or withdrawal. Again, if the person doesn't feel safe, this may be their response to that situation. Even if the current situation is not objectively unsafe, if it reminds them of a prior trauma, then they may feel unsafe affectively. When people feel unsafe and disempowered when their trauma is triggered, they may experience depression, anxiety, anger, blaming. They may be fearful of making or admitting to mistakes because they're afraid they're going to get punished or be abandoned or rejected. Mood disorders can be triggered cognitively. When people are in a state of fight or flee, they are more prone to notice the threats in the environment, which promotes an attitude of negativity and pessimism. They have difficulty with problem solving because those stress chemicals, those fight or flight chemicals, are not designed to allow people to think clearly. They're designed to encourage them to act and react. They may have reduced productivity and or quality of work. And this is obviously more particularly with staff. But when people are feeling stressed, when they're feeling threatened, it's hard for them to make decisions and it's hard for them to do what they usually can do as efficiently or effectively. And there may be frantic efforts to avoid abandonment. They may try to do whatever they need to do to get in the graces of their boss or good in the good graces of the organization, which may include undermining other staff members in order to try to keep keep their job. In terms of clients, they may do whatever they can in order to force the organization to keep them, even if they have been acting in a way that is contrary to, to what is needed in the organization, for example, using substances while in substance abuse treatment. They may engage in frantic efforts to prevent rejection. Relationally, there may be reduced commitment to the process, to whatever you're doing at that particular business or to the organization, and a sense of, or a fear of abandonment. So it can trigger other abandonment experiences. You can start seeing competition and alliances among staff because they're frantically trying to get power to avoid abandonment. They may compete against each other to try to prove that, you know, we're the department that deserves to stay, or they may bond together and try to rebel against senior management. You know, there are a lot of different ways that this can happen, but when we start seeing a lack of harmony and a lack of unified work towards the organizational vision, we need to explore why that is. There also can be suspicion, being suspicious of other people's motives, being suspicious, suspicious of, you know, what clients are saying to other staff members. Being suspicious of the organization itself, whether they are, you know, planning to have layoffs. A lot of times there starts to be rampant gossip and speculation if there's the threat of potential layoffs. And splitting is kind of like the alliances. It's bringing people over to your side to try to convince, to try to feel more empowered. Think about ways you see these behaviors in staff and clients in your organization. Is it due to your organization triggering their prior trauma reactions? Is it due to outside triggers? They're already under stress and they're bringing that sense of unsafeness with them when, when they come to your organization. Why is it your job to address issues caused outside of your organization? And you know, I read an article this morning about how a lot of people are having a lot of difficulty making very simple decisions right now because we have been in threat mode for so long. And that's true. So if somebody comes into your organization and they're already feeling stressed out or they're in threat mode, then it can be difficult for them to make decisions about buying a car or starting treatment or what they're going to do with their money, if you're a financial investor or whatever. So it is important to recognize that people are going to be much more motivated to action in a way that's mutually beneficial if they are feeling safe and Empowered. Even if outside those doors it's chaotic. How can you help them feel safe and empowered within your walls? Organizations also have trauma reactions. They may have reduced productivity and revenue. As you know, patronage starts to go down, or if there is budget cuts, then they may start seeing staff feeling hopeless and helpless, so they reduce their productivity. They're just like, screw it, you know. There may be increased workloads among staff as some people have to be laid off because the organization can't afford to keep them on, so workloads are doubled. There's often rapidly changing policies as the organization frantically tries to adapt to the current threats. Affectively, there may be frantic or resigned energy among staff. And a lot of times when you walk into an organization that is in crisis, you can feel it, it's palpable. Staff tend to be more irritable or more disengaged. Things that are happening tend to feel more pressured. You just, you get a sense that there's some urgency there cognitively in the organization. Top down management becomes more inflexible and authoritative. Executives will start making armchair quarterback decisions and, and enforcing them down the line because they are frantically trying to protect the organization and they assume that they know what's best. Environmentally, there can be reorganizations. People may get transferred to different departments in order to try to help the organization survive. Relationally, there may be layoffs or terminations, which contributes to grief and trauma. Among the people that don't get laid off. There's often a lack of responsiveness and possibly support from the organization. A lot of times the message comes down, well, you should be grateful that you've still got a job. You know, don't spend time grieving over the fact that your office mate was laid off. And there's often splitting between the C suite executives, your CEOs, etc. And the line staff because there are different perceptions of what the needs are and what needs to be done to rectify the situation. Think about what types of things have traumatized your organization? Your staff, your reputation, or just the organization's solvency, Its ability to stay open. In the past three years, how did your organization respond to how might the organization's response have traumatized staff and clients? Now, this is not an inclusive list of trauma triggers, but I wanted to give you sort of an idea about how these different things that are often characterized as adverse childhood experiences are common traumas to not only clients, but also staff in the organization. Abandonment clients can have prior abandonment issues triggered by sights, smells, sounds in the organization or even because your organization Represents being part of the system. For example, staff turnover, retirement, quitting, death. That can also trigger abandonment issues for clients and client turnover. Other clients, especially if you're doing group therapy, intensive outpatient, you know, something where clients get to know one another. If one of them suddenly disappears, you know, retirement homes, etc. That is very traumatic to the surviving clients in terms of staff. They can experience abandonment issues or have abandonment issues triggered in the same way as clients through sights, sounds, smells that remind them of prior abandonment experiences. They can also be traumatized through staff turnover, death, or retirement through client turnover or death. And that's important to remember that. I remember when I was working in probation and parole, There was. I was gone for a week for some reason. I think I was on my honeymoon. I can't remember. But I came back and one of my clients had suddenly died. And it felt like I had been absolutely kicked in the gut because, you know, there was no closure. There was no warning. There was no nothing. And it was very traumatic for me in the moment to find this out by just having a note, a letter on my desk. Then I needed to close his chart because he was dead. You know, that. That was big to me. Layoffs of other staff members can trigger abandonment fears. Abandonment because that person is gone, but also abandonment because the organization staff may perceive that the organization didn't fight hard enough to try to keep people on payroll. And poor supervision and mentoring can also lead to feelings of abandonment. When one organization I worked for. Well, actually, I think every organization I've worked for has had very, very poor onboarding. And so, you know, you go through the normal human resources stuff that's boilerplate, but when you get to your job. I have yet to walk into a job where there's actually been a job description. And this is how you do your job or any sort of mentoring in the first two or three weeks. Every single job I've had has been what we refer to in the south as baptism by fire. You walk into it, and you learn what you're supposed to do by making mistakes and getting in trouble. And that doesn't feel real comfortable for a lot of people. An organization can experience abandonment again through sensory experiences. When they see things or hear things that make them think that they may be getting ready to lose status, lose reputation, lose funding, staff turnover, and client turnover. The organization can feel abandoned. You know, a lot of times when I was a supervisor and people would leave, you know, oftentimes it would be, you know, great for them, and I was happy for them. But from my standpoint, there was a gaping hole in my staff now and there was a wound, so to speak, that needed to be healed and filled. Neglect or abuse can be experienced by clients when staff fail to do their jobs, or when they don't listen to clients needs and concerns, or heaven forbid, when they take advantage of clients. And I don't mean just, you know, hurting them physically, I mean manipulating them, upselling them to something that they don't need when you know good and well they can't afford it, or convincing them to do something that you know they'll probably later regret. So taking advantage of clients, disempowering organizational policies. For example, you may want to talk to your attorney, but you're never able to actually talk to that person. At best, you get to talk to their paralegal. And that can feel disempowering if you're paying an attorney to try to keep you out of jail or whatever. Transference again. And if somebody has a history of abuse or neglect, sights, sounds, smells, even people in the environment may remind them of that situation. And just plain unsafe environments. If you walk into an environment and some of the lights are out, or it truly feels unsafe in the present moment, you know that can remind you of other times you've been in environments that were unsafe. For example, walking through a dark parking garage at 11 o' clock at night, you know that's typically objectively an unsafe environment. So if people have to do that, then when they leave your building, it may trigger a sense of unsafeness. Clients or supervisors staff experience neglect or abuse by clients or supervisors being belligerent or manipulative, remembering that those behaviors are often from a place of threat or fear, and it can be responded to in a way that helps the other person feel safer. But in the moment when it's happening, it can make staff remember. It can trigger memories of when they've been in similar situations and have experienced abuse or neglect. Disempowering or unclear organizational policies, a culture of isolation or distrust, a lack of work, life balance, and again, objectively unsafe environments. All of these can trigger a sense of neglect or abuse, either because of what's happening right now, or reminds them of something that happened in the past. Among staff, when staff feel or have neglect or abuse traumas triggered, it's going to affect how they interact with clients, with each other, and for the organization. In terms of the organization, examples of neglect or abuse can be being canceled media or social media reviews, which often feel like somebody screaming at them. Staff not doing their job you know, so staff is neglecting the organization by coming to work and drawing a paycheck, but surfing on Facebook all day long. Frivolous lawsuits, you know, that can be. Feel very attacking and abusive and again, sensory stuff that reminds them of prior times when they have experienced being canceled or staff not doing their jobs or when they've been sued. Other loss among clients may represent something that reminds them of a loss of freedoms like involuntary commitment or being arrested or their rights or their children or their money as a result of staff actions. So if a staff involuntarily commits them, has them arrested, violates their probation, doesn't do what they need to do to keep the person out of jail, whatever the case may be, then that can be. That can be traumatic. And when they interact with that organization or that staff member again, then it may trigger those feelings of when the staff member or the organization has hurt them or let them down before. In terms of staff, they can experience other losses by a loss of their job, their license or money, you know, income as a result of client or organizational actions. And the organization can experience other losses like a loss of funding, that can be traumatic for the organization. If the budgets, you know, the state budgets suddenly get slashed, they may lose revenue or their license as a result of staff or client actions. So that can be really traumatic. There was one organization I worked for that we went through an audit and it turns out that one department had been fraudulently billing and that was found out. And we very nearly lost a contract that represented more than 50% of our organizational income, which would have essentially closed the organization. So that was very traumatic. And the organization felt very betrayed because they had no idea this was going on. Staff was doing it on their own. So there was a lot of conflict there which resulted in a lot of frantic changes. Natural disasters can also be very traumatic for organizations if the building floods or a tornado comes through and knocks the building down. You can't operate a lot of businesses if the business isn't there. Now there are some that can be done virtually, but there are a lot of businesses that can't be. So that can be very traumatic. Basic interventions physically and environmentally, they kind of go together, making people feel physically safe in their environment. Ensure a physically safe. Make sure the lights are on, that there are no. You keep the allergens down in this day and age that there's plenty of space so people can socially distance and a welcoming environment that reflects the culture and uniqueness of the staff, the clients and the organization. What sights, smells, sounds, spaces and ergonomic things do you need to address? If people that you work with, you know, if the clients that come to your organization tend to be of the age where they've got children, then it's often welcoming to have an area where children can safely play and you're not having to worry about them getting into things that, that can really reduce the caregiver's stress. Making sure that there are chairs that are comfortable for children so children can feel safe. If you've got people who are older and have difficulty with balance, making sure that there are chairs and environments that are easy to get up and down in and out of and, and that things aren't crammed in so close that they risk falling over the coffee table when they try to get out of the chair. The best way to find out what makes a physically safe and welcoming environment for people is to ask, interview, assess, question, whatever word you want to use. The staff and the clients in the organization, what would help you feel more relaxed and at ease in this environment? You don't have to stay safe and welcoming, or you can, whatever. You have people with sensory gating issues, and I mentioned that in prior videos, who can be extremely bothered by the humming of a ballast that's getting ready to go out, or really bright lights, or, heaven forbid, flickering lights. People with seizure disorders can have their seizures triggered by a flickering fluorescent light. It's important to be aware of these things. Smells that are too strong can be overpowering and overwhelming for people with sensory gating issues. And this is not just people who have autism spectrum issues. This is people with adhd, people with schizophrenia, and, you know, even some people with autoimmune issues. It's just important to recognize that what is pleasant to you may be overwhelming to them. So ask, go seek moderation or minimalist. In some cases, you have people who are clients as well as staff members who have an abuse and loss history. It's important to try to create an environment that is going to help them feel safe and not trigger. You know, after I had my hysterectomy, I had to go into the doctor's office for a checkup. And I was sitting in this obgyn, OBGYN office surrounded by all of these women who were like, you know, eight months pregnant or had infants in their arms. And I had to sit there for 45 minutes looking at this, knowing I would never have another child. And, you know, that was pretty tough. And, you know, it was what it was, but would it have reduced my stress and made me feel More comfortable to have a different waiting room or been called back faster even if I had to wait in a, an exam room for longer. Yeah, most certainly it would have affectively. Oh, and different skill sets. My son in law recently started working at Best Buy and it's important to remember that not all of us grew up with a tablet in our hands. So some people, and you know, I'm in that group, the little plugs that go in here is an A, C, B usb. I don't know, I just need something that plugs it in and charges it up. Not all of us know what we need to know when we go into places. So when someone like me or an older person comes into Best Buy and is looking for a charger, you know, it makes the person feel safe and welcomed if they are not chastised or ridiculed by the person. My son in law actually was working with this couple who needed a charger and they didn't have it at Best Buy and instead of saying, well just go online and you can look it up, he pulled it up online for them, he found the link and he gave them the link so they wouldn't have to try to figure out what they needed when they got home. Recognize that people that are in your business may have different skill sets. If they're going in looking for a car, they may not know lickety split about cars or they may know more than you do. So it's important to ask and inquire about, you know, what do they need, how much hand holding, how much information do they need versus you know, how independent are they? And they've already got their mind made up, how much do they need explained versus what do they want you to just do stuff for them. So it's important to ask those different things affectively and cognitively. Promote emotional intelligence awareness, which is the awareness and management of feelings, including distress tolerance and fact based reasoning. As I mentioned in the last video, many businesses are not medical or behavioral health so or even educational. So it may not be an appropriate place to try to teach these skills to clients. But as an organization and as staff within an organization, we can learn these skills like distress tolerance and fact based reasoning and we can model them. When clients observe those behaviors, they will likely take some of it home. You know, we learn through observation and we want to ensure policies and procedures promote empowerment and choice. Providing for example in health and behavioral health settings a thorough informed consent of the treatment as well as treatment options and going over it with them, making sure that they feel safe and they're aware of their options. How do you know what makes a safe and welcoming environment for your staff, for your clients, for yourself? Review your environment, your policies and procedures for elements that may make people feel unsafe or take away their personal power. Going to the, to the doctor for a general physical, for example, I hate it because a lot of times you walk in there and they don't tell you what they're going to do, what you're in for, what you're going to be charged extra for. They just start doing stuff and you're sitting there going, is this going to be an extra? What's going on here? Is my insurance going to pay for it? And that causes a great sense of stress among people that are there. And it also keeps a lot of people from even going to the doctor because they're like, it ain't worth the stress. Relationally, basic interventions inspire caring and commitment among staff, clients, and the organization. If you are as an organization, remember anniversaries. Treat your staff like they are part of a family, not just a number. Treat your clients like they are part of a family, not just a number. Encourage dialogue between the staff, the clients, and the organization. Always have ability for clients and staff to provide input and to get responses. Responses are so important. Provide motivational enhancement and nonviolent communication and supervisory training to all staff, not just, you know, your clinical staff if you're a client, or your line staff if you're in sales or something, but everybody, supervisors all the way on down. Demonstrate respect by asking instead of assuming that you know what somebody wants or needs and recognizing people's unique strengths and weaknesses. When something does happen, whether it's good or bad, recognize your part and other factors. You know, create a culture of responsibility. Yes, this happened. Yes, this was my part in it. And these are other things that may have contributed. It could be policies and procedures. It could be a variety of things. But a good root cause analysis can help prevent future iterations of that same problem. When it's something good, also recognize your part and other factors. Give credit where credit is due. Be impeccable with your word, including punctuality, job descriptions, and service and product descriptions. Don't hire people for a job and then have the line at the bottom that says, and perform other duties as assigned. And. And then a month into the job, all they're doing is other duties as assigned, not what they actually signed up for. That is sort of a bait and switch, and that promotes a sense of disempowerment, lack of respect and unsafeness. Make sure your job descriptions are clear as well as your service and product descriptions. If you say you're going to provide something, then provide it. And always do your best, avoiding favoritism and distractions. If you say you're going to do something, do it for all clients, not just this one client that happens to be your favorite. Review your organization. Identify three ways you could or already do each of these things. Explore your own behavior as both a staff member and as a client at other organizations. So if you were going into a, you know, one of your competitors, you know, how would you feel as a client if you were walking into that organization? And how could you personally do each one of these things? You know, as an organization, how are you doing it? But also how can you personally inspire caring and commitment, encourage dialogue, etc. Organizations and staff can learn a lot about how to create safe and welcoming environments by seeking first to understand understand each other as well as the clients and maybe even the community in which they exist. When the staff, clients and organization feel unsafe or abandoned, they will react in ways to protect themselves, often resulting in behaviors that trigger a sense of disempowerment and unsafeness in the others and results in a widespread trauma response.