Providing Grace and Resilience to Trauma Survivors, How To – Help Guide.

Provide grace & resilience to trauma survivors.

                           How to Provide Grace and Resiliency to a Friend or Family Member Who Discloses Trauma.

According to the United States Veterans Administration, about 50% of women and 60% of men will experience trauma at some point in their lives. Trauma is defined as an emotional response to a distressing event. Traumatic events can include witnessing or experiencing sexual or physical assault, violence, robbery, or attack. We are not all equipped with a vast understanding of psychology, and when a friend or family member turns to us with their memories of a traumatic event, more than ever we could benefit from some information on how to respond with validation, support, and compassion. The literature on trauma widely cites how important loved ones’ responses are to survivors’ disclosures of the events that they experienced. In fact, in a 2016 study by Lischner and Hong at the University of Washington, invalidating responses of friends, family, and others are correlated with an increased likelihood that the survivor will experience psychopathology including Post Traumatic Stress Disorder (PTSD). With the number of people who have survived trauma growing each year, it becomes ever more likely that someone will turn to you with their memories of a traumatic event. Below we will highlight some invalidating responses and provide validating responses so that each of us can do our best to provide caring support to those who may approach us with their heavy burden.

Validation is defined as responding with empathy, agreement, acknowledgement that we believe what was shared and that it makes sense. We can validate many levels of expression and meaning, feelings as well as thoughts. As a couples counselor, I help couples use the tool of validation to comfort each other in conflict. Validation is powerful. Some validating responses are;

• ‘Thank you for trusting me enough to share this.’
• Summarize the memories that were shared, always referring to them as memories or experiences.
• ‘That must be so (painful, scary, traumatic, other feeling word) for you.’ Summary of emotions, this is to indicate a full understanding of the feelings that the person shared.
• ‘You were so strong and brave in sharing your experiences.’ This is a compassionate response that highlights their survival skills.  
• ‘How can I support you further?’ Letting the person know that you are glad to discuss any of it further, that you want to be there for them in any way that they need.

Invalidating responses can cause survivors to feel anxious, depressed, panicked, overwhelmed, and called to defend themselves and their pain. Many trauma survivors cite that invalidation from family or friends of their traumatic event is at times just as distressing as the trauma itself. Invalidation can be consciously used as a tool to manipulate and coerce, and it can be unconsciously done because the recipient to the confidence doesn’t know how to respond or help. Some examples of invalidating responses are as follows:

• ‘Why are you bringing this up right now?’ Every survivor unfolds their trauma memories to different people and in varying times, when and how they will share their trauma and with who it feels safe to share. 
• ‘Are you sure you remember this accurately?’ The first duty of love is to listen and validate, provide understanding, care, warmth, and support. It is not a good time to put them on the witness stand for cross examination.
• ‘The perpetrator remembers it differently.’ Attend to the survivor’s feelings first and save the fact checking for a different time and day. Even if you feel called to defend the person or event that is being discussed as the source of trauma, this survivor is sharing something very vulnerable and the immediate need for understanding and care would indicate that we should triage and be delicate.
• ‘Try not to think about it and put it behind you.’ This response indicates that the person’s experience of grief, pain, panic, anxiety, is something that can be dismissed. Working with trauma clinically provides opportunity to experience the depth of the memories and emotions to be reprocessed. There is much evidence that the more we think we should be able to dismiss our responses to trauma, the more likely we develop PTSD.

Don’t be hard on yourself if you recognize after reading this that you may have been invalidating to someone in the past. ‘We all do our best and when we know better, we do better.’ Maya Angelou

Please pass this along. Every day another person survives and attempts to thrive in the wake of pain and anguish. Each of us has the potential power to be a safe zone, to provide support, help, and healing for those who are making sense of traumatic events, we have the ability to provide resiliency against emotional pain and we can create a buffer and reduce the development of Post Traumatic Stress Disorder.

With resiliency and hope,

Stephanie Wijkstrom, MS, LPC, NCC

Counseling and Wellness Center of Pittsburgh

*The is not a replacement for mental health support provided in a clinical setting by a licensed counselor, psychologist, or clinical social worker. If you or a loved one has experienced trauma and are working through its effects, reach out to a therapist near you.

Thank you to our editor, Dr. Stellan Wijkstrom.

For more reading;

Phan Y.Hong, David A.Lishner: General invalidation and trauma-specific invalidation as predictors of personality and subclinical psychopathology, Personality and Individual Differences. January 2016.

https://www.ptsd.va.gov/public/ptsd-overview/basics/how-common-is-ptsd.asp

Trauma Informed Care; We Have Evolved to be at risk for Trauma; Here is Why

Trauma Informed Care

We have fantastic and astonishing memory abilities, the human mind and its processes, particularly in the way we store and retrieve the effective memories which then effect the way that we store and respond to our other memories and sensory input. Evolutionary psychology examines the way some things that can be problematic are often helpful to us in the past and as we evolved. This is especially true for trauma survivors. According to the American Psychological Association, Trauma is an emotional response to a event like an accident, rape, or natural disaster, abuse or assault. Immediately after the event, shock, emotional upheaval, loss of ability to function, and denial are typical. Trauma is especially present in situations where a person feels powerless and their sense of control are taken. Long term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea, nightmares, inability to rest or calm down, feeling tearful, experiencing fear and heightened startle response. While these feelings are very universal response to the paralyzing fear that is associated with trauma even if the survivor reports feeling neutral in the moment. Biology offers some rational for how we can feel afraid but work through it in the moment of the traumatic situation, but it is later when we are safe and comfortable that the panic can emerge, generally emotions are something that can be seen and felt most when everything is alright around us, meaning the traumatic event is over and we are safe. Some people have difficulty moving on with their lives because trauma can result in long term effects such as PTSD, acute stress disorder, anxiety, depression, and addiction.

There are so many events that we experience which are traumatic, whether these develop into the more complex constellation of behaviors which we identify as PTSD, really depends on an interplay of biological, social, and other environmental factors. Some of the situations which can cause a trauma response include, domestic violence, sexual violence or assault, car accidents, national tragedies, serving in war, robberies. It is possible that we can experience a traumatic response my witnessing these events even if we are not the direct recipient of the threatening attack.

People who later feel the emotional and physical effects of trauma may wonder, what is wrong with me? Also, even if the event seemed manageable in the moment, it seems bizarre that they keep seeing flashes of it months or years later. The answer is while the effects of trauma  can be debilitating, our cognitive processes are primed to be traumatized. Evolution explains that we and our ancestors are wired to hold tight to frightening or threatening experiences, imagine what happened to all of the humans who did not startle and produce massive amounts of cortisol and adrenaline at the sight of the saber toothed tiger just through the northern passage on the savannah. They died and did not evolve to have offspring in our gene pool. Having memory of dangerous events, people, situations, and gearing up to flee or protect one’s self is a sign of an evolutionarily healthy adaptation, it allows us to stay safe by avoiding possibly dire situations. In fact, our Vagal nerve which communicates directly to our bodies, without having to yield the advice of our logic, there are long term changes in the way that our Vagal nerve responds to triggers after we have experienced trauma. The vagal nerve is what allows healthy people to experience the ‘startle response’ for example when someone sneaks up behind you, usually we respond with a physical jerking motion in our bodies, and literally jumping. In domestic violence survivors, being ‘jumping’ and easily startled when a person raises their hand, is a well noted phenomenon that may last an entire lifetime.

We are wired to remember traumatic events. Survivors of trauma know that the sight of the perpetrator of their violence, even a coat that’s the same color as the one their attacker had worn can evoke the fear response. ‘Triggers’ are any stimuli which we associate with the traumatic event. These triggers and their associated memories can and do produce a jolt to the vagal nerve resulting in heightened, panicked, and anxious response in the person who is perceiving them. The biological response when we encounter a trigger are a plenty, our bodies enter a state of hyper-arousal, respiration becomes more shallow, heart beat rises, and fear settles in, even cognitive function is impaired as our higher order reasoning is impeded and all neurological resources are yielded to the hind brain and its motor and autonomic functions. The one and only thought becomes fight, flight, survive, and in some cases freeze. Remember, just like on the savannah in the seat of civilization, the extra energy our bodies create allow us to escape danger.

Cognitive processing therapy, systematic desensitization, and exposure therapy, and some therapies which aim to change the tone of the vagal nerve are recommended ways to work through the trauma and empower the survivor to be able to withstand exposure to triggers and regain emotional wellness. It is recommended that trauma survivors do their best to limit exposure to triggers as they heal from the event and associated memories. If you feel that you may be experiencing long term effects from a traumatic situation, it is recommended that you work with a therapist who is specifically trained in trauma informed care. Healing will allow the processing of the entire event, client and therapist will identify triggers, developing the capacity to respond to triggers with mindful balance, and work through the effects of any other psychological effects from the trauma.

Counseling and Wellness Center of Pittsburgh, Serving Western Pennsylvania with Individual Therapy, Couples Therapy, Family Therapy and Wellness Services.