Self-care following trauma is very important. We need to look after
ourselves! Traumatic events can cause people to feel angry, frustrated,
helpless, and afraid. They can also make people want to seek revenge.
Studies have shown that acting on this anger and desire for revenge
can increase feelings of anger, guilt, and distress rather than decreasing
However, there are strong mechanisms that contribute to natural recovery
from traumatic events. Many trauma experts (Staab, Foa, Friedman)
agree that the psychological outcome of our community as a whole will
be resilience, not psychopathology. For most survivors, symptoms of
fear, anxiety, re-experiencing, urges to avoid, and hyper-arousal,
if present, will gradually decrease over time. This is true not only
of communities as a whole facing natural or unnatural disasters, but
also of individuals, such as surivivors of domestic violence and similar
events, eg. stranger rape.
There are a number of common strategies that individuals utilize
when coping with extraordinary stress in their lives. These strategies,
while effective at manageable levels of stress, can become unproductive
or detrimental when stress reaches overwhelming or traumatic levels.
It is important to remember that individuals have their own way of
and pace for processing traumatic events, and each individual must
listen to and honor his or her own pace and way. It is suggested that
survivors monitor their reactions and increase the coping strategies
that have worked in other stressful situations.
Research on individuals with positive responses after a traumatic
event indicates that their preferred coping mechanisms are to:
When problem-solving, focus on brief time intervals (e.g., think
only about what the next step is), or focus on a larger time interval
to obtain a less devastating picture of the trauma (i.e., as one
tragic event in a full and meaningful life)
Maintain a view of oneself as competent and a view of others
as willing and able to provide support
Focus on the current implications of the trauma and avoid regretting
past decisions and actions
The process of converting traumas into growth
experiences has the following characteristics:
It is usually done by the individual alone, but confidants can
also suggest new ways of viewing the situation.
It usually occurs between 2 weeks and 4 months following the
It can enhance one's ability to cope with subsequent stressors.
It usually depends more on an individual's psychological resources
than on the characteristics of the stressor event.
It is intuitive, rapid, and sudden rather than being an extended
logical thinking process (i.e., it is characterized by sudden
insight and revelation).
(Finkel and Jacobsen, 1977)
Specific Coping Strategies for Traumatic
Stress and PTSD Symptoms
Positive coping actions are those that help to reduce
anxiety, lessen other distressing reactions, and improve the situation
in a way that does not harm the survivor further. These types of coping
actions improve things not only for today but for the future as well.
Positive coping methods include:
using natural supports and talking with friends,
family, support group and coworkers at your own pace. It is helpful
to follow one's own natural inclination with regard to how much
and to whom you talk.
learning about trauma and PTSD. It is useful for
trauma survivors to learn more about trauma and PTSD
and how it may affect them. Learning how common PTSD is and finding
that these problems are shared by hundreds of thousands of survivors
of trauma can help people with PTSD recognize that they’re
not alone, weak, or "crazy."
talking to other trauma survivors for support.
When survivors are able to talk about their problems with others,
something helpful often results. Through the process of seeking
support from other trauma survivors, the survivor may come to feel
less alone, feel supported or understood, or he or she may receive
concrete help with a problem situation. One of the best places to
find support is in a specially designed support group. Being in
a group with others who have PTSD or have gone through similar experiences
may help a trauma survivor reduce his or her sense of isolation,
rebuild trust in others, and it may provide an important opportunity
to contribute to the recovery of other survivors of trauma. To help
you find support we provide the Hidden
Hurt Message Forum.
talking to a doctor about trauma and PTSD. Part
of taking care of oneself means mobilizing the helping resources
that are available. A doctor can take better care of a patient’s
physical health if he or she knows about the patient’s PTSD
symptoms, and doctors can often refer trauma survivors for more
specialized and expert care.
practicing relaxation methods. These can include
muscular relaxation exercises, breathing
swimming, stretching, yoga, prayer, listening to quiet music, spending
time in nature, and so on. While relaxation techniques can be helpful,
they can sometimes increase distress by focusing attention on disturbing
physical sensations or by reducing contact with the external environment.
Be aware that while negative or painful physical sensations may
become more apparent when a person is relaxed, continuing with relaxation
in a way that is tolerable (i.e., interspersed with music, walking,
or other activities) is, in the long run, helpful in reducing negative
reactions to thoughts, feelings, or perceptions.
increasing positive distracting activities. Positive
recreational or work activities help distract a person from his
or her memories and reactions. Artistic endeavors have also been
a way for many trauma survivors to express feelings in a positive,
creative way. These endeavors can help improve a person’s
mood, limit the harm caused by PTSD, and can help a person rebuild
his or her life. It is important to emphasize that distraction alone
is unlikely to facilitate recovery; active, direct coping with traumatic
events and their impact is also important.
calling a counselor for help. Sometimes PTSD symptoms
worsen and ordinary efforts at coping don’t seem to work very
well. If the survivor of trauma feels fearful or depressed, it is
important that he or she reach out and telephone a counselor, who
can help the survivor turn things around.
taking prescribed medications to tackle PTSD.
Many people with PTSD have found that by taking medications they
are able to improve their sleep, anxiety, irritability and anger,
or urges to drink or abuse drugs.
starting an exercise program. It’s important
to see a doctor before starting to exercise, but after getting the
OK, exercise in moderation will potentially benefit those with PTSD
in a number of ways. Walking, jogging, swimming, weight lifting,
and other forms of exercise may reduce physical tension. These activities
may also help distract the person from painful memories or worries
and thus give them a break from difficult emotions. Perhaps most
important, exercise can improve self-esteem and help people feel
that they have some control in their lives.
volunteering in the community. It’s important
to feel like you have something to offer to others and that you
are making a contribution. When you’re not working, you may
not feel that you are contributing anything worthwhile. One way
that many survivors of trauma have reconnected with their communities
and regained a feeling of connection and importance is to volunteer:
to help with youth programs, medical services, literacy programs,
community sporting activities, and so on.
Negative Coping Actions help perpetuate problems.
They may reduce distress in the short term, but in the long-term,
negative coping actions may short-circuit more permanent change. Actions
that may feel immediately helpful but that can cause later problems
include things like smoking or using drugs. These habits can become
difficult to change. Negative coping methods can also include isolation,
workaholism, violent behavior, angry intimidation of others, unhealthy
eating, and self-destructive behavior (e.g., attempting suicide, self-harming,
etc). Before people with PTSD learn effective and healthy coping methods,
they may try to cope with their distress and other reactions in ways
that lead to more problems.
Practicing Lifestyle Balance
(Excerpted from: Saakvitne, K. W., & Pearlman, L. A. (Eds.).
1996. Transforming the pain: A workbook on vicarious traumatization.
New York: Norton).
There are many ways to restore lifestyle balance, and keeping track
of and making progress with as many of the following changes is a
good way to regain balance after having been exposed to or witnessed
cumulative traumatic experiences:
Eat regularly (e.g. breakfast, lunch, dinner)
Get regular medical care for prevention
Get regular medical care when needed
Take time off when sick
Dance, swim, walk, run, play sports, sing, or do some other physical
activity that is fun
Take time to be sexual--with yourself, with a partner
Get enough sleep
Wear clothes you like
Take day trips or mini-vacations
Make time away from telephones
Make time for self-reflection
Have your own personal psychotherapy
Write in a journal
Read literature that is unrelated to work
Do something at which you are not expert or in charge
Decrease stress in your life
Notice your inner experiences -- listen to your thoughts, judgments,
beliefs, attitudes, and feelings
Let others know different aspects of you
Engage your intelligence in a new area, e.g., go to an art museum,
history exhibit, sports event, auction, theater performance
Practice receiving from others
Say no to extra responsibilities sometimes
Spend time with others whose company you enjoy
Stay in contact with important people in your life
Give yourself affirmations, praise yourself
Find ways to increase your sense of self-esteem
Reread favorite books, re-view favorite movies
Identify comforting activities, objects, people, relationships,
places, and seek them out
Allow yourself to cry
Find things to make you laugh
Express your outrage in social action, letters, donations, marches,
Play with children
Make time for reflection
Spend time with nature
Find a spiritual connection or community
Be open to inspiration
Cherish your optimism and hope
Be aware of nonmaterial aspects of life
Try at times not to be in charge or the expert
Be open to not knowing
Identify what is meaningful to you and notice its place in your
Read inspirational literature (talks, music, etc.)
When to Seek Help
Several studies have pointed out that following a traumatic events
many of those involved do not believe that they need help and will
not seek out services, despite reporting significant emotional distress
(Sprang, 2000). Sprang lists several potential reasons for this:
Some people may feel that they are better off than those more
affected and that they, therefore, should not be so upset.
Some may not seek help because of pride or because they think
that distress indicates weakness of some sort.
Some individuals may not define services they receive as mental-health
intervention, especially if such intervention is unsolicited (e.g.,
lectures, sermons, discussions, support groups, community or church
Many individuals are more apt to seek informal support from
family and friends, which may not be sufficient to prevent long-term
distress for some.
There may be times when self-help strategies are not effective in
reducing the effects of exposure to traumatic stress. Research has
shown that exposure to trauma may result in a change in brain chemistry
and function. Research has also shown that the use of antidepressant
or other medication reduces both PTSD and depressive symptoms in individuals
who are unable to use behavioral techniques to manage their symptoms.
Individuals have also experienced partial or full relief from posttraumatic
stress symptoms when using certain types of cognitive-behavioral treatment.
As stated above, it is recommended that you seek assistance from your
medical doctor or from a mental-health professional who is skilled
in the treatment of trauma if:
You are experiencing any symptoms that are causing distress,
are causing significant changes in relationships, or are impairing
functioning at work
You are self-medicating with alcohol or drugs
You are unable to find relief with the strategies listed above
Coping with PTSD symptoms and the problems they cause is usually
a continuing challenge for survivors of trauma. As stated above, those
who are able to convert traumas into growth experiences are often
able to do so through sudden insight or revelation.
For those who develop PTSD, however, recovery
is an ongoing, daily, gradual process. It doesn’t happen through
sudden insight and there isn’t a quick cure. Healing doesn’t
mean that a survivor will forget the trauma experiences or have no
emotional pain when remembering them. Some level of continuing reaction
to memories is natural and reflects a normal body and mind. Healing
may mean that reactions will occur less often and be less intense.
Healing also means having a greater ability to manage trauma-related
emotions and having greater confidence in one’s ability to cope.
When a trauma survivor takes direct action to cope with problems,
he or she often gains a greater sense of personal power and control.
Active coping means recognizing and accepting the impact of a traumatic
experience and then taking concrete action to improve things.
Where to get help:
Listed below are some ways to find help. When you call, tell whomever
you speak to that you are trying to find a mental-health provider
who specializes in helping people who have been through traumatic
events and/or who have lost loved ones.
Call your doctor’s office or ask friends if they can recommend
any mental-health providers.
If you work for a large company or organization, call the Human
Resources or Personnel office to find out if they provide mental-health
services or make referrals.
Call your local refuge or Women's Aid branch to ask about local
support groups or counselling services.
Contact your local mental-health agencies or family
doctor. (The National Center for Posttraumatic Stress Disorder has
a fact sheet with information on how to talk to your primary care
physician about trauma and PTSD.)
Lundy Bancroft has written what is
probably the most comprehensive and readable book on domestic violence,
the beliefs of the abuser and the dynamics of abuse. This truly is a MUST READ
for anyone seriously trying to understand domestic abuse and how to cope with
an abusive relationship:
Hear the voices of other women who
have lived through and escaped from domestic abuse. This
collection of personal survival stories help us understand the struggles,
the pain and ultimately, the courage of victims who are determined
to be survivors.
Maya Angelou - best known for "I
know why the Caged Bird Sings" is a wonderful woman and an inspiration.
Her books and poems are like sweet melodies that flow through your head. She
writes words of wisdom and truth and gives hope, encouragement and strength
to all women everywhere. If you need to fill up your spiritual and emotional
well, read this book: