In experiencing or witnessing a violent or shocking event(s), you may find that the effects of the trauma can take over all aspects of your life. When this happens, it feels as if the experience has reached into the very core of your inner being and has lodged itself there. You no longer feel comfortable or safe in the world. Your relationships become strained and your overall health is compromised. You feel like there is no escape and no end to the painful aftermath. You begin to live in terror of your own symptoms.
If you have been traumatized as a result of witnessing or being involved in a violent or shocking event or situation, intrusive memories, flashback episodes, debilitating anxiety, or terrifying nightmares may haunt you. You may experience episodes of uncontrollable crying, explosive anger, and intense periods of depression. You may feel yourself pulling away from loved ones and wanting to spend more time alone. You don’t have to keep living like this. Treatment can help ease your symptoms and can help you to deal with the after effects of trauma. You can return to a normal, satisfying and productive life. Here are the steps you need to move forward.
Start by seeing your medical doctor and discussing your symptoms. Ask your doctor to develop a treatment program that includes therapy with a psychologist to help you recover from your experience.
Next, on a daily basis begin to take back the control of your life. Use the following techniques to manage your symptoms as they emerge.
Anchoring: Intrusive memories and flashback episodes pull you back into the trauma and cause you to re-experience the events or some parts of the event. The memory or flashback is usually triggered suddenly and unexpectedly. As soon as you become aware of being drawn back into the traumatic event, anchor yourself in the present. Tell yourself that you are HERE and this is NOW. Use all of your senses – sight, smell, hearing, taste and touch – to keep you connected to the present.
Reassure yourself that the event is in the past and that you are safe right now. Remind yourself that the traumatic event(s) is only one part of your life and your experience; it is not your whole life. Be determined to shrink that event back to size and to put it in the past where it belongs. Refuse to let the trauma reach out and pull you away from the present. Visualize your anchor as being solid and secure in the here and now.
Thought Stopping: If your mind starts racing or is flooded with thoughts about the trauma, say to yourself, “STOP”. Intrusive or racing thoughts often occur during times of relaxation such as just before sleep, watching TV, or doing something enjoyable. You can’t keep yourself busy all of the time. Instead, when the thoughts emerge decide that you will be in control of what you are thinking about. Deliberately change the contents of your mind. Throw the unwanted thoughts out and replace them with something pleasurable or more appropriate to the situation. If you are trying to go to sleep, you can sing a song in your head, you can pray, or you can think about the positive aspects of your day.
You are choosing to consciously move your attention away from the traumatic experience and onto something pleasant. This isn’t always easy to do. You will likely need to gently re-focus your attention several times.
This doesn’t mean that you should always avoid thinking about the traumatic experience. If you want to recover and to eventually be free of your symptoms, you will have to deal with your thoughts and feelings. Therapy will enable you to do this in a productive way and assist you with integrating all aspects of your experience.
Relaxation: Teach yourself how to relax and to create what is called “The Relaxation Response” in your body. The science of biofeedback has proven that with relaxation you can control your heart rate, pulse, and rate of breathing, sweating, trembling, and muscle tension in your body. You can reduce the effects of an adrenaline response and/or a panic attack by using the relaxation response.
Initiate the relaxation response by breathing deeply and slowly, calming your mind, and systematically focusing on each different part of your body. If possible, close your eyes while you do this. It will help to remove distractions and to shift your focus within. Start focusing on your toes and then gradually moving up your whole body to the top of your head. Visualize your muscles relaxing and becoming soft and flexible. Consciously focus on your heart and tell it to slow down. Slow your heart rate so that it matches your breathing. Reassure and comfort yourself. Mentally tell yourself that you are okay, that you are safe, that your anxiety will pass, and that you can handle this. You will soon notice the change in your body as it begins to respond to your direction.
You can use the relaxation response as a way to ease into a restful sleep every night. This tool is also effective in controlling racing thoughts or to derail an obsessive thinking pattern.
Physical Exercise: Become physically active and develop a regular program for working out. Physical exercise increases the production of natural chemicals in the brain that make you feel good and has been called “nature’s antidepressant”. Your body carries the stress of the trauma in the same way that your mind gets overwhelmed with the psychological stress. By strengthening and moving your body you release tension, increase blood flow throughout your body, and stimulate the healthy functioning of all organs (including your brain). You will feel stronger, healthier, and more in control.
The symptoms of Posttraumatic Stress Disorder can physically and emotionally exhaust you. Do not attempt a vigorous workout program if you are exhausted. Start very gently and slowly to get your body moving. Gradually increase the time, pace and distance of your workout as you feel you are able. Don’t push yourself too hard. If you feel exhausted when you are done, you’re doing too much. It’s very important to listen to your body and to work with it rather than against it. A brief ten-minute walk outdoors can be enough to begin.
Writing About the Trauma: When you are flooded with thought and feelings about the traumatic experience, you may find it helpful to start writing about it. In your writing, try to connect your thoughts and feelings with your behavior. You can write about the past, i.e. your thoughts, feelings, and behavior while you were experiencing the trauma and also about the present, i.e. your thoughts, feelings, and behaviors as they relate to what you are feeling and to what is happening to you now.
Writing about your experience helps you to access and to become more comfortable with the powerful emotions that were triggered during the traumatic event. Remember, these are your thoughts, feelings, and behaviors and you do not have to be frightened of yourself. Your goal is to understand and to become more comfortable with your inner experience, and to not have your present life taken over by the traumatic event.
Feeling Your Feelings: A traumatic experience triggers a wide range of feelings, including anxiety, shame, and fear. You may lose confidence in yourself and in your ability to handle daily life. Consciously make a decision to learn from your experience. A significant part of your learning is to learn how to deal with your feelings and not let them overwhelm you. Decide that you will use the traumatic experience to make you a better and stronger person.
When your feelings surface, calm your body using the relaxation techniques described above, and then sit with your feelings. Explore what you are frightened of and explore the physical sensations of anxiety and fear in your body. Remind yourself that these are your emotions and that you are very capable of managing them. When you look closely at fear and anxiety, you will see that they are just feelings and while your feelings may be unpleasant, you can live with them.
If you feel ashamed of your thoughts, feelings and/or behavior during the traumatic event, think about where your feeling of shame comes from. It is likely that you feel ashamed because you did not live up to your own expectations of how you would like to have handled the situation. The only way to deal with shame is through forgiveness. Forgive yourself for being human, for being less than perfect. Be determined to learn from your experience and promise yourself that, should the opportunity arise, you will behave differently the next time. This is the best anyone can do.
As you sit with your feelings without trying to escape from them, you will become more confident and peaceful inside.
Reframing: As you think, talk, and write about the traumatic event, you can consciously make the effort to see your experience in a different way. Yes, you will recall all of the horrifying aspects of your experience but you will also begin to see your strengths, what you have learned from the experience, and how you can use your experience to become more flexible and resilient. You can decide to use your experience to make you a stronger person rather than becoming a victim.
Reframing means that you consciously work to understand the experience from a different perspective. In order to do this, you have to open your mind and be willing to incorporate new information. When you allow your life experiences to teach you about yourself and to open up your perspective, then you become psychologically mature. Trauma often speeds up the process of psychological growth and that’s why the initial stages of recovery are so challenging.
Making Healthy Lifestyle Choices: Choose to deal with the aftermath of the traumatic experience in healthy ways rather than trying to escape from your thoughts and feelings. Do not use addictive behaviors/substances as a way of coping. Enter into individual and/or group therapy to effectively process and integrate your experience. Decide to eat in a healthy way, get adequate and regular sleep, be physically active, develop a nurturing and supportive network, and stay in the stream of life.
Being Assertive: When you were traumatized, you likely felt overwhelmed by the situation and out of control. Some people become passive because they believe they can no longer control anything while others become aggressive, believing they must constantly fight for control. Some people alternate between being passive and aggressive and feel like they are on an emotional roller coaster.
Learn to be assertive in your behavior. Remind yourself that while you cannot control everything, you will control what you can. You do not have to be angry or aggressive to be in control of yourself. You have a right and a responsibility to meet your own needs in a healthy and responsible way. You do not need anyone’s permission to do so. Make your health and well-being your first priority, take good care of yourself, and be willing to ask for help and support when you need it.
Note: Practicing these skills will help you to manage your symptoms and to cope more successfully on a daily basis. Coping with your symptoms is not a substitute for dealing with the traumatic experience. Your symptoms are the signals that tell you what needs to be dealt with in therapy. Individual psychotherapy will help you to effectively process and integrate the physical, emotional, cognitive, relational, and spiritual impact of your experience.
Shirley Vandersteen, Ph. D., R. Psych.