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

1. 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!
2. 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.
3. 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.
4. 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.
5. 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."
6. Nightmares & sleepwalking-Do not wake the person. Try to guide them back to bed. Monitor to prevent injury.
7. 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.
8. 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.
9. 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.
10. 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.
11. 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.
12. 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.
13. 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. 14. Routine, structure, and predictability are extremely important to undue the shock, unpredictability of trauma & fear/anxiety. This also help decrease symptoms of depression.
15. 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.
16. 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

1. 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.
2. 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.
3. 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"
4. 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.

The most important thing to do to help a survivor of abuse, rape, torture or imprisonment...

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.******