Patient and Family
event, such as a motor vehicle crash, assault, fall or natural disaster
is something which many people may not have experienced before. It is
outside the range of normal day to day experience. Traumatic events
can be experienced directly (by the victim) or indirectly (eg by a witness).
Such traumatic incidents can be extraordinarily stressful.
Sometimes a traumatic event crisis leads to people questioning what
is happening to them. Some of these questions may be … Why did
this happen to me? Why has this happened now? Where should I go from
here? These issues are very valid. Dealing with these issues may be
a way of trying to make sense of this experience. A major life event
can lead to new directions.
Although everyone’s experience is an individual and personal one,
many people report that they experience physical, psychological and
behavioral changes that they may not have experienced before. These
experiences are sometimes called critical incident stress, acute stress
reactions or post trauma reactions. For most people these experiences
will lessen in intensity and disappear after a few weeks. Although these
signs and symptoms of a stress reaction to trauma can be unpleasant
and distressing, they are common and understandable responses to a traumatic
event. Many of these symptoms are part of the normal process of recovery.
Possible reactions to traumatic experiences are listed below:
• disbelief at what has happened
• feeling stunned, confused
• numbness, sense of unreality
• of a recurrence
• for the safety of oneself or one’s loved ones
• apparently unrelated fears
• of losing control
• of going crazy
• of being overwhelmed
• at who caused it or allowed it to happen
• at the injustice and senselessness of it all
• general anger and irritability
• asking "why him/her?", "why me?"
• about destructiveness
• loss of belief that our life is safe and predictable
• about past losses and grief
• for having appeared helpless or emotional
• for not having behaved as you would have liked
• for support, encouragement and reassurance
• for information
• not wanting to be alone
• feeling responsible
• self doubt
Linked to Psychological Reactions
• unable to sleep, waking during the night
• thoughts that keep you awake
• feeling tired and fatigued
• jerking awake
• restless sleeping
• disturbed dreams
• easily startled by noises
• general agitation and muscle tension
• palpitations, sweating and trembling
aches and pains
• clumsiness, bumping into things, dropping things
• nausea or gastric upset
• tightness in chest
• dry mouth
• dizziness or light-headedness
• hot flushes or chills
• appetite disturbances
Managing Your Reactions
There are many things you can do to lessen unpleasant responses to trauma.
Firstly, it is important that you look after yourself and give yourself
space and time to work through these reactions. It is also important
to remember that these reactions are to be expected and will lessen
Linked With Psychological Reaction
Sometimes after a traumatic event people report that they experience
unusual physical sensations, such as feeling disconnected from their
body, a racing pulse and other sensations detailed earlier. There are
strategies that can help you with these:
• Try to rest more, even if you cannot sleep.
• Make time for relaxation – perhaps this is a good time
to learn! Breathing exercises, meditation and yoga can be very useful.
• If possible, continue with regular exercise; exercise and relaxation
will help you reduce nervous tension and feeling ‘hyped up’.
If unsure about whether you should exercise because of injuries, please
seek medical advice.
• Sometimes you will want to be alone, but try not to become too
isolated as distressing feelings can appear greater when you are by
• Reduce your intake of stimulants such as tea, coffee, cola,
chocolate and spicy, hot food as these can make you feel more uptight.
• Avoid street drugs and alcohol; numbing or suppressing feelings
and unusual physical sensations may create problems in the future. You
may be tempted to increase your use of tobacco, but try to resist this,
as contrary to popular opinion, nicotine is actually a stimulant.
• Maintain a regular lifestyle and eat regularly and healthily
even if you don’t feel like it; familiar routines may be very
comforting and provide a framework for you to deal with some of the
disruptions to your life.
• You don’t have to feel everything at once – you
can deal with unpleasant feelings and memories one at a time.
• Feeling this bad can be very unpleasant, but try not to overreact
when feelings seem ‘out of control’ or overwhelming.
• Give yourself permission to ‘feel lousy’ from time
to time, after all you have been through a difficult experience; also
give yourself permission to distract yourself with pleasant activities.
• Where someone has been killed in the trauma, attending funerals,
memorial services and other rites can help you get in touch with your
feelings about the traumatic event; recognizing and naming your feelings
are the first steps in working through them.
• Try not to act on unpleasant feelings and make major life decisions
until you have recovered from your injuries – your judgment may
• Feelings are strongly influenced by thoughts and beliefs; by
monitoring your negative thoughts/beliefs and evaluating their usefulness
to you in your recovery, you can begin to master unpleasant emotions.
• Fight against boredom, look for ways to re-motivate yourself
so that you can get your life back on track.
• Learning and applying relaxation techniques may reduce tension
• After a traumatic event, distressing thoughts, dreams and ‘flashbacks’
are very common; don’t try to block them. They will decrease in
frequency and become less painful over time.
• Continue to talk to your family, friends and others in your
life about your trauma, your reactions and feelings as this will help
you master your distressing symptoms. Even though you feel detached
from other people, do not reject their support.
• Writing down thoughts in a diary or writing letters you may
not send can almost be as good as talking about them.
• Identifying negative and self-defeating thoughts can lead to
mastering them and enable you to think straighter and more rationally.
• Distraction techniques can help you gain control over unwanted
recurrent thoughts that are disturbing/distressing. For example, using
a thought stopping technique such as saying STOP silently to yourself
whenever a troublesome intrusive thought enters your mind.
How Can Relatives
and Friends Help
• Spending time with the traumatized person, especially in the
early days following the event;
• Offering your assistance even when they have not asked for it;
• Reassuring them that they are safe, that distressing symptoms
will pass and that these reactions are understandable given what you
• Giving them time and space;
• Allowing them to grieve for lost abilities, good health or the
loss of or damage to material possessions;
• Not taking their anger or moodiness personally;
• Not telling them to ‘buck up’ or
‘they are lucky it wasn’t worse’ - traumatized people
are rarely consoled by such statements;
• Offering practical help.
Trauma involves the whole
Although family and friends may have escaped actual injury they also
Where life seemed stable and predictable before the trauma, changes
have taken place, sometimes dramatically, sometimes forever. Career
paths, emotional well-being, financial stability, family roles may all
change. There may be stress and confusion where families try to process
new information (particularly medical and technical terms). It is important
to feel free to ask for explanations, even if you ask the same question
many times. Health professionals understand that it is difficult to
take in new information when under stress.
While family and friends will differ in their responses to the trauma
survivor, many find it difficult to treat the patient ‘normally’.
They may hide their true feelings in an effort to distance themselves
from distress or to spare the patient. Families may also cover up negative
feelings which they may see as potentially harmful to the patients (eg
anger, blame). It is, however, important for communication to remain
open and for deception to be avoided even if it initially appears to
protect the patient.
Recovery from Traumatic
Serious injury is a complex phenomenon and in the early stages of treatment
and recovery the patient is often in an emotional and beahvioral fog
induced by pain, medication and unfamiliarity with the hospital system.
These are some ideas that may help:
• To recover, making your own well-informed decisions about your
treatment is important. This can be difficult at first when you may
feel helpless and disoriented.
• Be open and assertive with health professionals about your concerns.
It’s OK to take time out to make important decisions or request
a second opinion.
• Your injury, treatment program and recovery are unique to you.
It is important that you refrain from comparing yourself to others.
• Emotional turmoil is to be expected in this early phase of recovery.
It may feel overwhelming at times, this may reflect adjustments your
• Self blame and guilt can increase pain and distress by increasing
This information should
not replace the expert advice and care of qualified healthcare providers.
Rapid advances in the medical field may cause this information to become
outdated, incomplete, or subject to debate.