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Are aid workers more ‘maladjusted’ than others?

Are aid workers more ‘maladjusted’ than others?

Are aid workers more ‘maladjusted’ than others – or does our work just make our maladjustments more obvious?

“According to the General Health Questionnaire (GHQ), a staggering 50% of aid workers could be classified as non-psychotic psychiatric cases. The authors offer three possible reasons for the result, the third being the most intriguing: the tendency of maladjusted individuals to choose to become aid workers.” (Brendan Rigby, WhyDev)

I first came across this notion of “maladjustment” many years ago in a study on what motivates international volunteers, and I was curious – was it my “issues” that motivated me into volunteering and aid work?  Certainly I felt like the choices I was making brought out my insecurities, but on the other hand everyone else I knew had their own issues, and most of those people hadn’t gone into aid work.

As I considered this question further in subsequent years it also occurred to me that the aid worker experience often cuts quickly through the superficial.  Any demons, vulnerabilities or insecurities you have will be exposed by the emotional, physical and intellectual pressure-cooker of aid work – particularly humanitarian work.

The authors of the paper referenced above speculated that their results could be explained by “a high incidence of people with psychological problems choosing to become aid workers.”  But the study did not compare pre- and post-mission data to check this hypothesis or provide other evidence to support it.  Another well-known study that did involve longitudinal research found on the other hand that aid workers with experience of severe childhood stress seemed less at risk, and postulated that this may be because their earlier experiences had helped them develop more effective coping strategies. This is intriguing, because exposure to early life stress is often considered to predispose a person to greater vulnerability later in life, not less.

So I was very interested to hear psychologist Carla Uriarte’s opinion about this.  She has been working in aid worker psychosocial health for more than a decade and in a recent interview about a new aid worker resilience training program she is co-teaching for the Garrison Institute in New York, she said:

“I’ve been intensively working with aid workers for the last eight years. Many aid workers, from a general perspective, show an exceptionally good resilience capacity.  I’ve worked with people who have better personal coping mechanisms than the majority of people, but they are confronted with very extreme experiences, which overwhelm in some cases, some instances, some moments, those coping resources.  [I think it is also true that] very stressful experiences bring out our vulnerabilities in a more clear way.”

She points out that when you put all of these individual cases together, the effect intensifies: “Now when you’re working with a team of people who don’t know you, and are trying to cope with their own difficulties, then it’s a lot more difficult for those issues to calm themselves.  So I think what happens is they get more acute.”

In her chapter on aid worker safety and security in the anthology Workplace Violence, Ros Thomas draws on research done with mental health workers to assert that: “…when aid workers experience trauma it brings to the surface uncertainties, fear and vulnerability in colleagues who have contact with them.”

But the same characteristics that the stresses of aid work bring to the fore may also motivate and equip people to do the work.  Aid workers “seek adventure, travel and to engage in something different,” says Thomas, but they are also “motivated by a wish to engage in meaningful activities that contribute to securing a better life for those in distress.” The constant change and adaptation aid work demands are known to be stressful, Uriarte argues, but they also attract people to it.  Other research indicates a strong sense of empathy often motivates people to get involved in helping or caregiving work, even while potentially making them more vulnerable to empathic distress.

So it does seem fair to suggest that rather than being less well-adjusted than the general population, we aid workers are equally maladjusted, but have chosen a line of work that makes it harder to mask or ignore our weaknesses and vulnerabilities.

If that’s true, the relevant question becomes: how do we maximise the way the “maladjustments” each of us brings to aid work make us particularly suited for it, while minimising the negative consequences?

As Uriarte points out, some claim people who choose to train as psychologists are similarly maladjusted.  But unlike aid workers, the connection between the individual’s own process and the work he/she does with others is explicitly recognized in the training of psychologists and social workers.   They’re required to maintain some kind of peer supervision and self-reflection process as part of their professional practice.

What might happen if that also applied to aid work?  The need for continuing “organisational learning” through reflection is a given (though not necessarily done well) in humanitarian and development best practice.  Systematic practice of reflection and learning at the individual level, going beyond the traditional work-output focus of an aid worker’s performance appraisal, might be equally valuable.

WhyDev piloted a Peer Coaching program for aid workers last year with a lot of success and is currently fundraising to launch a refined version of DevPeers.  For me yoga and meditation have been key in the process of self-reflection at both a mental and physical level and I recently partnered with Marianne Elliott to offer an online yoga course ’30 Days of Yoga’ targeted for Aid Workers.  The Contemplative Based Resilience Training offered by the Garrison Institute, for which Uriarte is part of an expert faculty, brings together meditation and yoga-based practices with psychosocial education in a multi-faceted resilience training program.

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Amanda Scothern

Amanda Scothern is an aid worker, yoga teacher and consultant with the Contemplative-Based Resilience Training (CBRT) program of the Garrison Institute.

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