Coping with Major Life Events

and Traumatic Incidents

by Anthony R. Ciminero, Ph.D., author of the iCope Book Series

From the book:

iCope: Building Resilience Through Stress Management

There is much that we have learned about how people react and cope with traumatic incidents. The news media often has helped educate our country about the benefits of mental health counseling after man made events like the 9/11 tragedy or school shootings as well as after natural disasters such as hurricanes, tornadoes, floods, fires and earthquakes. We have also been reminded that more isolated events such as accidents, rapes, murders, or other traumatic deaths can cause great difficulty for the survivors, family members, witnesses, and certainly the rescue workers that are frequently so involved in the aftermath of these events. We also have learned that there are many similarities in our reactions, regardless of the source of the trauma.

The purpose of this chapter is to share as much information as we can about post-traumatic reactions and what you can do to buffer yourself and your family from the negative effects of trauma. This article is educational in nature and is in no way meant to be a substitute for counseling or therapy if you experience a traumatic event. If you believe that you are in need of counseling, you are encouraged to contact your Employee Assistance Program (EAP), your primary care physicians, or spiritual advisors to get a referral to an appropriate therapist in your community.

TYPICAL REACTIONS TO EXPECT

Similar to the discussion of typical reactions to everyday stressors, there are a number of common reactions that occur after a traumatic experience. Although more intense, these reactions often can be grouped into the same four categories that describe our typical stress reactions:

PHYSICAL
EMOTIONAL
COGNITIVE
BEHAVIORAL

The physical reactions to trauma include the queasy stomach, nausea, sweating, rapid breathing, muscle aches, chills, cold hands or feet, and rapid heart rates. If a person stays in this state of physiological arousal for too long, they may experience other complications such as headaches, diarrhea or constipation, hyperventilation, chest pain, muscular pain, or dizziness. Sleep disruption and loss of appetite are very common. If you have any physical ailments such as a history of stroke, heart attacks, or autoimmune disorder it is recommended that you contact your physician.

The emotional reactions to trauma include differing degrees of anxiety/fear, sadness/depression, anger, grief, guilt, and helplessness. Sometimes the emotions are hard to isolate and identify. Individuals will say that they feel a general sense of being numb or overwhelmed. Although this heightened state of physical and emotional arousal is a fairly “normal” reaction to the traumatic event, much of the counseling effort by professionals is aimed at helping people cope with these emotions in a way that minimizes any risk of long term interference with the person’s life. Simply venting your emotions is not likely to make them go away for very long. Some of the sections below offer some guidance regarding how to improve our coping skills.

The cognitive effects of trauma are quite varied. Some of the most common reactions are temporary impairments of our memory, concentration, attention, and problem solving. If we witnesses the event and felt very vulnerable at the time we might have flashbacks or nightmares of the event. Intrusive thoughts about the event or issues related to it, worries, prejudicial over-generalization about certain ethnic/religious/racial groups, hyper-vigilance, and mistrust can develop. As we begin to cope with the overall physical and emotional stress, we will often see our general cognitive abilities (e.g., attention, memory, concentration) improve as well. However, the more complicated belief systems such as mistrust or prejudice that were not present prior to the trauma often need to be addressed directly in order to prevent these thoughts from becoming well ingrained as persistent beliefs.

Whenever we have to adapt to some major change in our lives, including exposure to a traumatic event, we also have behavioral reactions that go along with the physiological, emotional, and cognitive changes. Some of these changes are aimed at helping us cope with the events but they may not be effective in the long run. Some people will withdraw socially while others will want to spend time close to their loved ones. Some will avoid anything that increases their anxiety and may have difficulty getting to work or following through on basic responsibilities. Crying is a common reaction. Increases in alcohol, drugs use, and cigarette smoking also occur.

As you can see there are numerous ways that we react to trauma. Although there are some similarities in how we react, it is important to remember that we are all individuals and there are differences to be expected. Research clearly shows that those who are closest to the danger are likely to show the most extreme reactions. If a person is coping with other major losses or problems in their lives, they may have more difficulty coping with the trauma. If an individual has had other traumatic events in their lives, they may have extra resilience to cope, or they may be at more risk depending on other factors in their lives. Even our personality will influence how well we adapt to the trauma. In spite of all of these differences, there are many things we can do to help us minimize the negative effects of the trauma.

BEGINNING THE COPING PROCESS

If you have experienced a shared trauma such as a natural disaster or a workplace violence incident, hopefully you have been fortunate enough to talk about the events in a critical incident stress group at work, in your place of worship, or in your general community. If so, you have begun the healing process. If you have not had this opportunity the following guidelines which are similar to those described in Appendix C should be helpful.

Talk about the event and your reactions.

Even if you do not have a formal group setting, it is important to talk about how you are reacting to the events. Withdrawal and avoidance of others may feel natural in these times, but this will slow your progress. Talk to family, friends, co-workers, and other loved ones. Avoid isolating and keeping all of your feelings to yourself. It is helpful to hear from others you trust that they have some of the same feelings of vulnerability, anger, and sadness. Sharing your loss or experience with others who have had similar losses can also be quite helpful.

Engage in self-care activities.

Taking care of some of your basic needs will make you more effective in your coping. Try to:

Get adequate rest and sleep
Eat well
Drink plenty of non-alcoholic fluids, especially water
Stay active, exercise if possible – even if it is a brief walk
Find a way to relax – listening to calming music, taking a warm bath, getting a massage, meditation, etc.
Distract yourself with pleasant activities – go to a movie, read pleasant books, watch TV, etc.
Return to as much normal structure in your day as possible – normalize work and home routines
Limit exposure to news of the tragedy- stay informed but avoid becoming obsessed with the event

Take control of whatever you can.

Feeling out of control is not a healthy emotion and can easily lead to anxiety, depression, and potentially dangerous physiological complications. It is important to remind yourself that even though you cannot control everything that is scary, you do have a lot of control in your life. Avoid impulsive decisions that you may regret later. It is normal for anyone who is traumatized and has added vulnerability in their job to want to escape the situation. For example, flight attendants, pilots, police officers, firefighters, and bank tellers often question their career decisions after a traumatic event. If someone needs to take time off in order to make appropriate career decisions, this might be beneficial. Outside consultation with a professional may be helpful in these situations.

Many individuals canceled vacation or work plans after the terrorist attacks of 9/11/2001. Some took the day after the attack to be with family or friends as a way to cope. Taking control of these decisions promptly was important. These decisions helped reduce fear temporarily and were not likely to lead to permanent restrictions or changes in one’s life or career. However, at some point getting into anxiety provoking situations may be necessary such as going on a plane for work related reasons or for vacations. Going back to places where a trauma occurred such as your workplace or an area of your town may be important for one’s career. Those who believe that their life is being restricted in a negative way by a traumatic event might need outside help to overcome their fears.

Minimize other changes or demands in your life.

As discussed previously, significant changes in your life will create more stress. Therefore, it is wise whenever feasible to plan to take on new demands at the right time. This may not be possible after natural disasters like Hurricane Katrina where individuals were forced by the nature of the traumatic event to make drastic lifestyle adjustments. In less dramatic situations, temporarily avoiding some stressful changes may be helpful. For example, starting a construction project on your house, changing jobs, or moving to a new residence may need to be postponed in order to balance your other stress demands.

Find an active physical outlet to relieve some of the stress.

When the time is right, defusing your physical tension can be helpful. Working out physically, doing work on your yard or garden, hitting golf balls, playing tennis or other active sports, are all healthy ways to distract yourself and to defuse your tension. Even going for short walks in your neighborhood can be helpful if more strenuous activity is not feasible.

Avoid quick fixes.

At these times, using alcohol, drugs, or food, or acting out in violent ways may temporarily occur as an easier way to relieve your tension. However, these maladaptive coping methods will cause additional problems in the long run. Again, if you find yourself relying on these methods to cope after a trauma, outside consultation with a professional could be helpful.

OUR EXPERIENCE TELLS US

Healing is gradual after a traumatic event. Generally it takes a few weeks for things to begin to feel normal – in serious trauma it may take a lot longer. Do not place unrealistic expectations on yourself or your family. Everyone goes at his or her own pace. Normalizing your day to day activities is very important. Major life decisions can be postponed if possible. Our sense of security might not return to its previous levels for a long time. Any further incidents or reminders of our vulnerability will prolong this process.

Prejudicial thoughts may occur because of a psychological tendency to “generalize” from one situation/threat/person to others that share common characteristics. Use rational thoughts to remind yourself not to overreact. You may find that you are more “edgy” or vigilant and react more strongly to sudden noises or other external stimuli. This is normal after we experience a trauma. However, you need to avoid becoming so sensitive that isolation and paranoia begins.

The biggest challenge is to move beyond the immediate crisis stage when these events occur, and to begin to cope with the event in a positive way. By doing this you may be able to find some relief from the most intense feelings associated with the trauma. Remember not to expect anyone to make you feel comfortable about traumatic events. This will not happen. You can, however, find ways to relieve the intensity of your emotional pain and to minimize the impact of these events on the rest of your life.

If the level of distress seems unbearable for too long, consider a consultation with a professional or contact your Employee Assistance Program (EAP). Sometimes the issues are so complicated that having a professional as a resource will help you handle the stressful events more quickly and effectively. This may be particularly important for those who have a personal history of other tragedies in their lives. In cases where your functioning is impaired or you sense that your heath is at risk, it is advisable to consult with your physician regarding medications.

Many of the recommendations listed above are practical in nature. Following these guidelines can be helpful in buffering yourself and your family from the immediate trauma and its resulting changes in your lives. However, trauma specialists often remind victims and rescue workers that they will be forever changed by these events. Once people experience severe trauma, they cannot perceive the world in the same way that they did prior to the traumatic event. We may see the world as less secure and less predictable. We need to find some way to gain a new and healthy perspective that makes sense to us, and that allows us to function well in spite of any new worries and anxieties. There is no single prescription regarding how to do this. Some will find their answers through self‑reflection and discussions with family and friends. Some may need guidance from their spiritual leaders to accept what happened and move on with life. Still others will find help through therapy to integrate these new experiences into their lives in such a way that the negative impact is minimized. Try to find an approach that fits your personal values and situation.