The following is an excerpt from an ar
ticle written by two practitioners of the Low Arousal Approach on the relationship between staff stress and coping when applying Low Arousal.
Foreword by Professor Andrew McDonnell
This article was written by two passionate practitioners who apply the Low Arousal Approach in many different settings. The key aim of this article was to provide a personal perspective that demonstrates the power of stress management approaches in real-life settings. Readers are encouraged to engage with the on-going debate about Low Arousal Approaches on all Studio 3 forums.
The full article is available to download as a PDF for free here.
The purpose of this article is to help practitioners recognise and cope with the stress of those in their care, as well as their own, in order to create a Low Arousal environment and manage distressed behaviour. Difficulties with stress can be prevalent in care environments for all involved. In challenging situations, it is important to adopt effective coping strategies in order to care for ourselves. This allows us to care for others and make decisions that lower the stress of those in our care. This article will reflect on what stress is, how it can present and how to use effective coping strategies.
What is Stress?
There have been multiple models of stress developed, one of the most established being Lazarus and Folkman’s transactional theory (1984). Here, stress is defined as a relationship between a person and their environment that is perceived by the person as taxing, exceeding their resources, or endangering their wellbeing. Consequently, when an individual encounters a stressor that they believe they cannot deal with, their bodies and mind react with a stress response.
The first stage is seeing the stressor and evaluating whether we can deal with it or not. If it is decided that we cannot cope with it, the stress response is triggered. Activity in the autonomic (unconscious) nervous system increases, which results in higher levels of stress hormones such as Adrenaline and Cortisol. The response also heightens our heart rate and blood pressure, our breathing speeds up, our muscles tense up and we begin to sweat.
This activity leads to fight, flight or freeze responses. The body immediately becomes alert. These responses can be useful in high-risk situations, as they can prepare our bodies to engage in behaviours that can keep us safe. Unfortunately, these responses can be triggered when we do not need them. Frequently engaging in stress responses over a long period of time can be damaging for our physical and psychological wellbeing. For example, Cortisol is released when a threat is perceived, creating a bodily response often referred to as an ‘Adrenaline rush.’ Whilst Adrenaline reduces quickly, Cortisol remains in the system for much longer. This helps the body remain alert to other threats it may or may not yet perceive after the initial threat has dissipated.
Consider the following example which demonstrates how these physiological processes can affect us and our decision-making:
‘Late one night I was awoken from my sleep by a loudbanging and crashing sound in the kitchen downstairs. I experienced a heightened state of arousal and a surge of adrenaline, followed by the thought, ‘Is someone in my house?’ Instead of calling the police, I listened intently to check if I heard more sounds, my alertness most likely aided by the spike in my Cortisol levels. Upon hearing no more unusual sounds, I decided to sneak downstairs to investigate myself. My mind was racing: ‘What if there are burglars in my house? What should I do? How many of them are there?’ Had I been thinking instead of catastrophising, I might have made a lot of noise and turned on all the lights in an effort to scare the intruder away. In hindsight, I was probably using System 1 thinking, and therefore not really thinking sensibly at all. My Cortisol levels were very high indeed. I was hyper alert for any more sounds, but still the only thing I could hear was the washing machine on a spin cycle. Upon further investigation, it became clear that the crashing noise was made by a number of objects which had been on top of the washing machine. Sometime after switching the machine on before bed, the objects place on top of it had fallen to the ground with the movement of the drum. It took me nearly half an hour to get back to sleep as Cortisol was surging through my system’.
– from ‘The Reflective Journey: A Pracititoner’s Guide to the Low Arousal Approach’ by Professor Andrew McDonnell (2019)
This example shows how Adrenaline and Cortisol can impact our decisions and increase our vigilance. The ‘System 1’ thinking referred to here is a term used by Daniel Kahneman to describe fast processing that goes on constantly and unconsciously as we navigate the world (2011). For people who experience high stress, stress responses may occur in reaction to minor stimuli as their fight or flight responses kick in automatically. Individuals who have a tendency to be hyper-reactive may experience some of the long-term difficulties associated with stress if it persists for a number of months or years. Stressors can come in may shapes and sizes, and the impact they can have on both ourselves and those we care for is massive. They vary from person to person; for example, someone may become stressed at the thought of presenting at a meeting, but for others this may not be a stressor at all.
For the majority of people, common stressors are the loss of a loved one, family difficulties and problems with work. For those working in supportive settings, stressors may include supporting someone with frequent behaviours of concern, safeguarding issues or interpersonal problems between colleagues. Some of the people we support may have difficulties recognising and communicating the sources of their stress. Having a team who understands the individual’s unique needs is therefore essential in helping them to manage their stress. People we support may have to deal with substantial stress on a daily basis, resulting from difficulties such as social understanding, rigidity, and attentional difficulties. Understanding the children and adults we support allows us to effectively implement personal coping strategies to help them reduce their stress. Achieving this is helpful for all parties involved, and will help to reduce overall stress in the care environment.
Written by Ethan McGuirk and Matthew MacGillivray
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