Dr. Val Farmer
Rural Mental Health & Family Relationships

Don't Leave Trauma Victims Alone In Their Grief

February 17, 2003

We have witnesses an outpouring of national trauma and grief as a reaction to the Columbia tragedy.

A communal loss needs a communal response. We have all been touched by the bravery of those men and women who engage in space flight for the betterment of humanity and the sudden, tragic end to lives so full of talent, love and promise. Our tributes and days of mourning are important to ourselves but are also meaningful to the family and friends of those who perished.

NASA employees seemed to be especially good at reaching out and comforting each other. Having the nation mourn their loss also recognizes and soothes the deep hurt of friends and family members.

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 everyday occurrences. 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 doesn’t become part of a growing experience and becomes harmful. 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:

- create an atmosphere that is calm and free of distractions,

- provide warm liquids - not stimulants such as coffee,

- encourage exercise that releases natural body opioids,

- provide fluffy comforters, pillows, baths, showers and special foods,

- give something personal to help them feel less alone,

- relieve them of important responsibilities,

- listen to them,

- touch, embrace or massage,

- go out of your way to meet little needs,

- encourage them to have experiences with nature and music.

In soothing a trauma victim, also recognize his or her need to be left alone to grieve and mourn their loss. 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, a priceless gift.

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