Coping with Traumatic Stress

Once you have experienced traumatic event — although the event may be over — you may now be experiencing or may experience later some strong emotional or physical reactions. It is very common, in fact quite normal. for people to experience emotional aftershocks when they have passed through a horrible event. 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 or months may pass before the stress reactions appear.

The signs and symptoms of a stress reaction may last a few days, a few weeks or a few months and occasionally longer depending on the severity of the traumatic event. With the understanding and the support of loved ones, stress reactions usually pass more quickly. Occasionally, the traumatic event is so painful that professional assistance from a counselor may be necessary. This does not imply craziness or weakness. It simply indicates that the particular trauma was just too powerful to manage without help. Here are some common signs and signals of a stress reaction:

Physical signs

Fatigue
Nausea
Muscle tremors
Twitches
Chest pain
Difficulty breathing
Elevated blood pressure
Rapid heart rate
Thirst
Visual difficulties
Vomiting
Grinding of teeth
Weakness

Cognitive signs

Blaming someone
Confusion
Poor attention
Poor decisions
Heightened or lowered alertness
Poor concentration
Memory problems
Hypervigilance
Difficulty identifying familiar objects or people
Increased or decreased awareness of surroundings
Poor problem solving
Poor abstract thinking
Loss of time, place, or person orientation
Disturbed thinking
Nightmares
Intrusive images

Emotional signs

Anxiety
Guilt
Grief
Denial
Severe panic (rare)
Emotional shock
Fear
Uncertainty
Loss of emotional control
Depression
Inappropriate emotional response
Apprehension
Feeling overwhelmed
Intense anger
Irritability
Agitation

Behavioral signs

Change in activity
Change in speech patterns
Withdrawal
Emotional outbursts
Suspiciousness
Change in usual communications
Loss or increase of appetite
Alcohol consumption
Inability to rest
Antisocial acts
Nonspecific bodily complaints,
Hyperalert to environment
Startle reflex intensified
Pacing
Erratic movements
Change in sexual functioning

Coping Strategies

Give yourself permission and time to grieve.
Eat healthy meals and exercise.
Get enough rest.
Ask for support and help from your family, friends, church, therapists or other community resources.
Reduce expectations about your level of productivity for a while.
Set small realistic goals to help tackle obstacles. For example, reestablish daily routines for yourself and your family.
Be understanding and tolerant of others reactions. Remember that people react differently.
Continue to educate yourself and family about normal reactions to a disaster.
Talk to your children. Be supportive. Assist them in expressing their reactions to traumatic events.
Seek help from professionals if severe traumatic stress symptoms persist.
Take breaks from media coverage of crises.
When you feel ready, consider helping others in need.

For Colleagues, Friends and Family Members

Listen carefully.
Spend time with the traumatized person.
Reassure them that they are safe.
Offer your assistance and a listening ear if they have not asked for help.
Help them with everyday tasks like cleaning, cooking, caring for the family, minding the children.
Give them some private time.
Don't take their anger or other feelings personally.
Don't tell them that they are "lucky it wasn't worse" — traumatized people are not consoled by those statements. Instead tell them that you are sorry such an event has occurred and that you want to understand and assist them.

"Talking to Kids When Talking is Tough" (Adapted from Columbine High School)

The following excerpt was developed at Combine High School in the days following the shooting and distributed via list servers, web pages and handouts at programs.

Wars, shootings in schools, natural disasters, deaths at sporting events, terrorists attacks—as adults we hope that these and other tragic outcomes will never happen anywhere and definitely will not impact the children and youth we care about. We would like to protect those young minds from the pain and horror of difficult situations. We would like to ensure that they have happy, innocent, and carefree lives. So what is a parent, teacher, or other caring adult to do when disasters fill the airwaves and the consciousness of society?

Don't assume that the kids don't know about it.

They probably know more than you think. The reality of today's world is that news travels far and wide. Adults and children learn about disasters and tragedies shortly after they occur, and live video footage with close-ups and interviews are part of the report. Children and youth are exposed to the events as soon as they can watch TV or interact with others who are consumers of the news. Not talking about it does not protect children. In fact, you may communicate that the subject is taboo and that you are unavailable if you remain silent.

Be available and "askable."

Let kids know that it is okay to talk about the unpleasant events. Listen to what they think and feel. By listening, you can find out if they have misunderstandings, and you can learn more about the support that they need. You do not need to explain more than they are ready to hear, but be willing to answer their questions.

Share your feelings.

Tell young people if you feel afraid, angry, or frustrated. It can help them to know that others also are upset by the events. They might feel that only children are struggling. If you tell them about your feelings, you also can tell them about how you deal with the feelings. Be careful not to overwhelm them or expect them to find answers for you.

Help children use creative outlets like art and music to express their feelings.

Children may not be comfortable or skilled with words, especially in relation to difficult situations. Using art, puppets, music, or books might help children open up about their reactions. They may want to draw pictures and then destroy them, or they could want to display them or send them to someone else. Be flexible and listen.

Reassure young people and help them feel safe.

When tragic events occur, children may be afraid that the same will happen to them. Some young children may even think that it already did happen to them. It is important to let them know that they are not at risk—if they are not. Try to be realistic as you reassure them, however. You can try to support them and protect them, but you can not keep all bad things from happening to children. You can always tell them that you love them, though. You can say that, no matter what happens, your love will be with them. That is realistic, and often that is all the children need to feel better.

Support children's concern for people they do not know.

Children often are afraid not only for themselves, but also for people they do not even know. They learn that many people are getting hurt or are experiencing pain in some way. They worry about those people and their well being. In some cases they might feel less secure or cared for themselves if they see that others are hurting. It is heartwarming and satisfying to observe this level of caring in children. Explore ways to help others and ease the pain.

Look for feelings beyond fear.

After reassuring kids, don't stop there. Studies have shown that children also may feel sad or angry. Let them express that full range of emotions. Support the development of caring and empathy. Be careful not to encourage the kind of response given by one child: "I don't care if there's a war, as long as it doesn't affect me and my family."

Help children and youth find a course of action.

One important way to reduce stress is to take action. This is true for both adults and children. The action may be very simple or more complex. Children may want to write a letter to someone about their feelings, get involved in an organization committed to preventing events like the one they are dealing with, or send money to help victims or interventionists. Let the young people help to identify the action choices. They may have wonderful ideas.

Take action and get involved in something.

It is not enough to let children take action by themselves. Children who know that their parents, teachers, or other significant caregivers are working to make a difference feel hope. They feel safer and more positive about the future. So do something. It will make you feel more hopeful, too. And hope is one of the most valuable gifts we can give children and ourselves.

Bibliography

Bolton, Robert. People Skills. Simon and Schuster, Inc., 1979.
Borysenko, Joan. Minding the Body, Mending the Mind. Addison-Wesley, 1987.
Bramson, R., Coping With Difficult People. Valentine Books, 1981.
Bridges, William. Managing Transitions. Addison-Wesley, 1991.
Burns, David. Feeling Good. The New Mood Therapy. Avon, 1992.
Gardner, John. On Leadership. Free Press, 1990.
Lakein, A., How to Get Control of Your Time and Life. David McKay, 1973.
Sapolsky, R., Why Zebras Don't Get Ulcers. Freeman and Co. 1994.
Seligman, M., Learned Optimism, Knopf, 1990.
Woodward, H. and Bucholz, S., Aftershock: Helping People through Corporate Change. Wiley, 1987.
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