William J Koehler Ph.D., LCSW

Trauma-Informed Living

Stress

How Your Past Could Be Adding to Your Burnout

Looking for ways to cope with stress at work? Consider looking at your past.

Posted Oct 05, 2019

Nicole Verone, used with permission
Source: Nicole Verone, used with permission

The following conversations occurred between patients and therapists in my practice.

“The stress has been getting to the point where I start feeling physically sick when it’s time to go in to work,” he said. I gathered a few more details and told him one of us would be in touch by the end of the week. – 30-year-old middle school teacher.

Calls like this are happening more frequently, as people realize they need professional help with chronic workplace stress. The National Institute for Occupational Safety and Health (NIOSH) reports 40 percent of workers think their job is very or extremely stressful, and 75 percent feel their on-the-job stress is greater than a generation ago (Sauter, n.d.).  In a recent national survey of 6,700 adults (age 18-64), about 35 percent say their jobs are a regular source of stress with GenZers and Millennials having higher than average rates (44 percent) than Boomers and GenXers (Connolly & Slade, 2018). According to a Harris Interactive survey on Attitudes in the American Workplace, nearly half of the 80 percent of respondents who indicated they feel stress on the job felt like they needed [professional] help with this stress (Smith, 2002).

A little stress is actually good for you, and different people react to stress in more or less positive ways. For example, 43 percent of respondents to one survey stated that stress invigorates rather than overwhelms them. But the key is noticing when your stress levels start negatively impacting you. Unmanageable, unrelenting stress can negatively impact every aspect of our lives, our relationships, our mental wellness, and our physical health.

“I can’t do this,” she said. “They claim to be such a chill company, but when something goes wrong, suddenly it’s all about the numbers and how I’m disorganized. My manager doesn’t offer any training or have any suggestions, he just tells me I need to do better, or else...” – 24-year-old craft brewery events coordinator

While most of those who feel they need help with work-related stress do not seek assistance from a mental health professional, a growing number of people are. However, helping people understand and define their needs related to chronic work stress can be a challenge for mental health professionals. There are a myriad of factors contributing to what their clients identify as workplace stress. It can be next to impossible to create an antidote for clients overwhelmed by the toxic concoction of burnout, unrealistic productivity requirements, amorphous responsibilities, bullying and discrimination related to their jobs.

While sorting through this tangled mess, a critical yet surprisingly overlooked contributor to chronic work-related stress is a person’s trauma history. According to LaRowe (2006) “Trauma is one of the least identified and most under-treated underlying causes of human suffering today.” According to the Substance Abuse and Mental Health Service Administration, approximately 61 percent of men and 51 percent of women report at least one traumatic event in their lifetime (SAMHSA, 2014). In a well-known survey of more than 17,000 respondents, 64 percent of adults report having had at least one adverse childhood experience (ACE) prior to age 18, while 22 percent have experienced 3 or more (Hillis, et al., 2000).

Most who experience a traumatic event or adversity growing up go on without developing a traumatic-stress disorder, but that doesn’t mean they are unaffected. While diagnoses like Post-Traumatic Stress Disorder, Borderline Personality Disorder, and Dissociative Identity Disorder are at the extremes, there is a continuum of traumatic-stress related symptoms in between.

Trauma-Informed Care recognizes the critical role trauma history plays in a person’s current level of functioning and that addressing this traumatic past can assist with current problems like chronic work-related stress. Trauma-Informed Care (TIC) principles are being widely adopted across helping professional agencies today. When a provider infuses TIC into their practice, they’re better equipped to assist their client with their immediate problems and set them on a course for better coping in the future. Instead of just treating the immediate symptoms, TIC enables the client and therapist to collaborate and address the way in which the client responds to the current stressors that relate to beliefs they hold about themselves and the world resulting from their trauma histories.

Recently a couple of colleagues and I did a survey of over 100 Head Start workers. The mental health consultant team had reached out to us because the teachers and classroom assistants they were working with were suffering incredible levels of burnout, compassion fatigue, and vicarious trauma (suffering from hearing or learning about the trauma of others) from the trauma-induced behaviors, such as using dolls to re-enact their sexual abuse, of the children in their classrooms.

As we listened to the staff’s stories, it became clear to us that traumatic-stress symptoms were pervasive throughout the entire organization. With the administration’s permission, we collected the teacher’s own trauma histories and compared them to their Professional Quality of Life scale (Stamm, 2010). Results of this study are still being analyzed, but the preliminary implications were clear, as an employee’s trauma history increased, so did their levels of burnout, compassion fatigue, and vicarious trauma. This enabled the mental health consulting team to begin working with the Head Start employees from a different perspective, which in turn began to improve workplace morale and staff wellbeing.

While this example illustrates how adopting a trauma-informed lens can transform not only an individual worker’s experience, but the entire work environment, many mental health professionals struggle with asking clients about trauma histories. It is one thing to assume most people have experienced trauma in their past, it is an entirely different matter to understand how to gather this information and explain to the client why it is necessary. This is an important question to ask when a person realizes they need professional help with their chronic workplace stress. Finding and working with a TIC trained professional can be transformational in your treatment.

“I’ve not had a migraine triggered from work in over a year. Last school year, I’d get them two or three times a month. I didn’t realize there were so many similarities between my supervisor and my critical stepmother. Now that you’ve taught me to silence her voice inside my head, I can actually focus on teaching my students instead of trying to please her.” – 37-year-old Head Start employee

One basic skill a trauma-informed professional can help you develop is interoception, learning to notice how you are feeling in the moment. Practicing interoception, reflecting on when your body learned to feel that way and addressing the original source of the discomfort, can bring significant relief to stress symptoms you experience on the job.

“It worked! When my coworker started yelling at me again, I just pushed on the pressure point between my thumb and forefinger and remind myself I wasn’t 8 years old and about to be beaten by my father. For once I was able to realize his anger was his problem and how little it had to do with me. My day wasn’t ruined, and my friend and I laughed at him on our lunch break.” – 56-year-old insurance claims adjuster.

Once they’ve found a good match and can begin to see results at work, most people want to continue with their trauma-informed treatment to address other areas of their life as well. It can be incredibly freeing to realize how your past doesn’t have to keep you from enjoying your present and looking forward to your future.

I look back to a year ago when I first started to work with you. and I can’t believe the difference. My Crohn’s disease is in remission for the first time in 15 years and I don’t get nearly as stressed on the floor during my shift. My wife and kids have definitely noticed a huge difference.” – 48-year-old machine operator

References

Connelly, M., Slade, M. (2018). The United States of Stress. Retrieved from Everydayhealth.com/wellness/united-states-of-stress.

Hillis, S. D., Anda, R. F., Felitti, V. J., Nordenberg, D., & Marchbanks, P. A. (2000). Adverse childhood experiences and sexually transmitted diseases in men and women: a retrospective study. Pediatrics, 106(1), e11-e11.

Sauter, S., Murphy, L., Colligan, M., Swanson, N., Hurrell, J., Scharf, F., Sinclair, R., et al. (n.d.) Stress at Work. Retrieved from cdc.gov/niosh/topics/stress/default.html

Smith, S., (2002). Attitudes in the American Workplace Eight: The Eighth Annual Labor Day Survey. Retrieved from EHStoday.com/news/ehs_imp_35800.

Stamm, B. (2010). The concise manual for the professional quality of life scale.

Substance Abuse and Mental Health Services Administration. (SAMHSA, 2014b). Trauma-Informed Care in behavioral health services. Treatment Improvement Protocol (TIP) Series 57. HHS Publication No. (SMA) 13-4801. Rockville, MD: Author.