Healing from Tragedy & Trauma: What Comes Next?

Written by Dr. Darren Jones, PhD, LP & Dr. Julie Braciszewski, PhD, LP

After a tragedy or traumatic event occurs it can be difficult to know what to do next and when to seek additional support. Many individuals experience intense distress right after the event while some individuals experience little to no distress in the early days after a trauma, only to find the effects present themselves later on and seem to linger. Given the wide range of responses to traumatic experiences, it’s helpful to know the  typical responses immediately following a tragedy or traumatic event, as well as signs that it might be a good idea to seek professional support. Read below to also learn what effective treatment for traumatic stress looks like, what questions to ask your potential therapist, and to gain more resources for you or your loved ones.

What is a ‘normal’ response to a traumatic event?

Immediately following a tragic or traumatic event you may…

• Experience troubling memories that repeatedly enter your mind even when you are trying not think about them (intrusive thoughts or rumination)
• Feel on edge, and have difficulty sleeping and paying attention
• Feel mentally foggy and have trouble thinking clearly or remembering things
• Have strong emotions such as sadness, anger, fear, or guilt that flow from one to the next quickly, or happen at the same time at an overwhelming intensity
• Have blunted, or less intense emotions than usual
• Feel pulled to engage in highly distracting activities and even unhealthy coping strategies
• Want to avoid things, places, people and sensory experiences that remind you of the event
• Isolate yourself from others more than usual
• Have thoughts that amplify perception of potential risk; your thinking patterns might be looking out for danger and risky situations and over interpret potentials risks
• Feel highly stressed or irritated about things that typically would not bother you

These are a normal reactions to an abnormal event, and for most people these symptoms go away on their own within a few days or weeks.

• However, symptoms of Posttraumatic Stress Disorder (PTSD) may develop in some people who experience a traumatic event
• Anyone can develop PTSD at any age and in some cases the symptoms begin many months or even years after the traumatic experience

Who might experience traumatic stress as a result of a tragedy or traumatic event?

• Those present at the tragedy or traumatic event
• Those who were not immediately present but feared for their safety or the safety of others
• Parents who feared their children were in danger
• Those with elevated risk due to one or multiple Adverse Childhood Experiences or previous traumatic experience(s)

What are signs or symptoms that indicate more support is needed?

• The above reactions and experiences continue after a month or so
• Certain places, sensory experiences, people or things that remind you of the tragedy or trauma cause you to experience heightened physical and emotional responses that get in the way of your everyday life
• Avoidance of things, people, places or sensations that might remind you of the event
• You find yourself reliving the experience through upsetting memories or nightmares about the event
• You notice an increase in negative thoughts and feelings
• Ongoing sadness, anxiety or anger that persists several months after the event
• Feeling on edge and unsafe weeks, months or years after the event
• You are having difficulties at work or school
• Relationships seem strained or it is harder to feel connected with others

What are the treatments for supporting healing after tragedy or trauma?

There are several effective, evidence-based treatments for adjustment after a tragedy or trauma, as well as the disorder known as PTSD. Although there are many approaches to treating traumatic stress, research indicates that the two most effective psychotherapeutic treatments for these difficulties are Cognitive Behavioral Therapy and Prolonged Exposure. While treatments might feel scary to engage in, your clinician should be able to tailor your treatment to your needs and respect the pace at which you need to go to feel safe.

Treatments for traumatic stress often include:

• Working to reduce the power the experience has over your thinking, feeling and behavioral patterns
• If needed, working to regain a sense of control and safety in your everyday life
• Understanding and address changes in your nervous system due to the event
• Addressing how the event(s) have affected how your view of yourself and the world
• A respect for and awareness of your individual identity and life experiences as well as cultural and religious beliefs

Medications can also effectively treat some of the symptoms of traumatic stress. Some people find that a combination of both psychotherapy and medication treatment for traumatic stress is most effective. Your psychologist or therapist can work with your physician to help support and guide this process if this feels like a good route for you.

What questions should I ask when seeking treatment after a tragedy or trauma?

Treating trauma is a specialty in behavioral health and not all providers have the appropriate training and experience. Ask your provider about their training and experience.

• Ask a potential provider if they specialize in treating adjustment after tragedy and trauma, or PTSD and inquire about what evidence-based treatments they offer.
• If they do not have a background or training in treating PTSD it is important to move on to other providers that have that specialization. General ‘talk therapy’, and/or ‘supportive counseling’ are not effective treatments of traumatic stress.

References:

https://www.apa.org/topics/trauma/stress

https://www.ptsd.va.gov/understand/what/ptsd_basics.asp

https://www.nimh.nih.gov/health/topics/coping-with-traumatic-events