Dr Bill: it’s complicated
We see them every night on TV, on the frontline of some of the disasters that affect our world.
A first responder will likely arrive early to assist at the scene of an emergency such as an accident, natural disaster, or terrorist attack. They include police officers, firefighters, medical personnel, aid workers, and yes, funeral directors.
While these courageous people provide a vital service, it comes at a cost. First responders are at least twice as likely to suffer from Post-Traumatic Stress Disorder (PTSD), an acknowledged mental health condition triggered by experiencing or witnessing a terrifying event. The one thing we can say about the grief of first responders: it’s complicated.
Post-traumatic stress symptoms may start within one month of a traumatic event, but may not appear for months or even years after. They can cause significant problems in social or work situations and in relationships, as well as with one’s ability to go about normal daily tasks.
PTSD symptoms are generally grouped into four types:
1. Intrusive memories
Symptoms of intrusive memories may include:
• Recurrent distressing memories of the traumatic event
• Reliving the traumatic event as if it were actually happening again (flashbacks)
• Upsetting nightmares about the event
• Severe emotional distress or physical reactions to reminders of the event
2. Avoidance
• Trying to avoid thinking or talking about the traumatic event
• Avoiding places, activities or people that remind you of the traumatic event
3. Negative changes in thinking or mood
• Negative thoughts about yourself, others or the world
• Hopelessness about the future
• Memory problems, including not remembering important aspects of the traumatic event
• Difficulty maintaining close relationships, feeling detached from family and friends
• Lack of interest in activities you once enjoyed
• Difficulty experiencing positive emotions
• Feeling emotionally numb
4. Changes in physical and emotional reactions
• Being easily startled or frightened
• Always being on guard for danger
• Self-destructive behaviour, such as drinking too much or driving too fast
• Trouble sleeping
• Trouble concentrating
• Irritability, angry outbursts or aggressive behaviour
• Overwhelming guilt or shame
I believe post-traumatic stress should not be thought of as a ‘disorder’, but a ‘reaction’. ‘Disorder’ suggests their response is pathological. We need to move the conversation away from “what is wrong with you” to “what has happened to you”. In other words, we should change the focus of PTSD from a ‘sickness’ to consider the impact the event has had on the individual and their reaction.
Recent research has focused on ‘post-traumatic growth’. This may sound like a fancy psychological phrase, and someone experiencing PTSD may wonder: “How?”
What is essential to keep in mind is that post traumatic growth is not a direct result of trauma itself; but rather relates to how the individual struggles as a result of the trauma. As with many things, it is in the struggle we find strength. Growth is about maintaining hope that a traumatised person can not only survive, but experience positive life changes.
The goal of any therapy for people with post-traumatic reactions is to let them experience growth and development which, at least in some areas, surpasses what was present before the struggle with the crisis.
However, the development of post-traumatic growth does not mean there is an absence of distress.
Key factors in promoting growth include relationships where people feel ‘nurtured, liberated or validated’. Many first responders and professionals hesitate to seek help, believing they should be ‘strong’ and ‘able to handle it’.
We forget professionals are first and foremost human beings, so help begins with genuine acceptance from others. Attentive and compassionate listening not only helps alleviate symptoms, but encourages actual growth and resilience.
The person is always the expert on the person. To the first responder or anyone who has been involved in a traumatic event, I would simply say this:
“You are the expert on you. This reaction is not a sign of weakness, but an indication you have been impacted by a devastating hit. You may need some help to integrate this trauma into your view of yourself and the world. Begin by simply acknowledging even the possibility of a better future.
“Let a counsellor help you bring out the wisdom that lies within your own self. And you will discover that you can take control over this trauma, rather than allowing it to control you. And if you let yourself take that journey, you will discover strength you never knew you had, and return stronger and wiser.”
Grief Journey
Dr Bill Webster is the author of numerous books and resources for grieving people. He has some innovative resources which funeral directors and professionals can make available to their clients as part of an after-care programme. Check out Dr Bill’s resources at his website, www.griefjourney.com
Contact
Linda D Jones, Executive Director of Resources, Grief Journey
0333 8000 630
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Grief Journey