September 28 , 2001

Arm Yourself with Knowledge about Traumatic Stress Symptoms and Grief in the Workplace

Peter P. Greaney , MD
Board-Certified Occupational Physician
President, WorkCare

With the recent terrorist attacks on America , emotions have run high for the nation's workers.  People have experienced a range of uncomfortable feelings during this time. As an occupational health and safety professional, gaining an understanding of the effects of traumatic stress and grief can be an effective tool in providing a working environment that is both supportive to employees and business.  This article provides a summary of helpful guidelines and authoritative web links on managing/recovering from traumatic events.

Traumatic-stress symptoms may occur after an individual has experienced a sudden, overwhelming catastrophic and shocking event, such as a natural disaster, dangerous accident or terrorist attack.  Such events, like those witnessed on September 11, 2001 , may cause some, none or all of the feelings listed below:

·         Feelings of shock and denial (usually first response after traumatic event)

·          Fear and anxiety (common responses associated with a dangerous situation)

·         Depression

·         Irritability

·         Grief and sadness—feelings of hopelessness and despair, which may result in a loss of interest in normal-day activities

All these feelings are natural responses to abnormal events.  However, people process emotions differently, and the intensity, frequency and duration of these feelings vary considerably between individuals.  Some people may experience intense, prolonged feelings of sadness, while others may have a delayed reaction to the event.   Sights, smells and sounds associated with traumatic events may also trigger fear, anxiety and other feelings, on a periodic basis.

After a traumatic event, people may re-experience the trauma through nightmares, flashbacks and unwanted thoughts.  Individuals may also have an increased arousal level, causing jittery and jumpy nerves.  A prolonged arousal level can lead to impatience and irritability, and may also interrupt normal sleep patterns.  The arousal activity is the effect of the “Fight or Flight” reaction--our body's automatic response system that prepares the body to "fight" or "flee" from perceived attack, harm or threat to our survival.

Other common human reactions caused by traumatic events include:

• Avoidance of situations that are associated with the trauma
• Anger
• Guilt and shame—people may blame themselves for actions they took or didn't to survive
• Increased use of alcohol or other substances

In light of the nation's unfolding events, we can expect a continued impact on our workforce.  Therefore, understanding the signs and symptoms employees may face during these troublesome times will prepare you to go about the business of managing people and projects, while providing a supportive working environment.  These additional steps can aid you in this process:

• Provide an Environment that Fosters Open Communication
  Especially during chaotic times, employees may feel a greater sense of comfort if you, as a leader/manager, acknowledge their concerns and listen to them. You do not have to say anything deep.  Listening is very powerful and comforting.  
• Avoid Keeping a Stiff Upper Lip
  If you feel comfortable, you may wish to share your natural feelings—as this shows employees you care (and are human).  If you prefer to not express your feelings, that is okay as well, but be aware that others may feel the need to talk about a traumatic situation repeatedly.  Employees should not be discouraged from sharing their thoughts with others, as this may aid in the recovery process. 

Recovery Rates
Recognize that people recover from traumatic events at different rates.  There is no standard recovery timeframe.  “Don't expect employees to snap out of it.”  This advice by the University of Michigan's Faculty and Staff Assistance Program  reminds managers that grieving is a process that takes time.

• EAP
  If you have an employee assistance plan, inform employees that professional counseling services are available.  Let employees know that EAP services are designed to aid employees in their recovery.  There are often misperceptions about EAP services.  Employees may believe that such services are used by only very ill people.
• Get Involved
  People who have not been directly affected by the terrorist attacks may feel a sense of helplessness.  Provide employees resources and information on ways to help the victims or assist relief organizations.  
• Refresh/Review Disaster Policies
  It's a good idea to review your disaster planning procedures with your employees.  This step will give you and your employees a greater sense of control by providing realistic expectations and a managed approach to handling a disaster.
• Get Back to the Daily Routine
  For many people, getting back to a daily routine aids in the recovery process.  As a manager, you can set the example.  In doing so, proceed with sensitivity and respect the fact that others may not be ready to dive into their daily activities.

For more information and resources on specific guidelines to manage grief and the symptoms of traumatic stress, visit the following web sites:

http://www.opm.gov/ehs/traugdpg.htm

http://www.ncptsd.org/facts/disasters/fs_phases_disaster.html

http://web.vet.cornell.edu/public/petloss/ekr.htm

http://www.umich.edu/~hraa/griefandloss/managers.html

http://helping.apa.org/index.html