For Survivors of Traumatic and Life-Changing Events

An Important Message about Traumatic Stress, Post Traumatic Stress and How to Manage It
Traumatic Stress is About Survival Biochemistry
Psychotherapists are just starting to understand how much posttraumatic stress can affect an individual even long after the trauma has occurred. If you or someone you know have experienced a traumatic event (any event that causes people to experience unusually strong emotional reactions), these severe experiences have the potential to affect their ability to function at their school or workplace, within their families, and/or in other areas of their lives. This event and/or events may be time-limited or may be on-going or chronic.

Posttraumatic stress is a psychological and physical condition related to the massive release of survival hormones actually flooding into the body in massive amounts during a traumatic event and/or events. These biochemical’s literally flood the body and don’t dissipate quickly, and this accounts for most of the acute, persistent and frightening symptoms that people experience for at least a couple of months and sometimes more after a traumatic event occurs.

Even though the event may be over, you may now be experiencing, or may experience later, some strong emotional and/or physical reactions. It is very common, in fact quite normal for people to experience mild to moderate and even up to severe levels of emotional aftershocks when they have passed through a horrible event or be subjected to excessive on-going recurrent stress.

Sometimes the emotional aftershocks (or stress reactions) appear immediately after the traumatic event. Sometimes they may appear a few hours or a few days later. And in some cases, weeks, months or even years may pass before the stress reactions appear brought about by some unforsceen trigger.

Symptoms May Be from Mild to Moderate to Severe and Very Alarming in Terms of Their Frequency, Intensity, and Duration
The signs and symptoms of a stress reaction may last a few days, a few weeks, a few months, and occasionally longer depending on the severity of the traumatic event and its effect on the individual and community. With understanding however, and the comfort and support of others the stress reactions usually pass more quickly. They have found that early intervention and counseling of the victim and/or victims can lessen the effect and bring about a more rapid recovery. Occasionally the traumatic event is so painful that professional assistance from an experienced and qualified mental health professional may be necessary. This does not imply craziness or weakness. It simply indicates the particular event was just too powerful for the person to manage by themselves. Here are some very common signs that are often associated with a stress reaction:

The symptoms look and feel horrible as if you were having nightmares during your waking and sleeping life. Intrusive and disturbing images, thoughts, and feelings may be present, along with severe anxiety and even panic attacks, periods of moodiness, irritability, temper problems resulting from being startled by sudden noise and/or touch, emotional numbness, impaired memory and concentration, eating disturbances, depression, elevated blood pressure, excessive use of alcohol and other abusive substances, excessive confusion and worrying, heightened levels of alertness, loss of time, fear, feelings of disbelief, grief reactions, hopelessness, feeling overwhelmed and agitated, withdrawal, inability to rest or relax, nonspecific bodily complaints, pacing, erratic movements, and even changes in sexual functioning. But that’s the effect of these severe swings in biochemistry as the body alternately floods out from these massive doses of survival hormones and their aftershocks until the body begins to settle back down to its normal rhythm. People are generally relieved to know that they aren’t going crazy when this occurs and that this is a commonplace aftermath of trauma, physical and/or psychological.

These biochemical oscillations account for the scary mood swings survivors experience. People can be furious or terrified one minute as the biochemical’s resulting in alarm reactions are released, and numb and disconnected the next after the body tries to calm down by the release of certain hormones that try to counter-act the alarm response. These terrible fluctuations often result in physical exhaustion, detachment or a sense of numbness, and even disorientation.

It Usually Takes A Long Time to Settle Down
We have learned from recent studies of hurricanes and other natural disasters, bombings and other acts of terrorism that for many people it can take from four to nine months or more to settle back down, while for some survivors it may be a matter of weeks. With PTSD there is no general rule. Recovery and healing depends a lot on built-in neurological wiring, and how long, how frequent, and how intense the experience was, and whether or not the person suffered previous traumatic experiences.

And because traumatic memories are not stored in the language and thinking centers of the brain where normal memories are catalogued, they are harder to access with language and they don’t fade or dim over time the way normal memories do. Instead they stay in the primitive, survivor center of the brain (the limbic or primitive part of the brain), as flashbacks and nightmares, where they are experienced as actual replays of the original event – a virtual reliving of the trauma over and over again triggered by simple everyday events such as a car backfiring, the distant smell of something burning, the clanging of a glass on something. Even a word or phrase can trigger such "flooding." A trigger can come in any form using any of the five senses, and the responding reactions bring about feelings, sensations, emotions, perceptions, and muscular reaction sometimes even gaining in intensity and frequency, and duration with each repetition. And when the episode subsides it leaves the person feeling anxious, scared, exhausted, numb, drained and even disoriented.

Talking About It Is Not a Good Place to Start For Many
So getting thoroughly traumatized people to talk about the terrifying experiences right after they occur is often not as helpful as common sense might suggest. Either they can’t access what happened in words, or they tell it in a mechanical or disconnected and detached way, that doesn’t help; or they try to talk about it, and a panicky flashback gets activated, turning loose another cascade of alarm biochemical’s that keep the ugly cycle going full force. Each individual case is different, and it is important to find which way is the most effective way to help each person to stabilize and to begin the recovery process. Our approach is concerned first with:

Teaching a Survivor to Learn How to Self-Regulate Themselves Before Triggering Alarm
What is most helpful in the immediate aftermath of a trauma, once people are safe and their basic needs are being met, is to teach them simple self-soothing skills that help their out-of-control biochemistry return to normal. Once there is a nice, solid practice of one or more of these simple, self-regulation skills under their belt, people are usually able to discuss the trauma without being so overwhelmed, that is, if they still want or need to. Much recent research suggests that this may be one of the most important keys to speeding up recovery from acute stress and posttraumatic stress. Learning these relaxation and self-soothing practices is very important in order to lessen the danger of going back into the trauma and re-traumatizing themselves with the effects again and again.

Simple Practices that May Help Most
There are many of these practices that may help during such times, and they are simple to do. We teach them to do:
  1. Conscious Breathing (counting to five with each in-breath and out-breath), or on each in breath to think or say, "I am," and on each out breath to think or say, "at peace."
  2. Progressive Muscle Relaxation (tensing a muscle group one group at a time beginning from head, eyes, and mouth and face and going down to neck and shoulders, arms, hands, wrists, and fingers, to chest and breathing, down to waist and hips, to thighs and legs, ankles and feet and all the way down to the toes, holding the tension in each area at a time for a count from one to five and then releasing it, and then relaxing each one for a one to five count)
  3. Meditation
  4. Yoga
  5. Accupressure
  6. Therapeutic Massage
  7. Aerobic exercise
  8. (If it brings you comfort) Prayer
  9. Journaling and/or Art Work
  10. Reading
  11. Taking a Shower or Bubble Bath
  12. Using Guided Imagery
  13. Any or All of the Above, whatever it is that brings you calmness and peace of mind
Imagery is One of the Best Tools
Guided imagery is especially easy for people to use, because it demands little and does most of the "heavy lifting." Listening or even half-listening to a guided imagery tape can provide a receptive, relaxed state for body and mind which is surprisingly easy for most trauma people to do, thanks to those natural endorphins for calming down the alarm reaction. Simple calming images, sounds, and inspired music, as simple as it sounds, may relieve stress and reduce symptoms considerably, by serving to remind their agitated system that it knows how to re-establish a sense of safety and control, to settle back down, and to empower the body through the mind to get back into its balance.

A Few Other Things to Consider
  1. Be kind and comforting to yourself. Do things which have helped you to relax before. Remove as many stressors as possible and give yourself permission to get help when it is needed.
  2. Within the first 24-48 hours, make time for several periods of physical exercise and rest.
  3. Structure your time and keep busy doing the kinds of things which have reduced stress for you in the past.
  4. Remember you’re normal and are having normal survivor alarm reactions. Don’t label yourself as “weak,” “weird,” or “crazy.”
  5. Be aware of numbing the pain with overuse of drugs or alcohol or other dangerous forms of self-medication. You don’t need to complicate an acute stress reaction with an alcohol or substance abuse problem.
  6. Spend time with others. Talk to people you think will care. Reach-out to neighbors and friends who care. Most people do care about your well-being and will be responsive to your needs.
  7. Maintain as normal a schedule as possible.
  8. Entertainment and humor is often a useful panic blocker.
  9. Try reading a book that is calming and encouraging such as, "When Bad Things Happen to Good People," by Harold Kushner.
  10. Check on your family and friends and find out how they are doing.
  11. Give yourself permission to have the feelings you feel and to share your feelings with others even if you feel rotten.
  12. Write or draw your way through those sleepless hours.
  13. Do things that feel good to you.
  14. Realize that those around you may also be under stress and show them that you care by listening to them too.
  15. Don’t make any impulsive life changes.
  16. Do make as many daily decisions as possible which will give you more control over your life. If someone, for example, asks you what you want to eat, answer them even if you’re not sure.
  17. Get plenty of rest.
  18. Recurring thoughts, dreams, or flashbacks are awful but normal. Don’t try to fight them. They will likely decrease in frequency, intensity, and duration over time and become less painful.
  19. Eat well-balanced and regular meals even if you don’t feel like it.
  20. See your physician, a qualified mental health professional, or appropriate resource experts when you require any additional assistance and help.
Some Suggestion for Family Members and Friends
  1. Listen carefully and spend time with the person who is hurting. Remember just being there helps.
  2. Offer your assistance and a listening ear even if they have not asked for help. Do not impose yourself on them. Fear of pain and being alone are two of the top concerns that survivors may not be able to express but can be comforted by being reminded that they are not alone, and that help is available to assist them in coping with fear, anxiety, depression, and panic.
  3. Reassure them that they are safe and that others do care about them, their safety, and how they are feeling.
  4. Help them with immediate needs and assist them with everyday tasks that reduce their stress level.
  5. Give them some private time.
  6. Don’t take their anger or other feelings too personally.
  7. Don’t tell them that they are “lucky it wasn’t worse.” Traumatized people aren’t consoled much with things like that. Tell them you’re sorry this event has occurred and that you want to understand and help.
  8. Seek assistance if you or they need it from qualified and experienced people you trust.
We Hope These Comments Help Comfort You and Encourage You to Be Kind and Gentle with Yourself While Surviving a Crisis or Trying to Comfort One Who Is

  1. American Psychological Association.
  2. Rangell, L. (1976, March). “Psychic Trauma,” American Journal of Psychiatry, 133, 313-314.
  3. Horowitz, M.J. (1986). “Stress-Response Syndromes: A Review of Posttraumatic and Adjustment Disorders, Hospital and Community Psychiatry, , 37, 241-249.
  4. Post-Traumatic Stress Disorder, edited by Carroll Meek, 1990.
  5. “An Important Message about Traumatic Stress,” by Belleruth Napastek, LISW, September, 2005, at: "Health Journals Archives" .
  6. “The 12 Learning Opportunities Updated,” by Gary Zukav and Linda Francis, September, 2005, at:"Gary Zukave and Linda Francis" .
  7. “Comments on Healing from Trauma,” from noted author and lecturer, Marrianne Williamson, September, 2005, at:"Marrianne Williamson" .
  8. Jean Houston, September, 2005, at:"Jean Houston" .