Caring for Yourself After Trauma 
In recognition of Sexual Assault Awareness Month (April) and also the Take Back the Night event, the UNH Counseling Center is featuring this article on taking care of yourself after a traumatic experience. This article may be helpful for you if you have survived a traumatic event or if you are helping to support the survivor.
After a shocking and traumatic event, people continue to experience emotional reactions to it, often for weeks, months, or years. Some of these reactions are conscious and expectable; others come on unbidden, often in an overwhelming or else disguised way, in the form of nightmares, inexplicable anxiety or depressive symptoms, disturbance in eating and sleep patterns, or seemingly inappropriate emotional outbursts. There are many different forms of traumatic events, that is, events that are outside the range of usual human experience and would be markedly distressing to most everyone. For example, these events could include:
- natural disasters - earthquakes, floods, hurricanes, tornadoes
- accidental disasters - airplane crashes, ships sinking
- deliberate disasters - war, rape, sexual abuse
In addition to the person who has experienced the traumatic event, sometimes friends and family members who console and care for the traumatized person have emotional reactions that are worth attending to.
To take care of themselves well, people ideally need to perform a balancing act: depending on the event and the person's unique response, the balance may involve both going on with everyday life despite the unimaginable tragedy, and at the same time to continuing to talk and feel openly about feelings and experiences of the tragic events despite the need to carry on with everyday demands. People need to be mindful of taking care of themselves in whatever way possible, so as to remain healthy and centered in the face of a world seemingly spinning out of control.
Sometimes people who have experienced a traumatic event, such as being raped, may develop behaviors that help them cope in the moment, but over time may become more dangerous. Behaviors, such as cutting, substance abuse, and disordered eating represent desperate attempts by people to manage or avoid terrible pain (Sidran Foundation, 1999). These responses can be understood as normal reactions to extreme events. Giving up these coping behaviors may be like losing a friend; indeed, some apprehension about and resistance to letting go of these behaviors is to be expected.
What You Can Do for Yourself
Talk with others, especially those who also experienced the same (or a similar) event. Allow yourself to recount and talk about the experience. Each time the experience is recounted you further process and deal with what has happened. The uncomfortable feelings will gradually diminish with each retelling. Anxieties about the future and about safety will also diminish when you allow yourself to talk openly about your fears and concerns. Other important things you might try:
- Structure your time. Keep busy.
- Beware of numbing your pain with overuse of drugs or alcohol, which ultimately compound the problem.
- Maintain as normal a schedule as possible.
- Spend time with others.
- Help others as much as possible by sharing feelings and finding out how they are doing.
- Give yourself permission to feel out of sorts, nervous or blue, as you have been through an ordeal.
- Keep a journal. Write when you cannot sleep.
- Do things that feel good to you.
- Realize that those around you may be under stress too, and try to be patient.
- Do not make major life changes. Your thinking may not be as clear as usual.
- Do make as many daily decisions as possible that will give you a feeling of control over your life. For instance, if someone asks you what you want to eat, answer them even if you are not sure.
- Get plenty of rest.
- Since recurring thoughts, dreams, or flashbacks are normal, do not try to fight them. The symptoms decrease over time and become less painful. They represent your mind's natural adaptive efforts to process the information that your world has changed, and your expectable consequent feelings.
- Eat well-balanced and regular meals, even if you do not feel like it.
How to Help Others
If you are a friend or family member of someone who has survived a traumatic event, you can help them heal by:
- Validating the person's view of distress and trauma stories (rather than discrediting, discounting or minimizing) -help the person feel in touch with reality in the present moment (e.g., "you are safe now")
- Educating the person regarding triggers and relapse prevention planning (e.g., help to anticipate difficult times such as anniversaries of the event)
- Helping to explain what is happening in an affirming manner (e.g., "I believe you...you are not crazy. You are having a flashback
- This is difficult and you feel crazy but it's because you were hurt badly")
- Discuss directly with the person your concerns about them (e.g., if they are engaging in dangerous behaviors, express your concerns in a non-hostile, caring manner)
- Respecting the person's need to "numb," but also holding them accountable for their behavior
- Focus on enhancing choices, collaboration (e.g., you are not alone), and building and educating a support network
When to Seek Professional Help
Occasionally, the event may be so painful that professional assistance from a counselor or psychotherapist may be helpful. This does not imply emotional weakness on your part. It simply means that the particular event was just too powerful for the person to manage by him or herself. Often, one or two sessions with a counselor will help. Some common signs of stress reaction -- especially chest pain or difficulty in breathing -- should be checked with a medical person. Other persistent signs of stress can be ameliorated by talking with a counselor. These include persistent nightmares, disturbance in sleeping or eating, depression, and intensification of symptoms rather than a gradual lessening of them.
This information combines material from Crisis Management Group, Inc., (Newton, MA), Patti Levin, Psy.D. (New Haven, CT), Robert R. Read, Ed.D., Charles P. Ducey, Ph.D. (Cambridge, MA), and C. Patricia Hanley, Ph.D. (Durham, NH).
Post-Traumatic Stress Disorder (PTSD)
Sometimes people who experience a traumatic event will develop a psychiatric syndrome called Post-Traumatic Stress Disorder, or PTSD. PTSD occurs when someone is rendered helpless by overwhelming force.
The hundreds of thousands of people who are directly effected by PTSD have experienced these events as a:
- serious threat to one's psychological or physical integrity
- serious threat or harm to one's children, spouse, or close relatives or friends
- sudden destruction of one's home or community
- seeing another person who has recently been or is being seriously injured as a result of an accident or physical violence
Normal responses to living through an emergency, loss or tragedy
Some of these reactions may last just a few days or weeks, some for months or occasionally longer, depending on the severity of the event and its impact on a particular person. With understanding and support, these stress reactions will pass more quickly.
- irritability
- fatigue
- anxiety/helplessness
- fearfulness
- depression
- anger
- disrupted sleep, nightmares
- appetite changes
- being easily startled