medical trauma Articles

Ebola: Coping with Fear and Uncertainty

Wednesday, October 22nd, 2014

Something very different happens to us when we face an epidemic as opposed to a natural disaster.cemetery

When a natural disaster hits, there is anxiety, and traumatic loss but such events have a clear beginning and end. Natural disasters are devastating but there are few unknowns. With the collective loss, there is often collective care and support. In the aftermath of a hurricane that destroys and our neighbor’s home, we run to help him rebuild.

In the face of epidemics we lock our doors. Threatened by contagion, terrified by unknown risks, we move into fear-based survival mode. We isolate. We ruminate. We become saturated with media warnings and shaken by shards of frightening information and even conspiracy theories.


Non-Medication Strategies for Reducing Chronic Pain: Use and Effectiveness

Friday, July 25th, 2014

About 100 million Americans suffer from chronic pain. Lasting longer than six months, such pain can be mild or excruciating, episodic or continuous, inconvenient or totally incapacitating.

For too many, chronic pain is an invisible and debilitating condition. Often employers and even spouses can’t quite appreciate the impact of a migraine or the limitations imposed by back pain. As such, those who suffer often report feeling isolated in addition to feeling depressed, worried about levels of medication and anxious about a future of no relief from pain.file0001875581713

Scientifically Proven Non-Medication Strategies

The good news is that in addition to ever expanding medication options, there are an increasing number of scientifically proven non-medication approaches to reduce chronic pain, increase the effectiveness of medication, address flare-ups, and in some cases reduce need for medication.


Surviving and Succeeding in Face of Uncertainty: Six Strategies

Tuesday, April 30th, 2013

uncertaintyEvents like the Boston Marathon Bombing, Hurricane Sandy’s Devastation, The Newtown CT School Shooting and the many traumatic events they echo, assault us with the uncertainties of life.

Leaving death and destruction in their path, such events undermine our necessary denial that life is predictable, that children can be safe and that we can be in control.

For a time, we are left wounded, shaken, vulnerable and afraid. Caught in the traumatic moment, we fill in the future unknowns with expectations of more of the same trauma so that next time we will be ready.

Eventually, despite the memory, the extreme loss, the bodily injuries and even the fear, we want our lives back, we want our children to play, and we want to smile…

We need to find a way to survive and at times even succeed with life’s uncertainties.

Here are six strategies that may begin to answer that need. Some you may already use. Some you may want to consider.

Validation of True Self

  • Often recognition of who we are and what we need in life out-trumps the fear of uncertainty. In her personal description of running the Boston Marathon, runner and blogger, Chrissy Horan describes that although finishing as the first bomb went off, she has struggled with grief and sadness for those killed and injured, with “what if” she had walked through the last water stops, with tears and with questions of safety. Notwithstanding the uncertainty, however, she like many throughout the country put her sneakers back on to run. As she says, “ It is just what I do.”
  • Not dissimilar are Long Islanders now six months after Hurricane Sandy, who report that faced with extreme weather patterns, altered and destroyed shore lines, partial renovations, houses raised and more hurricanes coming–they are afraid. Many have for the first time considered leaving. Most will wait and see. They report a “magnetic draw” to the water. As one man who feels that his family could not survive another Hurricane Sandy said, “We don’t have very long memories . . . We live on an island and this is …

Tattoos After Trauma-Do They Have Healing Potential?

Monday, December 31st, 2012

Whether you have many tattoos or would never consider getting one, you may be surprised to learn that 40% of Americans between the ages 26-40 and 36% between ages 18-25 have at least one tattoo.

Once associated with marginalized, oppressed, victimized or transient groups in the population, tattoos are increasingly part of mainstream culture.

Americans spend $1.65 billion dollars annually on tattoos.

While the reasons for tattoos are as varied as the people who choose to get them, certain trends have been identified. One is the choice of a tattoo in the aftermath of trauma.

  • Across generations and wars, those in the military have used tattoos as tributes to fallen comrades.
  • In the aftermath of 9/11, civilians and firefighters throughout the world choose tattoos as an indelible reminder of the  terrorist assault, the courage of First Responders and the loss of so many.
  • Sociologists, Glen Gentry and Derek Alderman estimate that there are thousands of Katrina and New Orleans-related tattoos reflecting both horrific images of crumbling buildings and gushing floodwater, as well as signs and symbols of a beloved city.
  • In the wake of the unprecedented destruction from Hurricane Sandy, tattoos and tattoo fundraisers have emerged. The message of one seems particularly meaningful- “ Hold Steadfast.”

Do These Tattoos Have Healing Potential?

A close consideration suggests that both the reasons and the choice of tattoos reflect many of the factors associated with recovery after trauma.

Healing From the Body Out

  • Whether a traumatic event involves a car accident, escape from freezing floodwaters or the loss of a child, it is registered in our body in terms of the survival reflexes of fight, flight and freeze.
  • Encoded under these conditions, our memory of the traumatic event is not registered as narrative, but as fragments of highly charged visual images, bodily feelings, tactile sensations or sensory reactivity to reminders of the event.
  • As such, trauma experts encourage us to work from the body out in the course of recovery and healing—to attend to the sensations, senses, and images that carry the imprint of trauma.

The tattoo’s use of the body to register a …


Reducing Disaster’s Impact: A Simple Guide to Psychological First Aid

Thursday, November 8th, 2012

Nationally and internationally, the most endorsed response in the early aftermath of a disaster is Psychological First Aide.  Used by those responding to disasters, it is a set of guidelines that you can learn to use for yourself and others.

Just as knowing certain aspects of Medical First Aid can help you minimize injury and reduce future medical complications, knowing and using certain aspects of Psychological First Aid can help you reduce the emotional impact of a disaster and its consequences.

Here are Five Steps for Using Psychological First Aid

 I. Establish Physical Safety

  • Given the body-mind connection, it is necessary to secure physical and medical safety as a first step to psychological safety.
  • In securing what is needed to maintain physical safety (food, shelter, water, heat) it is often helpful to access options and then make a temporary or working plan that can be updated. This often mobilizes people to safety, as they know they are not making permanent decisions.  

 Families have moved in together in arrangements they never would have dreamed possible-as a way of keeping each other safe.

II. Establish Psychological Safety

  • Accept and normalize your feelings.Recognize that feelings of disbelief, fear, terror, helplessness, and anger are very common to the situation you have faced. For most people they may persist as difficulty sleeping, intrusive thoughts and memories, or a sense of numbing for a week or two and then dissipate.
  • In those cases where someone displays a sense of disorientation, unremitting panic or inability to cope, emergency medical care is warranted.
  • You have often heard the expression “ What doesn’t kill you makes you stronger.” – Well, Not So Fast.
  • Consider that while people differ, for most of us, it takes a while to adapt to a crisis situation. Even as people are busy surviving and helping others survive, survivors are often feeling a mix of relief, pain and uncertainty. It makes sense.
  • Recognize that in disasters – SMALL THINGS ARE BIG in making us feel less helpless.
  • Look for those things you can control. Set up achievable goals- be it playing a game with the children; finding …

Recognizing and Understanding Depression After Trauma

Thursday, August 9th, 2012

depression after traumaDisaster and trauma studies often focus on identifying the incidence of PTSD as the sequel to traumatic events.

Early interventions with those affected after a disaster or traumatic event increasingly utilize psycho-education to clarify and normalize common post-traumatic stress reactions and coping strategies.

While mentioned as a possible response, the high incidence of depression after trauma is less delineated and often goes unrecognized by those suffering.

Depression Occurs after Trauma:

  • A Rand corporation study reports that nearly 20 percent of military service members who have returned from Iraq and Afghanistan – 300,000 in all – report symptoms of Post-Traumatic Stress Disorder or major depression.
  • In the first long-term study of the health impacts of the World Trade Center (WTC) collapse on September 11, 2001, findings indicate that seven percent of police officers were diagnosed with depression, nine percent with PTSD and eight percent with panic disorder. Twenty eight percent of other rescue and recovery workers had symptoms of depression.
  • A survey of survivors from the Oklahoma City bombing showed that 23% had depression after the bombing.
  • Depression affects approximately 15 percent to 25 percent of cancer patients.
  • After a myocardial infarction, the incidence of major depression is from 15 percent to 20 percent, and an additional 27 percent of patients develop minor depression.

Both major depression and Post-Traumatic Stress Disorder (PTSD) occur frequently following traumatic exposure, both as separate disorders and concurrently.

Depression is the most common disorder suffered in conjunction with Post-Traumatic Stress Disorder.

Depression is nearly three to five times more likely in those with PTSD than those without PTSD.


Does Hope Really Make a Difference? Scientific Findings

Thursday, July 26th, 2012

Almost everyone has some experience with hope: We hope for the best. We hang on to hope. We despair when we lose hope.

It would seem that hope, which is broadly defined as an emotional state that promotes the belief in a positive outcome, is in inherent in human nature.

Reflections of the importance of hope are found in early mythology, religion, philosophy and literature.

Pandora, although forbidden, opened the box given to her by Zeus, and in a moment, all the curses were released into the world and all the blessing escaped and were lost- except one: hope.

“To have faith is to be sure of the things we hope for, to be certain of the things we cannot see.” ― The King James Version of the Bible

“Hope is a waking dream.” –Aristotle

“Where there is no hope, it is incumbent on us to invent it.” -Albert Camus

“Hope is that thing with feathers that perches in the soul and sings the tune without the words and never stops — at all.” -Emily Dickinson

Clearly we need hope, but even as we embrace it we often wonder – Does hope really make a difference? Is it myth, fiction, collective denial?

There is actually increasing scientific evidence that hope changes us psychologically and physiologically – that it makes a difference.


Important Validation for the Aftermath of Adult Trauma

Thursday, July 12th, 2012

Many people face a traumatic event in adult life. Be it a serious car accident, combat, rape, a natural disaster or the loss of a child, people are often confronted with a horrific event that threatens death or serious injury to themselves or someone else, or involves the traumatic loss of a friend or loved one.

While such trauma is in itself physically and emotionally assaultive, trauma theorist Robert Stolorow proposes that beyond the actual event, it is the emotions suffered after the event that become the unbearable emotional pain of trauma.

  • Difficult to articulate and unrecognized by many, the emotional aftermath of adult trauma often goes unvalidated and unhealed.
  • Drawing upon his own traumatic loss of a young wife, Stolorow reports that in the unreal time that stretches slowly after a trauma, there is an “excruciating sense” of being outside normal life, alone with feelings that no one else can understand.

Stolorow’s contribution to the field is his articulation of these feelings in a way that becomes an invaluable resource for validation.


Medical Illness as Psychological Trauma: Overlooked Pain

Friday, April 20th, 2012

In this era of advanced medical detection and intervention, the medical care of patients and the reduction of mortality for life threatening illness has never been greater.  Against this backdrop of success, however, what is often overlooked by professionals, family, even patients, is the experience of medical illness as psychological trauma.

  • While some efforts like the emerging field of Psycho-oncology are starting to address the totality of the patient and the American Psychiatric Association now officially considers “ being diagnosed with a life –threatening illness” a potentially traumatic event, it is perhaps most important that patients and families understand why and how medical illness often brings with it- anxiety, anger, depression, panic and post-traumatic stress symptoms.
  • Understanding, normalizing and validating common stress reactions can demystify and lower anxiety at a time when so much feels beyond understanding or out of control.
  • Given that the experience of trauma is a function of many variables including age, nature of trauma, duration and personal meaning, people will differ in their psychological response to medical illness.
  • Some may experience a few symptoms which abate within months, others will deal with a delay in the experience of depression or anxiety until well after the medical crisis, and for others the persistence of emotional distress may warrant professional help.

Why We Blame: Uses and Misuses

Monday, April 25th, 2011

why we blameTo err is human. To blame seems to be human also.

We blame nature, we blame God, we blame our enemies, our spouses and ourselves. We even blame politicians for never taking the blame!

Why?

The definition of blame is to hold responsible, to find fault with, to censure, for something that has happened, has failed to happen or which has had a negative impact in some way.

We need to blame for regulations of feelings, reparation of harm and restoration of order on personal, interpersonal and broadly social levels.

The Uses of Blame

In the best of circumstances blame for wrong doing once acknowledged results in apology, concessions to meet the demands of restorative justice or punishment to meet the demands of retributive justice.


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Suzanne Phillips, Psy.D., ABPP & Dianne Kane, DSW are the authors of Healing Together: A Couple's Guide to Coping with Trauma and Post-Traumatic Stress. Pick up the book today!

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