Post-Traumatic Stress in the Workplace

Hans Beihl, PhD

Reprinted from "Trauma and Victimization" issue of Visions Journal, 2007, 3 (3), pp. 28-29

In 2005 there were over 164,000 workplace injuries reported in our province. Most workplace accidents involve physical injuries ranging from minor back strains to more serious injuries such as loss of limbs or paralysis.

Coping with the adverse effects of an injury can be stressful, but most workers manage to adjust without serious difficulties. Sometimes, however, when a worker’s life is threatened or placed in serious danger, the person can become emotionally traumatized. That is, the person becomes overwhelmed by anxiety and stress and has great difficulty coping with even ordinary daily tasks.

Joe

Consider, for example, Joe, a healthy 47-year-old worker, who was installing windows in a high-rise when the scaffold collapsed and he fell to the ground 15 feet below. Joe suffered a neck injury and fractures to both his legs. At the time of the accident he thought he would die. He slowly recovered from his physical injuries, but remained highly fearful of working at heights. He had frequent dreams of falling and would wake up in a sweat. Even weeks later he often replayed the accident over in his mind as if it had happened yesterday. When he saw others climbing ladders, his anxiety would shoot up and his knees buckle. Joe worried that he would never be able to return to his job.

Mary

While most work accidents involve physical injuries, some do not. Mary, a single mother with two children, was working as a teller in a bank, when two masked men armed with guns stormed in. Everyone was ordered to lie down on the floor. One of the robbers kicked Mary and told her he would kill her if she moved. Mary was so frightened she lost control of her bladder. For hours after the robbery, she shook uncontrollably.

Before the robbery, Mary’s world had looked safe and predictable, but now she was afraid to leave her home on her own. She feared that someone would come up behind her and attack her. Even when her friends accompanied her to public places, she felt nervous and was constantly on the lookout for danger. At night, Mary often woke up in panic, thinking she had heard someone breaking into her home. She lost interest in everything and began to drink more heavily to numb her feelings.

Traumatic events and risk factors

Both Joe’s and Mary’s anxiety symptoms were diagnosed as post-traumatic stress disorder (PTSD). Their anxiety symptoms were controlling their lives, and they felt helpless to change their situation on their own.

In BC last year, there were over 100 work injuries resulting in PTSD. Assaults in the workplace, loss of fingers or limbs, falls and serious motor vehicle accidents are some of the types of accidents that can result in emotional trauma. Individuals who have a pre-injury history of sexual assault, problems with depression or anxiety or with alcohol and drug abuse, or prior exposure to emotional or physical abuse, are more at risk of becoming emotionally traumatized.

Cognitive-behavioural therapy

Sometimes the anxiety symptoms that develop following a workplace accident resolve over time. In more severe cases, however, treatment is required to help the person regain control of his or her life.

Cognitive-behavioural therapy (CBT)1 is the most commonly used non-medical approach to treatment of PTSD. This approach focuses on helping the client come to terms with the traumatic event and regain a more realistic perspective of the risks and dangers in the world. A key aspect of this treatment approach involves helping the person face the situations they avoid due to anxiety. This is one of the greatest challenges for the client, since the instinctive reaction is to keep distant from what is feared.

Antidepressant medications are also often used in combination with CBT, or as an alternative treatment approach.

Recovery

Individuals differ in their ability to tolerate anxiety and face their fears. Most people recover from PTSD within three to six months. In some cases, despite treatment, symptoms may last for years. In one study of 44 people who were emotionally traumatized in the workplace in BC, two thirds were able to return to work by 10 months, many returned to the same or a modified job, some workers were placed in a different job, and one third wasn’t able to return to work.2

Both Mary and Joe, however, with treatment, managed to regain control of their lives and return to work.

 
About the author

Hans provides psychological consultation for WorkSafeBC. The views expressed in this article are those of the author and do not reflect the official policies of WorkSafeBC.

Footnotes:
  1. Follette, V.M., Ruzek, J.I. & Abueg, F.R. (Eds.). (2006). Cognitive-Behavioral Therapies for Trauma (2nd ed.). New York: Guilford Press.

  2. Colotla, V.A. et al. (2000, November). Post-traumatic stress disorder (PTSD) in the workplace. Poster presented at the 16th annual meeting of the International Society of Traumatic Stress Studies, San Antonio, TX.