Reprinted from "Trauma and Victimization" issue of Visions Journal, 2007, 3 (3), p. 6
When an event threatens our safety or that of our loved ones, our inner psychological resources are called upon as we try to cope. Contrary to popular thinking, there is no one “best” way to cope, and people don’t all go through a set series of “stages” of coping. The reality of responding to stressful events is more complex than that.
Different individuals will respond differently to any given situation. Some people will respond with strong emotional changes that may include anxiety, fear, anger or depression. Others may experience little change in their emotional condition.
How individual people respond tends to be typical of the way each has faced other challenging or dangerous events in the past. One factor in how we respond is a lifetime of learning how to think about life’s challenges and learning how to regulate our emotions. Another factor that affects an individual’s response is his or her typical “background” emotional style or temperament, which has a significant genetic component—some individuals are more easily upset than others.
It is important to recognize that these individual variations are authentic and naturally occurring. An absence of vivid emotional symptoms should not be regarded as some sort of abnormal condition that needs intervention.
Most people who experience even very frightening and dangerous events do not develop mental disorders and do not seek treatment from mental health professionals. Instead, they work through their fear, relief, anger or other turbulent emotions, using habits they have developed throughout their lives.
Some individuals may talk about the event—with family members, a religious leader, a friend or a counsellor on a public “crisis line.” Others may not wish to talk, preferring to think about their experience and put it into a longer perspective of how they or others have handled tough situations in the past.
Some may seek comfort in distracting activities that have given them pleasure in the past, such as running, music, reading or travel. Yet others may conclude that their own best response is a kind of deliberate suppression. For some, this suppression may indeed be best, because we know that “avoidance” can be an effective strategy after an event with consequences that cannot be changed, such as sudden bereavement.
Keeping these individual differences in mind, there are, however, some responses after a frightening event that may represent a mental disorder. When a person’s emotional turmoil is so great that it interferes with normal activities, formal treatment may be required. In the mental health professions we differentiate between two main stress-related mental disorders: “acute stress” disorder and “post-traumatic stress” disorder (PTSD).
Acute stress disorder consists of strongly increased emotions of anxiety and fear that are so severe they impair functioning in everyday life for a time, but resolve within four weeks after the event.
PTSD is an event-attributed anxiety disorder that lasts more than one month after exposure to a dangerous event. It includes powerful symptoms of intrusive memories or dreams of the event, episodes of increased arousal, and efforts to avoid stimuli related to the trauma. If a person has these symptoms so severely that he or she is highly distressed, or is unable to function adequately in normal life tasks, then the disorder may be diagnosed.
The percentage of people who develop a turbulent and persistent emotional response to a dangerous event is about 15%, with some variations in different groups.
People show amazing resilience through experiences of war, rape, assault and terrible accidents, using their own coping styles. Humans are social animals. Most of us find comfort in our family and friends once we are returned to a situation of safety—and, we can help others by quiet offers of support. In daily life we help each other through fearful situations by recognizing and respecting the different coping tactics that we and others use, and by not imposing any rigid model of ‘how people are supposed to react.’
Whether our role is that of a family member or a professional, we should be sensitive to individual needs and styles, so that recovery of emotional well-being can arise naturally out of the person’s own unique being.
About the authorDr. Bowman is a Professor Emerita at Simon Fraser University. Her research and clinical interests have focused on neuropsychological effects of brain trauma, and psychological effects of diverse traumas. She retired last year from SFU’s Psychology department and a consulting practice in clinical neuropsychology.