Coping with trauma as a health professional - with Dr Yvonne Waft

SPEAKERS

Paula Redmond, Yvonne Waft

Paula Redmond: 00:04

Hi, I'm Dr Paula Redmond, a clinical psychologist, and you're listening to the When Work Hurts podcast. On this show, I want to explore the stories behind the statistics of the Mental Health Crisis faced by health professionals today and provide hope for a way out through compassion, connection and creativity. This season is brought to you by the Association of Clinical Psychologists, the representative professional body for clinical psychologists in the UK. Join me as I talk to inspiring clinical psychologists about their work in this field, and learn how we can support ourselves and each other when work hurts. As health professionals we are not immune to trauma. And in fact, many of us are motivated to become healthcare professionals as a way of understanding and even healing our own wounds. We're also vulnerable to experiencing trauma in our personal lives just as much as anyone else is, and especially likely to be exposed to trauma in our work. In this episode, I spoke with Dr Yvonne Waft clinical psychologist and EMDR, consultant, and author of a new book published by Sequoia books in association with the ACP-UK, called Coping with Trauma: Surviving and Thriving in the Face of Overwhelming Events. We talk about her own experiences of trauma, how these have informed her professional life, and how we as health professionals can look after ourselves when we are impacted by traumatic events, either in work, or in our personal lives. I started by asking Yvonne how you came to write the book?

Yvonne Waft: 01:56

Yeah, I mean, it's sort of a long story in a way, I grew up with significant trauma in my own sort of family of origin. I had a very, I would say, abusive, misogynistic, angry sort of father growing up, and a mother who wasn't able to protect her kids from the worst of his anger. So, you know, I grew up with a lot of criticism, a lot of kind of shouting and being shouted at sort of thing, seeing some physical violence, but I mean, my father was more sort of aggressive, physically aggressive towards the boys in the house, and verbally aggressive and misogynistic towards me. So there was that sort of backdrop. And then at 19 years of age, having sort of left home to go away to college, I contracted bacterial meningitis, which can be a bit of a tricky thing to have, I was about to use a bad word then! So, you know, it's is not a good thing to catch. And it came with a sort of side order of sepsis, it caused all sorts of complications, and very, very nearly fatal episode. So, I survived that by some sort of miracle. And that kind of, you know, meant that I had to kind of go back and reinvent myself as a human, you know, having just about done adolescence and sort of launched myself out into the world to go and redo all of that, work out who the heck I was in, you know, the middle of the 1980s, Britain, you know, suddenly having to deal with the world from the perspective of a wheelchair user, you know, and really sort of reinvent myself, and I found lots and lots of ways forward, fortunately. But one of the things that that left me with was obviously a lot of traumatic memories and, you know, sort of baggage, emotional baggage to do with the adjustment to disability and what I'd been through. And at that time, I wasn't really aware of it at the time, but later reflecting back, there wasn't the emotional support there. I mean, obviously, with the context of my family background, there wasn't the emotional support there. But then also within the sort of medical context, I don't remember there being any emotional or psychological support offered to deal with what was actually an extremely traumatic episode in my life. So I think in a roundabout way, what ended up happening was I found myself exploring psychology as a possible route to understanding myself, I think.

Paula Redmond: 05:05

And was that something that you had thought about before you were ill, or that hadn't been on your radar?

Yvonne Waft: 05:11

No, no, not at all. Not at all. And I've done quite well with languages at school. And they'd been a thought that I might go to Oxford or Cambridge to do modern languages. But being a stroppy teenager at the time I said, no, I'm going to Huddersfield Polly to do catering management. And off I went, you know, packed my bags, and went sort of thing. I mean, that's the nearest thing to a teenage rebellion I actually managed really, I think, but I wasn't on the right course at all, when when the meningitis struck, I was doing this catering management course, and it just wasn't really right for me academically. But, you know, I was 18 when I picked that and off I went, and I was already a traumatised 18 year old, you know, so maybe you don't always make the best decisions at that age. But what happened was, I ended up back home, you know, sort of having launched myself out there into the world, I ended up back home and, and I didn't really get the support that I needed at that time. And then I explored various different options, and I got jobs. And I sort of moved about a bit, I went to London for a while, ended up going to the University of East London doing a psychology degree. And that kind of really opened my eyes to some of the stuff that I was experiencing, gave me some understanding of just little things like, you know, a symptom of anxiety. And thinking, actually, I know what that is now, I wonder, you know, wonder what the roots of that are. And it just sort of created this curiosity, I think in me. And at some point, during my undergrad degree, someone told us that clinical psychology was a thing, but it's really hard to get into, so don't bother trying. So I thought, right, red rag, bull, I'm going for that. And so, you know, it just ended up that I started to pursue that as a direction. And through all the various sort of hoops that you have to jump through, I ended up being a clinical psychologist, and surprise, surprise, I ended up being drawn to working with people who've been through trauma. And, you know, that's kind of the background to it. And then obviously, the ACP about three years ago suggested, you know, as a result of Sarah Swan's book Coping with Breast Cancer and her sort of experiences, they suggested this series of books, and they put out an email just calling for ideas. And I, you know, for a moment there, my imposter syndrome was taking a break, and I just pinged back an email saying, Yep, I've got a book, I can, well, I haven't got a book, I've got a book idea. I've got trauma, I could write coping with trauma that would fit this series. And, yeah, so began a sort of two and a half year process of writing, which was fabulous, actually, it's really good to sort of bring all my knowledge together in one place and put it on paper and think, Gosh, I do know some stuff, you know, I actually really do know some stuff, which calms my imposter syndrome down a bit more. Although it did keep popping up through the process. There were certain points during the process where I suddenly thought I can't possibly, you know, for example, as the book was almost finished, I was told I would need to sort of get some endorsements, I'd need to, you know, approach some people and ask them to read the draft and suggest, you know, endorse it or not, you know, and the fear that that arose in me, you know, oh, my God, I'm gonna have to put this in front of real experts. And actually, you know, they're just colleagues, they're just peers, you know, they're just other people who work in trauma. And they gave me glowing feedback. So that was really reassuring.

Paula Redmond: 09:17

Yeah, good. And it's interesting, because I guess, and I suppose it depends a bit on your training and your, you know, the models that you might work in. But I guess there's a sense that as psychologists, you know, self disclosure is something that we have to be really thoughtful about, or, you know, some might suggest avoid altogether. What's that been like for you to, you know, kind of negotiate that, how much you share of your own story and...

Yvonne Waft: 09:52

Yeah, I mean, it's a tricky one for some people, I think, but I think just when you enter a room to be a therapist, you're already disclosing a lot about yourself. And for me as a wheelchair user, you know, I'm a double amputee, I'm really obviously disabled, I can't enter a room with people in person without giving a lot away about myself. And I think that's the same for therapists of colour, therapists with all sorts of difference and diversity. You know, we enter a room, and people can read a lot about us just from looking at us. For me, being open has always been part of my work, because I haven't got an option. I go into the room and people are already, you know, sort of projecting things onto me, you know, I have had situations where people have come into the room and said, well, I can't talk about my trauma in front of you, because you've obviously been through more than me. And I'm like, oh, okay, that's a lot to unpick. I mean, it's, it's all grist for the mill in the therapy world, isn't it? You know, whatever sense someone's making of what's there in the room, there's so much there to unpick and explore. And, you know, what does this mean to them? And, you know...

Paula Redmond: 11:11

And I guess, as you're saying, you know, we all carry our own scars, our own traumas, and often, I guess, people are drawn to this kind of work, because of those things, either, you know, that we are trying to heal ourselves in some way, or that we're really, you know, curious and just exploring those, those ideas more deeply. And I guess I'm really interested in, in thinking about how, how we manage that, as professionals, when our work brings us into contact with our own wounds. And, yeah, I wonder what your thoughts are on that, on how we sustain this kind of work and sustain ourselves, when, when that's bound to happen, whatever it is you bringing, you're gonna come into contact with it in some way, you know, work?

Yvonne Waft: 12:09

Yeah, completely, especially if you have a history of trauma, and you choose to work doing trauma therapy as your main specialty, that's, that's obviously going to be touching on your own stuff sometimes, isn't it? And I think there's a number of different things that I would say. There's different levels of sort of coping strategies, I suppose you might call it or, you know, ways ways of managing that, I think one is having your own therapy. And I've dipped in and out of therapy ever since I really realised that was a thing you could do. I think that took me a while to realise that was the thing you could do. But, you know, once I understood that there was that option out there, I have dipped in and out of different types of therapy, and benefited enormously from it, you know, I understand myself so much better. And that's an ongoing process. I think that's a life's work. You know, when you have had the sort of childhood I had, and it certainly wasn't the worst I've heard of, you know, my childhood was inadequate in many ways, but I have heard far, far, far worse. So, you know, I'm not sort of making out to have had the worst of experiences in that. But, you know, there's, there's a lot of work to unpick there. And I think, you know, dipping in and out of therapy and just continuing to explore myself, in that way, is one of the ways that I manage the impact of my work, actually. Another way that I manage the impact of my work is having excellent supervision. So as a clinical psychologist, it's a requirement of my registration that I remain in clinical supervision. I also deliver clinical supervision as part of my work, and those connections and those conversations that I have, both with my supervisors, and with my supervisees all sustain me in many, many ways. You know, just sharing that common experience, whether it's with a supervisor or a supervisee, that we're all in some way wounded healers, we're all in some way, dealing with our own stuff, but also, you know, carrying the weight of the traumas that we work with and, and having a space to share and offload and explore and, you know, just be real and sort of shed the veneer of, you know, I think we often carry around with us this don't with this veneer of being sorted, being a totally sort of completed human. It's such a lie, isn't it? We're not it's a very thin veneer at times, but we do doubt we will go to work, we put the mask on, and we try to be there for our clients and try to be as whole and as together as we can be for our clients. But, you know, we all have our story behind that. And I think therapy and supervision are both places where we can unpack that a bit. And, you know, work towards being that whole unmasked human that is sorted, and has everything resolved. I don't think that ever happens for anybody, but maybe it does, maybe it does, who knows. But then the other thing as well, that I do, I try really hard now to focus on things like self care. I think, from my childhood, I became very much a people pleaser, someone who would, you know, always put other people's needs before my own, and not attend to self care adequately, you know, I would be the bottom of the list, or if I was doing something for me, I would be doing it with a heap of guilt, you know, and feeling like it's not, I'm not allowed to this time for me. And what I've done very much as I've kind of moved forward in my life is found the things that really give me joy and focus on those, prioritise them. So, I mean, it's a bit weird, but open water swimming is one of those things, even in this weather, even at this time of year, you know, getting in a really cold lake and just swimming just grounds you, it connects you with nature, it does physiological things that I don't really understand, but it does, the buzz you get, you know, when you've been in a lake in the morning, in like, you know, two or three degrees water temperature, the buzz you have for the rest of the day is incredible. And I've heard of people with really tricky medical conditions, like multiple sclerosis, saying it completely resolves their symptoms for at least a few hours afterwards. So, you know, it's fascinating, but just things like that, that you know, I do now that I dislike, yeah, that's my time, that's for me. And I love it. So, you know.

Paula Redmond: 17:17

And what do you think has evolved to, to enable you to, to prioritise that, to give yourself permission to do that?

Yvonne Waft: 17:26

I think partly, I've just grown up, I've got older. I think, you know, as you get older, you start to think why am I sacrificing my own needs for everyone else all the time? I deserve something for me. I think awareness, I think, you know, sort of, you know, psychologists social media, you know, psychologists groups on Facebook, are incredibly supportive forums for thinking about these things sometimes. You know, people, people just putting a post on the psychologists in private practice group and saying, Oh, this is what I'm doing for self care today and thinking, Oh, we're allowed to do that? You know, so you just kind of gradually start to do that as you get older, as you connect with other people, but also therapy, you know, going through therapy and realising and just identifying, gosh, I do that. Or even in supervision, you know, your supervisor saying, Gosh, you're busy. You know, do you need to be that busy? Can you not try saying no to people sometimes? Yeah, so all of those things, all of those things. Yeah.

Paula Redmond: 18:36

And as you're talking, I'm thinking about health professionals more broadly. And I guess we are, you know, as psychologists, as therapists, you know, we know that we are working with trauma, you know, pretty much, you know, almost whatever you're doing, there's, there's trauma. And I guess, you know, our professional structures are set up, you know, in our communities to recognise that and acknowledge our needs around that. But I guess other health professionals, I think don't have that in terms of their... the professional support around acknowledging that they are exposed to trauma, you know, if you're working in the NHS at the moment, you know, you're going to be exposed to a lot of trauma, of the people coming through the doors, and I think that's compounded when resources are depleted. The moral injury around not being able to respond in a good enough way to people's needs. Yeah, and I guess I see that a lot in working with health professionals, almost that it's not named, the trauma that that people are exposed to, and then even, it's even harder than to to make that link with what the the individual might be bringing, their own traumas that might link in with that.

Yvonne Waft: 20:06

Yeah, completely, I think, you know, not just psychologists and therapists, but you know, most, well most people, many people in the healing professions I think are drawn to helping, because they carry their own wounds, they are wounded healers. It is, you know, not surprising sometimes when perhaps, you know, you might get a nurse or a paramedic referred to you, because of traumas that have occurred in the workplace, maybe, you know, they've maybe seen someone pass away or, or they've been, they've experienced maybe a suicide that they've had to go and, you know, I've worked with paramedics who've been really traumatised by some of the suicides that they've been to, and going to those sorts of events, and then that may be triggering something deeper for them that maybe lies way back in their childhood, you know, that they were maybe drawn to helping people and going into a helping profession, because they had that self sacrificing element from their own trauma, it seems to drive people to people pleasing, self sacrificing. And they're going into that, without a full understanding of why they've chosen that profession, what burdens they're carrying from earlier in life, and how the impact of the work is going to impact on them. And then, as you say, they find themselves in situations where they're under resourced. They're facing very, very difficult situations and dilemmas. And, you know, particularly through the COVID pandemic, you know, doctors were having to make horrific decisions about who got care. And then they've got to kind of somehow rationalise the decisions they made, and, you know, if they're coming at that from maybe an already traumatised perspective, and they're dealing, you know, in an under resourced service, with overwhelming need, and they're having to make these critical decisions about care. Of course, they're going to struggle with that, and of course, they're going to be left with, as you say, this moral injury, which is a form of, I suppose, post traumatic stress that we're starting to really identify in so many situations now. And it's not just the medics, it's the paramedics who, you know, maybe went out to a house and had to make a decision about whether that person warranted being taken into hospital at that time. And, you know, that's just so, so difficult for those people to be making those decisions. And they're just humans, you know, they're often wounded humans, they're not sort of some superhuman godlike people who can make those decisions without it having an impact on them on a very personal level.

Paula Redmond: 23:05

And I think I, if I'm working, you know, with someone, you know, who has PTSD, for example, it's often the aftermath, or people's responses to the events that can be the sticky bits for people, you know, a car crash, but, you know, not visited in hospital by someone, or you know, a sexual assault and not being believed. It can often be that response that is so painful, and really stays with people. And I guess, thinking about, you know, as you're describing, you know, people working in healthcare, it's so often the case that the system, the organisation doesn't recognise the impact of their work, and that can be... at least make it worse, if not be the core problem.

Yvonne Waft: 24:10

Yeah, I think what can happen in those kinds of workplaces sometimes is you get this sort of toxic, almost macho culture of, you know, oh, that's just what we deal with on a daily basis, you have to toughen up, you have to get used to it. I went through that, so you have to. You know, you get those kinds of narratives that are very unsupportive, and don't take into account the impact that this really does have, because we're all very good, aren't we it's kind of syphoning off our experiences, you know, cutting off our emotions and just soldiering forward really, and I think, you know, when people have learned to kind of park their emotional stuff, and just be very dispassionate, and, you know, soldier on on the day to day then they lose a bit of their compassion. And so workplace cultures can become very toxic and unsupportive. And then people feel as though that's how I have to be, I'm wrong for having the feelings I have, I have to learn to park those, put them somewhere else, and just soldier on like everyone else does. And then there comes a level of kind of self criticism of like, why am I struggling so much with this, everyone else seems to be coping? Well, of course, you don't know what people are dealing with outside of that environment, you don't know how they're coping, you know, whether they're going home and drinking half a bottle of whiskey on a night just to keep numbing those feelings out. But what you see is them seeming to function in a very dispassionate way, day to day, very macho or very sort of seemingly coping. And it's only when there's a sudden event, you know, a sudden suicide attempt or a sudden going off sick with, you know, stress, that you realise that maybe you're not the only one struggling. But that's such an unhealthy way to be. And I think, you know, we need a lot more understanding of trauma in the workplace. And I think, well, I hope that my book, Coping with Trauma, will help people, just the general public, and healthcare professionals and educators and social care workers, to understand why people might be behaving and acting and feeling the way that they do. Being more sort of open to the idea that people might be hiding trauma, they might be struggling and coping behind closed doors, but presenting that sort of mask on the day to day basis until they can't sustain that any longer. And I think, what I'm hoping is that if we can all understand trauma a little bit better, and be more open to thinking about it, talking about it, sharing our experiences of it, then workplaces can become healthier, because if we can talk about that stuff, and if we can not be dismissing, if we can support people with what they're dealing with, then everyone will be healthier, everyone will be mentally healthier. And I think you know, this sort of notion that trauma kind of is everywhere, and if we could just all just kind of calm down, take a breath, and try and be open and compassionate and find out what's really going on, both for our colleagues, for the kids in our classrooms, for the people we work with, our supervisees, our trainees, everyone that we come across, then, you know, everyone could hopefully feel a little bit better, start to heal, and workplaces could become nicer places to be.

Paula Redmond: 28:02

And I've come across this term recently, sanctuary trauma, have you come across that phrase?

Yvonne Waft: 28:09

No, I haven't, tell me about that.

Paula Redmond: 28:12

So the idea is that it's about how we might have experienced something traumatic, and reached out to a place of safety, to get support, but being dismissed or criticised as a response. And so there's additional then layer of trauma around the fact that your sanctuary is not a safe place. And I guess that's, you know, feels very relevant thinking about people working in health care, where often, you know, the work has taken a huge amount of self sacrifice, you know, people are going above and beyond all the time, for not great rewards. You know, really making a great deal of personal sacrifice. And then when they need something, it's not there. And how painful that can be.

Yvonne Waft: 29:12

Absolutely. You know, I think I mean, I do supervise some staff support groups around the country and it's really interesting, you know, when working with those people. The people that are coming to them have experienced, for example, bullying in the workplace or traumatic events happening in the workplace. And they've also got their own sort of pre existing burdens of trauma. And what happens is, you know, they go to occupational health, and they say, I'm really struggling and they get referred to the staff support and the staff support are extremely capable, competent, caring, wonderful clinicians. But they're allowed to see the person for 10 sessions, or 15 sessions, and it's not enough, you know, people are bringing complex trauma and staff supporter having to sort of hold all of that, and it's just too much to do in the short number of sessions that they've got. And you know that person then is, is left to feel kind of like, I'm too much, my burdens are too great, there's something wrong with me, why aren't I fitting into that box of easy to fix, quick 10 sessions? Or do it? And why am I having to be referred to this secondary care hub or whatever it might be, that I can't access because I'm not actually, you know, seriously unwell enough to meet their criteria either. So I fall in this gap, what's wrong with me? Why can't I just be fixed and helped. So there's that element of it. And then the other thing that struck me when you were talking about this sanctuary trauma kind of idea, the immediate thing that struck me was when someone has hurt themselves, or attempted to kill themselves, and they present to A&E, bleeding, or burnt, or, you know, broken in some way and desperate, desperate, desperate for some help, and they get very, very short shrift from medical professionals, sometimes, you know, they'll, they'll get the well, you know, there's people here who are really unwell, and you've done this to yourself kind of narrative, which is just so unhelpful, you know, when someone's hurting so badly, that the only way they can see to resolve it is either to kill themselves, or to hurt themselves and get some care somehow, it's just heartbreaking really. These are the people who are hurting the most in the world, and, and they are so so unwell in that moment that they've had to express it through some sort of really desperate act, and then they don't get the care that they need. And that's another trauma on top. It's another Oh, you're too difficult. You're too extreme. You're too much. You're a bad person, because you did this to yourself. And that's just another layer of trauma, isn't it? Yeah.

Paula Redmond: 32:14

And I guess, the, you know, often an extra layer to that is if those people who are hurting and desperate, are health professionals themselves, you know, how difficult it is to reach out for help, you know, to be going to colleagues for support is, it takes huge courage, doesn't it?

Yvonne Waft: 32:44

It really does, it really does. Because I think, as I said before, there's that kind of macho culture, and people put that mask on, and they go to work, and they seem to be coping. But you know, as we all know, people might have less healthy coping strategies behind the scenes that people aren't seeing. And, you know, I think the rate of alcoholism amongst medics at different times has been reported to be very high. I haven't seen any recent statistics on that, but I know that's often been a thing that it's a coping strategy, isn't it? It's not a great one, because it causes all sorts of problems around cognitive functioning, and, you know, decision making. And it impacts on sleep, which then makes all of those problems worse. But also suicides amongst medics, you know, we do see heightened levels of suicide. And I think what happens is people keep soldiering on, until they break, and because they do have that difficulty with saying to their colleagues who all seem to be coping really, really well, you know, the difficulty of saying, actually, I've reached my limits, and I can't do this anymore. And then, you know, there becomes some sort of desperate act that happens.

Paula Redmond: 34:01

I was also thinking where we've been talking about, you know, the sort of wounds that we might carry coming into this work and, you know, how that might relate to how we approach work and what we need to support us in that. But I also wondered, and maybe particularly in your role as a supervisor about what we need to think about when something happens, a trauma happens, you know, while we are working, so not necessarily about those things that you know, are things that we're going to carry through life, but, you know, if, you know, those things that happen out of the blue, and what we need to think about in terms of looking after ourselves, when we are affected by a trauma acutely, because it's it's really hard. You know, we're really bad at that. As you were saying, you know, we're people pleasers, and particularly, you know, when your work is supporting vulnerable people to step back from that is really difficult.

Yvonne Waft: 35:08

Yeah. I think it is difficult, isn't it? And I think this is something that comes up a lot on some of the psychologist Facebook groups, isn't it when people are dealing with something themselves, you know, they're having a bereavement, or they're, they've had a car accident, or, you know, just the stuff that happens to people, regular stuff that I'm sure in many jobs people would do, well, I'll just ring in sick for this one. But we start agonising about well, you know, how do I prepare my clients for if my parent dies this week? You know, because they're really ill? Or how do I prepare my clients? Or what what can I do? You know, because I've had this car accident, I'm going to be out of work for, you know, six weeks while my limbs mend or whatever? You know, should I work online? Should I find some way to be there for my clients? And, you know, I think we are, it is that self sacrificing thing again, isn't it? And we, we actually need to take the time off. You know, when, when something like that happens, as I'm saying this, I'm realising the irony of I would have those dilemmas, too, I would really struggle to take that time off. I'm just thinking, when was it? I think it was, a year and a half ago, I actually got a kidney infection and ended up in hospital. And I was in my hospital bed emailing clients sort of to say, look, I'm hopefully going to be back by, you know, like, imagining I was going to be back by like, this was, I think, the Monday and saying, oh, hopefully, I'll be back by the middle of the week. And no, I was still in hospital on the Thursday on IV antibiotics. And I think we do, don't we, we have that sort of sense that we're indispensable and that we, we need to somehow put other people's needs still before our own. And, you know, no, we need to, and I'm talking to myself as much as anyone else here, we need to take that time for ourselves sometimes. We need to just say no, actually, I'm not available. And we don't have to share why even, you know, we can just say look, you know, very sorry, not available this week, I'll update you next week if I can. But it's difficult, isn't it, because actually, the people that we work with are often vulnerable, they're depending on, you know, they're committed to a course of therapy, or they need their supervision or, you know, whatever the situation is, and it's complicated to cancel that and rearrange it and put our needs first. And, you know, we sometimes feel like we maybe need to give a lot of explanation that perhaps isn't needed. You know, maybe just saying that something's happened, I'm going to be okay, but you know, I'm going to have to take a bit of time off. It's all that people need to know. And most people will be very understanding of that. Certainly, you know, a year and a half ago when I had that week in hospital, people were concerned, you know, they asked concerned questions, nobody said, How dare you. Nobody said, you know, get out of that hospital bed and get to your clinic and see me. Nobody did that, everyone was happy to be rearranged, and, you know, I didn't have to give lots of detail. I just, you know, said that I was unfortunately unavailable, I was unwell, and I'd be in touch next week kind of thing. You know, after having all these thoughts in my head of can I be available by Wednesday, can I be available? But no, no, stop it. You know, I'll update them next week and see... but yeah, it's, it's a difficult one, isn't it? Because we, we people do also, you know, our clients sometimes do put us on a bit of a pedestal, and they need us and they want us and they do want to see us and often that's their trauma playing out, you know, if they've had attachment wounds, abandonment issues in childhood, neglect, you know, they're attached to us, and they really want us to be there, it actually creates a bit of a rupture in the relationship for us to be off. But I see that more and more as I get older, as an opportunity to discuss why that's important and why that's been a problem for them. So when I come back from you know, when I came back from that bit of leave, you know, discussing with clients, how was that for you? I understand that it's difficult when someone isn't there for you. You know, let's talk about that. So, you know, it becomes actually a useful therapeutic thing to explore. But I think we all have that anxiety of I'm gonna break all my patients if I if I take a bit of time out yeah.

Paula Redmond: 40:00

And I think there's also something about, you know, recognising trauma as something that can be really shattering, and that, you know, as you recover, the sort of the pieces don't always go back as to how they were. And I'm thinking, I'm just relating to that person who, I had a, I lost my mum a few months ago in quite a traumatic way. I'm still really negotiating how that's changed my relationship to work, and how, you know, all of those things may be initially about, you know, taking time off and, you know, you know, navigating that, but then there's the kind of the aftermath and what do I need and want for my life and I'm not the same person I was before that happened, and, you know, that's very hard to kind of, you know, figure out in the midst of this kind of work, when you when, you know, you're really, so much of your headspace and your, your work is a huge emotional labour. And I think that can be really challenging. So just thinking about how, or what advice you give to your supervisees, Yvonne, when, you know, they might be struggling with something that's come along in their personal life, something traumatic that has, you know, led them to question everything you know, about their professional identity, how, yeah, how you'd support people to navigate that?

Yvonne Waft: 41:58

I think really very much the same way I would with someone who was in therapy with me, you know, it might be that, you know, a monumental event has happened in life. And really, what needs to happen then is a bit of a sort of stop check, I suppose, you know, sort of, okay, this has happened, this is where we are, and maybe connecting with values and thinking have values changed because of what's happened. So, for example, I don't know someone who's working in a health care profession and is a little bit burnt out, but coping, but then has perhaps, you know, a bereavement or a traumatic event that makes them really think, gosh, I could just drop that at any moment. What do I want my life to be about? Do I really want it to be about this stuff that's really burning me out and leaving me exhausted, leaving me with very little time for pleasure and joy, and all the things that I value in life? I'd be encouraging that supervisee to really just, you know, stop and take stock and say, you know, what matters what really, really matters? And it might have changed, you know, whereas career success might have been a massively important value that has driven them and driven them and driven them for decades even. But then perhaps that death in the family makes them stop and think, d'you know, what, actually, you know, I really value time with my family, and actually, I really need to spend more time with my family and not do this thing that leaves me with not an ounce of energy for my family, you know, where maybe I'm crashing on the sofa all weekend, and I'm snappy, and I'm not making proper food for people and I'm not enjoying the time I have with people. Maybe I need to reevaluate just what, what is the point of it all. And I think, you know, trauma, it shatters your assumptions about life, often, whether it's a bereavement, even, you know, non traumatic bereavement, still makes you sit up and notice, you know, all that existential stuff about gosh, you know, life isn't indefinite, you know, we do have to, you know, think about doing the things we want to get done while we still can. And, you know, that might be spending time with your kids, your kids are gonna grow up, and they're going to leave home and they're going to go and have their own lives. If you don't, you know, spend that time with them while they're young. You've got to invest in things while you can, haven't you and it's, you know, often it's when people are faced with, you know, maybe a terminal diagnosis and a short prognosis that they suddenly start thinking gosh, what, what matters, what do I need to do? And then there's a, you know, sort of urgent bucket list kind of pressure on people to do all the things. Whereas, you know, we should really all be living our best lives as best we can, you know, all the time, we shouldn't really be waiting until we get that wake up call, you know, either a traumatic event or someone dying or, you know, us getting some sort of diagnosis that says, gosh, you know, actually I didn't do all the things, you know, we need to connect with our values before we get to those sort of urgent points, I think and start living our best lives now. Because really, you know, as all the mindfulness experts say, the only time we have any control over is now, you know, so get back in this moment and focus on what matters right here right now. Yeah.

Paula Redmond: 45:53

And I think we're all really good at being able to say that to other people, aren't we? And not very good at taking advice, which I think is where you started off saying about, you know, therapy and supervision and community are really important just to keep our feet on the ground with this stuff.

Yvonne Waft: 46:15

And just to remind ourselves that we're just humans too. We're not superhumans. We're not, you know, we're not somehow immune to all the stuff that everybody else has to deal with. We are just humans, and we break too.

Paula Redmond: 46:32

Though, Yvonne we're, you know, just thinking about, you know, trauma in the workplace. And I guess one of the other things that we're becoming more aware of, more kind of educated about in organisations is neurodiversity. And and I wonder what your thoughts are on how those two things sort of trauma in neuro diversity, you know, where they might cross over? And yeah.

Yvonne Waft: 46:58

It's a really interesting area, actually, and there's not enough research on it. That's the first thing I would say about it. But I do refer to the little bit of research that there is in my book, because I think it's a really important thing. You know, we are hearing more and more about sort of neurodiversity, and that would be things like autism, ADHD, learning disabilities as well, I think. But also things like dyslexia, dyspraxia, all of those kinds of conditions. But I think people who have neurodivergent conditions often experience more trauma in their lives for all sorts of reasons, they might stand out in childhood as being different, they might behave in a way that is difficult for teachers to manage, and then you know, sort of experience a lot of punishment sanctions, which is traumatising. And, for example, people with autism are much more prone to bullying at school, because they're a bit different, they don't fit in easily with their peers, they can get really severely bullied, and that then has a traumatising effect on them. But in addition, neurodivergent people often are very much more sensitive, both physically and emotionally. And so the impact of even quite a small trauma might be much more significant to them, and have a much bigger impact on them than it would a neurotypical person. So we've got that kind of interplay there; they're likely to experience more trauma, they're likely to feel it more traumatically, and then also, they're going to struggle to get the help with that a) because, for example, people with autism might not understand what's happening to them, they might not be able to articulate that and seek the help. People with ADHD might just get dismissed as, well, you're just a naughty boy, so of course, these things happen. Or you were just being so disruptive, of course, these things happen. So there's no sort of compassion and resolution to that then. And then, you know, these people go off into the workplace, then and again, these things get replicated again and again. So the burden of trauma is much greater. The impact on the individual is much greater. And then the ability to seek the help and get effective help for that is complicated by that interplay between the neurodiversity and the trauma. And even as a very experienced psychologist, I find it really, really hard to unpick, you know, when someone comes into my clinic, what is trauma and what is neurodiversity? Because sometimes, you know, you can see a really clear trauma history and you start working on that and you kind of clear up all the trauma and then the still this sort of, life's still difficult, things don't seem any better, what's going on here? And you start to look at the neurodiversity aspect. You know the what we might call the symptoms of neurodiversity are often very similar to the symptoms of trauma. So there's often a lot of difficulty unpicking what exactly is what, in the individual that sat in front of you. So, you know, it's a complex area. And I think, you know, as we start to understand neurodiversity, hopefully schools can become more informed and more neuro supportive environments. And then hopefully, workplaces equally, can become much more compassionate workplaces for these people to exist in. So that would be my hope that you know, that little bit of research that's out there that says that this is a complex area and needs more research, hopefully that will happen. And hopefully, we'll get that more... that better understanding and more support for these people.

Paula Redmond: 48:26

So Yvonne, just coming back to your book, anything else that listeners need to know about, about your book, about what, you know, what it might hold for them, where to get it, all of those things?

Yvonne Waft: 51:02

So it's available from the publisher, Sequoia books and from other booksellers, as well. So people can or, you know, people can contact me through social media, and I'm sure that will be in the show notes. How to contact me. So people can order it direct from me as well, if they want to, if they just want to make contact. It's, it's really aimed at self help, I would say, that's the primary purpose of my book. So the first half of the book, really, I mean, roughly half, is very much about understanding what trauma is, how it impacts us, you know, all that psychoeducation stuff that we do when we're doing trauma therapy, you know, explaining to people that, you know, your brain has certain hardwired processes that happen to help you survive overwhelming events. And sometimes those, you know, the fight flight freeze kind of idea that your brain is hardwired to do those and to make that choice itself. So it's not a free choice that you make. So for example, when perhaps a soldier freezes in combat, and is unable to do what his training told him to do, then he's left with trauma as a result of that, and guilt that, you know, he froze. And, you know, understanding the processes that are at work there a little bit better, understanding that that wasn't a free choice, and it doesn't mean they're a coward. You know, that, that really helps to free up people to say, ah, you know, this is, this is my body doing something to enable me to survive. And, you know, I couldn't help that. So that psychoeducation piece can be really, really helpful, it can be really de-shaming, in so many circumstances. The other time that comes up is when people have been assaulted or abused in some way sexually, and they feel like they should have fought back, and, you know, just realising that, you know, the freeze response is actually a survival mechanism that your brain goes to, when fight or flight isn't possible. And that's an instant response that your body comes to, you know, and a knowing that can be so de-shaming. So the psychoeducation pieces, what is trauma? How does it impact you. And then the second half of the book is more about kind of how you go from that to starting to heal. And it's very much aimed at self help. So it's not a therapy book. It's not, you know, I'm not going to start doing EMDR in the middle of the book, which is a trauma therapy that I use a lot. I don't really, I refer to EMDR throughout the book and mention it, but you can't do EMDR on yourself, really, unless you've been very thoroughly trained on it and work through most of your stuff in therapy yourself. So it's not a therapy book as such, it's more of a self help book, but where I think it will be useful in the therapy professions is for people at that early career stage wanting to get a bit of a better understanding of trauma, and how they can be helpful to people in the room, there's, there's some actual things you can do with someone in the room. You know, I remember being a trainee and an assistant psychologist before that and just thinking, you know, please God, will someone please tell me what I can do when I've got this person sitting in front of me apart from talking to them, and I don't know what I'm supposed to say, you know, am I being helpful? So there's some things that you can actually do with people and it might give trainees and you know, trainee counsellors, trainee therapists, trainee psychologists, a bit of a start in how to talk about trauma, how to psychoeducate someone about what's going on for them and how they're dealing with it. And then some things you can try in the room, some, you know, things like breathing exercises, things like grounding exercises, stuff like that. And it talks through, you know, I talked about from the simplest of trauma, all the way through to the most complex of trauma, you know, where we might see a really, really hurt individual who's maybe their personality is fragmented quite a lot and they're really struggling with inner conflicts between different parts of their personality. So I talk about all of that, normalise all of that, because that's all part of the package of what we deal with, isn't it? And there will be people out there that are functioning quite well, in some circumstances, but are really struggling in others. So you know, for example, the medic who goes to work and does, you know, makes life changing decisions and saves lives and does an amazing job. But behind closed doors is maybe drinking to excess, feeling worthless, really struggling, and there's those parts of self that are in a lot of conflict. So I normalise all of that, and, and talk about things that can be done to kind of just get a bit better understanding of that. And you know, maybe ground a little bit better and get back in the moment, get present, get connected, and things that people can be doing around just the sort of self care, self help sorts of things like maybe going for a run or going for a swim or baking a cake or doing craft or whatever it is that helps people to just kind of get back in this moment and just take a break, you know. So that's kind of where I think it'll be useful is for Self Help, for early career stage psychologists, but also then for the wider public. I talked before about maybe understanding trauma in the classroom, you know, maybe educators could benefit from having a bit better sense, you know, of a psychological theory, but distilled into an accessible format, that's hopefully the sort of selling point of my book is it's hopefully in a very accessible format that isn't overwhelmingly scientific and jargony. It's, it's meant to be very accessible, and that's the feedback I'm getting already is that it is very accessible.

Paula Redmond: 57:37

Okay, yeah. Beacuse it sounds like it'd be really useful for, you know, non psychological professionals too to have that really good, you know, understanding of trauma.

Yvonne Waft: 57:49

Exactly. I mean, you know, even in the corporate world, you know, I've had so many people who work in corporate industries, you know, accountants working with the big accounting companies, I've had, you know, people from all sorts of corporate backgrounds, where trauma's actually really prevalent, you know, and bullying in the workplace is really prevalent. And, you know, if there was a more trauma informed workplace, you know, if, if just the general population was more aware of what trauma is, how it impacts people, what to look out for, you know, if your colleague is struggling, if they have gone very quiet, if they have withdrawn, if they are turning down events, you know, if they, if they are sort of, you know, seeming a bit different, you know, maybe something's happened, or maybe they're just struggling with a past burden of trauma that's just caught up with them, and they just can't really keep carrying on at the moment. So yeah, I think I think everyone could do with reading something on trauma, and understanding it a little bit better. Yeah.

Paula Redmond: 59:09

Thank you for listening. If you've enjoyed this episode, please support the podcast by sharing it with others posting about it on social media, or leaving a rating or review. I'd love to connect with you, so do come find me on LinkedIn or at my website. And do check out ACP-UK and everything it has to offer. All the links are in the show notes. Thanks again, and until next time, take good care.