A Manager’s Guide to Mental Health: Workplace PTSD

Jun 26, 2022 | Blog Articles

Former police forensic investigator Esther Mckay has a lived experience of workplace PTSD after her medical retirement due to post-traumatic stress in 2001.

Since that time, Esther – who is now the Quest for Life Foundation’s Program Development Manager – has worked hard towards her own recovery while also advocating for more trauma-informed workplaces in Australia.

As part of her work with Quest, Esther helps organisations mitigate the risk of employees developing PTSD after trauma or burnout by tailoring Holistic Health and Wellbeing workshops and Moving Beyond Trauma programs.

Together with the Quest for Life team, Esther has delivered trauma-focused mental health and wellbeing programs for a range of organisations including law firms, large corporates, frontline or emergency services organisations, government departments and small businesses.

“One of the issues that a lot of organisations are struggling with is how to equip their managers with the skills to deal with their staff when they don’t seem ‘quite right’,” Esther says.

Esther says organisations should look at how they can assist their management teams with training to help them understand what trauma is and how to identify it in staff, rather than simply going down the path of performance management.

“Those managers can then give their staff skills and strategies to support themselves, rather than  looking at performance management, which may come across as, ‘you’re not up to scratch, and if your work performance isn’t up to scratch, we’ll have to let you go or move you into less skillful work’.”

What is PTSD?

PTSD, or post-traumatic stress disorder, is a set of reactions that can occur after someone has experienced or witnessed a traumatic event. About 12% of Australians will be diagnosed with PTSD at some point in their lifetime.

Some research suggests that more than half of all Australians will experience trauma at some point in their lives – many before the age of 17, which in turn suggests many more people may be living with undiagnosed PTSD.

At Quest, we’re hearing from many new organisations whose staff have found the last two years both traumatic and stressful.

People who develop workplace PTSD (or who develop it outside of work) may have difficulty recovering from the condition, which can last months, years or decades with triggers that bring up unwanted memories of the trauma accompanied by intense emotional and physical reactions. At Quest, rather than describing PTSD as a ‘disorder’, we call it an ‘injury’ to the brain and nervous system – a post-traumatic stress injury (PTSI). The body and brain are resilient and, with the right environment and tools, the brain and nervous system can be healed.

Burnout often precedes a PTSI, so it’s important for employers to ensure their staff maintain a healthy work-life balance.

What can cause a PTSI?

  • Military combat or civilian exposure to warzones
  • Childhood physical, emotional or sexual abuse
  • Natural disasters like floods or bushfires
  • Workplace bullying
  • Exposure to violent crime scenes
  • Being involved in a serious accident, e.g. a car accident
  • Domestic violence
  • Being the victim of a violent assault
  • The death of a loved one
  • The diagnosis and treatment of a life-threatening illness such as cancer
  • Any event where you feel severely threatened
  • Exposure to other people’s trauma (vicarious trauma)

What are the symptoms of a PTSI?

The signs and symptoms of a PTSI can differ between individuals; however, some broad patterns can indicate someone is experiencing post-traumatic stress.

  • Nightmares, unwanted memories or flashbacks of the trauma
  • Avoidance of situations that bring back memories of the trauma
  • Heightened reactions, anxiety, or depressed mood
  • Hypervigilance – an elevated state of constantly assessing potential threats
  • Difficulty sleeping
  • Poor nutrition and unhealthy eating habits – e.g. under or overeating
  • Substance abuse (self-medication with alcohol and drugs)

How to manage a team member with a PTSI or workplace PTSD

When checking in with staff, managers need to choose their language carefully and not exacerbate the stress or anxiety of a team member who appears to be struggling with burnout or trauma.

“It’s an awkward conversation to have with people if you don’t have any skills around how to open up that conversation,” Esther says.

“There’s all this information about asking ‘are you okay?’ which tries to reduce stigma, but we don’t really look at the best ways to assist people in management roles where people will actually come to them and say, ‘I’m not okay’.”

Esther gave the example of a medically retired former senior constable,  who attended a highly distressing scene as a rescue operator to retrieve the bodies of two teenage boys.

“When he went into the office the following week, he disclosed to a colleague that he’d cried afterwards,” Esther says.

“The manager walked past and overheard it, and said, ‘well, you’re finished. If you can’t control your emotions, your career is over.’”

“Talking about your emotions and how you feel is a normal process, and that should be accepted within the workplace. If you have a few tears after a particularly distressing job, that’s normal.

“His manager could have said to him, ‘is there anything we can do? Can we offer you some counselling to work through these emotions so that you can continue in the job that you love?’

“Saying ‘get over it’, ‘get on with it’, or ‘that was last week or last year,’ is not helpful.

“Allowing people to feel the way they feel is a good thing. It’s a positive step, allowing people to acknowledge that they’re feeling upset, and that perhaps they need to sit with someone who has the skills to guide them through  the processing of their emotions.

“You don’t want them to unpack the whole story if you’re unable to assist them, but you do want to hear the bones of what’s happened.

“You could say, ‘I don’t need to know the intimate details, but if you can tell me what’s happening in your world, I get an idea of how to assist you or find someone to help you.’

“Showing concern, listening 100%, and then maybe guiding them to some services is helpful. We can’t fix other people’s problems, but we can make some suggestions, that will guide them in the right direction. If it’s quite serious, you might want to go to another more senior manager and ask them, ‘what can we do about this?’”

Fight, Flight, Freeze, Fawn

Studies have shown that people with a PTSI have higher than normal levels of stress hormones, including cortisol. Normally, when someone is in danger, their body produces stress hormones to trigger a “fight, flight, fawn or freeze” reaction in the body.

“If you develop a PTSI, because the brain has been subjected to many traumatic incidents, or one traumatic incident then, when something reminds you of that trauma, the brain fires off immediately the stress reaction and you can go from zero to 100 in a flash,” Esther says.

“Maybe you raise your voice or burst into tears or run away. That’s that fight, flight, reaction. I was probably more in the freeze category.

“I’d be triggered, and I’d go into a sort of freeze. I wouldn’t cry, I wouldn’t laugh, I wouldn’t show any emotion… but we’re all different, other people might go into flight, they’ll run away. The fawn reaction is often a result of childhood trauma. To fawn is where people try to please everyone so that they don’t experience another person’s anger or even displeasure. Trying to get it right for everyone is exhausting! It also robs us of real intimacy and honesty in our relationships.”

Esther’s experience of PTSI after workplace PTSD

When asked about her own experience of developing a PTSI due to workplace PTSD, Esther says there were ‘two parts’ to her trauma which took place years apart.

“The first was in my first year in policing. I attended a tragic accident where two brothers were killed. We were the first on the scene and I witnessed one of the boys die.

“I was only 21 and I didn’t really know how to process that, so I just sort of pushed it down somewhere. My mother was a counsellor, so we discussed it and my partner and I discussed it a bit, but I didn’t understand how it was sitting in my body and how it impacted my life.”

Years later, Esther went into forensics as a forensic investigator and began to be regularly exposed to similarly distressing scenes.

“There was some pretty gory stuff. I was really interested in forensic science, so I pushed the sights and smells  aside and concentrated on learning the skills of investigation. What I didn’t realise was that each time I was exposed to trauma, I  pushed it down as I had with the incident with the death of the two boys.

“It was building up.”

One of the first signs something was wrong was a change in her language and tone towards colleagues.

“I was becoming really harsh, quite judgmental, and I didn’t really have much patience. I’d be rude at crime scenes to some of the general duties police who’d be ruining my crime scene by inadvertently walking through things.

“I’d yell at people saying, ‘you should know better’, that sort of thing. I did pick myself up on it a few times and thought, ‘that’s not me. Why am I being so rude?’ I was a bit shaky and nervy at the end of shifts, so I’d puff on a cigarette on the way home in the car when I’d never been a smoker.”

Although she couldn’t drink while on-call for 24 hours a day for week-long periods, once she was not on-call, Esther found herself turning to alcohol. Around that time, Esther also began to experience intrusive nightmares.

“It all culminated in me bursting into tears one night when I was eating a meal. There was something on the plate that reminded me of a post-mortem I’d attended – and I just went to pieces. I rang my boss and said, ‘I can’t come into work. I can’t stop crying,’ and he said, ‘well, you’re having a nervous breakdown’.”

“When I was going through that, my manager was so distressed himself. He was working harder than I was. He was a fantastic manager. I was so lucky to have him. He was the one that told me to take some time out.”

When asked about her own recovery, Esther says attending a Quest for Life 5-day residential program was her ‘game changer’.

“I did the Healing Your Life program. Afterwards I just couldn’t believe what I’d been living with after having post-traumatic stress for 15 years.

“I’d done PTSD programs, I’d done CBT or cognitive behavioural therapy, which helped a little bit, but I still didn’t really understand the impact that my trauma had on my body and my mental health. That’s why learning about yourself, your history and what you’ve made of that history – which is different for everybody – is really important. Understanding yourself and learning how to help yourself with meditation, breathing, mindfulness, nutrition, watching alcohol intake, and being very careful about being in the presence of people who are not good for your mental health can be life changing.

“Doing things that give you joy, honouring the things that make you happy, taking time out to actively nurture yourself. And exercising, I jog most days. People say, ‘oh, I don’t have time’, but you have to make time.

“Don’t be afraid to seek support, seek some counselling, seek someone to talk to at the earliest stages, because when it’s pushed down for 10 or 20 years, it becomes chronic and there’s a lot more work to do to get your mental and physical health back on track.”

PTSI resources – A manager’s guide to workplace PTSD

Healing from a PTSI after developing workplace PTSD is possible. We’ve seen countless people regain their physical and mental health and wellbeing so that they can return to work, retrain into new careers or find ways to live a happy and meaningful life. Their relationship with themselves and the people with whom they share their life has improved and they know and understand themselves in their depths. If ever we can be of service to you or those you love, please be in touch. We’re always happy to answer your questions and assist you to find a pathway forward to healing.

1-day Workplace Holistic Health & Wellbeing workshops tailored to your organisation’s culture.

5-day Moving Beyond Trauma program for individual employees experiencing the effects of post traumatic stress (workplace PTSD or CPTSD).

5-day Healing Your Life program for individual employees experiencing burnout, depression, grief, loss, anxiety, and chronic fatigue.

Befriending Anxiety (online course)

Beyond Burnout (online course)

Healing Sleep (online course)

Esther Mckay helped to establish Quest for Life’s acclaimed Moving Beyond Trauma program.

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