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Trauma Awareness and Self-Care for Hosts

Mental health, self care and being aware of trauma are things that we think hosts should be aware of. Becoming a host will expose you to many situations that you might not know how to approach, both for you and your guests. This resource is not a tool to diagnose or treat those who are experiencing the effects of trauma but to raise awareness and guide hosts on how to best offer understanding and support to refugees.
This resource was written for Reset by Dr Natalie Isaia and Dr Nicola Griffiths, clinical psychologists with experience of treating trauma in a range of settings, including working with refugees, asylum seekers and those who have experienced military trauma. They are keen to share their knowledge of this area to support hosts and help make the hosting experience as positive as possible for hosts and guests. The authors have written more, in-depth materials on this subject which you can access on their website., The Core Collective.

Understanding Trauma

When thinking about trauma it is helpful to look at the different ways that life events can impact upon our wellbeing. Trauma is conceptually split into two types, both of which can have significant impacts upon wellbeing and both of which may be present in people fleeing their homes due to war:

Big T Trauma

Refers to distressing events that we are involved in or witness that pose a risk to the life or body-integrity of ourselves or someone else. This is the type of trauma associated with Post Traumatic Stress Disorder (PTSD).

Little T Trauma

Refers to distressing events that do not necessarily have the perceived risks of big T trauma but have a significant impact upon a person’s wellbeing due to the risk they pose to factors that are important to a person (e.g. our emotional or relational wellbeing).

A refugee might have experienced both types of trauma. They may have experienced life threat to themselves or others alongside witnessing war. They may also be experiencing the loss of their home, communities and livelihood.

Trauma of both sorts can fundamentally change the way we see the world, can make us feel helpless or out of control and have a significant impact upon our emotional wellbeing. In addition to these understandable difficulties, the way that our brain processes and makes sense of trauma is different to the way in which other experiences are stored in our memory and this can cause significant difficulties.

During a traumatic experience our brains function to survive and therefore the focus is on action to remain safe rather than making sense of what is going on. After the event our brains might go back and do the processing however sometimes they don’t and therefore memories become fixed in the moment. This is compounded by the fact that the brain naturally doesn’t want to go back and look at something painful.

For people leaving their homes due to war there are additional complications in relation to processing traumatic events due to the sheer number of traumas they may have experienced. It is likely to take a significant amount of time before they reach a sufficiently safe place to feel able to process these experiences. This may mean that as they become settled into their new homes some refugees may be living with significant impacts due to trauma.

The Impact of Trauma

  • Memories of traumatic events are stored differently meaning that they are vivid, distressing and fixed in that moment. Unlike other memories which feel like they exist in the past and are perhaps more vague, trauma memories may feel like you are right back in that moment of threat – seeing, feeling and thinking all the same things you did in that moment.
  • Trauma memories that are not processed can leave the person feeling that they are in constant threat. This means that they may be hypervigilant, easily startled, struggle to relax, have difficulties concentrating and feel strong emotional responses.
  • Trauma memories are easily triggered. The brain is hyperaware of any factors in our experience or environment that are reminiscent of the trauma, so triggers could be small or difficult to anticipate but take the brain straight back into that moment of trauma.
  • Flashbacks occur in trauma; this is where a person experiences sudden involuntary reliving of a traumatic event usually due to a trigger. People experiencing flashbacks may experience significant distress, physical responses or may act out what they were doing in the moment of trauma.
  • Night-time can be difficult for people experiencing trauma, as they may experience distressing nightmares and are often more susceptible to flashbacks when falling asleep or waking up.

Different Types of Trauma

Vicarious trauma

Vicarious trauma is a response to engaging and empathising with the traumatic experience of another person. Not all hosts will experience this, but it helps to be aware so you can spot the signs early and manage them effectively if they do arise. Vicarious trauma is not technically a mental health disorder, but is associated with a higher risk of developing PTSD and other mental health difficulties.

Here are some signs of vicarious trauma[i]:

  • Experiencing lingering feelings of anger, rage and sadness about your guest’s victimisation (the key here is lingering – it is natural and appropriate to feel these emotions at certain times, but they should not become chronic experiences).
  • Becoming overly involved emotionally with your guest.
  • Being preoccupied with thoughts of your guest and/or their experiences.
  • Feeling responsible for “rescuing” your guest and over-stepping boundaries (e.g. trying to play the role of a therapist, parent, partner, etc).
  • Experiencing bystander guilt, shame, feelings of self-doubt.
  • Loss of hope, pessimism, cynicism.
  • Emotional distancing, numbing or detachment.
  • Avoiding your guest.

Compound loss and uncertainty

Not all refugees will have symptoms of trauma, however being displaced is still a very difficult experience. It would be natural for an individual to feel low in mood or anxious and uncertain about the future. This may cause them to withdraw and isolate themselves, which could make it feel harder to offer support. It is important to remember that their hardship isn’t ‘over’ now that they are in the UK.

Anyone who has been displaced will have experienced multiple losses which will compound on each other. Some of these losses will be obvious: your guest may have left behind loved ones, pets, treasured possessions and their home. This will lead to a total loss of familiarity, comfort, and personal space, all of which are important for our wellbeing. On top of this they will have lost their routine, their social status and occupational identity (e.g. someone may have been a respected lawyer in their country of origin, and now they are on benefits), their independence, and some of their cultural identity. All of these losses together would naturally make an individual feel low.

While resettled refugees may now be physically safe, they will be holding a lot of uncertainty about their future. Human brains have evolved to dislike too much uncertainty, so sitting with this for months or even years can take a significant toll on wellbeing. Alongside this they will be going through a major adjustment process, trying to get used to an entirely new way of living. During moments of conflict or stress, try to hold in mind all that they are coping with.

Common Emotional Impacts

In addition to low mood and anxiety, there are some emotional impacts that would be common after being displaced.

Anger

They may experience anger at the injustice of what they have experienced. Anger is also a symptom of PTSD, as trauma may cause an individual to be jumpy and irritable due to their heightened fight-or-flight response (the physiological threat response). While unlikely to be deliberate, this anger may be displaced onto those close by or trying to help. For example, a guest might feel anger or resentment at seeing a happy family in their country of origin, as a response to the grief they feel for their losses.

Dissociation

This is when we become cut off (physically, emotionally or even consciously) from an overwhelming experience. This can look like someone zoning out or appearing to show no emotional response at all.

Physical Response

All emotions manifest in our bodies, for example anger and anxiety cause physical sensations such as racing heart, sweating, tense muscles, feeling dizzy or sick, etc. Over time, trauma or chronic stress can lead to a variety of physical health issues. Your guest might be struggling to sleep, they may lose their appetite, they may feel extremely fatigued, they might feel aches and pains, rashes, migraines, or other physical illnesses. In many cultures there is shame and stigma around discussing emotions, it can be seen as vulnerability or weakness – if your guest is feeling like this, they may be more likely to show or discuss physical symptoms (e.g. “I feel tired” rather than “I feel depressed”).

Top Tips for Supporting your Guests

1- Know when to listen and when to problem solve.

For many of us, when someone is talking about their problems, we feel an urge to jump into problem-solving mode. Sometimes this is appropriate – when the issue is practical, solvable and they have requested practical help. Often there is no “right way” to respond. Having someone truly listen to what we say and hearing the response, “That sounds really hard, I can understand why you feel that way” can be so much more powerful than when someone tries to jump in and fix our problems.

2- Respect their privacy.

Equally, don’t pressure your guest to talk about their feelings or their experiences. ‘Getting it all out’ is not always helpful and can be retraumatizing for the individual. Also, remember that there is still a lot of shame and stigma associated with experiencing and discussing mental health problems or emotional distress.

3- Be patient.

Recovering from trauma and displacement takes time and people may only start to process what they have been through once they are in a safe permanent setting. Allow the person space and try not to have expectations of them or the hosting experience.

4- Respect their boundaries and be consistent with your own.

If your guest doesn’t want to talk about their experiences, if they don’t feel comfortable joining you for dinner, if they don’t want to take you up on your kind offer to accompany them to an appointment, that’s fine. Respect their boundaries, while trying not to take it personally or feel rejected.Clear communication and asking questions sensitively will help you work out where their boundaries lie. Holding consistent boundaries for yourself is also important so that they know what to expect and can feel safe. It also means that you are able to share your needs and therefore find an approach that works for everyone.

5- Be mindful of common triggers

such as the news (discuss with the person if they are happy for the radio or TV to be on in the background or newspapers lying around), loud noises such as fireworks, planes flying overhead or large vehicles passing, weapons (in the house, as part of hobbies or toys), violent video games or movies etc. Let the person know if there is something upcoming that could be triggering.

6- Discuss with your guest how you can best support them to feel safe or at home.

This might be to do with the physical environment (e.g. the decor of their room, presence of a lock on their door or having their own space to relax in), the house norms (e.g. supporting autonomy, adaptation for cultural differences) or in your behaviour (e.g. being consistent, validating their experiences, not asking too many questions etc).

7- Be mindful that there is a power difference.

Your guest may feel indebted to you so try to be considerate when making requests of them. Ensure that your communication is clear that your hospitality is without strings attached.

8- Be mindful of personal space.

We all have different norms and needs in relation to personal space but for people who have experienced trauma this is particularly important. Allow the person plenty of personal space, try to avoid following them closely behind, looking over their shoulder or touching them when they don’t expect it. As a rule, follow their example in relation to personal space and physical contact; it might be your norm to offer a hug if you see someone distressed but others might find this intrusive or culturally inappropriate, so get to know your guest and follow their lead.

9- Support your guest to engage in the community around them.

Orientate them to the local area, give them resources to find out about services, groups, local refugee projects, etc.

10- Signpost to professional support if necessary.

If your guest expresses the need for specialist psychological support, if your guest is in crisis, or if you think your guest is being taken advantage of in some way, you should encourage them to reach out to their local authority contact for specialist support or you can signpost them to other sources of formal support like the Barnardos helpline.

Top Tips for Supporting Yourself as a Host

1- Basic self-care.

The importance of basic self-care should never be overlooked when managing your wellbeing. This includes keeping the balance of your own work and leisure activities – make sure you give attention to all areas of your life, not just focusing on your guest. Remember, you can’t pour from an empty cup.

2- Be realistic

About what you can do. You can’t “fix” the situation. Don’t take on responsibility for your guest’s wellbeing. It is better to support and empower them by guiding them towards tools and support networks, so that they can regain their sense of self-efficacy and autonomy. It’s nice to put in effort to make your guest feel welcome and supported but you are hosting someone for a long period of time, so it can be helpful to think of the relationship in terms of being housemates, rather than hosting a visitor for the weekend. For example, your guest might prefer to cook for themselves or might enjoy taking it in turns to cook, so it is helpful to have these discussions and find a rhythm that works for you.

3- Keep to your role.

Remember that you are a host not a therapist, you are not expected to fix someone’s difficulties. When it comes to trauma, it is important that someone receives suitable professional support. Don’t forget that offering a safe space to live is an amazing gift in its own right and this is the first step for someone to feel able to start their journey to feeling safe. Also be mindful of not getting pulled into familial roles that aren’t yours e.g. parent, child, partner.

4- Set explicit boundaries.

Holding emotional boundaries is crucial for maintaining healthy wellbeing in general, and for preventing vicarious trauma in particular. Practical boundaries are also crucial – before your guest arrives, take some time to sit and reflect on what your boundaries should be. Consider setting some boundaries around how much time you think would be reasonable to spend with your guest or supporting your guest, without losing the balance with your own life and commitments. Try to think through any practical boundaries that might arise, and where you stand on these.

5- Clear communication

is one of the most important factors in creating good interpersonal relationships and miscommunication can happen easily even with people who know us well. Sometimes we assume that people know our intentions, we believe we know what people think about us, we believe we know what their underlying intentions are. Unfortunately, none of us are mind-readers. The more explicitly you can communicate underlying assumptions, expectations, intentions and feelings, the more effectively you will be able to navigate and negotiate situations.

6- Notice and validate your feelings.

Awareness of emotions is the first step to staying on top of emotion regulation and stress management. Mindfulness practices are great for this! Don’t judge yourself if you notice negative emotions creeping in, try to validate your experience and avoid self-criticism. See those emotions as a sign that it is time to step up your self-care or review whether your approach and boundaries are working for you.

7- Don’t be too hard on yourself.

Stressful situations and exposure to someone else’s trauma can lead to negative and self-critical thoughts. In situations like this, we can’t deny the truth of the reality or pretend everything is OK. The best strategies are therefore those that help balance our thoughts rather than deny them. Self-compassion will help you to hold healthy boundaries and look after your own wellbeing. A great trick is to ask yourself the following question when you’re being self-critical or hard on yourself: “What would I say to a friend if they were in this position?” If your response is warmer and more encouraging, try and apply this to yourself.

8- Don’t take it personally.

It’s human nature to personalise things, so although it’s very hard to do in practice, it is helpful to take a step back from your immediate emotional reaction and think about what is really going on for your guest under the surface(e.g. consider how their anxiety may be coming across as irritability).

9- Seek social support.

Social support is one of the best predictors of wellbeing. Whether it is your friends, family or networks of other hosts – reach out! Speaking to others about your experience is important for processing the resulting emotions and gaining a sense of solidarity.

10- Ask for help if you need it.

If you are struggling, reach out for professional support. It is brave and courageous to know when to ask for help and there is support out there. Consider making an appointment with your GP to ask for specialist support. This is especially important if you are noticing signs of vicarious trauma in yourself.

11- Enjoy it!

Remember you are doing something amazing by offering up your home. Take time to acknowledge this and enjoy the experience of getting to know someone new.

To read more in-depth information on this subject, please visit https://www.corecollective.uk/refugee-hosting

[i] Adapted from the British Medical Association website.