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MANAGING TRAUMATIC STRESS: The terrorist actions on the United States on Tuesday, September 11, 2001 were the type of events we thought could never happen. Like other types of disasters they were unexpected, sudden and overwhelming. In some cases there are no outwardly visible signs of physical injury, but there is nonetheless a serious emotional toll. It is common fir people who have experienced traumatic events to have very strong emotional reactions. Understanding normal responses to these abnormal events can aid you in coping effectively with your feelings, thoughts and behaviors, and help you along the path to recovery. WHAT HAPPENS TO PEOPLE AFTER A TRAUMATIC EVENT? Shock and denial are typical responses to terrorism, disasters and other trauma, especially shortly after the event. Both shock and denial are normal protective reactions. SHOCK is a sudden and often intense disturbance of your emotional state that may leave you feeling stunned or dazed. DENIAL involves your not acknowledging that something stressful has happened or not experiencing fully the intensity of the event. You may temporarily feel numb or disconnected from life. After the initial shock subsides, reactions vary from one person to another. However, here are some normal responses following a traumatic event: ¨ Feelings become more intense and sometimes unpredictable. You may become more irritable than usual, and your mood change back and forth dramatically. You may be especially nervous or anxious or depressed. ¨ Thoughts and behavior patterns are affected by the trauma. You may have repeated and vivid memories of the event. These flashbacks may occur for no apparent reason and may lead to physical reactions such as rapid heartbeat or sweating. You may find it difficult to concentrate or make decisions, or become more easily confused. Sleep and eating patterns may also be disrupted. ¨ Recurring emotional reactions are common. Anniversaries of the event, such as one month or one year, as well as reminders such as the sounds of sirens can trigger upsetting memories of the traumatic experience. These 'triggers' may be accompanied by fears that the stressful event will be repeated. ¨ Interpersonal relationships often become strained. Greater conflicts, such as more frequent arguments with family members and coworkers are common. Or you may become withdrawn, isolated and avoid your usual activities. ¨ Physical symptoms may accompany the extreme stress. Headaches, nausea and chest pain are common symptoms and may need medical attention. Pre-existing medical conditions may worsen due to the stress. HOW DO PEOPLE RESPOND OVER TIME? It is important to know that there is not one 'standard' pattern of reaction to the extreme stress of trauma. Some people respond immediately, while others have delayed reactions-sometimes months or even years later. Some have adverse effects for a long period of time, while others recover rather rapidly. Reactions can change over time. Some people are energized initially by the event to help them with the challenge of coping, only to later become discourage or depressed. A number of factors tend to affect the length of time required for recovery including: ¨ The degree of intensity and loss, events that last longer and pose a greater threat, and where the loss of life or substantial loss of property is involved, often takes longer to resolve. ¨ A person's general ability to cope with emotionally challenging situations. Those who have handled other difficult circumstances well may find it easier to cope with the trauma. ¨ Other stressful events preceding the traumatic event. Persons faced with emotionally challenging situations, such as serious health problems or family-related difficulties, may have more intense reactions to the new stressful event and need more time to recover. HOW CAN YOU HELP YOURSELF AND YOUR FAMILY? Trying to restore emotional well being after a traumatic event and recovering a sense of control will include the following: ¨ Give yourself time to heal. Anticipate that this will be a difficult time in your life. Allow yourself to mourn the losses you have experienced. Try to be patient with changes in your emotional state. ¨ Ask for support from people who care about you and who will listen and emphasize with your situation. But keep in mind that your typical support system may be weakened if those who are close to you also have experienced or witnessed the trauma. ¨ Communicate your experience in whatever ways feel comfortable to you-such as by talking with family or close friends, or keeping a diary. ¨ Find out about local support groups that often are available such as for those who have suffered from natural disasters or for women who are victims of rape. These can be helpful particularly for people with limited personal support systems. ¨ Engage in healthy behaviors to enhance your ability to cope with excessive stress. Eat well-balanced meals and get plenty of rest. Use relaxation techniques to help you sleep and concentrate. Avoid alcohol and drugs. ¨ Establish or reestablish routines such as eating meals at regular times and following an exercise program. Take some time off from the demands of everyday life by pursuing hobbies or other enjoyable activities. ¨ Avoid making any major life decisions such as switching careers or jobs because these activities can be highly stressful. ¨ Become knowledgeable about what to expect as a result of trauma. HOW DO YOU TAKE CARE OF CHILDREN WHO EXPERIENCE A TRAUMATIC EVENT? The intense anxiety and fear that often follows a disaster can be especially troubling for children. Some may regress and demonstrate younger behaviors such as thumb sucking or bed wetting. Children may be prone to nightmares and a fear of sleeping alone. Performance in school may also suffer. Other changes in behavior patterns may include throwing tantrums more frequently or withdrawing and becoming more solitary. ¨ Spend more time with your children and let them be more dependent on your during the months that follow the trauma --for example, allowing your children to cling to you more often than usual. Physical affection is very comforting to children who have experienced trauma. ¨ Provide play experiences to help relieve tension. Younger children in particular may find it easier to share their ideas and feelings about the event through non-verbal activities such as drawing. ¨ Encourage older children to speak with you, and with one another, about their thoughts and feeling. This helps reduce their confusion and anxiety related to the trauma. Respond to questions in terms they can comprehend. Reassure them repeatedly that you care about them and that you understand their fears and concerns. ¨ Keep regular schedules for activities such as eating, playing and going to bed to help restore a sense of security and normalcy. WHEN SHOULD YOU SEEK PROFESSIONAL HELP? Some people are able to cope effectively with the emotional and physical demands brought about by a natural disaster or other traumatic experience by using their own support systems. It is not unusual, however, to find that serious problems persist and continue to interfere with daily living. Sometimes a person feels overwhelming nervousness or lingering sadness that adversely affects job performance and interpersonal relationships. Individuals with prolonged reactions that disrupt their daily functioning should consult with a trained, experienced mental health professional. A psychologist or other mental health provider can help to find constructive ways of dealing with the emotional impact. With children, continual and aggressive emotional outbursts, serious problems at school, preoccupation with the traumatic event, continued and extreme withdrawal and other signs of anxiety or emotional distress all point to a professional's assistance. Please contact me if I can be of help or you need a referral. (The content of this article is reproduced from: APA HELP CENTER) ------------------------------
Dr.
Dorothy J. Marron, Ph.D., |
