Stress is a normal reaction to abnormal situations. We are now living in a new day and time in American society - an uncertain time where stress is common and can be perceived as uncontrollable. It is nearly impossible to go through one day without hearing alarming information on the news about national security concerns, terrorism or disaster. With the anniversaries of 9/11 and the Katrina and Rita hurricanes approaching, we are reminded that it is no longer a calm and innocent world. In the wake of these disasters, stress management has become vital for individuals, families, employees and businesses. This article will address common reactions to living in these trying times, and coping skills to practice for minimizing the consequences and maximizing the recovery of this exposure.
Normal Reactions to an Abnormal Situation
The experience of trauma and living in uncertain times
Trauma is the perception of life-threatening experience combined with an overwhelming sense of helplessness to do anything about it. The nervous system becomes so stressed that it stops functioning normally and doesn’t return to a normal state of balance; instead, we stay frozen, anxious or stuck in some debilitating way that diminishes our ability to act, to feel or to think.
People can be resilient in the face of traumatic experiences but they can’t avoid them. Sooner or later, if we live long enough, we all face grave dangers and grave losses. We can’t avoid trauma–instances where we feel threatened, helpless and/or overwhelmed. Resiliency lies in being able to act–in feeling that we are not helpless, we can do something to make things better–if not for ourselves than for others. Resiliency also lies in the ability to reach out to others for help and support–to avoid isolating ourselves.
The Impact of Trauma
Trauma is an everyday event, natural and widespread. Trauma impacts victims of "ordinary" events such as traffic accidents, falls, illnesses, sudden losses and abuse as well as "extraordinary" events such as natural disasters, violence, torture, terrorist attacks and war, labor camps and holocausts.
The majority of people exposed to traumatic events do not suffer from long-term emotional damage. However, 20 percent of the population exposed to trauma will develop PTSD, and a higher percentage will feel some traumatic effect on their lives.
Furthermore, events like the Sept. 11 attacks, and the ongoing threats of anthrax, small pox epidemic and bio-chemical warfare and terrorist attacks, impact the nation as a whole and the "collective nervous system" becomes activated and on edge. The population is on alert, feeling unsafe, overwhelmed and helpless when facing on-going unpredictability.
Trauma directly impacts the victims of terror and their families and friends. But the viewers of televised terror are also vulnerable to secondhand trauma; furthermore, there is a cumulative stress from the on and off exposure to the threat of terrorist attacks that impacts the collective nervous system. Traumatic situations have also the characteristic of awakening old traumas and activating dormant symptoms. The effects of trauma are often not immediately apparent.
The Cost of Trauma
The impact from experiencing a traumatic event can be pervasive and destructive to individual lives, families, communities and nations.
The cost of unresolved trauma to society is incalculable. Trauma has been correlated to:
- physical and mental illness
- learning disabilities
- deviant or aggressive behavior
- polarization of belief systems
- racial, ethnic and religious intolerance
- violence in individuals, in schools and communities, between groups and between nations.
Furthermore, traumatic reenactment or repetition is one of the most dangerous and daunting aspects of trauma. It creates a downward spiral of traumatic symptoms, gaining a life of its own called metaphorically "the trauma vortex." When their trauma is not healed, people will likely continue to repeat or reenact their traumatic experience in some way or another. The "trauma vortex" has a magnetic pull and is contagious.
Emotional First Aid Brief Guide
“When traumatic events happen, they challenge our sense of safety and predictability and this may trigger strong physical and emotional reactions. These reactions are normal. Emotional First Aid gives you information on how to help yourself, your family and friends in response to witnessing, hearing or living through the traumatic events.”
-Emotional Brief First Aid Guide, International Trauma Healing Institute
What is psychological or emotional trauma?
The ability to recognize emotional trauma has changed radically over the course of history. Until recently psychological trauma was noted only in men after catastrophic wars. The women's movement in the sixties broadened the definition of emotional trauma to include physically and sexually abused women and children. Now, because of the discoveries made in the nineties–known as the decade of the brain–psychological trauma has further broadened its definition.
Recent research has revealed that emotional trauma can result from such common occurrences as an auto accident, the breakup of a significant relationship, a humiliating or deeply disappointing experience, the discovery of a life-threatening illness or disabling condition, or other similar situations. Traumatizing events can take a serious emotional toll on those involved, even if the event did not cause physical damage.
Regardless of its source, an emotional trauma contains three common elements:
- It was unexpected;
- The person was unprepared; and
- There was nothing the person could do to prevent it from happening.
It is not the event that determines whether something is traumatic to someone, but the individual's experience of the event. And it is not predictable how a given person will react to a particular event. For someone who is used to being in control of emotions and events, it may be surprising–even embarrassing–to discover that something like an accident or job loss can be so debilitating.
One way to tell the difference between stress and emotional trauma is by looking at the outcome - how much residual effect an upsetting event is having on our lives, relationships, and overall functioning. Traumatic distress can be distinguished from routine stress by assessing the following:
- How quickly you become upset
- How frequently you become upset
- How intensely threatened you feel by the event
- How long the feelings last
- How long it takes to calm down
If we can communicate our distress to people who care about us and can respond adequately, and if we return to a state of equilibrium following a stressful event, we are in the realm of stress. If we become frozen in a state of active emotional intensity, we are experiencing an emotional trauma–even though sometimes we may not be consciously aware of the level of distress we are experiencing.
Problematic Stress Responses
The following responses are less common and indicate that the individual will likely need assistance from a medical or mental-health professional:
- Severe dissociation (feeling as if the world is unreal, not feeling connected to one's own body, losing one's sense of identity or taking on a new identity, amnesia)
- Severe intrusive re-experiencing (flashbacks, terrifying screen memories or nightmares, repetitive automatic reenactment)
- Extreme avoidance (agoraphobic-like social or vocational withdrawal, compulsive avoidance)
- Severe hyper-arousal (panic episodes, terrifying nightmares, difficulty controlling violent impulses, inability to concentrate)
- Debilitating anxiety (ruminative worry, severe phobias, unshakeable obsessions, paralyzing nervousness, fear of losing control/going crazy)
- Severe depression (lack of pleasure in life, feelings of worthlessness, self-blame, dependency, early wakening)
- Problematic substance use (abuse or dependency, self-medication)
- Psychotic symptoms (delusions, hallucinations, bizarre thoughts or images)
Some people will be more affected by a traumatic event for a longer period of time than others, depending on the nature of the event and the nature of the individual who experienced the event. One of the most debilitating effects of traumatic stress is a condition known as Posttraumatic Stress Disorder (PTSD). The current trauma literature suggests that many factors are related to the increased or decreased risk for PTSD. The likelihood of developing PTSD and the severity and chronicity of symptoms experienced is a function of many variables, the most important being exposure to a traumatic event. It is therefore important to bear in mind that, even among vulnerable individuals, PTSD would not exist without exposure to a traumatic event.
Critical Incident Stress Debriefing (CISD)
Critical Incident Stress is the normal reaction to a sudden and unexpected event that is beyond the range of normal everyday human experience. On the average, 80% of people exposed to a critical incident will develop some sort of stress reaction. A critical incident is any event that adversely affects an employee or department and causes an increase of stress or stress reactions, immediate or delayed. The most common workplace critical incidents are tragedies, deaths, serious accidents and injuries and threatening situations.
Critical Incident Stress Debriefing is a process designed specifically to prevent or mitigate the development of post stress related issues. It involves a series of interventions at the workplace for any employees involved in the critical incident and affected by the incident. Contact Centerstone Crisis Management Strategies at 866.696.4267 for CISD services in Tennessee.
Some people are able to cope effectively with the emotional and physical demands brought about by a natural disaster or other traumatic experience by using their own support systems. It is not unusual, however, to find that serious problems persist and continue to interfere with daily living. For example, some may feel overwhelming nervousness or lingering sadness that adversely affects job performance and interpersonal relationships.
Individuals with prolonged reactions that disrupt their daily functioning should consult with a trained and experienced mental health professional. Centerstone offers appropriate mental health providers to help educate people about normal responses to extreme stress. These professionals work with individuals affected by trauma to help them find constructive ways of dealing with the emotional impact.
Stress is part of life, part of being human, but that does not mean that we have to be victims in the face of large forces in our lives. It is important to remember to take care of yourself and to monitor your own emotions during difficult times. Tending to your own mental health and emotional well-being will make you a better, more reliable resource for friends and family members during their times of need.
Tips for Coping
It’s normal to have difficulty managing your feelings after major tragedies. Because everyone experiences stress differently, don’t compare yourself with others around you or judge other people’s reactions and emotions. Here are some tips for coping with stress:
Talk about it. By talking with others about the event, you can relieve stress and realize that others share your experience and feelings.
Spend time with friends and family. They can help you through this tough time. If your family lives outside the area, stay in touch by phone if possible. If you have children, encourage them to share their feelings and concerns with you.
Take care of yourself. Get as much rest and exercise as possible. Try to continue any religious practices or centering activities.
Take one thing at a time. Getting things back to normal can seem impossible. Break the job up into doable tasks. Complete that task first and then move on to the next one. Completing each task will give you a sense of accomplishment and make things seem less overwhelming.
If you can, help. Give blood; help prepare meals for others including the elderly. Volunteer to help clean up or rebuild your community. Read to children in the shelter. Helping others can give you a sense of purpose in a situation that feels beyond control.
Avoid drugs and excessive drinking. Drugs and alcohol may seem to help you feel better, but in the long run they generally create additional problems that compound the stress you’re already feeling.
Ask for help if you need it. If your stress is so strong it gets in the way of your daily life, talk with someone. Don’t try to go it alone. You can start with a trusted friend, relative or minister. You may want to talk with a mental health professional to discuss how well you are coping with recent events. This could be especially important for people who had existing mental health problems or those who’ve survived past trauma. You could also join a support group. Don’t try to go it alone. Asking for help is not a sign of weakness.
If you or someone you love needs help, contact Centerstone at 888-291- HELP (4357) or visit http://www.centerstone.org.
If you are in crisis, call Centerstone’s 24-Hour Crisis Intervention Hotline at 800-681-7444.