Page 161 - EMCAPP-Journal No. 14

1. severe and pervasive problems in affect regulation;
2. persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and
pervasive feelings of shame, guilt or failure related to the stressor; and
3. persistent difficulties in sustaining relationships and in feeling close to others. The disturbance
causes significant impairment in personal, family, social, educational, occupational or other im-
portant areas of functioning.”

Dissociation for Coping
In the face of extreme emotional pain, a survival mechanism—dissociation—can be activated that
shuts down the capacity to feel to varying degrees. Typical dissociative behaviors include emotional
numbing, lack of awareness of or inability to connect with feelings/ emotions and/or sensations. As
trauma symptoms become more widely understood, the role dissociation plays can sometimes be
undetected. The function of dissociative behaviors is to allow a person to escape, avoid or even get rid
of unpleasant personal experiences. These are often situations that would make an individual feel fear,
anxiety, pain, disgust, shame and guilt, among others. Signs of dissociation include:

• Spacing out, day-dreaming
• Glazed look, staring
• Mind going blank
• Mind wandering
• Sense of world not being real
• Watching self from outside
• Detachment from self or identity
• Out of body experience
• Disconnected from surroundings
• Amnesia
• Inability to feel some part or parts of your body.

If a humanitarian worker is attending to vulnerable populations in a dissociated state, the possibility
to cause further harm to self and others can be high. And yet, it is rare to find organizations that pro-
vide routine checks for symptoms of dissociation for staff working in vulnerable settings. A tool that
is easily used to assess for dissociation is the Dissociative Experiences Scale (Carlson and Putnam,
1993).

One of the best interventions when working with dissociation is to provide assistance in staying in the
present moment. Having the person who is experiencing dissociation smell something with a strong
odor, such as coffee or mint; asking them to sing; or name a list of objects/colors they can see around
them, all contribute to supporting the dissociated person in coming back to the here and now. Further
resources are found also in providing safety and soothing. Encouraging the person to take off their
shoes and feel their feet on the ground while placing a hand on their heart and abdomen is another
very effective tool.

PART TWO:

PERSPECTIVES AND RESOURCES FOR SUPPORT

1. Resilience and Spirituality

“There will come a time, if you pursue this career for long, when a profound lack of understanding
will threaten to sweep away your actions, beliefs, achievements, and even reason for being. Knowing
this challenge will come, and ensuring that there are close friends who can hear your questions with-
out harming you, is . . . essential.” Fawcett (2003, cited in McKay, 2010, page 11)
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