First Aid For Trauma Survivors

Assembling a First Aid Kit for those moments when PTSD symptoms are about to kick your butt is an empowering thing for any trauma survivor. What can you do to take care of yourself when you are having a hard time? How can you supplement the help you are getting in healthy compassionate ways?

SAFE OBJECTS: On of the easiest methods is to carry a safe object. These range from a bit of silk or velvet to smooth stones or even a vial of a safe scent (one that instantly makes you feel safe0. The idea behind this is to engage the pre-verbal parts of the brain in self-soothing, running your hands over a bit of fabric or a smooth stone grounds you, brings you back to the here and now. Using the earth as an object, simply by planging your feet and being rooted is also an option. Some people carry very small stuffed animals.

Melissa Wattenberg, Ph.D., has been working with severely traumatized veterans in Boston and has found that a person can pull himself out of a flashback or its emotional after-effects by using a "safe" scent. This is based in brain anatomy. Smells don't have to go through normal channels, up to the forebrain where they are turned into verbal thoughts. Smells go straight from nose to brain. A reassuring "safe" smell seems to dump you right out of the reexperiencing loop. Since smells can also trigger flashbacks, it is nice to know you can reverse the process and use a safe smell to free yourself from one or even ward one off. Finding a safe smell is a matter of trial and error. Carry it with you.

A written affirmation on a card can also serve as a safe object.

AWARENESS TECHNIQUES: The practice of meditation or any technique which slows breathing can be used to counter reexperiencing (because it brings you back to here and now), hypervigilance (because it calms you) and numbing and avoidance (because it increases awareness). The simplest meditation technique is following your breath in and out. When you find yourself triggered, you can go back to following your breath and see that this is now, not then. Or use battle breathing, a technique used by elite military groups and others to keep their heart beating below 175 beats per minute where they can still think clearly. To do this, you simply count to four on the in breat, hold for four, exhale for four and hold for four. This increases your ability to be aware of waht is actually going on, since when your heartbeat is above 175 beats per minute, most people only focus on one sense.

YTour brain is set up to narrow its focus to survival information when you are being traumatized. Broadening your awareness and slowing down your reactions are by-products of battle breathing and of most meditation/breathing techniques. There are many books, CD's, magazine articles and teachers available. Find one that speaks to you and practice! Basically this is a new form of the old "count to ten" idea we learned as kids. You can do that, too.

Keeping a list of what triggers you may also help. Be aware of situations you are going into which might be triggers. It helps to know something triggers you instead of thinking you are crazy because you can't go to a CHristmas party or sit through a violent movie.

The HEALS technique, developed by Dr. Steven Stosny, is anothe ruseful form of first aid for anger that might accelerate into violence. It involves becoming aware of the emotion under your anger and applying self-compassion. He says if you are having a problem with anger, do this many times a day till it is automatic.

Finally, learn and keep a list of the signs in yoru body that you are feeling threatened or getting stressed. Since emotional numbing is a symptom of PTSD, checking on bodily signs can be an effective way to keep track. Then you can either beat feet or use any technique from affirmations to battle breating to be in the present and tell yourself, "This is not the past and I don't have to react as if I were still in the middle of the trauma".

HEALS:

1. H: See the letters flash in bright colors: HEALING
2. E: Explain to yourself the worst of the core hurts you're covering up: disregarded/

REMOVAL TECHNIQUES:

Beat feet. Removing yourself from situations is number one. Don't stay to be harassed or insulted or endangered. Sometimes you can't leave, however, so developing a safe space inside your imagination is a very helpful thing to do. Imagine a place where you feel safe, with as many details as you can, and go there when needed.

Sometimes things seem to be living in your head -- thoughts or images you can't shake. Try to see them on a TV screen adn step back so they get smaller, or visualize yourself stepping out of the room or taking the tape out of your VCR and putting it in a safe container, an iron box, a locked closet or whatever. Repeat as often as necessary. Another one is to write out what is bothering you and put it in a box (sometimes called a God box). This may have to be done repeatedly, too, at first -- but it can become very effective with practice.

REPLACEMENT TECHNIQUES:

Replace the thoughts or images with your safe place inside. Drown them out with the serent prayer or any other healing woreds that help you, including slogans like "Step, Breath, Think, Decide", or "One Day at a Time" or "This too shall pass". You might tape a message, "Yuo are safe now", with detailed affirmations that are meaningful to you and have it ready to play when you need it.

An excellent replace is Belleruth Naparstek's "Healing Trauma: Guided Imagery for PTSD", Image Paths Inc., 891 Moe Drive, Suite C, Akron, OH 44310, 1-800-800-8661. Written for trauma survivors, this is a marvelous tape/CD with half an horu of guided imagery and half an hour of affirmations. I recommend it highly.

You can also re-place yourself in the most literal sense. Go outside and sit in the sun. Place your body in the middle of natural beauty and focus on that. Or get in the bathrub and take a warm bath while listening to comforting music.

Stretching releases some of the tension in your muscles and therefore reduces the chemical load of stress hormones in your body. Walking, running, swimming and other forms of exercise can also replace tension and stress with endorphins.

For motional numbing, sometimes recreating an aspect of the numbed emotion evokes the emotion. Scientific studies show that if you smile, it causes changes in mood and even body chemistry. When my son realized he was emotionally numb from living with PTSD, he decided to get his feelign back by going out on the lawn and twirling around hollering hurray like a little kid whenever anything good happened. He says it worked for him.

When I couldn't cry, I sued to listen to country music howlers, particularly George Jones' He Stopped Loving Her Today, and foudn I could cry alone in the car with that playing. It is a good way to practice crying.

Writing is anothe rquick way to get at feelings. Start with "I'm feeling numb, and what just happened was ..." Write the circumstances; then write "This reminds me of when ...", and see if you get an incident or incidents and some probably very painful feelings. Remember, when you can tolerate bad feelings, good ones start to show up, too.

Music is always a good replacement for overwhelming thoughts or feelings. Reading can also serve this function, whether you read an affirmation book for survivors or escape into a novel that won't retraumatize you. Many people use TV or video tapes this way. In emergencies that is good, but keep in mind that watching a lot of TV is associates with depression and weight gain.

ASKING FOR HELP:

Calling someone from your group is one of the standard tools of 12-step groups. People who have been through what you are going through can be very helpful in validating you and suggesting thigns that might help. Take what you like and leave the rest.

Talking to your nearest and dearest or a minister/priest/rabbi may help too if that person is not thinking you should be over it and saying so. Or that if you had faith, it wouldn't bother you. (If they had faith, it wouoldn't bother THEM that you have problems, and since God made human beings so that trauma affects them). I think if the critic's relationship were right with God, they wouldn't be denying the normal effects of trauma or have to believe in a cruel simplistic solution to a complex painful problem.

Talking with someone safe and healthy is important. I know I say this every issue, but I want to emphasize the safe and healthy part: someone who won't say "get over it" or "pray about it" as if that were the whole answer. And someone who can tolerate the fact that you are in pain without cheering you up or criticizing you. A trained therapist is a gift you can give yourself.

Education and information can normalize what feels like some pretty crazy feelings (or lack of feelings), reactions or symptoms. It helps to know what is going on.

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The Serenity Prayer for Trauma Survivors

Grant me the serenity to accept the things I cannot change: the past, what happened to me, that what happened was traumatic no matter how effectively I have stuffed it.

Courage to change the thigns I can: my attitude towards my simptoms - help me to accept them as a normal response to trauma and evidence that I need to take care of myself by talking about this and getting help; my actions - I no longer have to drug or deny my symptoms. I can just accept them. My reactions - instead of freaking out, I can focus on the sumptom, feel what I feel, go through and deal with the pain an dlearn whatever it is that my Higher Power wants me to know and share about the effects of trauma on people. Finally I can change how I see these sumptoms - as normal and helpful to me in my recovery even if they are painful. Eventually I will be able to help other people who share a history of trauma.

And the wisdom to know the difference: I can change my actions and reactions. Help me to be willing, teachable and to learn about myself and what I have survived, even if it is frightening.

PRAYER FOR PEOPLE WITH PTSD:

I know that it's not within the harmony of the universe that I be healed from the trauma of remember (list your traumatic incidents) without pain. Help me through the pain. Surround me with the golden light of healing, fill me with the white light of peace and love. Help me to bear the pain as I go through these memories. Help me to cry. Help me to remember. Help me to love myself no matter what happened to me or what I did to survive. Help me to release and to let go of my survival skills, the things such as anger and numbness that helped keep me alive, as I become aware of how ineffective they can be in getting me what I want today. Fill me with light and love until I am green and growing again in the harmony of the universe, if it be Thy will. Amen.

Suggested Affirmation for People Recovering from PTSD

I'm (name) and I'm (_____) years old. I'm in a safe place in (town), (state). I'm with (_______), and he/she/they are for me. There's no one in my life who wants to hurt me. I can cry and be scared and everyone will still love and accept me. I need to have these feeligns so I can let them go. I may feel them repeatedly, but each time I need to accept them so I can let them go. If I am feeling guilt, shame or other painful feelings, I don't have to believe that I am guilty, did something shameful or whatever. I can say to myself, "Isn't that sad. I am feeling an old pattern, but I need to feel it , so it will pass".

Please adapt these in any way that works for YOU!

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