Phoenix Australia - understanding trauma and renewing lives
29 June 2022
Phoenix Australia is the Australian National Centre of Excellence in Posttraumatic Mental Health. As well as undertaking research, providing education and training and setting standards for best practice, they also have comprehensive and valuable resources for practitioners, organisations involved in high-risk activities and for individuals who have been exposed to trauma.
What is trauma?
Exposure to trauma is common for many healthcare workers, including doctors. This is more likely when working on the frontline in the Emergency Department or General Practice or Acute Psychiatry. Traumatic events include natural disasters, accidents and violence. Healthcare workers and emergency service personnel are at risk of vicarious trauma, when witnessing a traumatic event or assisting others who have been involved in a traumatic situation.
Almost everyone who experiences trauma will be emotionally affected, and there are many different ways in which people will respond. Being distressed and upset is a very normal reaction to being in a dangerous and life-threatening situation or observing it or helping those who have been involved in a traumatic event. When something traumatic happens, it is often overwhelming, and it can be hard to come to terms with what has happened. The experience is likely to be very different from anything you have gone through before. Trauma is very different to other stressful events. Stressful events can affect mental health, but they are not the same as the traumatic events. Recognising this difference is important, because the recommended treatments to help people recover from trauma are different to those generally used for mental health problems caused by stressful life events.
Immediate reaction to trauma
In the first days and weeks after a traumatic event, it is common to experience strong feelings of fear, sadness, guilt, anger, or grief. These reactions can be severe and are at their worst in the first week after the event, however, in most cases, they fade over a month. As you begin to make sense of what has happened, these feelings usually begin to subside. If day-to-day functioning is seriously affected for more than one month after the event, it's important to discuss it with a GP or mental health professional.
Most people will recover quite quickly with the support of family and friends. For some though, a traumatic event can lead to mental health issues such as posttraumatic stress disorder (PTSD), depression, anxiety, alcohol and drug use, as well as impacting on relationships with family, friends, and at work.
Steps to recovery after a traumatic event
Individual or group debriefing is no longer recommended in the early stages of recovery from trauma but rather self-care and support from family, friends and colleagues. The Australian Guidelines for the Prevention and Treatment of Acute Stress Disorder, Posttraumatic Stress Disorder and Complex PTSD include a conditional recommendation against individual or group psychological debriefing within the first three months after trauma exposure. Instead, these guidelines suggest providing information, emotional support, and practical assistance in preference to individual or group psychological debriefing.
These steps may help individuals to come to terms with the trauma and reduce some of the distress associated with it.
- Recognise that you have been through an extremely stressful event and it is normal to have an emotional reaction to it. Give yourself permission to feel rotten, but also remember your strengths.
- Look after yourself by getting plenty of rest (even if you can’t sleep) and regular exercise. Eat regular, well-balanced meals. Physical and mental health are closely linked, so taking care of one will help the other.
- Cut back on stimulants such as tea, coffee, chocolate, soft drink, and cigarettes. Your body is already ‘hyped up’ enough and these substances will only add to this.
- Try to avoid using drugs or alcohol to cope, as they can lead to more problems long term.
- Make time for relaxation, whether it’s listening to music or taking a bath – whatever works for you. It might be helpful to learn a relaxation technique like meditation, yoga, progressive muscle relaxation, or breathing exercises.
- Plan your days to schedule at least one enjoyable or meaningful activity each day..
- Get back to your normal routine as soon as possible but take it easy. Don’t throw yourself into activities or work in an attempt to avoid painful thoughts or memories of the trauma. Tackle the things that need to be done a little bit at a time and count each success.
- Try not to bottle up your feelings or block them out. Recurring thoughts, dreams and flashbacks are unpleasant, but they are normal, and will decrease with time.
- Avoid making major life decisions such as moving house or changing jobs in the days and weeks after the traumatic event. Do however make as many smaller, daily decisions as possible, such as what you want to eat or what film you’d like to see. This can help you to feel more in control of your life.
- Spend time with people you care about, even if you don’t want to talk about your experience. Sometimes you will want to be alone, and that’s OK too, but try not to become too isolated.
- Talk about your feelings to someone who will understand, if you feel able to do so. Talking things through is part of the natural healing process and will help you to accept what has happened. As you start to feel better, you may want to provide support to others who have been through similar situations.
- Write about your feelings if you feel unable to talk about them.
- Keep informed (about the event you experienced) through media and other information sources, but don’t overdo it. Try to avoid repeated viewing of disaster or trauma scenes.
- Give yourself time to re-evaluate. A traumatic event can affect the way you see the world, your life, goals, and relationships. Again, talking this through with others might help.
If after a couple of weeks of trying these strategies, you are not improving or you are having trouble coping it is time to see your GP for support and if necessary, referral to specialised services.
Recovering from trauma doesn’t mean forgetting your experience or not feeling any emotional pain when reminded of the event. Recovery means becoming less distressed and having more confidence in your ability to cope as time goes on.
Post-Traumatic Stress Disorder (PTSD)
PTSD disrupts our everyday lives and makes it hard to cope. It stops us from enjoying things and is overwhelming and exhausting. If your day-to-day functioning is seriously affected for more than one month after the traumatic event it is time to seek professional help. To diagnose PTSD, a mental health professional will reference the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)
PTSD has four groups of symptoms:
- Re-experiencing the trauma – intrusive thoughts, nightmares, flashbacks
- Avoiding reminders of the event
- Negative changes in thoughts and mood after the trauma
- Feeling ‘on edge’ and overly aroused
Treatment for PTSD
There are a range of treatment options for the treatment of PTSD including
- psychological treatments (talking therapies)
- physical treatments (medications)
- exercise, mindfulness and self-help.
Often a combination of treatments works best. Treatment needs to be individualised.
More information about trauma management including the treatment of PTSD can be found in the list of further reading.
- Phoenix Australia | Centre for Posttraumatic Mental Health
- Australian PTSD Guidelines | Phoenix Australia
- Natural disasters and your mental health | Beyond Blue
- Post-traumatic stress disorder (PTSD) - Information & Resources | Black Dog Institute
- Post-traumatic stress disorder treatment | Black Dog Institute
- Post-Traumatic Stress Disorder (PTSD): Definition, Criteria, Causes, Treatment | Verywellmind