Originally Posted October 25th, 2014
In the wake of this most recent school shooting, this time in Marysville, WA, I thought I would share some information and tools for recovering from traumatic events. As a Mental Health Professional, and a trauma specialist, I have gathered a great deal of information over the years that I would like to share some of it to support those who find it useful. I have provided critical incident stress services to police, fire and other emergency service personnel, and for large and small private sector companies since 1997. This has included a number of line-of-duty-death incidents and employee deaths. This is never easy.
This article contains a wealth of information and possibilities. Because it does it is long which can be overwhelming. So please read it in sections so you can receive all the tools and possibilities it offers.
Upon experiencing or first hearing about this kind of traumatic event people often experience shock. Things slow down, sometimes people freeze, what you are hearing or witnessing does not fit into how you view the world so there is almost a split of not believing what you are hearing or experiencing and your normal way of viewing the world.
The good news is our lower limbic brain kicks us into a fight or flight reaction to handle the situation if we are directly involved in the event. The bad news is our higher brain function shuts down to minimum maintenance level, so we do not have access to all of our capacities for a time. We may not be able to think clearly or remember things. This is just how our preservation systems work.
This emotional and psychological shock is just as physically impactful as if you were suffering from a severe physical injury. And, people who experience a severe physical shock will also experience emotional and psychological shock. People often become very cold, and begin to shake, either during the event or afterwards. There are stress chemicals that your body released into its system to handle the crisis. It can take a while for these chemicals to dissipate out of your system, hours, days, months, even longer depending on a myriad of circumstances.
Other initial symptoms may include confusion, irritability, memory loss, feeling numb, difficulty focusing or concentrating, loss or increase of appetite, fatigue, anger, profound sadness, feeling immobile, loss of interest in your usual life activities, loss of faith, wanting to withdraw or having to have people around all of the time, your mind spinning out of control, trying to make sense of things, apathy, easily startled, feeling isolated or lonely, headaches, chest pains, weight changes, negative attitude, low productivity, continuous daydreaming, poor job performance, lack of intimacy, family or marriage problems, lashing out at others, lowered sex drive, crying spells, stoical, mood swings, and urge to use alcohol or drugs to stop the symptoms, increase I tobacco use, feeling empty, cynicism, looking for magical solutions, spiritually lonely.
It is important to note you will not experience all of these and you may not experience any of them. Everyone is different! There is no right or wrong or comparisons. Each person’s system has its own way of handling things. You have an innate wisdom within you that knows how to move you back into health. Just like how your body knows how to heal a cut or repair a broken bone.
Some people find the list of symptoms helpful knowing that others have experienced similar things. It is important that you do not expect to have these symptoms. I list them so you know you are already on a healing path. That does not mean that it is comfortable or easy, in fact it is often quite the opposite. These are NORMAL reactions to traumatic events.
There are some things you can do to support your system to return to balance. First, your thinking is not your friend in this case. Our minds will start spinning out of control to try to make sense of things. Everything that has not been resolved for you personally or in relationships with others can come flying out and muddy up the waters. How can you handle this?
Any thought that makes you suffer is some sort of limitation. Take a moment to notice how the thoughts are making you feel and if it is anything other than soothing or joyful let it go. I know, easier said than done. Thoughts will come and go, and you can just witness it and let it go, much how water flows around rocks, and keeps on moving out. You can coach yourself by saying things like: “These are just thoughts and I do not have to believe them or take them seriously. I just let them go.” I like to use humor so you can say: “Thank you for sharing but you are not helping so you are fired!”
If you have already practiced meditation or self-awareness techniques, you will already have some of these tools in place. Use them. If you attach to disturbing thoughts, make them real or significant, they act like glue and lock you into the suffering. Your mind cannot tell the difference between what you are thinking and what is actually occurring. Even if you are sitting quietly in your home with people who love you around you, if you are thinking something disturbing your body will respond as if it is occurring. Even though the memory you are thinking of is over. Your body thinks it is real and dumps more stress chemical to handle the disturbance.
Reminding yourself that the event is over and bringing yourself back to what is occurring right now helps your body dissipate the stress, instead of reinforcing it. Again, easier said than done. It takes tenacity. Just keep breaking up the broken record replay and eventually it will dissipate.
It is important that you receive support and talking about what you are experiencing is important. Stuffing it will keep things stuck in your system. Re-living the event over and over re-stimulates the activation. It is a tricky balance. It is important you talk enough to keep things moving.
Doing Self Soothing Activities helps calm your nervous system and supports your body to dissipate the stress chemicals. Coloring, drawing, gardening, knitting, tinkering with your car, building something, staring into a fire, sitting on a beach and watching the waves come and go, or near a river and watching it flow by, are all soothing activities for your nervous system. Just make sure the activities are about soothing and not about accomplishing something.
If you already have some of these hobbies be sure to use them frequently to restore balance. If not pick something up. Coloring, drawing or doodling can be very soothing. Pick up a coloring book for yourself if you do not have anything else. Or make copies of pages in your kids coloring book.
Measured breathing is an excellent tool for self-soothing. This kind of breathing tends to calm the limbic part of your brain that gets overactive after a traumatic event. There are many ways to do this. Breathing in for 4 counts and then out 4 counts, repeatedly until you feel the stress dissipate is one way. You can increase the number of counts as your system relaxes. You can also breathe in 4 counts, gently hold your breath 4 counts, breathe out 4 counts and gently hold your breath 4 counts, and repeat until you feel more ease. It is hard for some people to do the later so the first one helps.
There is a phone app for Android and Apple devices called the Virtual Hope Box that is full of tools for helping relieve stress. It has a measured breathing meter and some guided meditations you can use. It also has a section you can add inspiring messages that help refocus your thinking and some games for distracting your mind from negative thoughts. There is also a section for coping cards. These allow you to write down what things keep you stuck and a place to write down tools you can use to change your state of mind. This app was created for military personnel who suffer from intrusive thoughts and dysregulation in their nervous system. I have had clients who have found it especially useful.
Surround yourself with life affirming people and activities while you are recovering. Watch funny movies, avoid trauma drama movies and tv shows. Do things that are self-soothing and bring peace. In the height of a recent even you may not feel the full benefit initially, but you will not be re-stimulating your nervous system with stress chemicals.
Make sure to get physical activity. If you already have an exercise program stay with it but do not expect to do your typical level of workout for a while. If you do not do some gentle walking, bike riding or swimming can be very helpful. Particularly if you find your emotions are stuck. If you do not want to cry around others go for a walk by yourself in a less populated area. It can get the emotions moving so they can move out of your system. You may not feel like moving but doing so will give your body some relief. Do not push it. Maybe only go out for a walk or bike ride for 20 minutes. You will sleep better too.
Sleep is often disturbed by the incessant thoughts. If you are busy distracted from what comes up through the day, then they will show up when you finally get quiet. This is often bedtime for many. By allowing some measured breathing activities and quiet time throughout the day, and you release stuff through the day and at some point, things will be more quiet by the time you go to bed. This is useful in daily life as well. Not just after traumatic events.
Avoid increasing alcohol and drug use, tobacco use, and sugar and caffeine use. These are often what people crave after an incident. The problem is they can re-stimulate the stress chemicals and take you longer to return to normal. Eat protein and complex carbs instead of high sugar and starch items. Do some sort of physical activity before defaulting to any of these. Then see how you feel. This will help your body and mind get back into balance quicker.
If you are a boss or manager do not expect full productivity from people who have gone through a traumatic event. Take the pressure off them for a while. The stress chemical in their brain take time to dissipate and will interfere with their normal ability to think, remember, concentrate and their productivity. They will bounce back quicker the less they are re-stimulated with more stress regarding their performance.
I had an employee once who suffered a traumatic loss of a family member once. They were one of my most productive and dependable people. They were having a great deal of difficulty attending appointments with clients, doing paperwork and accomplishing typical productivity numbers. And they were beating themself up over it. I told them to take the pressure off themself. To cancel appointments if they found themself flooded with emotions, and when the emotions passed to go onto the next appointment. To do the best they could on paperwork, and I did not expect them to make the typical numbers right now.
I knew they would recover quicker if they did not have the added stress of keeping up his typical productivity. They argued with me that they did not want to slack off. I ordered them to “slack off” for now. I told them I was not worried about their productivity right now and that the stress chemicals would work out of their system quicker if they were not reactivating them by beating themself up over what is a NORMAL reaction to traumatic experiences.
If the symptoms do not dissipate fully after a number of weeks, then look into working with a mental health provider that specializes in working with trauma. Choose providers who use tools for desensitization tools, not talking. Why do I say that? As I mentioned before when you talk about it you just re-stimulate the traumatic material. It does not dissipate it out of your system. You will need enough talking to get a hold of the activation to desensitize it so it can clear your system, not recycle. There are several possibilities.
EMDR has a recent trauma protocol that is especially useful for recent events. It breaks the event down frame by frame and desensitizes each section until it clears. The standard protocol does not work for recent events as the memory has not yet generalized in how it is stored. So be sure to choose a practitioner who knows the recent trauma protocol. I have used this with police officers and firefighters who have suffered from overwhelming events, and with people who have had a variety of traumatic exposures.
For those of you more interested in alternative methods, have an Access BARS session, or use TAT. Not everyone is comfortable with all of what the Access program has to offer. But the BARS techniques can offer particularly good results very quickly for some. TAT has a protocol on their website you can use yourself and if you are really overwhelmed it is best to get help from a practitioner.
These are just some off the top of my head. There are many others as well.
It is important that any form of treatment you approach that you find a competent practitioner that you are comfortable with. Every modality has its strengths and different practitioners may employ those same tools differently. Getting a good recommendation and feeling supported by your practitioner is crucial to your recovery.
Watch for the gifts! This may seem like an odd statement in a time of tragedy, but I have seen some amazing things occur in the midst of tragedy. Take them in. It is extremely easy to focus only on the trauma. Letting the gifts and resources in is crucial to quicker recovery. For some it can be easy to dismiss them. Do not. Practice your receiving! In the case of the Marysville shooting we have already seen the Oak Harbor football team step up with multiple gestures of support and caring. There will be more to come. Receive it all and let it nourish you. You will recover quicker.
In conclusion, this has been a lot of information and there is soooo much more. This will get you started. First and foremost, take good care of yourself and you will recover quicker.
Debra Littrell, LMHC October 25, 2014