Common Struggles Following Trauma

Following are some common struggles that you or your loved one might encounter following violent trauma.

• Acute Stress Disorder
  

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  Acute Stress Disorder (ASD) is a relatively new mental health diagnosis, with many of the same characteristics of Post Traumatic Stress Disorder (PTSD) (see below). However, ASD differs from PTSD in that it is considered a more immediate and shorter term post-traumatic condition, which may or may not lead to longer-term PTSD. If ASD symptoms persist for more than a month, then PTSD may be diagnosed.

  Another notable distinction between ASD and PTSD is that those suffering from ASD often show more pronounced "dissociative" symptoms. They can become extremely withdrawn or unsociable, or exhibit a mental or emotional "distance" between themselves and their violent experience, which is often viewed as a natural, subconscious effort to escape the emotional anguish caused by the violence. They may talk about their experience in distant-sounding or overly generic terms. Many experts agree that this represents a quest for immediate emotional "survival"; survivors may not be ready to directly address the trauma they have endured because it is simply too painful.

  For more information on Acute Stress Disorder, you can visit the National Center for Post Traumatic Stress Disorder.

• Post Traumatic Stress Disorder (PTSD)
  PTSD is a mental health condition caused by virtually any kind of deep emotional trauma (especially one that's unexpected). PTSD brings about both emotional and physical suffering. People experiencing PTSD usually feel shattered and torn apart, like they will never feel "normal" again. PTSD can make you feel different from everyone else, changed forever or, in some cases, even make you question your sanity. Psychologists and counselors with experience treating trauma survivors can be very helpful in working through PTSD, and there are certain medications that can lessen the symptoms of PTSD while you work through the healing process. PTSD can be a serious, long-term condition that should not be taken lightly.

  For more information on PTSD, you can visit the National Center for Post Traumatic Stress Disorder, the PTSD Alliance, the National Mental Health Association, or the Dart Foundation's Gateway to PTSD Information.

• Emotional "numbness" and withdrawal (also symptoms of ASD and PTSD)
  This is a natural coping mechanism. The pain and horror may be too intense and the people around you may not understand what is going on inside you.

• Trouble sleeping
  Dreams, nightmares and insomnia are common following trauma.

• Anger and mood swings
  Anger is as normal as any other part of the healing process. After all, your world was turned upside down.

• Flashbacks and "triggers"
  As you begin to heal and "re-engage" life, certain sounds, smells, situations, images, or stories can act as "triggers" that take you back to the trauma you experienced, almost instantly opening the flood gates to a potentially overwhelming emotional experience. These flashbacks can be frightening and paralyzing. Recognizing and, when possible, steering clear of your triggers may be helpful in managing or avoiding flashbacks. In the event that you experience a flashback, focusing on where you are and what you need to do to feel safe in the moment can help to disrupt the flashback or at least minimize the suffering it causes you.

  Painful reminders of the violence you survived may also come through associations with people, particular circumstances or certain places. Healing may require putting distance between yourself and uncomfortable reminders, at least for a while. While a time may come to reconnect with certain individuals or revisit places or situations, consider focusing more on what is best for you and your survival during the healing process, particularly during the initial stages of healing.

• Secondary wounding
  While interacting with people who lack understanding is always frustrating, the vulnerability and hypersensitivity that many survivors experience can make even casual interactions painful and damaging. While they may mean no harm whatsoever, it is not uncommon for others to pose insensitive or redundant questions to survivors. People who have never experienced the horror of violent trauma simply are unable to relate. They may unintentionally inflict secondary wounding by asking for details at inappropriate times or offering misguided and oversimplified assurances such as "just try to get over it" or "put it behind you." Consider explaining what you are going through, and if someone says something hurtful, you may want to let him or her know and try to explain why the remark was upsetting.

• Depression
  Depression feels like a heavy, dark, and sometimes endless cloud hovering over you. Survivors experiencing depression may feel exhausted, tired, and deeply sad. Depression can last for days, weeks or years, and can fluctuate in intensity over time. It can stifle any longing to engage with others or even to get out of bed or eat. In its worst form, depression can induce feelings of intense hopelessness and suicidal thinking. It is important to remember that there is hope, help, and healing. If you are struggling, do not be afraid to seek a psychologist or counselor with expertise in helping trauma survivors. You are not alone.

• Lack of interest in physical and sexual intimacy
  Lost interest in physical and sexual connections with others is also common following trauma, especially for those who have experienced sexual violence. It takes time and patience to rekindle an interest in romance, and this can be stressful on relationships with significant others. It is important to talk with your partner about what you are going through so that he or she can try to understand and be supportive in giving you the space you need to heal.

• Decreased ability to trust
  Learning to trust again is a major emotional hurdle for many survivors of violence. After a violent encounter, it is not uncommon for victims to feel as if they can no longer give some people, especially those they do not know very well, the benefit of the doubt. Do not feel as if you need to force yourself to trust people in an effort to get back to "your old self." In general, trust should be something that is earned anyway. But also consider that adopting a policy of complete distrust probably will not help you heal in the long run.

• Grief
  For some, part of the healing process involves grieving the life you had and the person you were before you encountered violence. Mourning your personal loss is completely normal - after all, a lot has been taken from you. Allow yourself to mourn.

• Lowered self-esteem
  Following violence, victims often reflect on what they could have done differently to avoid being victimized, whether they were in some way responsible for what took place, whether others can see how they were violated, and whether friends and family can notice the changes taking place within them as a result of the violent trauma. Being stuck in this kind of thinking can negatively impact your self-esteem and engender self-doubt. Try to avoid this rut by focusing your energies on healing, progress, and other positive pursuits.

• Faltering faith and spirituality While some may say to you "a guardian angel must have been watching over you to keep you alive," many survivors wonder how God could have let such a horrible crime happen in the first place. Questioning faith and belief systems is also very common among survivors of violent trauma. Consider talking about faith and spirituality issues to someone you trust, someone who will not make judgments about what you should or should not believe or deliver patronizing answers to silence you.

• Pursuit of safety measures Some survivors feel that they need to take additional safety or security measures such as purchasing security devices or weapons, or creating new living arrangements to make their homes and lives safer. While some such measures can increase safety and security, staying alert and aware of your surroundings is probably the single best safety measure anyone can take.

• Hypervigilance
  If you have gone through periods of sleepless nights where you have to get up and "do something" or find yourself having a hard time sitting still, you may be experiencing an episode of hypervigilance. Hypervigilance is a natural response to danger. Your mind and body want to stay alert to any possible threats, real or imagined. Focusing on a healthy and constructive activity may help to feel more in control again. Rest and peace eventually will come, especially as you do what is needed to heal.

• Difficulties focusing at work/school
  It is not hard to understand that since your world was just turned upside down, it may be difficult to focus at work, school, or social events. It is important to give yourself time to heal and to understand that you may not be up to a full schedule, at least not right away. Try to do what you think will most help you, given what you know about your personality and needs. Maybe take some time off or limit your schedule. Also, talking with your human resources manager or school counselor to explain what is going on may help protect your job or grades. Healing takes time and requires a lot of energy.

• Using alcohol or other drugs as a coping mechanism
  The stress and anxiety following a violent incident can be very difficult to sustain, especially over long periods of time, and many victims turn to substances as a means to relax and obtain a sense of some short-term relief. But contrary to helping us work through our issues, using alcohol and other substances tend only to numb us to our reality, and only for a short while. Substances can never take away the source of our pain or anxiety. If anything, they leave us more powerless and, in the particularly vulnerable state following trauma, substance abuse can more easily lead to addiction. The road to healing is difficult enough. Reach out to resources that will build you up and make you stronger. If you are using alcohol or illicit drugs to numb the pain, please consider getting help now. Talk with a doctor or counselor about how to work through the struggles in a healthy, productive manner.

• Exaggerated startle response
  Because of the trauma you experienced, you may feel "on edge" or "jumpy." In time, as you develop a new sense of safety and work through the healing process, these feelings will eventually dissipate.

Remember that the healing process takes time and that many hurdles and frustrations may surface along the way. Following are some suggestions of positive steps you can take immediately to begin healing.

• Recognize your loss.
• Establish safety for yourself.
• Respect the way you feel and your right to feel that way.
• Talk about your feelings with those you trust.
• Connect with other survivors of violence, many of whom experience similar difficulties.
• Do not be afraid to seek professional help.
• Try to recognize triggers that may take you back to the memory and fear of your trauma.
• Try to be patient and avoid making rash decisions — it can take time to figure out where you are, where you want to be, and how to get there.
• Take care of yourself —exercise, eat right, and take a deep breath when you feel tense.
• Try to turn your negative experience into something positive — volunteer, donate, or do something else to constructively channel your energy and emotions.
• Do not abandon hope — believe that healing can and will take place.

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