Understanding my response to trauma and stress  

The idea of potentially traumatic events

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Our responses explained

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“Emergency responders are at risk of psychological injury, it’s an occupational hazard”

LIFELINES ESSENTIALS #2

For many of you, your job involves regular and frequent exposure to the kinds of events and situations that, if they’re lucky, most people never encounter.  Road traffic collisions, fires, accidents, terrorist attacks, body recovery following suicide or drownings; a list of things which may endanger you and your colleagues, and expose you to the suffering of your fellow human beings.

We’re going to explain what happens to us when we’re exposed to potentially traumatic events. It’s a biopsychosocial model because trauma exposure affects our bodies, minds and relationships.

The same biological processes shape our response to the everyday stresses of life; whether these are impossible workloads, problems in relationships, money worries or a global pandemic.  

A little bit of pressure can be good for us but too much stress, going on for too long will have a negative impact on our physical and mental health.

Our responses explained

Biological responses
Our minds and bodies are brilliantly designed to help us survive when we’re in danger. Think about what happens when you’re walking in the woods and duck to avoid a low branch or when you jump back onto the pavement just before a car speeds by. Our brain tells our body to react before we register the thought that we need to do something. Our ability to do this has evolved over millennia and involves three primary responses: fight, flight or freeze.  

Our animal cousins tend to have one dominant response to threat or danger, determined by evolution to ensure their survival. All will be hyper-sensitive to the warning signs that a predator is close by. Some will respond with aggression (fight) and those not strong enough to win a fight, either will be designed for speed to help them escape (flight) or will play dead (freeze). When an animal does this, it switches off the predator’s chase instinct and makes them more likely to look elsewhere for a fresh kill.  

Human beings can have any one of these instinctive responses when we are in stressful or dangerous situations. We don’t choose our response, it happens automatically and that’s why you do so much training so you can channel your adrenaline response to improve your performance. Without rehearsal and training, your survival instincts could have you running away from some of the dangerous situations you face. Or freezing.  

The fight and flight responses involve HYPER-arousal as our bodies get ready for action and focus on the threat. Our heart beats faster pumping blood to the muscles (which we tense), we breathe more quickly, empty our bowels and bladder (to make us lighter and faster) and switch off digestion. Blood goes to the vital organs and away from the skin (to protect us against superficial wounds) and we release a natural anesthetic so that pain doesn’t impede our escape. All our senses are heightened (including dilating our pupils) so that we remember as much as possible about this moment, to learn from it and recognize similar threats in the future.  

The freeze response of HYPO-arousal response shares some of the biological changes of hyper-arousal but rather than action, the purpose is to stay very still, to look dead. Our heart and breathing rates slow down and blood pressure drops. As well as the natural anesthetic, we may feel as if things aren’t real, like we’re watching things from outside our body. This kind of psychological anesthetic is for our protection, offering a kind of escape when that isn’t physically possible. Depending whether, or how much this happens, we may remember a great deal or very little about the experience.  

Once the dangerous or stressful situation is over, our body’s alarm system switches off and our body returns to a calmer state. That’s when the psychological responses come to the fore as we try to make a memory and understand the experience.  

Have a look at How will I know to recognise the warning signs that your mind and body are stuck on red alert and at What can I do for help if it happens.
Psychological responses
Our brains are information processing machines and their job is to “process” these memories; they get a time code, so we know they’re in the past, and we learn from what happened so we can stay safe in the future. To do this our brain will bring the raw data (smells, sounds, images) into our awareness during the day and while we’re asleep. This isn’t very pleasant because until the processing is complete, the memories are vivid and it can feel like we’re right back in the frightening experience. But if we can allow the memories to come and go, then our brain will do its work and they’ll get filed away. They’ll always be more vivid than non-trauma memories, but they won’t pop up unless we choose to think about them.

While this processing is happening, our minds are trying to make sense of it all. We’re a species of big thinkers, so we need to learn what the experience says about us, other people, and the world. How well we do this depends on our thoughts and feelings before, during and after the traumatic event.  

That’s why expectation, preparation and training are your Protective Armour. If the experience was something you predicted and rehearsed, and you think you did your best during, then the processing and sense making is likely to be quite straightforward. However, even then it’s not unusual for you to ask questions like, “Did I do enough?” “Why do things like this happen?” “Could this happen to me or someone I love?” and you may feel sad or worried in the days and weeks after a challenging job.

It’s hard to feel positive when we’re in danger and common for us to feel negative emotions like fear, horror, and helplessness during and immediately after a traumatic experience. These feelings become part of the trauma memory along with all the sensory data and can make it harder to process and understand the event. For example: 
  • If we thought nothing bad would ever happen to us, then it can be hard to accept it did.
  • If we thought that we could protect ourselves then we may feel like a failure
  • We may blame ourselves for not being able to prevent it
  • Now that this has happened, we may worry that it will happen again, and conclude that we’ll never be safe
As our brain processes the trauma memories, it revisits the feelings and thoughts we have about the experience. If we have the support of others, can think flexibly and are kind to ourselves then we have a good chance of making our peace with what happened. We may even experience something called post-traumatic growth when we have a greater appreciation of what matters to us and confidence in our own resilience.  

Processing and understanding is more difficult if we don’t have good support (or worse, are blamed) or if we have fixed ideas about who we are, either positive or negative.

For example, if we had low self-esteem before the traumatic event then we may believe it confirms our weakness or lack of worth. And if we’ve experienced earlier traumas, we may be convinced that other people and the world are dangerous. On the other hand, if we felt invincible before the trauma, or have super high expectations of ourselves, then we may misinterpret our reactions as a sign of weakness or failure. The kind of social support we have plays a huge part in this.  

We need to trust our brains and let them do their work by:
  • focusing on our present safety    
  • tolerating and accepting our emotional responses
  • allowing remembering and processing
  • recognizing that our thoughts about us, others and the world may have changed
Have a look at How will I know and What can I do for tips on coping if processing gets stuck.
Social responses
The quality and availability of social support is the thing that makes the biggest difference to how we recover following a traumatic experience. Like our animal cousins, we live in family and social groups which are essential to our survival and if the response of our social group (at work, at home, in the wider community) is accepting and protective then we have a strong chance of recovery. The group keeps us safe, comforts us, lets us talk about what happened and helps us make sense of what it means. If we don’t have good support, then recovery is still possible, but harder.

We get into trouble when our access to and ability to make use of social support is damaged by the traumatic event.  This can happen in several ways:
  • we may be injured and separated from our support networks (at home or at work)
  • we may lose people we care about (through injury or death) in the event
  • we may worry about hurting others by sharing our distress about the event (a "toxic burden")
  •  the trauma may be interpersonal (caused by another human being) making us afraid and distrustful of others
  •  we may be blamed or rejected by our friends, family, community
Social support is especially important for emergency responders where your colleagues may have shared the potentially traumatic experience or had similar ones. This is why informal discussions over coffee and formal operational debriefs are helpful but remember that we may have different reactions depending on our individual responses during and after the traumatic event. Please go to How will I know if I’m not OK? and What can I do if I’m not OK? to find out more about the warning signs to look out for after trauma exposure and learn what you can do to manage them.

To help you build your social support please look at the resources on Why I’m OK most of the time and Information for family, friends, and colleagues pages

Please go to How will I know if I’m not OK? and What can I do if I’m not OK? to find out more about the warning signs to look out for after trauma exposure and what you can do to manage them.

You can also take a look at these two films. The first details a Mountain Rescue volunteer's experience after responding to a fatal avalanche, and the second one has an animation explaining our brain's response to trauma.

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