It is widely recognised that a normal life cannot be led without stress, that is to say, without a minimum of tension. Stress definition points to a normal biologically based mechanism that helps adapt and survive, and not an illness. It allows us to focus our attention, mobilise our energies, and so prepare for a given task or course of action.However, if stress becomes too intense or too repetitive, or if a person is vulnerable (children, the sick, the elderly), it can lead to a change in the capacity to function normally. This is called “negative stress” which develops in three stages:

  • The “alert” phase in tense situations: the body calls on its defence mechanisms in order to react rapidly
  • The “resistance” phase which allows adaptation over a longer period
  • The “exhaustion” phase when an individual’s resources are no longer adequate to adapt to stress factors.

Signs of stress in the life of an aid worker

Basic stress, in a humanitarian mission undertaken on foreign soil, operates at a usually higher level than in one’s country of residence. Added to the usual stress factors of daily life (excessive workload and/or problems in one’s private life) are:

  • The necessity to adapt rapidly to alien customs and traditions and learn to work in a different cultural environment; and also the need to adapt to a different climate, often hotter or more humid or colder, and to exotic or monotonous foods.
  • Moreover, the aid worker is obliged to operate with colleagues or in a team he or she has not chosen. This often demands much more self-control and tolerance
  • Finally, the supervisor may not be particularly sensitive to the worker’s individuality or personality and may not be a good manager under stressful field life conditions. Or conversely, it may be necessary to operate independently, as often happens, in remote areas with little or no supervision, and the need to fall back on one’s own personal resources.

The worker’s ability to cope depends on a number of factors, including preparation before departure for a mission, ability to stick it out in an emergency or in the face of danger, the degree of openness or curiosity with regard to the local population, the capacity to adapt to an alien or unfamiliar cultural environment, flexibility when faced with the unexpected, etc…

Cumulative Stress

In the field, repeated confrontations, over long periods of time, with difficult or even painful situations has a cumulative effect. This may weaken you, plus affect your functioning in your work. Moreover, if you live through a sudden deterioration of a political conflict, a natural catastrophe or simply an excessive workload over a long period, you may experience what is called cumulative stress. In other words, your organism can no longer adapt because it has gone beyond its limits.

“Burnout” and its different stages

Some situations may even go one step further: it is called : Burnout

Four stages are usually recognised:

  • At first, you realise that you are physically, mentally and emotionally exhausted: in the evening, after work, you find yourself to be “semi-comatose” and you are no longer able to do whatever helps you relax. You feel that the more you work, the poorer the results. You realise that you accept more and more responsibility but are unable to organize your work in a coherent manner. You no longer know how to say “no” to the extra load.
  • You then begin to feel more and more guilty for not being able to function as you should. You are ashamed of not being up to the job and you begin to doubt yourself. You see no value in anything you do and are sure that your colleagues despise you. You feel more and more vulnerable
  • In a third phase, to defend yourself against this feeling of vulnerability, you may put on a mask of cynicism and bitterness, blaming and criticising others. You become disagreeable and cause others to avoid your company, which in turn reinforces your lack of self-esteem and you may begin to despair of the world around you.
  • Finally, the feeling of failure and the powerlessness to change the situation, leads to a crisis and you crack. You overreact, either in anger or in tears. You become suspicious, even paranoid, your state of humour continually changes, going rapidly from euphoria to depression and vice-versa.

It becomes impossible to establish your priorities. This is perhaps the first stage of a burnout.

How to deal with stress? Tools to cope 

Negative stress is like bad cholesterol; it accumulates insidiously. The best way to prevent it is to be well informed on the work context and to know your self well:

  • Before leaving for the field, find out as much as possible about the context of the mission: the climate and geography of the region, living conditions, food, working conditions and the “ambiance” of the work group, the political and socio-cultural context of the host country; you can then evaluate in advance the degree of stress to which you may be subjected and thus prepare yourself psychologically.
  • Get to know yourself and your limits! Your needs with regard to food, rest and exercise – how much privacy you need – how you adapt to extreme climatic conditions and put up with forced periods of inactivity or else with abnormal working hours – how you manage your own irritation, anger, or conflicts with others – how you manage not being recognised by your superiors, your colleagues, or even by the beneficiaries?
  • Be vigilant in the first place concerning:
    • Your diet
    • Sleep and rest
    • Physical exercise

The key to normality is discipline, exercised on a daily basis, 24 hours at a time, without undue projections concerning what the next day, or next week or month, may hold, and worrying yourself to death – sometimes literally! Yesterday is the past which cannot be brought back. You have no control over what tomorrow may bring. The only day that matters is today. Before becoming a “secondary victim” and being caught up in compassion fatigue you must:

  • Look for support from your colleagues
  • Analyse your denials, your false and displaced hopes, your cynicism, your feeling of powerlessness
  • Come to terms with past and present losses and trauma
  • Turn difficulties into opportunities for change

It is important to be able to get away and relax outside your work context and perhaps you organisation has anticipated such situations and can help you, for example, by providing for periods of leave in a congenial environment away from your duty station, or in another country.

And finally, the effects of stress, how negative it may appear, is not the end of the world! Deep down, you still have the resources and the tools to recover. This is what is called resilience.

© CHP 2014

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