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Welcome to Episode 17 of the Haelan Nurse Chronicles.  I’m your host Dr. Lorre Laws, a nurse, author, and trauma-burnout expert.  In today’s episode we’re going to discuss how nurses who have been traumatized in their roles can develop the trauma response known as hyper-independence.  Importantly, we’ll explore how nurses who have experienced nurse-specific traumatization, much of which is avoidable, can begin their healing process today.

What is hyper-independence?

Hyper-independence often stems from prior traumas, such as childhood trauma or nurse-specific trauma.  In response to that experience, which is partially and not yet wholly healed, the person adapts and protects themselves by not relying on others – not asking for help and even rejecting help when it is offered.  Even when refusing that help is not in their best interest.  The hyper-independent person may have difficulty delegating tasks or receiving the love and support that they crave from others.  Hyper-independence leaves many feeling unsafe and alone, feeling like they are responsible for everything all by themselves.

Factors contributing to trauma related hyper-independence:

There is a core assumption, a faulty one that reflects the unintegrated trauma or unhealed bit of wisdom as I like to call them, that believes that social support is either not deserved or unacceptable.  The person may have experienced prior traumas or neglect that required them to become self-reliant, often at an early age. Given all that the individual has endured, a sense of mistrust, loss of control, or uncertainty may develop in response to the traumatic experience.

How trauma can lead to a hyper-independence response:

For nurses, we have the Trifecta of Trauma to navigate that most people do not.  Sure, we are exposed to the same individual traumas as everyone else (acute, chronic, complex, developmental, neglect, etc.) but then we are exposed to two more trauma layers.  There’s the unavoidable trauma exposure, such as vicarious trauma, that is inherent to our profession.  Then there’s the avoidable trauma exposure that is secondary to healthcare system and organizational inadequacies, such as unsafe practice conditions and nurse-patient ratios. 

Nurses who have experienced the Trifecta of Trauma quickly learn that their management, leadership, and C-Suite executives are not supporting them with safe practice conditions and ratios.  In response, nurses adapt and start depending upon themselves for their professional survival.  After hearing broken promise after broken promise, nurses naturally develop a distrust of others.  The world is metaphorically resting on their shoulders and there’s no one to help them. So, as a protective survival response, nurses tend to develop hyper-independence.

You might be experiencing hyper-independence if:

You’re an overachiever:  Do you take on too much, overcommit, or have a hard time saying ‘no’ to being overworked or under-resourced?  You probably take on too many responsibilities without giving it much thought.  It’s what you do.

You have an underlying (perhaps subconscious) mistrust in others/  People who have been neglected or repeatedly been denied the resources and support they need for a safe nursing practice.

You tend to be a perfectionist:  sometimes, perfectionism results from trauma as we try to gain an outward sense of control to compensate for the lack of control we feel in our inner world.

You avoid depending on others, don’t like to ask for help:  This is a quintessential trauma response, for your have been conditioned, through your hardships, to believe that there isn’t help for you . . .and if that’s the case, then there’s really no point in asking for help anyway.

You have few or no close relationships:  This is a protective response to traumatization.  Relational neuroscience tells us that relationship is everything where trauma integration is concerned.  If you didn’t have the people that you perceived that you needed before, during, and after the traumatic event (in either your personal or professional life), then you didn’t learn how to lean into others during hardship.  This leaves us feeling utterly alone despite craving close relationships.  It’s like an uncontrolled diabetic whose cells are literally starving in the land of plenty.  We are surrounded by people who love and want to help us, but we don’t know how to let them in through the hyper-independent trauma response.

You are stressed and burned out.  This describes nearly every nurse I’ve encountered in over four decades.  But there is hope and there is a way out.  That’s what my work is all about.

Signs & Symptoms of Hyper-Independence

Nurses tend to carry a lot of shame . . .shame that was not ours to carry in the first place.  Shame surrounding the near misses, adverse and sentinel events that were secondary to system inadequacies.  There are adaptations to the traumas one has endured.

Nurses tend to self-isolate.  We tend to feel anxious, social anxiety, depressed, burned out, and resentful towards others. There are adaptations to the traumas one has endured.

Nurses tend to be emotionally exhausted, burned out, perfectionists, mistrusting that others can or will help us, refusing help when offered because we’ve been let down so many times before.  We may have difficulty starting or nurturing our relationships or may be closed off or secretive as we protect ourselves.  There are adaptations to the traumas one has endured.

In other words, in response to the nurse-specific and other traumatic events we’ve endured, we have adapted by becoming ultra-independent, self-protective, controlling (as a self-protective subcategory), avoiding vulnerability, intimacy, or trust.  We have been conditioned to believe that we are undeserving of support, especially by healthcare systems, organizations, and many colleagues.

Well, I am here to tell you that after conducting five years of research across four disciplines, that you are so worthy and deserving of support and that it is here for you, right now.  To the extent that your hyper-independent self feels comfortable, please explore if and how you have been affected by taking this five-question self-assessment here:

https://drlorrelaws.com/burnout

We’ll send you a complete report, along with actionable steps that you can take towards healing when the time is right for you.  So please, if you are like I used to be, feeling like I had to heal by myself and that there wasn’t anyone I could count on to help me . . .know that that is a faulty assumption that developed as part of your trauma response.

Slowly allow yourself to open to the possibility that there is help.  Evidence-based help that was drawn from four disciplines – integrative nursing, medical sociology, neurophysiology, and relational neuroscience.  All processed into very manageable bite-sized healing nuggets just for you.

Until next time, thank you for all that you are and do.  

I see you.

I feel you.

I hear you.

And I am here for you.

From my healer’s heart to yours,

Dr. Lorre 💕

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