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Surviving the Stress After a Natural Disaster
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Natural disasters come in many forms. Fires, floods or drought can leave behind a trail of destruction. One thing common to most disasters is the overwhelming stress felt by those affected.
Stress impacts those who may have lost homes or loved ones. But even those who don't suffer these direct losses may feel anguish because of the devastation to their communities.
Effects of stress
Stress can cause both physical and emotional reactions, but how any one person will respond can be hard to predict. When disaster strikes, some people fall apart and can hardly move. Others spring into action and seem to pack their emotions away. Some find it hard to eat, while others turn to food for comfort. Anxiety may make it hard to sleep or may cause headaches. Some people get sick because their defenses are down.
If you have been affected by a disaster, you can expect you'll have a range of emotions, whether they start right away or later on. Many people will feel anger that so much was taken from them. Grief will strike those who lost friends, family members, beloved pets or a lifetime of treasured possessions. Others may experience guilt if their home or family survived, but others nearby did not.
First steps to recovery
Recovering from a disaster is a long process, both mentally and physically. These steps may help you get started.
If you have survived a disaster and need help, try the following sources:
There are many way you can help in the wake of a disaster:
Stress impacts those who may have lost homes or loved ones. But even those who don't suffer these direct losses may feel anguish because of the devastation to their communities.
Effects of stress
Stress can cause both physical and emotional reactions, but how any one person will respond can be hard to predict. When disaster strikes, some people fall apart and can hardly move. Others spring into action and seem to pack their emotions away. Some find it hard to eat, while others turn to food for comfort. Anxiety may make it hard to sleep or may cause headaches. Some people get sick because their defenses are down.
If you have been affected by a disaster, you can expect you'll have a range of emotions, whether they start right away or later on. Many people will feel anger that so much was taken from them. Grief will strike those who lost friends, family members, beloved pets or a lifetime of treasured possessions. Others may experience guilt if their home or family survived, but others nearby did not.
First steps to recovery
Recovering from a disaster is a long process, both mentally and physically. These steps may help you get started.
- At first, just put one foot in front of the other. It's easy to get overwhelmed if you take on too much at once. Put aside difficult long-term issues for now. Deal with what's most important today or this week. Expand your scope when you feel able to.
- Take care of your health. Be sure to eat regularly, get as much rest as you can and drink fluids to avoid dehydration. Take any prescribed medicines.
- Try to get back to your routine. Go to bed and get up around the same time each day, if possible. Have meals at your usual times. Get back to work or school when you can.
- Reach out to others. Spend time with people you care about. Tell your story and listen to theirs.
- Grieve your losses. Cry when you need to. Rant if it helps. Let your emotions out and urge your loved ones to do the same. Expressing your feelings can help you heal.
- Get professional help if you need it. Sometimes, the emotional reaction to a stressful event can be too much to deal with on your own. Asking for help is not a sign of weakness. It just means you're human.
If you have survived a disaster and need help, try the following sources:
- The American Red Cross maintains a "Safe and Well List" where you can list your status and search for family and friends. Go to https://disastersafe.redcross.org.
- The Federal Emergency Management Agency (FEMA) Web site has general information on dealing with emergencies. Check the Web site at www.fema.gov or call 1-800-621-FEMA.
- The U.S. Department of Labor helps people who've survived disasters get unemployment benefits, find jobs and get job training. In some cases, it provides grant money to pay people to help with disaster cleanup and recovery. Look on the Web site at www.dol.gov or call 1-866-4-USA-DOL (1-866-487-2365).
There are many way you can help in the wake of a disaster:
- Give blood. Check with local hospitals or blood banks, or call the American Red Cross at 1-800-448-3543.
- Volunteer. The nonprofit VolunteerMatch can help you find opportunities in your area using their Emergency Response map. Check the Web site at www.volunteermatch.org.
- Give money or goods. Check with trusted organizations in your area to find out what supplies are needed and where to take them or how to make a cash donation. FEMA supports the AidMatrix Network, which can help you find nonprofit organizations in your area (www.aidmatrix.org/fema).
- Donate pet food and supplies. After a disaster, animal shelters are often overwhelmed with injured, lost or abandoned pets. Contact your local Humane Society or Society for the Prevention of Cruelty to Animals (SPCA) to find out what goods are needed.
PTSD SYMPTOMS AND RECOVERY
Finding Peace After Trauma: PTSD Symptoms and Recovery
You don't have to suffer in silence from PTSD. There is help and treatment available to you.
It seems with all of the wars, natural or human disasters, and domestic crimes, it’s no wonder health care professionals are seeing Post-Traumatic Stress Disorder (PTSD) on the rise. PTSD is a type of anxiety disorder that develops after an individual has witnessed or experienced a traumatic event. PTSD was thought to primarily be associated with war veterans, but it is now prevalent amongst victims of sexual assault, abuse, domestic violence, divorce and accidents. PTSD is also being reported amongst our emergency response personnel like firefighters, police officers and paramedics.
In terms of mental health disorders, anyone can be susceptible to PTSD simply because we are all human and have the same response to extreme stress and trauma. Our brain and body is designed to handle stress, especially the threat of physical danger. We have a fight or flight reflex that sends messages from our brain to our body to help keep us protected. However, someone suffering from PTSD still feels threatened or re-lives that threat even when there is no danger present.
It’s hard to get exact statistics with number of people who have PTSD because many people do not want to report they have a mental health disorder. However, it is estimated in the United States 3.5 percent of adults suffer from PTSD and the average onset of PTSD is 23 years old.
People who suffer from PTSD may experience symptoms such as trouble sleeping, memory loss, blackouts, and phobias about certain places or people. In addition, they can suffer from flashbacks, hyper-vigilance, irritability and anger. Unfortunately, those who suffer from PTSD are more likely to turn to alcohol and drug use, especially if their PTSD goes without treatment.
It’s best to seek out professional help if you suspect you are or a loved one is affected by PTSD. There are a variety of treatment options, including counseling, group therapy, educational classes and medication. Health care professionals have found that educating their patients about PTSD is therapeutic because the patients understand that they are not the only ones going through it.
The first step in recovering from PTSD is to seek out professional help. During treatment, patients can acquire the tools and skills necessary to cope with their traumatic experience. It is possible to find joy and peace after trauma and that is what seeking treatment is all about.
In terms of mental health disorders, anyone can be susceptible to PTSD simply because we are all human and have the same response to extreme stress and trauma. Our brain and body is designed to handle stress, especially the threat of physical danger. We have a fight or flight reflex that sends messages from our brain to our body to help keep us protected. However, someone suffering from PTSD still feels threatened or re-lives that threat even when there is no danger present.
It’s hard to get exact statistics with number of people who have PTSD because many people do not want to report they have a mental health disorder. However, it is estimated in the United States 3.5 percent of adults suffer from PTSD and the average onset of PTSD is 23 years old.
People who suffer from PTSD may experience symptoms such as trouble sleeping, memory loss, blackouts, and phobias about certain places or people. In addition, they can suffer from flashbacks, hyper-vigilance, irritability and anger. Unfortunately, those who suffer from PTSD are more likely to turn to alcohol and drug use, especially if their PTSD goes without treatment.
It’s best to seek out professional help if you suspect you are or a loved one is affected by PTSD. There are a variety of treatment options, including counseling, group therapy, educational classes and medication. Health care professionals have found that educating their patients about PTSD is therapeutic because the patients understand that they are not the only ones going through it.
The first step in recovering from PTSD is to seek out professional help. During treatment, patients can acquire the tools and skills necessary to cope with their traumatic experience. It is possible to find joy and peace after trauma and that is what seeking treatment is all about.
Fewer and fewer stories of radiation realities in and issuing from Japan are being reported
Emotional Resilience In Traumatic Times
By Carolyn Baker
15 April, 2011
Carolynbaker.net
Carolynbaker.net
While mainstream media has been encouraging collective dithering over a possible U.S. government shutdown, the chilling realities of off-the-chart levels of radiation from the Fukushima nuclear power plant disaster, escalating upheavals throughout the Middle East, and surging oil prices have been simmering in the background, remaining the lethal environmental, geopolitical, and economic time bombs that they are. Weeks ago, I was well aware that a government shutdown was highly unlikely but would be used to distract our attention from more urgent matters, and thus, I reported only one story about it in my Daily News Digest.
I recently returned from Northern California where residents there were profoundly anxious regarding the effects of radiation on the West Coast from Fukushima. How not, when on April 1, the San Francisco area newspaper, Bay Citizen, reported that “Radiation from Japan rained on Berkeley during recent storms at levels that exceeded drinking water standards by 181 times and has been detected in multiple milk samples, but the U.S. government has still not published any official data on nuclear fallout here from the Fukushima disaster”?
In typical American media fashion, out of sight, out of mind. Fewer and fewer stories of radiation realities in and issuing from Japan are being reported. An occasional comment surfaces, usually assuring us that we have nothing to fear. It’s all so benign. Apparently, we can now move on to “really important” stories like Obama’s 2012 campaign and the royal wedding.
And yet, whether explicitly stated or not, Americans and billions of other individuals throughout the world, are not only terrified about radiation but about their economic future—an economic future which will be inexorably more ruinous as a result of the Japan tragedy and its economic ripples globally. By that I do not mean that they feel mild anxiety about embellishing their stock portfolios, but rather, are feeling frightened about how they are going to feed their families, where they will live after losing their house in foreclosure, where they might find employment in a world where having a full-time job is becoming increasingly rare, how they will access healthcare without insurance or the money to pay out of pocket, or how they will make ends meet in forced or voluntary retirement.
Obviously, these anxieties are relevant to the world’s middle classes and not to teeming masses of human beings living on two dollars per day or less. Ironically, however, it is frequently the case that for all the suffering of abjectly impoverished human beings, they have seldom known any other standard of living and have learned how to survive on virtually nothing. They hear no reports of nuclear meltdowns, and even if they did, such news would seem insignificant in the face of needing to secure food or water for today—a type of existence that contains its own traumas and yields dramatically short lifespans.
Having inhabited a middle class existence, one can only comfort oneself for so long by reflecting on the plight of the destitute in far off places. One’s immediate reality is an anomalous deprivation, a stark loss of the familiar, and the looming reality that things will not get better, but only worse, and that these losses are unpredictably punctuated with frightening events such as extreme weather, natural disasters, nuclear meltdowns, or the terrifying consequences of rotting infrastructure such as pipeline explosions or collapsing bridges. These realities take their toll on the body—sleepless nights, a weakened immune system, moodiness, anger, depression, despair, and often, suicidal thinking. Whether the trauma is dramatic and frequent such as a 9.0 earthquake in Japan followed by high intensity aftershocks, or whether it slowly grinds on amid a disquieting sense of the permanent loss of so much that one held dear, the landscapes of countless lives are forever, painfully altered, emotionally littered with charred shells of once exuberant and robust routines.
Yes YOU Have Been Traumatized
But, you may argue, I haven’t been traumatized. My life is amazingly normal. I’m weathering the collapse of industrial civilization reasonably well and feel profoundly grateful.
Indeed I celebrate your good fortune, but I must add that no inhabitant of industrial civilization is without trauma because that paradigm is by definition, traumatizing.
It is only when you understand the extent to which you have been traumatized outside of your awareness that you can effectively prepare for and yes, welcome, the demise of empire and its ghastly assaults on your soul and the earth community.
In the face of extreme weather events and earth changes, skyrocketing food and energy prices, increasingly dramatic expressions of civil unrest globally, massive unemployment, global economic evisceration of the middle classes, and the proliferation of toxins worldwide—whether from fracking in Pennsylvania or leaking reactors in Japan, we are all in varying states of emotional breakdown and breakthrough. The sands are shifting under the feet of all human beings on this planet. Nothing is as it seems. “Things fall apart,” said William Butler Yeats, “the center cannot hold.”
Call it whatever you like—collapse, Transition, Great Turning. Put a happy face on it or a terrified one, but regardless of how you spin it, regardless of how much you want to feel good about it—and there is much to feel good about, the changes are dizzying, sometimes delightful, sometimes devastating. Yes, it’s an exciting time to be alive, and it’s an excruciating time to be alive. Sometimes one feels schizophrenic, sometimes bipolar. But all of that, yes all of that, is traumatizing to the human nervous system, and if we don’t recognize that, we’re probably hiding out in the “Hurt Locker” of empire.
So how do we not hide out? How do we face our trauma, begin healing it, and protect ourselves as much as humanly possible from further wounding, particularly as life becomes even more traumatic?
The Transition movement has provided us with a treasure-trove of resources for cultivating logistical resilience in our communities through awareness-raising, reskilling, and creating self-sufficient and sustainable communities. Anyone not involved in this kind of logistical preparation is only half-awake, yet many individuals believe that no other preparation is necessary. Might that not, in fact, be one characteristic of trauma? Just as the PTSD-scarred combat veteran insists that all he needs is another good battle to make him feel better, it may be that the hunger for one more gold or silver coin, one more case of freeze-dried food, one more bucket of barley, one more permaculture class, one more emergency response training is yet another means of avoiding the emotional healing and preparation work every human being needs to do in order to navigate the accelerating unraveling of the world as we have known it.
A Few Ways Of Developing Emotional Resilience
1) Understand that industrial civilization is inherently traumatizing. Make a list of the ways it has wounded you and those you care about.
2) If you are involved with a Transition initiative, start or join a heart and soul group where the psychology of change (see The Transition Handbook) can be discussed in depth and group members can share feelings about the acceleration of collapse as well as share how they are preparing for it emotionally.
3) Become familiar with your emotional repertoire and how you deal with your emotions—or not. Imagine the kinds of emotions that you and others are likely to feel in an unraveling world. How do you imagine yourself dealing with those emotions? How would you prefer to deal with them?
4) Think about how you need to take care of yourself right now in an increasingly stressful world. What stresses do you need to pull back from? What self-nurturing activities do you need to increase?
5) Who is your support system? If you do not have people in your life with whom you can discuss the present and coming chaos, you are doubly stressed. Find people with whom you can talk about this on a regular basis.
6) What are you doing to create joy in your life? Do you have places in your life where you can have fun without spending money or without talking about preparation for the future?
7) What are you doing to create beauty? Life may become uglier on many levels, including the physical environment. How can you infuse more beauty into the world? Use art, music, poetry, dance, theater, storytelling and other media to enhance the beauty of your community and your immediate environment.
8) Consider creating a regular poetry reading salon in which people come together perhaps monthly to share poems or stories which express the full range of human emotions. Many communities have found poetry sharing events to be incredibly rich venues for deepening connections and their own emotional resilience.
9) Spend as much time as possible in nature. Read books and articles on ecopsychology and take contemplative walks or hikes in which you intentionally engage in dialog with nature.
10) Engage at least twice a day in some kind of mindfulness practice such as meditation, inner listening, journaling, guided visualization. Still another tool for mindfulness and community deepening is sacred earth-based rituals which can be done individually or shared in a group.
It is important to remember that challenging experiences are not necessarily traumatizing experiences. The collapse of industrial civilization will be challenging for those who have been preparing for it; for those who haven’t, it will constitute massive trauma. The less attached we are to living life as we have known it, and the more open and resilient we are—the more we are utilizing the myriad tools that exist for preparing our emotions, our bodies, and our souls for collapse, the more capacity we create for navigating a formidable future.
All of the above suggestions are related to releasing stress from the mind and body. As the external stresses of an unraveling civilization accumulate, we all need ways for letting go of them. My friend, Jerry Allen, of Transition Sebastopol, California who is also a Marriage and Family Therapist, recently penned an article entitled “The Importance of Effectively Discharging Accumulated Stress As Our World Moves Into Crisis,” in which he states:
Learning to effectively release accumulated stress is not some peripheral process that is needed primarily to treat returning soldiers and victims of abuse, as important as that treatment is. Learning to let go of accumulated stress and discharge new stresses is a vital skill for all of us who are preparing ourselves to face the unknown future. It is as important as doing physical emergency preparations. We have witnessed the chaos, rage and panic that can grip communities when devastating changes happen. When panic hits as someone yells “fire” in a crowded theatre, other voices need to be ready to stand aside and start singing loudly to calm the people and re-direct their energies. Such work has saved hundreds of people from trampling deaths in panicked crowds. If we are still too activated by our own build up of trauma, we will not be in a position to discharge fast and take quick decisive community initiative.
As we prepare to serve in a helping role among many, it makes sense to train a vibrant cadre of our community members on how to cultivate body awareness, let go of stress fast, remobilize our adaptive capacity and be ready for action. It also makes sense to explore and adapt the use of story, song, dance, ritual and whatever works to help our communities come together, heal together and strengthen our joint body for action.
My just-published book Navigating The Coming Chaos: A Handbook For Inner Transition is chock full of re-usable tools for creating and maintaining vibrant emotional resilience. It is also ideal for use in Transition heart and soul or study groups focused on creating emotional resilience.
I do not assume that a world of increasing crises will be a world devoid of cooperation or community building. In her brilliant 2009 book, A Paradise Built In Hell: The Extraordinary Communities That Arise In Disaster, Rebecca Solnit notes that in most natural disasters, human beings, in most cases, unite in a spirit of cooperation to support each other. While I certainly concur and reviewed Solnit’s book in an article entitled, “Disaster: The Gift That Keeps On Giving,” I am also well aware that cooperation is not the only response to trauma. Furthermore, the collapse of industrial civilization is most likely to play out in an irregular, “lumpy” fashion in different locations at different times. How it plays out and over what period of time will dictate how humans respond. One thing is certain: Responses will not always be benevolent, caring, and cooperative.
Thus we must prepare for a very uncertain future by consciously cultivating emotional resilience. This involves addressing the myriad ways in which we have been traumatized by the current paradigm and training with intention for encountering situations in the future which may be even more emotionally challenging in a world unraveling.
For readers living in Northern California, I recommend “Readiness Amid Chaos,” a support group facilitated by Jerry Allen and Suzie Gruber, beginning May 9 in Santa Rosa. For more information, contact Suzie at suzie@suziegruber.com.
Male Victims of Domestic Abuse May Show Signs of PTSD
-- Men who are victims of domestic abuse by their female partners can develop psychological trauma, such as post-traumatic stress disorder (PTSD), depression and suicidal thoughts, new research finds.
Researchers looked at a group of 302 men who sought professional help after experiencing what the researchers called "intimate terrorism," which refers to high levels of violence and controlling behavior by female partners.
Another 520 men took part in a telephone survey that asked about their relationships. Sixteen percent of these men said they had experienced minor acts of violence and mental abuse during arguments with their female partners. This type of abuse was referred to as "common couple violence."
In both groups of men, who ranged in age from 18 to 59, there were associations between abuse and PTSD symptoms. However, the men who experienced "intimate terrorism" had a much greater risk of developing PTSD.
The findings appear in the April issue of the journal Psychology of Men & Masculinity.
"This is the first study to show that PTSD is a major concern among men who sustain partner violence and seek help," study leader Denise Hines, a research assistant professor in the department of psychology at Clark University in Worcester, Mass., said in a journal news release.
A second study in the same journal summarized past research on domestic abuse against men. Prior research has found that men are less likely to report injuries from abuse, and police are less likely to arrest women accused of domestic violence against men.
More information
Oregon Counseling has more about domestic abuse against men.
Copyright © 2011 HealthDay. All rights reserved.
Another 520 men took part in a telephone survey that asked about their relationships. Sixteen percent of these men said they had experienced minor acts of violence and mental abuse during arguments with their female partners. This type of abuse was referred to as "common couple violence."
In both groups of men, who ranged in age from 18 to 59, there were associations between abuse and PTSD symptoms. However, the men who experienced "intimate terrorism" had a much greater risk of developing PTSD.
The findings appear in the April issue of the journal Psychology of Men & Masculinity.
"This is the first study to show that PTSD is a major concern among men who sustain partner violence and seek help," study leader Denise Hines, a research assistant professor in the department of psychology at Clark University in Worcester, Mass., said in a journal news release.
A second study in the same journal summarized past research on domestic abuse against men. Prior research has found that men are less likely to report injuries from abuse, and police are less likely to arrest women accused of domestic violence against men.
More information
Oregon Counseling has more about domestic abuse against men.
Copyright © 2011 HealthDay. All rights reserved.
How to Find a Therapist for PTSD Treatment
Tuesday, 22 Mar 2011 03:58 PM
Article Font Size 
Post traumatic stress disorder, more commonly known as PTSD, is an anxiety disorder that results from experiencing or witnessing a traumatic event(s) where physical harm occurred or was threatened.
Known as shell shock and battle fatigue syndrome in the past, in modern day, PTSD was first noticed among Civil War soldiers, and later among WWI soldiers. In fact, PTSD was brought to the attention of the medical community by veterans who were suffering from it, although anyone who has experienced or witnessed trauma can develop it. PTSD is very common among soldiers who have been in active duty, as well as among abuse victims and emergency and rescue workers.
Thanks to years of research, today psychologists and medical professionals know more about what causes PTSD than they did in the past, as well as how it is best treated. Depending on the person and the details of the trauma they witnessed or suffered, PTSD treatment involves psychotherapy, PTSD medication, or in some cases, both. PTSD Medication is used to treat anxiety and depression associated with PTSD, while the goal of therapy is to help the PTSD sufferer learn skills to manage their symptoms. A secondary goal of therapy is to help patients develop healthy ways to cope with the trauma they suffered.
Because of the unique nature of PTSD, it's important to choose a therapist who is trained in and experienced with treating PTSD. This means talking with multiple therapists, and finding one who is not only experienced in PTSD treatment, but who you feel comfortable working with. A good starting place is to talk with your family doctor or a local mental health agency, to get a list of recommendations. If you have insurance, you can also call your insurance provider and get a list of mental health service providers in their PPO.
Things to look for in a therapist include:
Known as shell shock and battle fatigue syndrome in the past, in modern day, PTSD was first noticed among Civil War soldiers, and later among WWI soldiers. In fact, PTSD was brought to the attention of the medical community by veterans who were suffering from it, although anyone who has experienced or witnessed trauma can develop it. PTSD is very common among soldiers who have been in active duty, as well as among abuse victims and emergency and rescue workers.
Thanks to years of research, today psychologists and medical professionals know more about what causes PTSD than they did in the past, as well as how it is best treated. Depending on the person and the details of the trauma they witnessed or suffered, PTSD treatment involves psychotherapy, PTSD medication, or in some cases, both. PTSD Medication is used to treat anxiety and depression associated with PTSD, while the goal of therapy is to help the PTSD sufferer learn skills to manage their symptoms. A secondary goal of therapy is to help patients develop healthy ways to cope with the trauma they suffered.
Because of the unique nature of PTSD, it's important to choose a therapist who is trained in and experienced with treating PTSD. This means talking with multiple therapists, and finding one who is not only experienced in PTSD treatment, but who you feel comfortable working with. A good starting place is to talk with your family doctor or a local mental health agency, to get a list of recommendations. If you have insurance, you can also call your insurance provider and get a list of mental health service providers in their PPO.
Things to look for in a therapist include:
- One you feel comfortable with
- One who respects you, including your opinions, feelings, individuality, and right to disagree
- One who acts as a doctor, and is not interested in being your friend or partner
- One who is willing to share his or her experiences with you when relevant, but who doesn't spend time talking about his or her own problems
- One who is not going to force you to talk about things you aren't ready for
© Newsmax. All rights reserved.
The Japan Quake: Resources for Reporters
The Japan Quake: Resources for Reporters
As shock waves resonate in the 9.0-magnitude earthquake, tsunami and unfolding threats from damaged nuclear power plants that have devastated Japan, the Dart Center offers these resources for journalists:
A Japanese version of the Dart Centre' Europe' s "Trauma and Journalism," by Mark Brayne:
Earthquake and tsunami resources assembled by Google, including Google's person-finder.
Dart Center resources on covering earthquakes.
"Tragedies and Journalists," the Dart Center's comprehensive guide for reporters, editors, photographers and managers on every aspect of reporting tragedy.
"Working with Victims and Survivors," Advice from journalists, researchers and mental health professionals on how to deal with people caught up in tragic events.
Guidance on mental health issues and how they evolve in regions devastated by natural disasters, from psychiatrist Alexander McFarlane.
Guidance on working with emergency services from Dr. Anne Eyre, specialist in trauma and disaster management.
Quick tips, in-depth resources and links to other organizations on "Covering Disasters."
Caring for Kids After Trauma, Disaster and Death:
http://www.aboutourkids.org/files/articles/crisis_guide02.pdf
After the Crisis: Healing from Trauma after Disaster
http://gainscenter.samhsa.gov/atc/pdfs/atc_concept_paper.pdf
9 STEPS TO AVOID COMPASSION FATIGUE WITHOUT FAILING TO CARE
From OperationSAFE, Int'l ...Traumatic Stress is brought on when we experience events that are highly abnormal. Our organization,OperationSAFE is dedicated to helping children who have gone through trauma such as disasters, abuse, trafficking, and extreme poverty.
...how to deal with trauma in children we also give them suggestions on how to keep themselves from developing Secondary Traumatic Stress Syndrome, in some degree the same suggestions are helpful for all of us as we struggle to keep a heart of compassion in the midst of unrelenting bad news...
9 Steps to Avoid Compassion Fatigue Without Failing to Care
The Best Way to Care for Others is to Care for Yourself!
In the field we know that lives are depending on us so it is vital that we take care of ourselves so that we can care for them,
- Eat, Sleep and Relax as you normally would,
- Make sure to Exercise Physically to help relieve stress,
- Avoid the use of Chemicals to either enhance performance or induce rest.
Share the Care!
If there is only a one-way flow of stress coming in, it rapidly becomes too much to bear. One way to reduce the strain is to share it in part with others,
- Talk about the things that are heavy on your heart with friends and supporters,
- Journal, write a blog, send an e-mail to a friend, tweet,
- Pray, meditate, or have a small group discussion with others who care.
Look for Signs of Hope!
Unfortunately, bad news is news. Good news doesn’t often make the front page unless it is dramatic. However, there are less dramatic stories of hope that surround us every day. Be on the look-out for the signs of life returning to normal.
- Make a point of writing or sharing one good thing that happened each day,
- Look for lessons that can be learned even in the midst of the worst situations,
- Celebrate even the smallest victories and personal accomplishments.
I believe that one great contributor to compassion fatigue in the public is that the media overexposes the need and underexposes the great response and difference that is made in people’s lives. This is the nature of the media of course and it is much easier to report the thousands dead than to find each story of individual lives that recover. Another contributor to compassion fatigue is the vast scale of donationsthat are given to charities and the lack of communication of the results. Donors are given a full disclosure of the pain and suffering but are deprived of the hope and results needed to relieve the trauma they have been exposed to.
My recommendation for those who seek to be compassionate without fail is to become personally involved with a smaller charity – volunteer for hands-on work, give time to be on their board, lend them some of your passion and creativity and share in the the reward of seeing lives changed for good.
Triage for Emotional Trauma
From Healing the Green Soul
TUESDAY, DECEMBER 22, 2009via @jadt65 & in support of the iranian people following the elections of 2009
- It is normal to feel "numb" or to have mood swings. It is important for family, friends & loved ones not to criticize. Pay attention for signs of self-harm or aggression toward others. If a survivor seems suicidal or homicidal, seek professional help immediately!
- It is important for family, loved ones, & friends to let the survivor know he/she is not alone and they are there to support the survivor.
- One of the psychic injuries of rape, torture and/or trauma is a lack of control. Allow the survivor to do as much as he/she is able and wants to do.Listen if they want to talk, but do not push for information. This helps decrease anxiety & assists in regaining a sense of control.
- It is crucial to get professional help as soon as possible from someone trained in providing treatment to survivors. The closer in time treatment starts, the less severe the long-term aspects. For physical & sexual abuse immediate medical attention is crucial.
- Be aware of "masking," a far away, blank expression with survivors....this is an indicator of "flashbacks" or disassociation ( becoming unaware of the environment but still able to speak, act, ect). If observed, using a "mantra" (repeated meaningful word, ex. safe. home) & gently touching the person(if they are not reactive to touch) or maintain eye contact will help keep the person in the here & now."
- Nightmares & sleepwalking-Do not wake the person. Try to guide them back to bed. Monitor to prevent injury.
- It is common for a person to feel fine & not show any symptoms for 6-12 months after the last abuse incident, & then show symptoms (crying, lack of sleep, anxiety attacks). This is part of the reason immediate treatment is crucial...it prevents the development of symptoms.
- Many times the thoughts and feelings of the abuse are too strong for words. It is helpful for the survivor to write, draw, read poetry, sculpt, paint or create to to let go of these emotions. It also helps the survivor in gaining a sense of control.
- The survivor might emotional distance him/herself from loved ones & friends. This is similar to a cast for a broken bone. While respecting the individual's space, be there for them....sit in silence with them, eat meals together, walk together. This provides the survivor w/ a sense of belonging and security.
- Remember, if the person is alive and away from the one who inflicted the abuse...the person is no longer a victim, the are a survivor who is recovering from the abuse. Caregivers & friends should avid expressions of pity....express admiration for the strength, courage, creativity is took for the person to survive the abuse.
- Avoid saying what you what to happen to the perpetrator of the abuse....the survivor gains a sense of control and power when deciding consequences for the abuser.
- Certain sounds, odors, sights, or even movements may "trigger" memories of the abuse. These triggers can cause flashbacks or disassociation. The survivor needs to avoid the triggers until a professional is able to help him/her become desensitized (non-reactive) to the trigger.
- Caregivers, friends & family member need to avoid projecting their emotions into the survivors experiences. Example: Survivor talks about about being beaten with a baton. Family member says,"You must have been mad". FAIL> the caregiver does not know how the survivor felt; this takes away the survivor's right to feel whatever his/she wants, and the survivor might not be ready to deal w/ the feelings.*** Helpful response: "what were you feeling/thing when that happened?" Caregivers need to be ready to accept the survivor's response.
- 14. Routine, structure, and predictability are extremely important to undue the shock, unpredictability of trauma & fear/anxiety. This also help decrease symptoms of depression.
- Attending groups with others who have had similar experiences under the guidance of a professional are helpful to decrease the feelings isolation & help w/feelings of shame & guilt.
- Family members, friends & caregivers are likely to experience secondary trauma with emotional symptoms similar to a person who has experienced abuse first hand (this is especially true for children whose parent has been traumatized). Professional help & support groups are helpful.
***Often when people are imprisoned or abused for a long time they develop Stockholm syndrome (builds a positive emotional relationship with the perpetrator----this functions as a survival mechanism). Trained professionals need to work through Stockholm Syndrome w/ the survivor due to the sensitivity of the thought & emotional issues.
Special considerations for children- Children who have been sexually abused are especially vulnerable because the have not been exposed to sexual issues. A talk about "good touch/bad touch" helps & keeping "private parts" private.
- Children tend to "play out" what they do not understand. Abused & traumatized children need to be supervised w/ peers & redirected if they try to "play out" the abuse. It is important to have traumatized children work w/ a professional who specializes in doing trauma specific therapy to help the child in developing appropriate interaction skills with other children.
- Children usually do not have the words to talk about what happened and their feelings. Encourage drawing, painting, and puppet/ doll play to help them "work things out"
- Help the child identify their "special people" (those who the child has a bond with) to go to when the child does not feel safe. It is helpful to have the child carry a picture or some other kind of remembrance of the person. Special toys (stuffed animals, dolls, action figures) are also helpful in this regard.
Believe what they tell you about their experiences
****This information is "first response", it is important to work with a local counselor, therapist, psychologist familiar with trauma-specific therapy on a regular basis as soon as possible.******
****This information is "first response", it is important to work with a local counselor, therapist, psychologist familiar with trauma-specific therapy on a regular basis as soon as possible.******
Psychological First Aid Provider Care
Psychological First Aid Provider Care
Providing care and support in the immediate aftermath of disaster can be an enriching professional and personal experience, enhancing satisfaction through helping others. It can also be physically and emotionally exhausting. The following sections provide information to consider before, during, and after engaging in disaster relief work.
Before Relief Work
In deciding whether to participate in disaster response, you should consider your comfort level with this type of work and your current health, family and work circumstances. These considerations should include the following:
Personal Considerations
Assess your comfort level with the various situations you may experience while providing Psychological First Aid:
• Working with individuals who are experiencing intense distress and extreme reactions, including screaming, hysterical crying, anger, or withdrawal
• Working with individuals in non-traditional settings
• Working in a chaotic, unpredictable environment
• Accepting tasks that may not initially be viewed as mental health activities (e.g. distributing water, helping serve meals, sweeping the floor)
• Working in an environment with minimal or no supervision or being micro-managed
• Working with and providing support to individuals from diverse cultures, ethnic groups, developmental levels, and faith backgrounds
• Working in environments where the risk of harm or exposure is not fully known
• Working with individuals who are not receptive to mental health support
• Working with a diverse group of professionals, often with different interaction styles
Health Considerations
Assess your current physical and emotional health status, and any conditions that may influence your ability to work long shifts in disaster settings, including:
• Recent surgeries or medical treatments
• Recent emotional or psychological challenges or problems
• Any significant life changes or losses within the past 6-12 months
• Earlier losses or other negative life events
• Dietary restrictions that would impede your work
• Ability to remain active for long periods of time and endure physically exhausting conditions
• If needed, enough medication available for the total length of your assignment plus some extra days
1Provider Care
Family Considerations
Assess your family’s ability to cope with you providing Psychological First Aid in a disaster setting:
• Is your family prepared for your absence, which may span days or weeks?
• Is your family prepared for you to work in environments where the risk of harm or exposure to harm is not fully known?
• Will your support system (family/friends) assume some of your family responsibilities and duties while you are away or working long hours?
• Do you have any unresolved family/relationship issues that will make it challenging for you to focus on disaster-related responsibilities?
• Do you have a strong, supportive environment to return to after your disaster assignment?
Work Considerations
Assess how taking time off to provide Psychological First Aid might affect your work life:
• Is your employer supportive of your interest and participation in Psychological First Aid?
• Will your employer allow “leave” time from your job?
• Will your employer require you to utilize vacation time or “absence-without-pay time” to respond as a disaster mental health worker?
• Is your work position flexible enough to allow you to respond to a disaster assignment within 24-48 hours of being contacted?
• Will your co-workers be supportive of your absence and provide a supportive environment upon your return?
Personal, Family, Work Life Plan
If you decide to participate in disaster response, take time to make preparations for the following:
• Family and Other Household Responsibilities
• Pet Care Responsibilities
• Work Responsibilities
• Community Activities/Responsibilities
• Other Responsibilities and Concerns
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Appendix C: Provider Care
During Relief Work
In providing Psychological First Aid, it is important to recognize common and extreme stress reactions, how organizations can reduce the risk of extreme stress to providers, and to how best to take care of yourself during your work.
Common Stress Reactions
Providers may experience a number of stress responses, which are considered common when working with survivors:
• Increase or decrease in activity level
• Difficulties sleeping
• Substance use
• Numbing
• Irritability, anger, and frustration
• Vicarious traumatization in the form of shock, fearfulness, horror, helplessness
• Confusion, lack of attention, and difficulty making decisions
• Physical reactions (headaches, stomachaches, easily startled)
• Depressive or anxiety symptoms
• Decreased social activities
Extreme Stress Reactions
Providers may experience more serious stress responses that warrant seeking support from a professional or monitoring by a supervisor. These include:
• Compassion stress: helplessness, confusion, isolation
• Compassion fatigue: demoralization, alienation, resignation
• Preoccupation or compulsive re-experiencing of trauma experienced either directly or indirectly
• Attempts to over-control in professional or personal situations, or act out a “rescuer complex”
• Withdrawal and isolation
• Preventing feelings by relying on substances, overly preoccupied by work, or drastic changes in sleep (avoidance of sleep or not wanting to get out of bed)
• Serious difficulties in interpersonal relationships, including domestic violence
• Depression accompanied by hopelessness (which has the potential to place individuals at a higher risk for suicide)
• Unnecessary risk-taking
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Appendix C: Provider Care
Organizational Care of Providers
Organizations that recruit providers can reduce the risk of extreme stress by putting supports and policies in place. These include:
• Limiting shifts so that providers work no more than 12 hours and encourage work breaks
• Rotation of providers from the most highly exposed assignments to lesser levels of exposure
• Mandate time off
• Identify enough providers at all levels, including administration, supervision and support
• Encourage peer partners and peer consultation
• Monitor providers who meet certain high risk criteria, such as:
- Survivors of the disaster
- Those having regular exposure to severely affected individuals or communities
- Those with pre-existing conditions
- Those with multiple stresses, including those who have responded to multiple disasters in a short period of time
• Establish supervision, case conferencing, staff appreciation events
• Conduct trainings on stress management practices
Provider Self-Care
Activities that promote self-care include:
• Manage personal resources
• Plan for family/home safety, including making child care and pet care plans
• Get adequate exercise, nutrition, and relaxation
• Use stress management tools regularly, such as:
- Accessing supervision routinely to share concerns, identifying difficult experiences and
strategizing to solve problems
- Practicing brief relaxation techniques during the workday
- Using the buddy system to share upsetting emotional responses
- Staying aware of limitations and needs
- Recognizing when one is Hungry, Angry, Lonely or Tired (HALT), and taking the appropriate self-care measures
- Increasing activities that are positive
- Practicing religious faith, philosophy, spirituality
- Spending time with family and friends
- Learning how to “put stress away”
- Writing, drawing, painting
- Limiting caffeine, cigarette, and substance use
As much as possible, providers should make every effort to:
• Self-monitor and pace their efforts
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Appendix C: Provider Care
• Maintain boundaries: delegate, say no, and avoid working with too many survivors in a given shift
• Perform regular check-ins with colleagues, family, and friends
• Work with partners or in teams
• Take relaxation / stress management / bodily care / refreshment breaks
• Utilize regular peer consultation and supervision
• Try to be flexible, patient, and tolerant
• Accept that they cannot change everything
Providers should avoid engaging in:
• Extended periods of solo work without colleagues
• Working “round the clock” with few breaks
• Negative self-talk that reinforces feelings of inadequacy or incompetency
• Excess use of food/substances as a support
• Common attitudinal obstacles to self-care:
“It would be selfish to take time to rest.”
“Others are working around the clock, so should I.”
“The needs of survivors are more important than the needs of helpers.”
“I can contribute the most by working all the time.”
“Only I can do x, y, z.”
After Relief Work
Expect a readjustment period upon returning home. Providers may need to make personal reintegration a priority for a while.
Organizational Care of Providers
• Encourage time off for providers who have experienced personal trauma or loss
• Institute exit interviews to help providers with their experience – this should include information about how to communicate with their families about their work
• Encourage providers to seek counseling when needed, and provide referral information
• Provide education on stress management
• Facilitate ways providers can communicate with each other by establishing listservs, sharing contact information, or scheduling conference calls
• Provide information regarding positive aspects of the work
Provider Self-Care
Make every effort to:
• Seek out and give social support
• Check in with other relief colleagues to discuss relief work
• Increase collegial support
5
Appendix C: Provider Care
6
• Schedule time for a vacation or gradual reintegration into your normal life
• Prepare for worldview changes that may not be mirrored by others in your life
• Participate in formal help to address your response to relief work if extreme stress persists for greater than two to three weeks
• Increase leisure activities, stress management, and exercise
• Pay extra attention to health and nutrition
• Pay extra attention to rekindling close interpersonal relationships
• Practice good sleep routines
• Make time for self-reflection
• Practice receiving from others
• Find things that you enjoy or make you laugh
• Try at times not to be in charge or the “expert”
• Increase experiences that have spiritual or philosophical meaning to you
• Anticipate that you will experience recurring thoughts or dreams, and that they will decrease over time
• Keep a journal to get worries off your mind
• Ask help in parenting, if you feel irritable or are having difficulties adjusting to being back at home
Make every effort to avoid:
• Excessive use of alcohol; illicit drugs or excessive amounts of prescription drugs
• Making any big life changes for at least a month
• Negatively assessing your contribution to relief work
• Worrying about readjusting
• Obstacles to better self-care:
o Keeping too busy
o Making helping others more important than self-care
o Avoiding talk about relief work with others.
Disaster Responders
Psychological First Aid: Field Operations Guide 
For disaster responders
Developed jointly with the National Child Traumatic Stress Network, PFA is an evidence-informed modular approach for assisting people in the immediate aftermath of disaster and terrorism: to reduce initial distress, and to foster short and long-term adaptive functioning. It is for use by first responders, incident command systems, primary and emergency health care providers, school crisis response teams, faith-based organizations, disaster relief organizations, Community Emergency Response Teams, Medical Reserve Corps, and the Citizens Corps in diverse settings. The 5th appendix consists of Handouts for Survivors (PDF).
NOTE: The latest version of Adobe Acrobat Reader* is needed to download these files. Not having the latest version (8) of this reader may cause error messages that the PDF file is "damaged".
Hardcopies of the PFA Field Operations Guide can be purchased at www.castlepress.net/nctsn* for around $10 each.
The Psychological First Aid Manual Contents
Chapter/ Topic | Title of Chapters and Topics |
|---|---|
| Complete Guide With Appendices | PFA Manual complete with Appendices (PDF 60mb) |
| Complete Guide Without Appendices | PFA Manual without Appendices (PDF 1.6mb) |
| Chapter 1 | Introduction and Overview |
| Chapter 2 | Preparing to Deliver Psychological First Aid |
| Chapter 3 | Core Actions |
| Topic 1 | Contact and Engagement |
| Topic 2 | Safety and Comfort |
| Topic 3 | Stabilization |
| Topic 4 | Information Gathering: Current Needs and Concerns |
| Topic 5 | Practical Assistance |
| Topic 6 | Connection with Social Supports |
| Topic 7 | Information on Coping |
| Topic 8 | Linkage with Collaborative Services |
Appendices (5) for Psychological First Aid Manual | |
| 1 | Overview of PFA (PDF 379k) |
| 2 | Service Delivery Sites and Settings (PDF 381k) |
| 3 | Psychological First Aid: Provider Care (PDF 900k) |
| 4 | Provider Worksheets (PDF 491k) |
| 5 | Handouts for Survivors (PDF 2.1mb) Includes: |
Available in other languages on the National Child Traumatic Stress Network website: PFA in Chinese, Japanese, and Spanish*
Training on PFA
- Training in PFA: Psychological First Aid Online.* Login to learn about this intervention.
- Subscribe to PFA Channel and View the PFA Online Videos.*
PFA was created with the Terrorism Disaster Branch of the National Child Traumatic Stress Network as well as others involved in disaster response. Production of this information was supported by SAMHSA.
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