Living Through and Surviving Traumatic Events

by Kirsti A. Dyer MD, MS, FAAETS, FACW, NCBF, CW

Article from www.medicalwellnessassociation.com

Suffering breaks our world.
Like a tree struck by lightening —splintered, shaken, denuded
Our world is broken by suffering, and we will never be the same again.
…Nathan Kollar

In just the past few months, we have witnessed two major hurricanes in the Gulf States and now a massive earthquake in India, Pakistan and Afghanistan. Thousands of people have been killed, others have been left homeless without possessions, towns and cities. The massive evacuation of people in anticipation of Katrina and Rita in Alabama, Louisiana, Mississippi and Texas disrupted the lives of thousands of residents. People were often given little warning when told to evacuate. They left homes, pets and possessions behind and put lives and businesses on hold to avoid the path of these natural disasters. Some returned to intact homes, others to shambles, rubble or debris. Hurricane and earthquake survivors, witnesses and evacuees have been left dazed, tired, angry, confused and devastated. Their lives have been shattered, like the tree struck by lightening, and they may never be the same again.

Natural traumatic events—hurricanes, fires, earthquakes, tsunamis, tornadoes and floods—are strong reminders of how vulnerable we are to the powerful unexpected forces of nature. Whether the loss of a home, or the loss of a loved one, sudden traumatic events shatter a person’s world, destroy what was once familiar and upset the normal sense of safety and stability. Viewing images of destruction, waiting and worrying about safety of family and friends in these areas, have left many witnesses, observers and others feeling shaken and unsure. Survivors are left splintered, shaken and denuded.

Equally damaging has been the result on the overall health and well being of survivors to these disasters. The emotional impact of a traumatic event may be felt for years, and for many whom have lost everything—a lifetime. This article provides survivors and professionals who may be treating survivors with information to understand traumatic events, the resulting normal responses and coping strategies to start restoring their health, so disrupted by these unexpected events.

Understanding Traumatic Events

A traumatic event is “an experience that causes physical, emotional, psychological distress, or harm,” (1) or “an event, or series of events, that causes moderate to severe stress reactions.” They are characterized by a sense of horror, helplessness, serious injury, or the threat of serious injury or death. (2) A traumatic event is perceived and experienced as threat to one’s safety or stability. It may involve experiences, changes or emotions, such as: physical injury or illness, separation from parents (perceived abandonment), death of a friend, family member, or pet, violence of war, terrorism or mass disaster, divorce, loss of trust, a move to a new location, hospitalization, anxiety, fear or pain. (1)

Devastating, natural trauma—hurricanes, earthquakes, fires and floods—can significantly impact a person’s overall health and wellness. (3) The effects of a natural disaster can be long lasting. Traumatic events affect those who have been directly affected by suffering injuries or loss(es) (primary survivors). They can also affect people indirectly, those who have witnessed the events either firsthand or on television (secondary survivors). Additionally rescue workers, emergency and medical personnel, counselors, relief work volunteers, chaplains, friends and relatives of victims who have been involved may also be impacted by the traumatic event as secondary survivors.

Focusing on the Basics of Coping
When helping traumatic event survivors, their physical and safety needs must be addressed first. Surviving the first 72 hours can be difficult and chaotic. Survivors may need to be reminded to simply care for themselves and attend to the basic survival needs of the body. Focusing on the basic necessities—personal safety, basic health needs, eating and sleeping—can help to re-establish some sense of control, in coping with events that may been beyond anyone’s control. (4,5)

Initially, survivors need to:
1. Take it one day at a time.
2. Eat a well balanced diet.
3. Drink plenty of water.
4. Avoid using excess alcohol, medications or drugs to mask the pain.
5. Try to keep up basic hygiene. Remember basic grooming and appearance.
6. Get enough sleep or enough rest.
7. Get some kind of exercise. Even walking can help relieve stress and tension.
8. If at all possible try and maintain some type of a normal routine, such as sleeping and eating at your regular times.
9. Talk to others, especially those who have lived through and survived similar experiences.
10.Remember healthy coping strategies you have used to survive past challenges. Draw upon these inner strengths and skills again.

More Suggestions for Living Through a Traumatic Experience

After tending to the basics necessities, survivors can focus on a bit more. Additional suggestions for coping during traumatic times are found in the table below. They are developed from Dr. Mark Lerner, clinical psychologist and traumatic stress consultant and President of the American Academy of Experts in Traumatic Stress.

Common Normal Responses Following a Traumatic Event

The recent series of natural disasters have served as powerful reminders that we cannot control the events in our lives. We can, however, control how we will respond in difficult times and choose to view traumatic events. Gaining knowledge and understanding the common responses that occur following a traumatic event can return a sense of control over the chaos and seemingly random occurrences that result in the aftermath of a natural disaster.

The stress reactions and grief responses that follow a traumatic event are normal and very common. Many survivors have lost loved ones, their homes and worldly possessions, experiencing multiple traumas and multiple losses.

Traumatic events impact physical, emotional, psychological, behavioral, social, spiritual, environmental and financial well being, disrupting the survivor’s normal balanced state of wellness. (3,5) Grief is the normal reaction to loss. Grieving is the process a person goes through while restoring the balance to his or her health and life.

Some of the common reactions that occur include fear, anxiety, numbness, sadness, depression, anger and rage. Other reactions include:

• Negative view of the world
• Moodiness
• Impatience or irritability, feeling jumpy
• Startling with loud noises
• Changes in appetite—eating too much or not being hungry
• Problems concentrating
• Difficulty in school
• Wanting to be alone more often than usual, or not wanting to be alone at all
• Re-experiencing the trauma—in daymares, nightmares or flashbacks
• Increased use of alcohol/drugs to cope with traumatic event, impairing recovery
• Tearful at unexpected moments, crying more easily or wanting to cry all the time
• Avoidance of situations that remind the survivor of trauma—places, time of day
• Difficulty sleeping, nightmares
• Loss of interest in previous activities
• Plans for the future no longer matter (7)

Common physical responses include nausea, diarrhea, stomachache, headache, dizziness, rapid heart rate, lightheadedness, allergies, rashes, grinding of teeth, increased colds and flu-like symptoms.(2, 7)

Understanding the normal responses that may result following a traumatic event can help survivors realize that certain responses may even be expected; they are normal reactions to a major loss.

It helps survivors to know that they are not “losing it” or “going crazy,” rather what they are experiencing are normal responses to an abnormal event. Survivors need to take care of themselves and understand that these normal responses and feelings are their body’s way of coping with a major life-altering event. This knowledge can make physical and emotional responses less disturbing and overwhelming. (3,4)

When to Seek More Support

Most people who have been directly involved with a painful, extraordinary stressful, traumatic event will be affected in some way. Many will require some form of assistance, whether financial, environmental, physical, emotional or psychological. How a survivor reacts to a traumatic event depends on that person’s perception of the events, his/her previous experiences with prior challenges or traumas, his/her coping abilities and the level of available existing support.

Read more here: http://www.medicalwellnessassociation.com/articles/traumatic_events.htm

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