No Bull Support

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

2. 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

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

4. 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

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

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

7. Depression and AnxietyExternal factors Environment Finances Isolation Chronic Illness Trauma The Bouverie Centre Rycroft, Whittle & Turpin 2009

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

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

10. DepressionUnhelpful 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

11. DepressionMore 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. …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

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

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

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

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

24. 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

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

26. 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

27. 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

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

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

30. 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

31. 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

32. 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

33. 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

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

35. 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

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

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

39. 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

40. The Bouverie Centre Rycroft, Whittle & Turpin 2009

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

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

43. The Bouverie Centre Rycroft, Whittle & Turpin 2009

44. 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 Environ- ment Perspective The Bouverie Centre Rycroft, Whittle & Turpin 2009

45. 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