Recognizing and Dealing with the Traumatic Stress of
Tuesday September 11, 2001

By Paul and Layne Cutright.

Copyright (c) 2001, all rights reserved.


What is Trauma?

A trauma, or critical incident, occurs whenever you are faced with sudden or unexpected events that involve elements of threat, loss or disruption of basic value systems. The traumatic reaction almost always has an impact on your "comfort zone", (what is familiar, comfortable and safe). Traumatic events can range from a single, overwhelming event such as a hurricane, fire, sexual assault, shooting, robbery, airplane crash or car accident, to the more complicated and enduring situations such as child abuse, domestic violence and war. These can be individual or shared events.

Although the traumatic event may now be over, you are likely to notice strong physical and emotional reactions. It is very common, in fact normal, to experience emotional and physical aftershocks when you have passed through a critical incident. Sometimes these aftershocks or stress reactions appear immediately after a traumatic event, and/or they may not appear for weeks, months or even years in some cases.

Natural disasters occur as a force of nature; atrocities occur as a result of other human beings. According to trauma expert Judith Herman, the nature of the trauma determines how emotionally harmful the incident will be. There appears to be a direct relationship between the severity of the trauma (number of people affected, intensity, duration of harm) and its psychological impact.

Understanding trauma can be challenging because a definition of trauma must include more than the terrible event itself. It also includes the individual reactions that follow the trauma, which can temporarily incapacitate victims with overwhelming force.

Trauma Phases

Trauma or critical incidents can be understood in terms of both their phases and symptoms associated with them. The following phases outline what people commonly experience during, immediately following and for some time after a traumatic event.
Shock

This phase begins with the onset of the traumatic event and can continue for as long as a week. Your senses are overwhelmed; sensory information floods your brain in sights, smells, sounds, touch and tastes. Your brain is unable to process it all and begins to go emotionally numb. This will frequently result in time, auditory and visual distortions. You may be aware of physical symptoms, including agitation and hyper-alertness or over-activity.

Impact

This phase begins when you leave the location of the incident and can last from a few days to several weeks. It often lasts until you can resume routine patterns. This phase frequently brings confusion as you come to realize and assess the extent of the damage, death or injury. You may become highly emotional.

Recoil

This phase begins when you return to a near-normal routine pattern, accompanied by stable days. You should begin to experience a decrease in the symptoms present during the impact phase. There will be a gradual return of awareness, reasoning ability, recall and emotional expression.

Post-Trauma Resolution

This phase occurs after you have developed a routine pattern. It is here the trauma's impact will show in changes in behavior, thinking and perception. These changes may be irreversible. There are two possible outcomes of this phase: positive resolution or negative reaction with no resolution. The positive course will lead you to acceptance of the event and your actions, along with a positive re-evaluation of your goals and values. Keep in mind this may be a lengthy process. Without trauma resolution, there is a strong likelihood of a chronic struggle throughout life with distress, family problems, job difficulties, chemical dependency and potential suicide.

Excerpted from Trauma Recovery Handbook by Charlene Slover and Debra Tasci
http://www.amazon.com/exec/obidos/ASIN/0967371007/thecenterforenli /104-9616793-6422313

The following information is help you recognize and deal effectively with stress within yourself and others. The closer people are to the traumatic incident, the more severe the symptoms are likely to be and more long lasting. The more distant from the event, the less severe and short lived.

The following list of physical, cognitive, emotional and behavioral stress and trauma symptoms is provided by the International Critical Incident Stress Foundation, Inc.

PHYSICAL
Chest tightness
Chills
Cold
Diarrhea
Dizziness
Fast breathing
Fatigue
Grinding teeth
Headaches
Hormone changes
Nausea
Profuse sweats
Rapid heartbeat
Sleep problems
Thirst
Tremors (hands)
Twitching
Upset stomach
Visual difficulty

COGNITIVE
Blaming
Confusion
Difficulty calculating
Difficulty concentrating
Difficulty in problem solving
Difficulty in making decisions
Difficulty naming common objects
Difficulty reading
Disorientation (place/time)
Distressing dreams
Hyper vigilance
Increased/decreased alertness
Intrusive memories
Memory problems (short or long)
Offensive/defensive self reviews
Overwhelmed by normal routines
Poor attention span (decreases)
Seeing event over and over again
Slower thought processes

EMOTIONAL
Feeling abandoned
Agitation
Anxiety
Apprehension
Denial
Depression
Fear
Feeling isolated
Feeling lost
Feeling numb
Grief
Guilt
Intense anger
Irritability
Limited contact
Sadness
Uncertainty
Wanting to hide
Worry

BEHAVIORAL
Alcohol consumption
Antisocial actions
Changes in activity
Changes in sex life
Emotional outbursts
Erratic movements
Harsh with family
Hyper alert to environment
Inability to rest/relax
Increase/loss of appetite
Job changes
Nonspecific body pains
Relationship problems
Speech pattern changes
Startle reflex intensified
Suspiciousness
Withdrawal into oneself


All of the above symptoms are normal and natural reactions to exposure to a traumatic incident. These symptoms of stress normally occur in individuals who have encountered an extreme threat or loss. They are basic responses of the mind and body and are designed to assist you with coping and surviving.

If you have not been the victim of a trauma directly but someone you work with, love or care about has, you may also experience symptoms. This is called secondary traumatic stress or vicarious victimization. It seems likely that anyone who has watched the horrific images of last Tuesday's attack on New York and Washington would suffer at least secondary stress, especially if the images were watched over and over again.

Also, it is normal for people to be unable to recognize their own stress reactions. If someone you know and love is exhibiting any of the above symptoms, share this article with them and/or gently inquire how they feel they are handling this situation. Likewise, if someone suggests that you are exhibiting some of these symptoms, be open to looking and taking care of yourself.

Here follows a list of things to do and not to do to minimize the effects of traumatic stress:

Remember, you are normal and having common reactions to an abnormal situation.

• While exercise is always important, vigorous exercise is especially critical within the first 24 to 48 hours of a traumatic incident to offset physiological stress reactions. Move around, stretch, walk, run. Alternate relaxation techniques such as deep breathing with exercise.
• Take naps or just rest. Get more rest than you usually do.
  
• Eat healthy food and snacks. Eat meals on your regular schedule even if you are not hungry.
  
• Drink more than your normal amount of water. This helps rid your body of toxins built up by the body's physiological stress reaction.
  
• Reduce your use of caffeine and alcohol. Both interfere with normal sleep and the processing of the traumatic incident.
  
• Contact friends and talk to people you trust. This is the most healing action you can take. Talk about your reactions to the event and its effects on you.
  
• Realize that those around you, especially your family, may be under stress, too. Talk to them about what is going on with you.
  
• If you live alone, have someone stay with you for a day or two.
  
• Structure your time, keep busy and follow your routine of eating, sleeping, exercising, spending time with family, etc.
  
• If you cannot sleep, talk to a counselor. Proper sleep is essential to recovery.
  
• Give yourself permission to feel rotten. You may feel sore muscles in various parts of your body from the physiological stress.
  
• Do not make big life changes or major decisions for some time after a major event.
  
• Make as many small, daily decisions as you can. This will give you a feeling of control over your life.
  
• Recurring thoughts, intrusive memories of the event and flashbacks are normal. Don't try to fight them. They will decrease over time and become less painful. If they do not decrease after 30 to 45 days, seek the help of a professional counselor.

 The authors of this article are: Paul and Layne Cutright. Contact them by e-mail at: partners@enlightenedpartners.com    www.enlightenedpartners.com   

For more information about Richard Ross, visit
http://www.emotionalfreedom.com
or call him at (505) 828-3527

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