So far in this blog, I’ve mainly written about those people – the majority of people – who will be upset and distressed by their experience through the earthquake and aftershocks. However, I thought it would be worth putting up a post that focuses upon those who are, or may be, more profoundly affected in a negative way.
The Canterbury earthquake was certainly distressing and threatening, and may have been experienced as so intense that it can temporarily disrupt a person’s ability to come to terms with it. Thinking you might die, seeing others injured (or killed – but thankfully not in this case), intense fear, abuse or being forced to do things out of your control are all traumatic experiences. While traumas occur all the time, they only affect to a few people. The reactions of those affected often cause those close to them to be confused and unsure about what to expect or how to help. People who have been traumatised can respond in ways that may seem unusual, make things worse for them or they may be concerned about things that seem unreasonable.
The effects of trauma
A traumatic experience can temporarily shatter basic assumptions about life or other people such as trust, safety, predictability. The feelings caused may be so intense that unlike normal distress, they do not fade with time, but either continue the same or get worse after a while.
People affected by trauma may feel fear even when it is quite safe. They may be constantly on edge and not respond to normal reassurance or opportunities to relax. Their tiredness may continue on for much longer than seems reasonable. They may have periods of appearing numb or detached and not wanting contact. This may be followed later by over-excited behaviour and a need to cling to family or familiar things. They may feel they failed or did the wrong thing at the time (even if this is not true). Usually they remember a combination of very intense fragments of the event that do not go away, combined with important gaps that make them feel uncertain about what really happened.
Recovery from trauma
Most people recover from traumatic experiences, but it usually takes them longer than would be expected for non-traumatic crises. It is common for there to be an initial period of several days with strong emotions of fear or distress, and a constant preoccupation with the events. Many people then feel a need to get back to normal and put it out of their minds. Although this can often be beneficial in the short-term and help recovery from normal crises, it often only postpones problems for people who have been through traumas. Sometimes they can maintain normal routines for some time (although those around them often see that all is not well) and eventually something happens that brings it to the surface again. This can happen months after the event.
The important thing about recovery from trauma is to go back over what happened so the feelings fade and the person can come to terms with the event, realise it is in the past and how they can be safe again. But this has to happen at a time and rate that is comfortable for the individual. Other people are the most valuable support for recovery, but it is often difficult for them to be confident about what to do. Uncertainty and the wish to avoid distress can make those close to the affected person keep away from the experience or from them. It is usually best to ask how you can help and to let them know they can talk if they want to.
Helping someone who has been through trauma
- Spend time with the stressed person, without judging or demanding, their recovery will occur in its own time.
- Offer support and a listening ear: talking is one of the best things they can do to work things out; but they may need to go over things many more times than you expect. Try to be interested in what they want to say; avoid giving advice or trying to solve the problems. The talking itself is important and helps to make it fade. Remember though, this is likely to happen at their pace, not yours.
- Help with practical tasks and chores as this enables more of their energy and time to be given to the recovery process.
- Give them time, space and patience: don’t take it personally if at times they are irritable, bad tempered or want to be alone. These are a natural part of the stress response and will pass as they recover.
- Don’t try to talk them out of their reactions, minimise the event or say things like “you’re lucky it wasn’t worse,” or “pull yourself together,” or try to get them to look on the bright side; stressed people need to concentrate on themselves at first; they will feel supported if you let them know you are concerned, want to help and are trying to understand. They will see your viewpoint as they recover.
When to seek additional help
Sometimes it is important for people to know when their own recovery activity requires additional help. Personal recovery may need to be supported by specialist knowledge to ensure stress does not linger unnecessarily or lead to later health problems. Stress problems respond rapidly with professional advice and information.
Indications for this are:
- if recovery has stalled or does not seem to be proceeding
- if physical or other symptoms are causing concern
- if there is no one to talk to or relationships are being affected by the stress
- if there is continuing emotional numbness, depression or anxiety
- if there is continued disturbed sleep and nightmares
- if they are unable to handle the intense feelings or physical sensations
- if they are becoming accident prone or increasing use of drugs and alcohol.
Looking after yourself
Don’t forget that to have a loved one, friend or colleague go through a trauma can be very stressful for you as well and you may find that you have strong reactions of anger that it happened, sadness for them, fear for yourself, changes in how you see life and the world, nightmares or general moodiness. Often the best thing may be to seek support from others for yourself so you can be more available to your loved one for the time it takes them to get over it.
Information and counseling
Counseling with someone trained in trauma is often helpful not only to talk about the trauma, but to give a better understanding about what is happening and how to get over it. Sometimes the person who has had the trauma may not be willing to seek help for a time. In this case it may be beneficial for those close to them to seek professional advice and this often helps them take the step themselves.
I have adapted from information issued by Queensland Health: Fact Sheets for Psychosocial Disaster Management. I have also compiled a version that you can download here.