We catch our breath as we hear that Virginia Tech has once again faced a shooting and the violent deaths of two people on campus.  In this case seven minutes after police reported the shooting, students were informed and alerted by email, text, twitter and campus broadcast to stay where they were in locked down locations, to remain off campus or to be escorted to safety areas. As the students reported, they waited in fear for four hours uncertain of what would unfold. When told it was safe, they hesitated leaving.

As is the nature of trauma, those who faced this present trauma live in the shadow of the tragic past and those in the past may be re-awakened to the horror and loss they have been carrying. To a large degree many emotionally and physically once again bear witness to a terrifying and unimaginable event.

While a person’s reaction to trauma is a function of the personal meaning of the event to them, their physical and emotional proximity to the traumatic event as well as their personal history, we have come to know that as an initial help, Psychological First Aid (PFA) can mediate the impact of trauma and make possible steps toward healing.

Dealing with trauma across the timeline from acute impact to long term recovery, I have found personally and professionally that there are aspects of Psychological First Aid that are vital in helping and healing at any time.

Here are some suggestions worth knowing and owning in the aftermath of trauma and re-traumatization.

Establishing Safety

Once someone is out of physical and medical danger, the most viable way to establish a sense of psychological safety is connection with familiar networks of support – partners, family, friends, school or church communities. In cases as the Virginia Tech Shooting, often those who have faced the trauma together may become cohorts that for a time provide “ substantive validation” to each other.

Talking together as a validating peer group, meeting together with school counselors or even connecting on-line with family, friends and peers can reduce the isolation and terror. People heal in community. Connection helps normalize feelings and lightens the burden of trauma.

Making Meaning of Common Responses to Trauma

Validating and Normalizing the common stress responses experienced in the aftermath of trauma moves such responses from pathological to understandable. Making meaning of what we feel empowers us; it reduces the sense of helplessness and anxiety so common after trauma. The three common response groups include Hyperarousal, Intrusion and Numbing and Avoidance.

Hyperarousal or the Persistent Expectation of Danger

This is your human fight/flight response in the presence of danger. It is as if your mind and body does not yet know you are safe. Such hyperarousal is reflected in an inability to relax, exaggerated startle response, inability to sleep, concentrate, and irritability. Not everyone experiences this and such responses rarely last more than a few weeks for most. Strategies to address hyperarousal include:

• Self-Care and Buddy Care for basic needs — are you sleeping, eating and do you have a way that you relax?
• If you run, exercise, play music, read the paper, pray or do something that calms you – this is the time to use your relaxation strategies. In the upset of trauma people often forget these valuable routines.
• How are your friends doing? Model and support self-care in the aftermath of trauma for those close to you.
• Be very careful about the use of alcohol and drugs. People often see them as quick ways to relax, but they actually add to the physical and emotional disorganization experienced after trauma.

 Intrusion or Re-experiencing

Feeling caught in the imprint of the trauma, many re-experience the images or sensations felt at the time of trauma as nightmares, flashbacks, or intrusive memories. While bewildering, they are the mind and body’s way of assimilating an incomprehensible event into life experience. Strategies to deal with them include:

• Re-frame them as understandable sequels to an event outside your life experience.
• Share them, write about them, express them in music, art or some medium – move them from frightening fragments to something you have more mastery of.
• Use positive re-focusing — once you have identified them as unassimilated glimpses and traumatic memories, turn to something that feels transformative. People find nature, pets, sports, prayer and helping others to be effective.

 Numbing and Avoidance

Numbing is a response to trauma that involves physical and psychological shutdown. Like the other responses to trauma, it is actually a functional way to survive in the face of overwhelming danger. When numbing persists if often unfolds into avoidance and isolation as an attempt to avoid triggers of traumatic memory or intolerable feelings of loss, grief or pain. The problem with avoidance is that it leaves a person alone with the trauma. It does not allow for the sharing, diluting, normalizing or integrating of a traumatic event. Strategies to deal with numbing and avoidance include:

• Reach for and accept the offer of someone who knows what you have faced and can be a compassionate presence – a friend, a partner, a family member, a professional, a spiritual caregiver.
• Words are not necessary. Just being with someone who cares regardless of whether you are walking, cooking, or shooting hoops or listening to music takes you away from the trauma and allows you to dare to feel again – a crucial start.

Access You Coping Skills

In the aftermath of trauma, it can feel as if you are frozen in time with the trauma. The past seems gone and the future seems impossible. It is really important to reach behind the wall of trauma to your resiliency traits because they still belong to you and they are what you have drawn upon in life to cope in situations of pain, disappointment, adversity and even loss.

• Individual resilience traits include physical strength, intelligence, interpersonal strengths, independence, sense of humor, creativity and spirituality.
• Resilience is also reflected in social skills, problem solving ability, utilizing positive emotions, strong family and community networks.
• Resilience also means knowing when too much time has passed (usually after a month) and you are still suffering in the aftermath of trauma and traumatic loss and you need professional help to reclaim you functioning and your sense of self.

Whether you have just experienced the horror of the recent shooting at Virginia Tech, you are jolted by your loss from the last Virginia Tech Shooting or you have just re-visited the pain and assault of a personal trauma – you are not alone as you try your best to heal and hope.

Frightened boy photo available from Shutterstock.

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    Last reviewed: 11 Dec 2011