Surviving trauma

A traumatic event or situation is one where:

• ­ There has been threat or violence to yourself, your loved ones, or companions
• ­ You or someone close to you has been involved in a serious accident
• ­ You work with people for whom traumatic experience is the prevailing norm
• ­ You work with peoples traumatic stories
• ­ You witness the pain, suffering, dying or death of others
• ­ You are working in a natural disaster area
• ­ You are working where there is conflict, for example domestic violence,  civil upheaval, or in a war zone

In these circumstances powerful feelings and thoughts are often aroused and can affect our behaviour and outlook.  This is normal and is not a sign of personal weakness.

The impact of trauma

Whatever you have been caught up in there are no right or wrong ways to respond.  Your responses are personal to you.  Normal traumatic stress reactions include:

• Intrusive thoughts, images, sounds, smells & sensations in the body.  Scenarios go over and over and over in your mind.  You can't stop it.  When you try it keeps intruding and taking over your thoughts.  You are likely to feel the impact physically through anything from a racing heart, sweating and difficulty breathing, to nausea, a dry mouth, tight chest, back ache and head ache.
• Flashbacks - You feel as though it were happening right now.  It may be in a nightmare which you wake up from feeling full of terror or pain which feels unbearable, or in fear for your life.  It may happen in the day when an image, a sound or smell or sensation in the body just overwhelms you.  You cannot control these flashbacks.  You can't stop them from happening and you don't know when they might happen.
• Feeling cut off - It's as though you were in a dreamlike bubble, isolated emotionally from people around you.  You feel like your 'old self' is gone out of reach, your normal range of feelings and interests cut off and you cannot imagine a future.
• Tiredness - This is an understatement!  You feel exhausted a lot of the time.  Your energy is used up with the attempt to survive.  You may sleep many long hours or you may not be able to sleep, tossing and turning with everything racing in your head.  Or you may just feel ill rather than going over it in your mind.
• Poor functioning - You may be snappy and irritable.  You may be aggressive.  You keep forgetting ordinary things.  It's difficult to concentrate.  You jump easily and you cannot relax.  You may feel withdrawn, lacking interest in life around you.  Your appetite is disturbed and you cannot eat as usual or else you cannot stop eating.  Your sexual desire is disturbed and you may find yourself with no interest at all or you may crave more physical and sexual contact than usual.  Your sleep pattern is disturbed.
• Taking unaccustomed risks - You may be taking unaccustomed risks like driving too fast or having unsafe sex.  You may feel alarmed that you have lost control of yourself and worry that you might not be able to regain it.
• Avoidance - You might find yourself avoiding all thoughts, reminders and people associated with the bad thing that has happened.  You are full of determination to put it behind you and get on with your life.  You don't want to experience the pain of engaging with it.
• Guilt /feeling bad - It's not immediately obvious, but it's common for people to feel guilty about the fact they've survived.  You might be struggling with it.  It's especially difficult when people around say you are lucky or blessed to have survived when you feel anything but.  In fact you are likely just to feel bad.

If you are struggling with responses like these seek support from people you trust as a priority.

Overcoming trauma

Historically the approach to people’s distressed responses to trauma has been on symptom reduction and treatment to prevent PTSD (Post Traumatic Stress Disorder), using a medical model.   While this has its place it is often unacceptable to people for many different reasons.

Feeling disturbed after being caught up in disturbing situations is normal.  People may feel disturbed physically, psychologically, emotionally and spiritually.  They may feel numb or unmoved or entirely out of control.  People are most helped, if possible, by all of these or as much as can be achieved:

• ­ Having a place of safety
• ­ Having reliable people to turn to (psychosocial support)
• ­ Good information from a reliable source 
• ­ Psychological First Aid
• ­ Understanding that it is normal to feel disturbed

Evidence shows being in a safe place, having psychosocial support and reliable information are very helpful.  Allowing people to take time off work and to gather together in a structured or semi-structured way is advised.

Ways to help yourself

1. Remember traumatic stress responses are normal.
2. Give yourself time. When we experience something traumatic, we can feel out of control and struggle to make sense of the chaos.  It takes time - weeks or months - to accept what has happened and to learn to live with it.
3. Distressing events that shatter the way we see ourselves can evoke a loss of meaning, purpose and hope. You may need to grieve for what you have lost.
4. It can help to spend time with others who have been through the same experience as you.
5. Ask for support. Most people who experience a traumatic event need support and understanding from those around them to help them recover. Sometimes you will want to be with other people but not to talk about what has happened.
6. Take some time for yourself.
7. Don’t avoid talking about it.  It can be a relief to talk about what happened. Take things at a pace that you feel comfortable with.  You don't need to wallow in it but it is unhelpful to avoid it.
8. Get into a routine. Exercise, have regular meals and eat a balanced diet.  Don’t force yourself but aim to re-establish a routine.

When to seek further help

You may need to seek further help in the following circumstances:

• ­ You have no one to share your feelings with
• ­ You feel overwhelmed by sadness, anxiety, or nervousness
• ­ You feel that you are not returning to normal after six weeks
• ­ Your nightmares are preventing you from getting sleep
• ­ You are struggling to get on with those close to you
• ­ You want to withdraw from other people more and more
• ­ You feel numb and notice that you increasingly don’t care
• ­ Your work is suffering and it’s difficult to concentrate
• ­ Those around you suggest you seek help
• ­ You only feel alive in high risk or very stressful situations
• ­ You are drinking or smoking too much, or using drugs or other high risk strategies to cope with your feelings
• ­ You bury yourself in work in order to avoid your feelings
• ­ Even in a safe relationship you are not able to talk about the traumatic event
• ­ You feel you are the only one suffering like this

Speak to someone such as your Area Dean who can help you access further professional help.  This may be with a doctor, psychologist, counsellor or specialist psychotherapist.  It might be with an elder or religious leader you trust.  Trauma focussed psychological therapy may be indicated for some who have been caught up in a traumatic situation if their disturbance does not abate. 

It is not recommended to use drug treatments as first line interventions. Current published research indicates that the single intervention post trauma Critical Incident Debriefing is not recommended as effective in promoting recovery and may sometimes be harmful.