Recovering from trauma

Whakaora ake i te ngaukino

What is a trauma reaction?

Post-traumatic stress reactions can occur after someone has experienced a traumatic event. A traumatic event is an experience that causes a lot of stress and might be marked by a sense of helplessness, horror, and threat of serious injury or death. It can affect survivors, whānau, rescue workers, or victims of the events. Service members can experience this as part of their military duties, such as during combat. They can also experience them as part of their non-working life, either before or after they join the NZDF.

People with post-traumatic stress reactions have three different types of reactions:

• Re-experiencing reactions
• Avoidance and numbing reactions
• Psychological arousal reactions.

Re-experiencing reactions

After a trauma, it is common for people to re-experience the event. You may have unwanted memories of the trauma that seems to come from out of nowhere. These memories are particularly strong and are referred to as nightmares and flashbacks, which can make it seem like the experience is happening again. This often causes bodily-reactions like a racing heart, sweating, shaking, and emotional reactions.

These nightmares and flashbacks are what happens when the part of your brain responsible for deciding how important an event gets overloaded by how overwhelming a traumatic event is. The sensory memories of the event are put aside to be processed later. When you re-experience the memories, that’s exactly what is happening. For most people, after a time these are processed and disappear by themselves. But for other people, they get stuck. That experience of being stuck is Post-Traumatic Stress Disorder.

Avoidance and numbing reactions

One way people try and cope with the upsetting memories they experience after trauma, is to push them away, or to try to avoid thinking about the event. You may also try to avoid talking about what happened because it brings up upsetting feelings. Many people also avoid situations that remind them of the event, this might include the same location, or similar tasks, or places with similar features, such as crowds.

The upsetting memories people have can lead to feeling numb or empty inside. You may feel distant or detached from other people, even people you love. You may lose interest in activities you used to enjoy. Sometimes the painful thoughts or feelings can be so intense that your mind just blocks them out altogether and you may not remember parts of what happened. This way of responding to trauma can make it difficult to get the support you need from others. It can be associated with feelings of depression and social isolation or withdrawal. It’s also common to have strong feelings of resentment and anger toward either an organisation or other people.

Unfortunately, these avoidance or numbing behaviours can end up being part of why those sensory memories continue to stay stuck. This creates a cycle that can serve to maintain the very thing that you want to be rid of.

Physiological arousal reactions

Arousal reactions include feeling keyed up and jumpy, irritability, being easily startled, feeling overly watchful and on edge, and having trouble sleeping or concentrating. These reactions are caused by your body’s fight, flight, or freeze response to fear, which is normal when faced with a sudden, unexpected traumatic experience. As a result of your experience, you know there is danger in the world and you want to be ready for it. However, having your body in a constant state of arousal takes a great toll on you and can interfere with your day-to-day life, such as your sleep patterns and mood.

Managing post-traumatic stress reactions

Coping with post-traumatic stress reactions is an ongoing daily gradual process. It doesn’t happen through a sudden insight or cure. Some level of continuing reactions to memories is normal, and reflects a normal body and mind. Recovery means having fewer and less intense reactions. But it also means a greater ability to manage trauma-related emotions, and a greater confidence in your ability to cope.

When you take direct action to cope with problems, you will often gain a greater sense of personal power and control. Positive coping methods can include:

• Doing your best to get good sleep. It’s not always easy. But getting good sleep early on has been shown to reduce post-traumatic stress reactions after a traumatic situation. If you need a distraction to help you settle, try leaving some quiet music playing, or a podcast you’re not too interested in. Listening to that can be enough of a distraction to quiet your own mind. The Headspace app has a great range of audio tracks that are designed to put your mind to rest while you fall asleep. Currently NZDF regular serving and territorial force personnel may qualify for a free Headspace subscription, refer to the internal health webpage on the ILP for more information.
• Practice relaxation methods. Try strategies such as progressive muscle relaxation exercises, breathing exercises, meditation, swimming, stretching, yoga, prayer, listening to quiet music, spending time in nature, and so on. Some people find that particular relaxation techniques can increase distress by focusing attention on disturbing physical sensations or reducing contact with the external environment. If this happens to you, try one of the more active relaxation strategies such as swimming, listening to music or spending time in nature.
• Starting an exercise programme. Exercise, in moderation, has a number of possible benefits for those with post-traumatic stress reactions. Exercise may help you manage painful memories or worries, and give you a break from difficult emotions. It can also improve self-esteem and create feelings of personal control. Good physical health also reduces the impact of chronic stress on your body. Military personnel can reach out to a PTI for support and advice.
• Understand what is happening. Learn about trauma and post-traumatic stress reactions. Understand how common post-traumatic stress reactions are. Recognize that you’re not alone, weak, or "crazy." It’s just your brain, still processing something that is well beyond the ordinary.
• Reduce alcohol and other drug consumption. Consider visiting www.alcoholdrughelp.org.nz to receive practical tips on cutting down your drinking, or other drug use. If you do not make any progress through the use of self-help materials, consider seeking professional help. Alcohol and drugs may temporarily help you forget, but they impair your ability to effectively work through a trauma reaction. Facing life now is what helps tomorrow to be better.

Stay connected

• Talk to another person or professional for support. Reach out to loved ones to help you feel supported or understood, or receive concrete help with a problem situation.
• Increase contact with other survivors of trauma. Being in a group with other survivors may help you reduce a sense of isolation, rebuild trust in others, and provide an important opportunity to contribute to the recovery of other survivors of trauma. A range of group treatments are available through NZDF, Veterans' Affairs New Zealand and DHB funded post-traumatic stress disorder treatment programs.
• Reinvest in personal relationships with family and friends. Often, by taking action to have more contact, and working at improving relationships, you can re-connect to others and get more good things happening in your life again.
• Increase positive activities. Positive recreational or work activities help distract you from your memories and reactions, express your feelings in a positive way, improve mood, and help recharge you for the tasks ahead.
• Start to volunteer in the community. It’s important to feel like you’ve got something to offer to others, that you’re making a contribution. If you’re not working, it can be hard to get this feeling. One way that many survivors of trauma have reconnected with their communities and regained a feeling of contribution is to volunteer – to help with youth programmes, medical services, literacy programmes, community sporting activities, and so on.

Build mental flexibility 

Practice helpful thinking. You can try challenging your thinking to see if your upsetting feelings are triggered by unhelpful thoughts. If so, develop an alternative thought and action plans. For example, if you find yourself thinking, “I can’t do it,” you can ask yourself if that is true under ALL circumstances, and if you could do it if you had the right assistance. Then you can deliberately substitute the thought “with the right help, I can get through this.”

Useful resources

• Post-traumatic stress disorder - Health Navigator NZ 
• Post-traumatic stress disorder - Mental Health Foundation NZ
• PTSD coach App