Dr. Val Farmer
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How Soothing Helps Trauma Victims

October 12, 2009

We have all been touched by incomprehensible loss of life of friends, loved ones and relatives who die in a tragic accident or those who succumb to disease that came out of nowhere. These events are sudden, traumatic and life changing for those who survive.

There is no script for death but this is not the way it should happen. Family, friends and colleagues come together to mourn their loss and to pay tribute to the memories of those who departure was so abrupt and final.

A communal loss needs a communal response. It helps when others besides immediate family take the time and care enough to reach out and comfort the bereaved with their loss. Having others mourn their loss also recognizes and soothes the deep hurt of friends and family members. Just being there is soothing.

What it means to soothe. The dictionary definition of soothe is to bring comfort, solace, reassurance, peace, composure and relief. Even the sound of the word "soooothe" tells you it is something special.

Soothing has a long history. Mothers and fathers do this for their babies. A mother provides the protection a child needs when its own resources are exhausted. When her child is hyper-aroused and over-stimulated, a mother steps in to calm, soothe and lower arousal.

When this protection doesn't occur, a pattern of protest with an increase of adrenalin sets in. This is followed by despair after the adrenalin has been depleted. The same thing happens to a trauma victim.

The trauma reaction. The usual coping skills of a trauma victim are overwhelmed by an uncontrollable, terrible life event. During the protest phase, a trauma victim may experience panic, aggressiveness, irritability, nightmares and possibly an intrusive reliving of the trauma. The emotions are primitive, intense and overpowering. The victim feels helpless and incapacitated.

Once the stage of protest/despair is triggered by events that resemble the initial trauma, the emotional phases can be triggered by a victim's own thoughts or an everyday occurrence. Victims often show all-or-nothing responses even to minor stress. To ward off anxiety, a trauma victim may try to seal their unwanted emotions and memories from their conscious awareness. This takes a great deal of psychic energy and fragments their sense of self.

It may seem strange, but trauma victims sometimes try to calm themselves by re-exposing themselves to trauma to release natural body opioids that have tranquilizing or calming effects. More often though, victims compulsively use illicit drugs, alcohol, eating or exercise to calm themselves.

Being left alone is worse. Perhaps the most subtle and devastating effect is not the original trauma but the lack of caring and support after a traumatic experience. Studies have shown that when a victim is left alone with a traumatic experience, without comfort and calming, the trauma is not integrated into their experience and becomes injurious. Victims fail to moderate their emotions. They sense a loss of control. Failure to comfort a victim has a

long term impact on his or her functioning.

The current trauma may also trigger heightened stress reactions in victims who have unresolved abandonment or trauma issues from their past. They have already been traumatized and left alone in the past. The current trauma brings back feelings of past hurts and abandonment.

How to help a trauma victim. The first step is to help the victim understand the physical and psychological aftereffects of trauma. The effects need to be identified in the victim's own situation.

Helping the victim to know that their reactions are normal and expected helps him or her regain a sense of control and esteem. He or she also needs to be reminded of their history of effective coping and that the trauma they went through would overwhelm anybody. Victims should be encouraged to soothe themselves in ways they know work for them.

Often victims feel guilty about their symptoms. They feel they should be able to fix themselves. Trauma victims need to know that recovery from trauma is not something they can do just by themselves.

Victims need relationships of trust. They need someone to challenge their irrational beliefs about themselves, someone to support their healthy functioning and someone to be emotionally available to them to offer them safety and comfort. This is similar to how a mother would respond to her child's upsetting experience.

Soothing trauma victims. As important as it is to know how to self-soothe, being soothed by others tells victims they belong, are cared for, and their loss is recognized. Here are some ways that soothing can be offered:

- creating an atmosphere that is calm and free of distractions;

- providing warm liquids - not stimulants such as coffee;

- encouraging exercise that releases natural body opioids;

- providing fluffy comforters, pillows, baths, showers and special foods;

- giving something personal to help them feel less alone;

- relieving them of important responsibilities;

- touching, embracing or massaging;

- going out of your way to meet little needs;

- encouraging them to have experiences with nature and music;

Soothing tells them that they are not alone, that they are cared for and worthy of love. It reaffirms faith at a time when they need it the most. Soothing is a gift. In a time of great need, it is a priceless gift.

Thanks to psychologist Elise A. Brandi of Harvard University, for her ideas on the importance of soothing trauma victims.