No Bull Support Doing what youre doing already

No Bull Support Doing what you’re doing already but better! The Bouverie Centre Rycroft, Whittle & Turpin 2009

The No Bull Support Program • • • • Warm-up (eg. Rural Bingo) Introductions Brainstorm session: – Challenges and fears – Hopes for the workshop Some information about: stress, grief, blame, anxiety and depression The wisdom of experience: sharing what's helpful What to do when someone is suicidal BREAK about Hope and Resilience SALVE and CALMER: strategies to assist others and role play No Bullshit Therapy: some basic ideas What about the children? tips on loving a SUPERCHILD Self-care and personal signs of stress RENEW: strategies to take care of yourself Closing exercise - eg. meditation The Bouverie Centre Rycroft, Whittle & Turpin 2009

Stress . . affects…. . Physical functioning Mental functioning Emotional well-being Relationships The Bouverie Centre Rycroft, Whittle & Turpin 2009

Disenfranchised Grief (Doka, 1989) A grief which cannot be openly acknowledged, socially validated or publicly mourned, which can occur when … The Relationship is not recognised The Griever is not recognised The Loss is not recognised The Bouverie Centre Rycroft, Whittle & Turpin 2009

Blame can … Help us to avoid feeling responsible Relieve us of the ‘moral’ responsibility to act Create a sense of comfort, even control Distance us from those we blame Help us avoid pain The Bouverie Centre Rycroft, Whittle & Turpin 2009

So what do we do with Blame? We talk about blame …without being blaming The Bouverie Centre Rycroft, Whittle & Turpin 2009

Depression and Anxiety External factors Environment Finances Isolation Chronic Illness Trauma The Bouverie Centre Rycroft, Whittle & Turpin 2009

Depression and Anxiety Personal factors Relationships Beliefs and Values Coping strategies Personality Genetic & Chemical Makeup The Bouverie Centre Rycroft, Whittle & Turpin 2009

Depression – Protective factors Positive Relationships Connectivity Laughter Role of Community The Bouverie Centre Rycroft, Whittle & Turpin 2009

Depression Unhelpful approaches • Telling the depressed person to snap out of it • Staying away and avoiding • Advising the person to stay busy • Pressuring her or him to be active, or party • Assuming the problem will go away The Bouverie Centre Rycroft, Whittle & Turpin 2009

Depression More helpful approaches • Think about how you will approach the person • Discreetly indicate you have noticed a change • Talk openly • Provide good information • Try to find ways of breaking isolation The Bouverie Centre Rycroft, Whittle & Turpin 2009

Suicide • Is relatively rare, but • Is a major health issue for families, communities, society. • People who suicide usually send out warnings. The Bouverie Centre Rycroft, Whittle & Turpin 2009

Suicide – Danger Signs • Feelings of uselessness, hopelessness. • Unbearable pain, worry, misery. • Behaving more withdrawn, isolated, secretive. • Thinking about how people would cope without you. • Expressions of thoughts about death, or clear plans or intentions. The Bouverie Centre Rycroft, Whittle & Turpin 2009

Suicide – How to Help • Clearly express your concern • Speak openly and honestly • Ask direct questions • Remove obvious risks • Stay, Refer, Enlist support The Bouverie Centre Rycroft, Whittle & Turpin 2009

Hope and Despair • Hope and despair are not opposites, nor are they in balance (ie. the more hope, the less despair) but they do co-exist • We can do hope, even when we can't feel hope • Hope can be a communal act • There is a ‘neurobiology of hope’ • Resistance can be an act of hope • Talking to others is an act of hope The Bouverie Centre Rycroft, Whittle & Turpin 2009

Some more thoughts about Hope and Despair • Hope is not something we can always give to others • But sometimes we can help others find their own sources of hope • We must be able to hear the despair if we are going to help people to move past it…able to tolerate and be ready to believe the horror • Our society tends to support hope and condemn despair - the ‘tyranny of optimism’ (www. despair. com) The Bouverie Centre Rycroft, Whittle & Turpin 2009

Hope and Despair (Contd. ) • The very expression of hopelessness (if it is heard and acknowledged) can be an act of hope • It is uncomfortable to talk about death or the threat of death: such conversations are 'closed down' by friends, family members and professionals, and yet • 'Speaking the Unspeakable' can reduce a sense of isolation The Bouverie Centre Rycroft, Whittle & Turpin 2009

Some Useful Questions about Hope • What is the history of hope in your life? • Who has taught you most about surviving despair? What did they teach you and how? • How have you survived despair in the past? • What difference would it make to you if you kept this realization alive on a day-to-day basis? The Bouverie Centre Rycroft, Whittle & Turpin 2009

…and some more useful Questions • What do you know about yourself / your family that helps you to hold faith that despair is survive-able? • When you feel as though hope is not available to you, where would you be most likely to find it? • Who do you most need around you - and where do you most need to be at these times? • If hope is hard to hold onto, who would you most trust to help you hold it? The Bouverie Centre Rycroft, Whittle & Turpin 2009

Supporting Others (General) S ocialise (make comfy) A sk (seek their opinions) L isten (hear their story) V alidate (normalise) E mpathise (show warmth) The Bouverie Centre Rycroft, Whittle & Turpin 2009

The Importance of Listening S ocialise (make comfy) A sk (seek their opinions) L isten (hear their story) V alidate (normalise) E mpathise (show warmth) The Bouverie Centre Rycroft, Whittle & Turpin 2009

Supporting Others (Complex) C ontact (any way) A cknowledge (be upfront) L isten (for their pain) M anage (your own feelings) E mpathise(show warmth) R efer (don’t be a hero) The Bouverie Centre Rycroft, Whittle & Turpin 2009

No Bullshit Therapy (Jeff Young, The Bouverie Centre) Marries honesty and directness with Warmth & Care The Bouverie Centre Rycroft, Whittle & Turpin 2009

What about the children? The SUPERCHILD mnemonic SUPERCHILD is an acronym we created (at Bouverie) to help you keep in mind the particular needs of children and adolescents following a crisis. The Bouverie Centre Rycroft, Whittle & Turpin 2009

But we realise it may also apply to a few children that you know and love! The Bouverie Centre Rycroft, Whittle & Turpin 2009

Tips for loving your SUPERCHILD after a crisis: what you can provide (1) • • • Safety and sustenance (physically & emotionally) Understanding … that they hurt Permission and patience to grieve what’s lost Empathy, even when it’s hard to give Responsiveness and respect … when they are ready to talk, be ready to listen, but respect their privacy about sharing their feelings. The Bouverie Centre Rycroft, Whittle & Turpin 2009

Tips for loving your SUPERCHILD after a crisis: what you can provide (2) • Connection … to you, family, friends and the wider community. • Hope is necessary, even when it’s hard to find. • Integration of the traumatic experience will happen if the child is able to talk and/or express his distress in some other way (play, art, etc. ). • Love (of course!) • Distraction from the aftermath of the disaster; no matter what, kids need to get on with life. The Bouverie Centre Rycroft, Whittle & Turpin 2009

Most children are naturally hopeful and (fortunately) pretty resilient… The Bouverie Centre Rycroft, Whittle & Turpin 2009

But even a Superchild could use a little help sometimes! The Bouverie Centre Rycroft, Whittle & Turpin 2009

When to call for help (1) • The best indicator that it is time to call for help for your child or adolescent is when you or they become concerned that what they are experiencing is … – – – Too frightening Too disturbing Too destructive, or Too hurtful to themselves or others And/or has been going on for way too long to allow it to continue its course. The Bouverie Centre Rycroft, Whittle & Turpin 2009

When to call for help (2) • The impact of psychic trauma often manifests in the form of physical pain, discomfort, or illness. This is especially true in young people who are not yet very skilled at expressing themselves with words. – If your child or adolescent complains of physical ailments, it is a good idea to take them to see the paediatrician or your family GP; but let them know that there has been a traumatic incident in your child’s life. The Bouverie Centre Rycroft, Whittle & Turpin 2009

When you really should call for help right away (1)… • If any of these symptoms are evident, it is best to seek immediate help from a professional who is skilled in helping children through trauma recovery – Severe dissociation (the lights are on, but no one’s home) – Severe intrusive re-experiencing of the event (flashbacks) The Bouverie Centre Rycroft, Whittle & Turpin 2009

When you really should call for help right away (2)… – Extreme avoidance (of reminders of the event) – Severe hyper arousal (extreme agitation or excitability that’s hard to soothe) – Debilitating anxiety (gets in the way of desired daily routines) – Severe depression (lethargy, lack of appetite, or – esp. in children – excitability or irritability) – Substance misuse or other self-harm (eg. cutting) The Bouverie Centre Rycroft, Whittle & Turpin 2009

When you really should call for help right away (3)… – Psychotic symptoms (disengaged from reality, hearing voices, experiencing delusions or hallucinations) • NB: fantasy and makebelieve play in childhood are natural and desirable and are not psychotic. The Bouverie Centre Rycroft, Whittle & Turpin 2009

A point to remember: Teens, no matter how grown-up they look on the outside, can be pretty childlike and tender on the inside. At times of crisis, they may regress into a more needy and fragile emotional state that seems younger than their actual years. However, they may still want to borrow your car and your bank account! The Bouverie Centre Rycroft, Whittle & Turpin 2009

Putting ourselves in the Picture How we respond to situations and deal with our own feelings depends on our ……. . Personal History Coping strategies The Bouverie Centre Rycroft, Whittle & Turpin 2009 Current Life stresses

Supporting Self (& your family) R efer (don’t do it alone) E xpress (Talk to others) N O heroism (you’re not ‘It’) E ngage (In family / life) W arning signs (anger etc) The Bouverie Centre Rycroft, Whittle & Turpin 2009

A Life Balance Audit -8 factors- • • Physical Health Psychological Health Career Family Knowledge and Learning Finances Values, beliefs and spirituality Social Life The Bouverie Centre Rycroft, Whittle & Turpin 2009

The Bouverie Centre Rycroft, Whittle & Turpin 2009

Preventing Compassion Fatigue (The ABC’s) Recognising your own signs of stress Awareness Tapping into your self-talk Good communication Knowing (and perhaps challenging) your own history and style of seeking help The Bouverie Centre Rycroft, Whittle & Turpin 2009 Knowing your resources and limitations

Preventing Compassion Fatigue (The ABC’s) Mental - learning how to encourage rather than discourage yourself Humour Rest and recreation Physical - exercise! The Bouverie Centre Rycroft, Whittle & Turpin 2009 Balance

The Bouverie Centre Rycroft, Whittle & Turpin 2009

Preventing Compassion Fatigue (The ABC’s) Connecting (to yourself, to others, and to something larger) Doing more of what you know is good for you, and being open to new spiritual explorations The Bouverie Centre Rycroft, Whittle & Turpin 2009 Perspective The Environment

Mindfulness is • … the cultivation of an intimate relationship with the present moment, through a continual attending to it with care and discernment • …the art of conscious living • . . . the opposite of taking life for granted The Bouverie Centre Rycroft, Whittle & Turpin 2009