Thursday's Therapy - Self-Care Amidst Violence and Trauma

Thursday's Therapy

Self-Care Amidst Violence and Trauma

Common Reactions to Violence and Trauma

Suggestions for Self-Care

~by the Community Crisis Response Team,
a Service of the Victims of Violence Program, Cambridge Hospital, Cambridge, MA

Which people are most affected by violence and trauma?

Many people may be affected by a violent event - both people who have been direct victims of violence, as well as family, friends, or others who have connections to the victims.

Following a traumatic event - whether it happens to you, or to someone you know - it is normal to feel it personally. We know that when people are direct victims of violence, they often have physical and emotional reactions that can last for a long time. But other people - family, friends, co-workers, emergency service personnel, neighbors, professional caregivers, witnesses to the violence, or others who have something in common with the victims - may also have reactions to a particular violent event. Although each person reacts differently, according to his/her personality, past experiences, and connection to the event, a wide range of common feelings and reactions can occur after a person has been involved in or heard about a traumatic or violent event.

How do people react to violence and trauma?

It depends on the individual. Each person will have his or her own set of reactions.

Here is a partial list of normal reactions to violence and other traumatic events. Each individual may have a number of several of these reactions.

COGNITIVE

• Difficulty remembering things
• Hard time making decisions
• Confusion
• Distortion of time
• Difficulty concentrating
• Too many thoughts at once
• Thinking about suicide
• Threatened assumptions (that the world is not safe or less safe than before
• Intrusive images
• Flashbacks
• Replaying the event

PSYCHOLOGICAL

• Feeling helpless, hopeless or powerless
  
• Grief/numbness
  
• Dread/fear/safety concerns
  
• Guilt
  
• Dependency
  
• Feeling overwhelmed or vulnerable
  
• Feeling not yourself
  
• Triggering of prior trauma or losses
  
• Emotional rollercoaster
  
• Nightmares

PHYSICAL

• Fatigue/change in sleep habits
  
• Eating/appetite problems
  
• Stomach problems
  
• Vomiting/diarrhea
  
• Sweating, rapid pulse, chest pains
  
• Dizziness, headaches
  
• Back or neck pain
  
• Startle reactions
  
• Catch colds or flu

SPIRITUAL

• Loss of faith
  
• Spiritual doubts
  
• Withdrawal from church community
  
• Lapses in spiritual practice
  
• Despair
  
• Questioning old beliefs
  
• Sense of the world being changed, out of kilter

RELATIONAL

• Withdrawing from, or clinging to, others
  
• Alienation from friends, family, co-workers who "don't understand"
  
• Breakdown in trust
  
• Changes in sexual activity
  
• False or distorted generalizations about others
  
• Doubts about relationships
  
• Alternately demanding or distant with others
  
• Irritability

What can you do to recover from trauma?

Different strategies work for different people. In the aftermath of violence and other trauma, people sometimes find themselves at a loss for how to deal with their feelings and reactions. One of the most important things is to establish some kind of routine, even if it is temporary or differs from your usual one. Listed below are some specific strategies that can help speed your recovery from trauma.

• Strategy: Diet
  As best you can, try to eat regularly. You may be tempted to eat lots of sweets, soft drinks, or coffee. Sugar and caffeine can actually increase your overall stress level, so try to limit how much of these you use. Sometimes under extreme stress, people use more alcohol or other drugs than usual. Alcohol and drugs may postpone some feelings or reactions, but they can actually make them worse. Use common sense about what you put into your body at this particular stressful time.

• Strategy: Rest and Relaxation
  It is important to maintain a regular schedule that allows for adequate amounts of sleep and relaxing, stress reducing activities. If you know any formal relaxation techniques, such as meditation or deep breathing exercises, use them. Otherwise, use whatever strategies usually help you relax: listen to music, read, go to church, take a walk, play with your children.

• Strategy: Physical Activity
  Exercise is one of the best ways of reducing stress. Although it may be difficult to find time for this, try to work it into your day. If you usually exercise, try working it back into your schedule. Walking is a great form of exercise. Be sure to check with your physician if you do not usually exercise. Encourage your children and yourself to play. It isn't just fun; it is a way for them and you to manage stress and anxious feelings.

• Strategy: Social Contacts
  Keeping contact with your family, friends, and co-workers and others who have gone through similar experiences, is another good strategy to reduce stress. You may sometimes want to be by yourself and that is fine. However, isolating yourself from those who know and care about you may make matters worse. Try to keep in contact as much as possible. Children, in particular, may need the attention and close physical contact of their parents and other caretakers.

• Strategy: Support Systems
  Talking about your own reactions to violence does help, even though it can be difficult. It is important that you choose people who will really listen to how you feel. Supportive listeners may be friends, family, clergy, teachers, or self-help groups. They may also be professional counselors. Keep in mind that people benefit most from counseling when they want it.

• Strategy: Support to Others
  Offering support to others, in addition to taking care of yourself, can help in recovering from the emotional impact of trauma. Many people find strength in participating in special events or community activities which honor victims or offer support to their loved ones. Religious services, community discussion and support groups, public ceremonies or memorials, and political activities are not for everyone. It is important that you become involved in such activities only when you choose to.
  

What can you expect in the course of recovery?

Recovery from the emotional impact of violence takes time and involves many different feelings. While we know there is a wide range of common, normal reactions to the experience of violence or trauma, we also know that each person may not have exactly the same feelings or reactions. Sometimes feelings change quickly or seem to go from one extreme to another. Try to be understanding of yourself and those you care about and recall that you may not have the same feelings or have them at exactly the same time.

Often people expect that their reactions should go away quickly, but this is not usually the case. Outside events sometimes slow down the recovery process. These may include media coverage of the event, court dates or times such as birthdays, holidays, or the anniversary of the event. If often helps to anticipate you might have feelings or reactions during these times. Keep in mind that this is common and usually passes with time. You will probably find that others are having similar reactions. Again, talking with someone you trust can be very helpful...

KEY POINTS:

* Many people may be affected (by) violence and trauma,
including direct victims and many other people who have
personal or work-related contact with victims.

* Each person has a unique reaction composed of many
different normal reactions. Reactions may be cognitive,
physical, spiritual, psychological or relational.

* Self-care is very important. Different strategies of
self-care will be effective for different people.

* Recovery takes time but will take place given adequate
support.

~This text was prepared by staff and colleagues of

The Community Crisis Response Team -

a service of the Victims of Violence Program,

The Cambridge Hospital (617)498-1180.