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Coping With Traumatic Incidents That Puncture Mental Skin

02/07/2017 21:24
NIKLAS HALLE'N via Getty Images

Nowadays it's common for almost anything that's upsetting to be referred to as "traumatic".

But we mental health professionals reserve the word for events that are much more like the major incidents the UK has experienced in the last month in London and Manchester. These are events that are often sudden, shocking, and bring us face-to-face with the possibility of death or serious injury.

They overturn our basic assumptions that we live in a safe and orderly world and that other people will not try to harm us. Sigmund Freud described these events as like puncturing a mental skin.

If you are present at one of these events, you may have experiences that in any other situation would be very unusual. Time may speed up or slow down, your emotions may be numb, other people may seem unreal, and you may see your own body as though from the outside. These reactions may take hours or even days to settle. In the next days and weeks other reactions are common: being jumpy, seeing danger everywhere, problems sleeping or concentrating, nightmares, and having extremely powerful and distressing images of what you saw or heard popping into your mind unexpectedly during the day.

Although some of the traumatised people I see are worried about these reactions, they are entirely normal and most will settle of their own accord in a few weeks. We do not recommend counselling at this stage. But this does not mean reactions should be ignored - during this period I advise people to focus on eating and sleeping properly, to try to re-establish a routine, to take extra care on the roads or in other potentially dangerous situations, and to avoid making important decisions.

If you have recently experienced a major trauma, do not try to carry on as though nothing has happened. Some of my clients are extremely impressive copers who are used to having their colleagues, friends and family look to them for support in times of trouble. They sometimes throw themselves into helping others without considering how the incident has affected them. This can get them through the immediate distress but at the expense of problems later. This is particularly relevant if work in a hospital, or for the emergency services. Don't assume that your job means you should be able to cope better than anyone else, or that you do not have permission to be traumatised.

As far as possible, try not to rely on alcohol, cigarettes, or drugs (prescribed or non-prescribed) to get you through this period. They are likely to prevent you dealing properly with the event and cause extra problems later. Appreciate that these events take a toll on everyone and notice any changes in your feelings or behaviour. They are not a sign of weakness but indicate that your body's defensive systems are operating as they should do.

The best thing you can do may be to take some time off to reflect quietly on what you went through. Reconnect with friends and family who are important to you. Talk about your experiences if you want to but don't carry on if you feel the other person's response is not helpful. Don't feel obliged to talk about the events or answer questions about them just because others are curious.

If you have children or someone with a learning disability in your family, bear in mind they may be very frightened by the threat to you. They may need to talk to you to understand what happened and to receive extra reassurance.

If your reactions are still there after four weeks and are not getting better, or you are worried about someone in your family who does not seem to be making a good recovery, now is the time to consider seeking advice.

Useful information and support is also available online.

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