Working With Refugees Using NLP

05 March, 2022. Refugee Ukrainians walk from Ukraine to Isaccea in Romania after crossing the border.
Photo used with permission © Tutye2001

Videos of our training discussion about this topic:

These videos are edited from online trainings.

Are you trained in NLP and available to help with Refugees?

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Free Book on Resilience and Crisis Recovery

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General Comments on Work with Refugees

  • My experience working with refugees involves some work in New Zealand, in Sarajevo, and in the Ukraine invasion online. Mostly what I am restating here was mentioned briefly in our Resilience course so study that first (summary below).
  • Refugees in general are highly resilient, and, for example, Ukrainian research suggests a very high resilience level (only 16.7% scored positive on the below Refugee Health Screener test: Lupone et alia 2017).
  • Being a refugee involves several dislocations: close family separations, cultural-linguistic-geographical separations, fear of war or persecution following the person, personal sense of grief, homelessness and failure.
  • Distress may also be expressed in ways difficult to like for helpers: anger, resentment, withdrawal
  • While generally resilience is linked to sense of “being in charge” in one’s own life, where this contradicts religion it is not true. Other strengths include adaptability, purpose, belonging, gratitude
  • Fostering bonds, e.g. by play with new friends, can help but not override family distress levels.
  •  “Mental health services” may have very different meanings (e.g. stigma) in some cultures.
  • NLP “processes” are a small part of a larger field. That field includes ensuring food, sleep, clothing, physical safety, family connections. It involves available physical contact, places to rest and calm down privately, a toilet and place to vomit, self-nurturing (e.g. The Havening Process) …. 
  • Reframing panic as not helpful to safety, creating simple plans for how to manage everyday challenges, and creating simple anchors e.g. by slowing breathing … are more urgent than trauma recovery techniques.
  • For trauma recovery: The NLP Eye Movement Process is easier to teach than RTM or the NLP movie theatre technique, and can be explained as helping your brain do what it does when you sleep and dream.

Resilience for Those Caring for Refugees

Burnout:  Three factors: 1) an overwhelming exhaustion, 2) feelings of cynicism and detachment from the job, 3) a sense of ineffectiveness and lack of accomplishment” The ICD-11 disease classification requires that this apply only to occupational context. Affects about 1/3 of caregivers. In caring for refugees this usually starts at 2-3 weeks (i.e. much earlier than people expect).

Secondary Traumatic Stress: stress that results from helping, or wanting to help, a traumatised person, and knowing about the traumatising events they have experienced. Affects about ½ of caregivers. Symptoms may look like PTSD. Symptoms may also include unexpected changes in spiritual beliefs, sense of identity and changes in interpersonal trust and intimacy, or physical ill health and exhaustion. Nb. Secondary Traumatic Resilience also occurs (being inspired by others resilience and life-affirming choices).

Burnout + Secondary Traumatic Stress = Compassion fatigue.

Solutions:

  1. Review. Review what you learned about resilience in general! Look for inspiring examples of resilience in yourself and others.
  2. Values and Outcomes. Have clear person outcomes and values for your work. Know why you are doing it (values) and have indicators that let you know you are doing something useful (outcomes) but that are not dependent on others. This means getting clear what things you can control and what things you can’t. Important reframe: Caring for yourself not only gives you the energy to care for others, but also models healthy self-care to them.
  3. Basic Self Care. Ensure every day you have time for preparing enjoyable food, for physical activity, for contact with friends, for spiritual self-nourishment. Consider keeping a journal, writing a case study or article about your work, or having a regular time to talk to others about what is happening. Your balance between caring for others and caring for others is unique to you, and cannot be found by comparing to others.
  4. Symbolic Control. Find small things you can control (such as tidying your desk) and do them. If you work always in a team, take some alone time / if you work always alone, take some time out to be with a friend.
  5. Monitor self. Monitor your own most common signals of stress. Perform simple self-care activities: meditation, prayer, “Havening”, calm breathing exercises, yoga. Detect and stop “rushing”, and “gossiping”, and “awful-izing” (imagining how things can get much worse).
  6. Extra Health Care. Think of yourself as a health professional and start behaving professionally: take care of your health. War usually increases the risk of pandemic and epidemic diseases. Monitor your intake of vitamin C and D, vaccinations etc. Use safety precautions such as masks.
  7. Meet. Organise a regular meeting with others who do similar work, a) so you can remind yourself that the challenges you face are not evidence of your individual deficiencies, but are characteristic of the situation; b) so you can get other ideas for managing these challenges in your unique situation; c) so you can relax and engage with someone outside of the role of being a primary helper.

References

Resilience Summary (From Richard Bolstad’s Resilience Training)

A. There are 3 stages of Crisis

1. In the event. Use the 4 steps of first aid to help someone:

  1. Aid (Give first aid and call for help)
  2. Rapport (say your name, rapport skills and reflective listen “That’s really scary.” I can see that hurts.”
  3. Comfort (“The worst part is over.” “Can you help me to help you. Could you hold this …”
  4. Suggestions (“As you notice that … you can also notice this other more positive thing…. “)

2. As the event settles down over the next weeks, and the memory reorganizes. Use the resilience skills below.

3. Long term. If you still have high stress, sleep problems etc, use NLP trauma recovery processes.

B. There are 3 responses to Crisis

1. Resilience

  1. Anchor yourself into positive states fast. Breath with slow exhale.
  2. Reframes: being calm doesn’t mean losing alertness, it means making better decisions. Sirens don’t mean death, they mean someone cares. Having survived doesn’t mean you betrayed people, it means you can help others.
  3. Simple goals for each day.
  4. Have a bigger perspective. Life/God wants you to survive.
  5. Human contact is the biggest part of resilience.

2. Recovery

3. Chronicity

  1. What if: “What If… the worst possible scenario happens?”
  2. Why: “Why did this happen to me?” “Why didn’t I do better?”
  3. Problem focus: “Can I still get back my problem feelings?”
  4. Naming it: “I have Trauma” / “I have a Clinical Depression.” etc
  5. Out of control: “I can’t control my emotions – they just happen to me.”

Richard Bolstad in Sarajevo, 1998

Refugee Health Screener (RHS-15)

We are not recommending you administer this, but simply that you know what is best to check for. Instructions: Using the scale beside each symptom, please indicate the degree to which the symptom has been bothersome to you over the past month. Place a mark in the appropriate column. If the symptom has not been bothersome to you during the past month, circle “NOT AT ALL.”

0. NOT AT ALL  1. A LITTLE BIT  2. MODERATELY  3. QUITE A BIT  4. EXTREMELY

1-9 are General Symptoms. 10-14 may be related to traumatic experiences during war and migration. How much in the past month have you:

  1. Muscle, bone, joint pains 0 1 2 3 4
  2. Feeling down, sad, or blue most of the time 0 1 2 3 4
  3. Too much thinking or too many thoughts 0 1 2 3 4
  4. Feeling helpless 0 1 2 3 4
  5. Suddenly scared for no reason 0 1 2 3 4
  6. Faintness, dizziness, or weakness 0 1 2 3 4
  7. Nervousness or shakiness inside 0 1 2 3 4
  8. Feeling restless, can’t sit still 0 1 2 3 4
  9. Crying easily 0 1 2 3 4
  10. Had the experience of reliving the trauma; acting or feeling as if it were happening again? 0 1 2 3 4
  11. Been having PHYSICAL reactions (for example, break out in a sweat, heart beats fast) when reminded of the trauma? 0 1 2 3 4
  12. Felt emotionally numb (for example, feel sad but can’t cry, unable to have loving feelings)? 0 1 2 3 4
  13. Been jumpier, more easily startled (for example, when someone walks up behind you)? 0 1 2 3 4
  14. Generally over your life, do you feel that you are:
    • Able to handle (cope with) anything that comes your way 0
    • Able to handle (cope with) most things that come your way 1
    • Able to handle (cope with) some things, but not able to cope with other things 2
    • Unable to cope with most things 3
    • Unable to cope with anything 4
  1. Distress Thermometer  10. “I feel as bad as I ever have” – 0. “Things are good” Circle the number from 1-10 that best describes how much distress you have been experiencing in the past week, including today. 0  1  2  3  4  5  6  7  8  9  10

Screening is POSITIVE (person is likely to seek medical health for PTSD etc within a year) if …

  1. Items 1-14 add up to greater than or equal to 12
  2. Distress Thermometer is greater than or equal to  5