Health effects of trauma linked to performance at work

LAWRENCE — Renowned photographer Diane Arbus said, “Most people go through life dreading they’ll have a traumatic experience.”

But most people actually undergo a traumatic experience — and then are ill-equipped to deal with it.

“When we think about trauma, we traditionally think about refugees, veterans, victims of natural disasters. We picture the extremes,” said Elizabeth Embry, assistant professor of entrepreneurship at the University of Kansas.

“The reality is that 70% of the population has experiences with or is currently experiencing a traumatic event, and that has physical ramifications.”

The fact these ramifications are often ignored or dismissed in the workplace is the impetus behind Embry’s new paper titled “If the Body Keeps the Score, What Happens When You Bring the Body to Work? Exploring the Health Effects of Trauma on Human Capital.” It offers a theory linking health effects of trauma to performance outcomes at work, suggesting how managerial awareness of trauma manifestations is a necessary step toward workplaces becoming supportive or healing.

It appears in the special issue “Health is Everyone’s Business” in Business & Society (Sage Journals). 

“Wise employers have always known that human capital is their greatest asset, and if an employee is not able to fully show up to work, then they can’t produce for the company,” said Embry, who co-wrote the paper with Lisa Jones Christensen and Paul Godfrey of Brigham Young University and Arielle Badger Newman of Syracuse University.

She noted that before the advent of modern technology, employees typically needed physical health to do jobs — whether it was working long hours at a conveyor belt or performing manual labor.

“Over time, business has moved from a practical sense of ‘our company needs this for output’ to ‘if you’re here from 9 to 5, we need to care about you.’ Turnover and burnout are all real things that not only decrease productivity but also the overall culture of a workforce and have significant implications for the individual,” she said.

Embry’s research reveals how three key manifestations of trauma exposure — hyperarousal, intrusion and constriction — affect employee health and performance.

• With hyperarousal, the body is perpetually in a state of vigilance to ensure self-protection and self-preservation.
• Intrusion represents an episodic and physiologic re-creation of a traumatic experience through vivid flashbacks and surfacing of deep memories.
• Constriction occurs when an individual’s physical state becomes one of avoidance and dissociation from emotions to avert feelings of pain, rage or terror.

According to Embry, few companies take an ideal approach to dealing with these trauma manifestations.

“There are some that have done work to promote psychological safety but are struggling with connection and collaboration. There are some that are good at trust and transparency but not good at peer support. Realistically, there’s no perfect trauma-informed workplace, but many companies are interested in doing better,” she said.

What would the ideal workplace look like?

“A trauma-informed workplace would create an environment where management and leaders can put practices in place that benefit those who are dealing with trauma and its ramifications, and actually these practices are going to help everyone,” she said.

For example, Embry said this can be applied to planning meetings. Because employers are uncertain who has dealt with domestic violence, for instance, they can preemptively take precautions to avoid triggering responses of hyperarousal, intrusion and/or constriction by employees. 

She said, “When you send out that agenda, include the names of who’s attending. Let’s say I’m dealing with a previous experience of sexual assault; I could look at that list and realize I’m the only woman on it. That allows me to either prepare myself so I know what I’m walking into or to advocate for, ‘Hey, I saw Lisa’s name isn’t on the list. Shouldn’t she be at this meeting as well?’”

Similarly, there are advantages to telling employees where the room is in advance, as this can address several physical and psychological safety perspectives.

“There are individuals who will always sit where they can see the door, which is most likely linked to a trauma response. Knowing where a meeting is in advance allows you to prepare for where it is and how it is set up. It decreases your anxiety walking in. Ideally, you can decide where you want to sit and how to position yourself physically,” she said.

Now in her second year at KU, Embry began her career in public health and disaster management. She holds a doctorate in entrepreneurship and strategy from the University of Colorado-Boulder, an MBA in international business from Saint Louis University and a Master of Public Health in global health from Boston University. Her ongoing work explores transforming existing practices from trauma-informed care into establishing principles and practices for a trauma-informed workplace.

“I hope this research generates a conversation that also allows people to think from a management perspective — how can I do better? How can I support my workforce? How can I help minimize turnover, burnout and fatigue?” she said.

“We are working to build out the principles of trauma-informed workplaces and would love to see it become reality for the workforce.”