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Medical Whistleblower Advocacy Network

Human Rights Defenders

“All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood.”

 Universal Declaration of Human Rights

Article 1

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Secondary Victims of Trauma - Vicarious Trauma

Pathway to Healing from PTSD

Healing is a pathway from vulnerability to strength.  Those with PTSD will pass through these stages sometimes going from one to another during the same day.  Healing occurs over time and when a person spends most of their day in the later stages of healing then they are improving and becoming more healed.  When a person is retraumatized they revert back to the vulnerable stage and thus loose the ability to feel safe and secure.  When that happens they lose their ability to be the complete person they are meant to be - to celebrate their individuality and to be a fulfilled and happy person.

 

These are the steps to that pathway to healing.

 

Vulnerable

Elimination of Danger

Denial of Vulnerability

Identifying Safety Needs

Exploring Protection Needs 

Sharing with Others 

Compensation - Self Esteem Needs (Sense of Belonging)

Overcoming Vulnerability  - Recognition

Celebration - Self Actualization

Understand Maslow's Heicharcy of Needs

Maslow's Heicharcy and Whistleblower Trauma

Maslow's hierarchy of needs is a theory in psychology that Abraham Maslow proposed in his 1943 paper A Theory of Human Motivation. Maslow's hierarchy of needs is often depicted as a pyramid consisting of five levels: the four lower levels are grouped together as being associated with Physiological needs, while the top level is termed growth needs associated with psychological needs. Deficiency needs must be met first.  The need for food, water, clean air, shelter and basic medical care are physiological needs. These are the most basic needs for life and they must be recognized and satisfied first. Then there are the needs for security and safety and these must be met before a person can be fully healed from life wrenching traumatic experiences.   Higher on the scale are the social needs.  Every person has the need for human companionship and a social life and the right to association with others.   There are even higher needs of self esteem.  Once these are met, seeking to satisfy growth needs drives personal growth and self actualization.  The higher needs in this hierarchy only come into focus when the lower needs in the pyramid are satisfied.  Once an individual has moved upwards to the next level, needs in the lower level will no longer be prioritized.  But it is possible for a person to fluctuate between one level and another even within the same day depending on what is happening in their life.  A sudden incident that frightens them will immediately then prioritize the safety and security needs.   If a lower set of needs is no longer being met, the individual will temporarily re-prioritize those needs by focusing attention on the unfulfilled needs, but will not permanently regress to the lower level.   For instance, a businessman (at the esteem level) who is diagnosed with cancer will spend a great deal of time concentrating on his health (physiological needs), but will continue to value his work performance (esteem needs) and will likely return to work during periods of remission.


This theory has special relevance to those facing whistleblower trauma.  Whistleblowers are often persons who have reached a high level of professional competence and  skill.   Many have been working in a stressful work environment for years,  when suddenly they, because of ethical considerations,  feel they must report something they see as wrong.  This may be motivated by a need to protect the vulnerable - such as a child, the elderly or the disabled.  Or it may be motivated by the need to right a systematic injustice such as racial hatred or economic injustice to the poor.  These Whistleblowers are persons who in the Maslow's Hierarchy of Needs were intially self actualized persons.   But when whistleblower retaliation takes place,  and the whistleblower becomes defamed, discredited, and blacklisted at work,  the economic and social realities of the person's existence dramatically change.   Some Whistleblowers have faced such severe economic hardship that they have become homeless and fighting for the basic physiological needs such as food, water, shelter and basic medical care.   So the pathway to recovery for a traumatized Whistleblower is up through the Maslow's Hierarchy of Needs.

Self- Actualization

“Better indeed is knowledge than mechanical practice (of religious ritual). Better than knowledge is meditation. But better still is surrender of attachment to results (of one's actions), because there follows immediate peace.”

Bhagavad Gita 12:12

Cognitive Behavioral Theapy CBT

CBT or Cognitive Behavioral Therapy has been found to be helpful to those suffering from PTSD.  Cognitive-behavioral therapy is based on the idea that our thoughts  cause our feelings and behaviors, not external things, like people, situations,   and events. CBT is Briefer and Time-Limited.  Clients understand at the very beginning of the therapy process that there will be a point when the formal therapy will end.  CBT therapists believe that the  clients change because they learn how to think differently and they act on that learning.  Therefore, CBT therapists focus on teaching rational self-counseling skills.   Most emotional and behavioral reactions are learned.  Therefore, the goal of therapy is to help clients unlearn their unwanted reactions and to learn a new way of reacting. 

For Further Information: 

National Association of Cognitive-Behavioral Therapists

http://www.nacbt.org/

EMDR - Eye Movement Desensitization and Reprocessing

Eye Movement Desensitization and Reprocessing (EMDR)  is an integrative psychotherapy approach.  This therapy is based on information processing.  EMDR therapy discusses past experiences that trigger dysfunctional emotions, beliefs and sensations and the positive experience needed to better adaptive behaviors.    During the process the person pays attention to past memories and present triggers while focusing on a set of external stimulus.   The positive outcome is the emergence of insight, changes in memories and new associations.

 

For Further Information:

The EMDR Institute, Inc.

http://www.emdr.com/index.htm

 

Workplace Bullying

Workplace bullying is usually seen as acts or verbal comments that  could 'mentally' hurt or isolate a person in the workplace. Sometimes,  bullying can involve negative physical contact as well. Bullying usually  involves repeated incidents or a pattern of behaviour that is intended  to intimidate, offend, degrade or humiliate a particular person or group  of people. It has also been described as the assertion of power through  aggression.

 

Workplace Violence

Workplace Bullying

How Should We Address Workplace Bullying

"When a person responds to the joys and sorrows of others as if they were his own, he has attained the highest state of spiritual union."

Bhagavad Gita 6:32

 

Counseling

General open ended long term psychological counseling will achieve little if the cause of the  stress is not addressed. So removing the person from the hostile workplace environment is crucial to the healing process.  This is sometimes the most difficult challenge we face in getting health and healing for our whistleblowers.

PTSD is caused by response to stress so creating an atmosphere conducive to the person feeling safe and secure is essential to the healing process.  People who advocate deliberately confronting a frightened and anxious person with what they fear should reconsider this approach and recognize that confronting one's fears can only be done when there is a base of emotional support and safety already established, otherwise the person may be forced into flight or fight mode and the situation could be dangerously escalated. 

Often those whose wrongdoing the whistleblower is exposing will deliberately try to push on the trigger points that frighten the whistleblower, so as to precipitate an acute stress reaction and anxiety.  This is meant to discredit the whistleblower  and their complaint or allegations.  This tactic is often used to defame their professional and personal character.

Long term open ended counseling which digs deeply into one's personal life is itself  a stressful process and as such should be entered into cautiously and may be contraindicated for people who are already suffering from significant acute stress. 

General counselors are often trained largely in dealing with people's endogenous or intra-psychic problems (those which come from within), and may be highly skilled in doing so.   However, they may have less training or experience in dealing with employment-related concerns such as stress and/or workplace bullying, where the source of the difficulty is external. Misplaced or misguided counseling, however well intentioned, can do serious damage to stressed and bullied people by feeding and reinforcing their own feelings of failure and self-blame, challenging their reality, and pushing them further into stress breakdown.   Employees may feel concerned that their confidentiality could be compromised, and this concern is not entirely groundless.  Hostile psychiatric evaluations used to remove the targeted Whistleblower from his/her employment are commonplace, so is a Fitness for Duty examination that removes the Whistleblower’s badge or security clearance.   Medical Peer Review practices are aimed at removing the medical license from the Medical Whistleblower not at assisting them in Telling Truth to Power.   Referring stressed people for work-based counseling helps perpetuate the myth that it is the person who is the problem, rather than the working environment.   In addition, where workplace bullying and whistleblower retaliation is involved, and/or the whistleblower’s continued employment is under question, there can be boundary problems.   Where the stress has been caused by workplace harassment and bullying, it also allows the perpetrators to switch the focus of attention away from their own abusive behavior by inferring, usually under the guise of sympathy and support, that the person they are targeting is mentally ill, and that it is their "mental illness" which is responsible for the current problems within the workplace.   The whistleblower may feel safer talking to someone who is further removed from their situation.   A better option would be to tackle the actual problems in the working environment.   A responsible employer should look to see what changes can be made in the working environment, and to reduce the expectations on the stressed person.

 

 
"For he has not despised or disdained the suffering of the afflicted one; he has not hidden his face from him but has listened to his cry for help."

Psalm 22:24

A Little Inspiration

"The three parts of the theory are analytical ability, the ability to analyze things to judge, to criticize. Creative, the ability to create, to invent and discover and practical, the ability to apply and use what you know."

Robert Steinberg

Drs. Zoellner and Bryant talk about PTSD

“Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around.”

― Leo Buscaglia

Medical Whistleblower Advocacy Network

MEDICAL WHISTLEBLOWER ADVOCACY NETWORK

P.O. 42700 

Washington, DC 20015

MedicalWhistleblowers (at) gmail.com

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"Never impose on others what you would not choose for yourself."  Confucius

"It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat."

Theodore Roosevelt- Excerpt from the speech "Citizenship In A Republic", delivered at the Sorbonne, in Paris, France on 23 April, 1910