arrow pointing left

All Insights & Tools

Articles & Publications

Organizations Must Mitigate Occupational Trauma and Its Effects

Written By: Siddharth Ashvin Shah, MD, MPH

Trauma. We encounter it just about everywhere we look these days. We absorb it through news stories of victims and from witnesses of violent plots, shootings, and cruelty. We feel it through natural disasters, poverty, and homelessness. You don’t have to be someone’s mother to ache with empathy and compassion for those suffering from such horrific experiences.

For many, news stories trigger memories of their own direct traumas. Unfortunately, most people have experienced some form of trauma at some point in their lives. However, what we may overlook is that a vast number of people must withstand psychological trauma within their own jobs – especially those in “helper, protector and healer” occupations.

In a prior blog, we shared a simple definition: trauma is the negative effects on our emotions, psychology, or behavior due to an event or multiple experiences. It means that someone is suffering from at least a trace of stress to which the mind — for whatever reason — has not coped. Trauma burrows into people’s psyches. It’s distress that still aches.

Trauma has myriad causes and potentially long-term effects

It comes in many shapes, sizes, and forms – big traumas, little traumas, vicarious trauma, sub-threshold trauma, Adverse Childhood Events (ACEs). In addition to those very public and blatant causes mentioned above, private traumas are commonplace from emotional neglect, accidents, illnesses, addiction, medical procedures, hunger, homelessness. Another hidden source for trauma?  Bullying at work. Though it’s impossible to cover the full gamut, here’s a high-level list of occupational traumas:

  • Acutely disturbing work experiences without adequate interpersonal support
  • Chronic work stress overwhelming one’s adaptive capacity
  • Violent incidents
  • Bullying, abusive treatment, sexual misconduct
  • Excessive exposure to the trauma of others
  • Mismanaged breaches of psychological safety

More than ever, we understand what trauma does to the mind, body and, relationships. We can trace such changes to increased activity in the amygdala, volume decreases in the hippocampus and medial pre-frontal cortex, and a dysregulated release of cortisol.

How does this neuroscience-speak show up in real people’s lives? A person doesn’t need all the symptoms of PTSD – an actual disorder that results in broken lives – to qualify for true traumatic suffering. Just having a few of the following trauma symptoms from workplace trauma is enough to warrant steps for remediation:

  • Continual state of high alert
  • Difficulty sleeping
  • Negative view of self
  • Helplessness, guilt, and shame
  • Emotional detachment
  • Negative worldview
  • Relationship dysfunction

Many in high-risk occupations are missing the signs and impacts of trauma

Consider people in occupations that require exposure to others in traumatic situations or, in many cases, where workers are more likely to have traumatic experiences themselves. Physicians and nurses, humanitarian aid and international development teams, military personnel, employees at social services and other non-profits, journalists, and trauma counselors.

These occupations heroically operate under a tremendous amount of direct and vicarious trauma exposure as well as fear and anxiety about upcoming traumatic events – and their exposures are only getting worse as violence becomes more commonplace. Yet, few high-risk employer organizations are taking actions to help their people better prepare for, respond to, and heal from trauma. Remarkably, even just basic awareness of trauma as a given fact in the occupation varies greatly among high-risk sectors and organizations.

One of the reasons for overlooking trauma is that it is jarring to accept. Individuals frequently find themselves taking years to label their past experiences as traumas. And it is painful to take a close look at the significant suffering traceable to personal trauma. For organizations that are sustaining hit after stressful hit, it is all the harder to step back and take stock of all the traumas its people have sustained and worked through.

Lack of trauma awareness is causing even more problems for traumatized employees

Organizations in high-risk sectors cannot afford to ignore the costs of psychological trauma to their workforces, missions, and overall enterprises. Healthcare is a notable example. Hospitals do a great deal to protect their staffs from infectious hazards – today no one questions why we have protocols for gloves and masks. However, we overlook psychological hazards in the enterprise that naturally cause extreme stress – knowing that some will walk away traumatized from that extreme stress.

Of course, many in healthcare have an intense focus on burnout – a systems-based condition with distinct causes, no agreed-upon brain changes, and institutional solutions. Dealing with burnout is critical, but its remedies will not do much for occupational trauma. Of course, in many cases employees are suffering from both burnout and trauma.

Because awareness and acceptance of workplace trauma are so low, it’s easy for leaders and managers across high-risk sectors to be confused about persistent difficulties in their workplaces. In some cases, employees may seem to display incompetence or attitude problems when the behaviors are really manifestations of psychological trauma. Some desperate bosses write up employees, unknowingly giving them performance improvement directions that miss the target and won’t help resolve the issues at all.

To be clear, knowing the signs of how trauma manifests as performance issues does not mean that everything gets re-labeled as trauma. But it expands the aperture on different types of stress exposures and their impacts so that the right remedies are implemented.

Trauma-Informed Design is the path to improved wellbeing

How do organizations address the noxious plume of accumulated traumatic stress in a diverse group of otherwise ultra-capable, altruistic, technical experts?

Today, academics and service providers, including Greenleaf, have advanced “trauma-informed” principles for which organizations can learn competencies. Trauma-informed design can counteract unnecessary suffering, mitigate risk, and secure positive change. To start, an organizational assessment can reveal the trauma vulnerabilities that slowly sap resources, or in other cases lead to dramatic distress.

Effective solutions must be customized to the related missions and operations. Trauma-informed design gives organizations “Do No Harm” processes and systems as well as enabling staff knowledge, appropriate care, new behaviors, and emotional resilience.

In some people, traumatic stress can resolve naturally over time. Others find help to be critical. Either way, studies and experience show that recovery – and post-traumatic growth – are accelerated when we take an active approach based on good sense and evidence. Organizations, particularly high-risk and high-exposure organizations, will always have some people who are coping reasonably well, other struggling greatly, and many in the middle.

These organizations cannot afford to hope for the best and ignore the risks of untended trauma. Taking action – trauma-informed action – holds forth considerable rewards for growth, productivity, and wellbeing. It protects the selfless worker, as well as the enterprise as a whole.

As always, we’d love to know your thoughts and invite you to reach out.

Related Resources

Articles & Publications

Mitigating Workforce Impacts of COVID-19 and Other World Events

In this article published in the Journal of Emergency Management, Greenleaf staff offer helpful insights for navigating the stress of events that affect the wellbeing of staff and organizations.

Articles & Publications

Trauma-Informed Design: What is it?

Learn about how trauma-informed approaches and using trauma-informed design at an organizational level improve client experience and program outcomes.

Articles & Publications

Pre-Traumatic Stress: What’s Next?

Learn about the impact of post-traumatic and pre-traumatic stress by exploring the experience of state and national capital workers around the events of January 6, 2021.

Articles & Publications

3 Principles of Effective Staff Care

How can organizations better discern the specific difficulties faced by their staff? How might we fine-tune staff care programs so that prevention and intervention both hit the bull’s-eye for diverse needs and mindsets?

Articles & Publications

Ethical Standards for Transnational Mental Health and Psychosocial Support

Important components of bioethics are routinely underappreciated in cross-cultural and transnational mental health and psychosocial support (MHPSS) efforts. Explore examples of cultural errors and/or harm by outsiders delivering MHPSS.

Articles & Publications

Mental Health Emergencies and Post-traumatic Stress Disorder

Complex emergencies and large-scale disasters produce enormous and multifaceted mental health morbidity. Explore a “best practices” framework for selecting and applying mental health interventions for public health emergencies.

Articles & Publications

Partial Recovery from the Pandemic: Still Picking Up the Pieces

The Partial Recovery phase after a crisis experience involves risk of fragmentation. Learn individual and group practices to move toward integration and build healthier tools for coping.

Articles & Publications

Reflections on 9/11 and the Suffering of Our Helpers

Greenleaf founder, Dr. Siddharth Ashvin Shah, shares learnings from his experience as a medical resident in New York City during the 9/11 attacks and their aftermath.

Articles & Publications

Preparing Workforces for Demanding Environments

Health care, construction, law enforcement, counseling and social work professions have threats, pressures, and circumstances that create high levels of cumulative stress. How can workplaces mitigate these circumstances?

Articles & Publications

“To do no harm,” Spiritual Care and Ethnomedical Competence

Explore a framework for psychosocial trauma recovery involving re-fashioned categories and new terminology in hopes of bringing to life the pitfalls and potential solutions of global trauma work.