Monday, January 12, 2009

Trauma First Aid...

As family carepartners and helping professionals, we are exposed to secondary trauma, or indirect wounding, through witnessing or hearing of the traumatic experiences of others.

Whether we discover a loved one collapsed on the floor after a heart attack, assist a patient suddenly hemorrhaging from his gastrointestinal tract, respond to a serious motor vehicle accident or preside at the funeral of a four year old child, we are vulnerable to secondary traumatic stress. How do we practice good self care in such situations? How do we help ourselves to reduce long term trauma effects?

Peter Levine, PhD,  in his books, Healing Trauma and Waking the Tiger, gives first aid guidelines for helping adults who have experienced traumatic events. From these guidelines, I have drawn the following suggestions:

Stage I:  Immediate Action:

As soon as possible after ensuring the immediate safety of the primary victims and your own safety:

1.  Rest, lying down if possible. (This may go against your natural inclination to "do something" or to deny the impact of the trauma but it is essential to be still so the trauma energy can be discharged from your body.)

2.  Have a trusted person stay with you quietly.

3.  Allow yourself to fully experience your body sensations. These may include adrenalin rush, numbness, shaking and trembling, feeling hot or chilled.

4.  Remind yourself or allow others to remind you that it is not only okay to shake, it is good and will help you to release the shock. You will feel a sense of relief after the shaking is completed and may feel warmth in your hands and feet. Your breathing should be fuller and easier. This initial stage of discharge could easily take 15 - 20 minutes.

5.  Stay quiet and resting until the acute shock reaction is over.

Stage II:  Later

1.  Allow time for processing the traumatic experience. Always take a day or two off work or rest more than usual if you are at home in order to reintegrate. This is important even if you don't perceive your situation to justify staying home or resting. (This resistance can be a common denial mechanism and defense against feelings of helplessness). As Peter Levine says, "A day or two is good insurance".

2.  Allow your emotions to be felt without judgement. You may experience feelings such as anger, fear, guilt, sadness and anxiety. There may also be continuing body sensations such as shaking or chills. This is often the case.

Stage III:  Begin to Access and Renegotiate the Trauma: (Often coincides with Stage II)

1.  Work with someone who understands the body effects of trauma to recall both the direct and peripheral images, feelings and sensations experienced during the traumatic event. Work slowly, one step at a time, to bring up and discharge the trauma energy.

Dealing with a traumatic event at the time that it happens goes a long way toward preventing long term trauma reactions. If you would like to understand more about the importance of processing traumatic events and the physiology behind the process above, I recommend Peter Levine's two books and his CD collection, Healing Trauma.

 (As always, use your own best judgement to assess your particular circumstances before using the guidelines above.)

No comments: