For advice on how to get through the festive season while coping with a reaction to trauma, I spoke to Dr Claudia Herbert, Director of the Oxford Stress and Trauma Centre.
Much of the guidance on how to look after yourself when you are experiencing a reaction to trauma, talks about avoiding too much stimulation. Don’t push yourself too hard. Don’t force yourself to put up with crowds or loud music if you find it overwhelming.
However, during the holiday season it can seem impossible to find any peace and quiet. Streets become crowded with shoppers and lined with flashing lights. Shops blast Christmas music and casual social invitations turn into obligations.
How can a person, worn down by grief and trauma, find an easier path through those weeks?
Dr Herbert explains that Christmas can be harder for some people and less so for others. “Each person has different triggers,” she says, “which cause reminders of painful or unresolved emotions. If Christmas was important to someone then there are lots of reminders – all the preparations, the special types of food, the shopping – even very little things can be triggers for any anniversary or special occasion.”
So the holidays are not just about the physical impact of people, lights and sound, they are also about memories.
Dr Herbert calls the effect of an occasion or time of year being full of these memory triggers, an “anniversary reaction.” She says, “They can be very difficult and are different for each person”.
Is it possible to reduce the impact of all that?
“You need to really, really pace things. Really take things slowly”, says Dr Herbert. “Do what you can and leave out what you can’t. Educate your peer group. Learn to be kind to yourself. And listen to your body. Your body is very good at telling you what is too much – listen to those signals.”
I ask what kind of signals we should be looking out for, to let us know we need to take it easy and do less. Dr Herbert says: “Things like increased heartbeat, shortness of breath, palpitations, the feeling of almost having a panic attack, headaches, migraines, restlessness, agitation, being irritated or grumpy or being very sad.”
She goes on to say, “People learn to suppress feelings of sadness by comfort eating and doing other unhealthy things so wanting to do more of an unhealthy thing could be a signal.
“Also, poor concentration. Sometimes this can be caused by aging but more often it is caused by being very stressed or even post-traumatic stress. Another signal might be tinnitus or visual problems.”
I ask about alcohol because in this part of the world, Christmas and especially New Year are synonymous with heavy drinking.
“When emotions get too much,” says Dr Herbert, “many drink more than is good for them. This is often caused by unresolved emotional issues and so it is best to seek help.”
The holidays can stir up unresolved emotional issues at the best of times. How should we cope with these feelings at the worst of times? Rather than reach for a drink or a mince pie, what should we do instead?
Dr Herbert recommends, “LOTS of healthy comforters.” Examples of healthy comforters are: “Make a cosy retreat for yourself at home where you can go with a soft blanket and maybe some soothing music or whatever makes you feel comforted. Also, try mindfulness. This is just learning how to be with yourself, even when you’re sad, and to just appreciate being in the present.”
And how do we deal with the friends who think we just need a good party to take our mind off things? And the family members who feel that their way of doing Christmas is best for everyone? For a widowed person’s first Christmas without their partner, family and friends are likely to be more insistent than ever.
“Healthy boundaries,” says Dr Herbert. “You know who is not that sensitive so you need to find ways of distancing yourself from them right now.” She continues, “It’s important to not isolate yourself but to find a group of people you can trust.”
And what do you actually say to someone who doesn’t know about boundaries? “You can say something like:
‘I appreciate your advice but I just need time on my own right now.’”
I think one of the difficult bits of the holidays is that there is so much pressure to do things a certain way at this time of year. People don’t understand that a trauma reaction can make the holiday traditions very difficult to deal with.
Dr Herbert says, “Everyone takes their own time – there are no hard and fast rules. It’s very important to say to people, ‘Let me go my way’, and that others recognise that there’s nothing wrong with you saying that. You need to be able to say, ‘Look, it takes as long as I need.’”
So far I’ve been trying to match Dr Herbert’s advice to my own experience of my first Christmas as a widow. When I said, “No, I don’t think I can handle that”, people were offended and worrying about offending people made me feel ten times worse. I’ve met many other widowed people who’ve been trampled under good intentions. What are we doing wrong? As I’m thinking this, Dr Herbert says something that might just be the answer.
“You also need to give yourself permission,” she says, “And people can pick up on that.”
Did I give myself permission? No. I hoped other people would see my exhausted self and give me permission to step down. My words said what I knew I needed but they sounded more like a question. And the energy behind my words was all uncertainty.
I puzzled over friends going all out to reassure me that they definitely wanted to see me and it was no inconvenience to them at all. I didn’t doubt their sincerity but I was doubting if I was allowed to turn down their kind offers.
A couple of times people said that to prove their point, they would not take “no” for an answer. I quietly freaked out over why such normally considerate people were refusing to listen to me.
There is also the fact that they were grieving too so none of us were as clear-headed as we could’ve been. Still, maybe the main reason my words weren’t heard was that my doubts over my right to say them, spoke louder.
Dr Herbert suggests that another strategy for dealing with peer pressure is to choose an ally or two. “Enlist friends to go with you to do things or to create an alternative that better suits you or to act as a spokesperson, talking to your peer group for you and explaining to them what you need.”
How do we find a group of people we can trust if such people are in short supply? Are support groups a good idea for people with a trauma reaction?
Dr Herbert says it varies from person to person. “Sometimes groups can be re-traumatising. Sometimes the pain of others can be too much. People need to allow themselves to trust their own feelings – trust your own judgement on whether something is overwhelming or helpful.” As an alternative, Dr Herbert says that helplines can be very good as they offer one-to-one support.
We get into a conversation about re-traumatising. Our society generally doesn’t understand much about trauma reactions and it understands considerably less about what can be re-traumatising.
A local family has been campaigning for better morgue facilities after a deeply upsetting experience when their dad died, which led them to discover many other families had experienced the same thing. It’s easy to think that the death is bad enough; nothing can make things worse than that, but things can be made worse by thoughtless words, careless actions or additional stress and intrusion, occurring in the aftermath of trauma. Things like press attention, gossiping neighbours or a bruising encounter with an official can all reinforce the original symptoms and so cause them to take a bit longer to heal.
It becomes clear that the importance of educating our peers about trauma is not just for our own benefit but for people they might encounter in the future.
Where people are struggling to deal with a trauma reaction, there are therapies that have been shown to help. Dr Herbert suggests that where unpleasant images get stuck in the mind and overtake happy memories, a qualified EMDR practitioner should be sought. You can find a list and more info about this at http://www.emdr-europe.org There are also some trauma centres and lots of trauma specialists across the country.
I found Dr Herbert’s book, Understanding Your Reactions to Trauma, A guide for survivors of trauma and their families, an enormous help. Not only did it give me practical advice on what to do but it also gave me a way of explaining what was going on, to myself and to those around me. If I’d found it before that first Christmas, I’d have photocopied pages and handed them to friends and family. She also has written together with Ann Westmore, another trauma book called Overcoming Traumatic Stress. A newly revised edition of this will come out in 2017.
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What is a trauma reaction
Traumatic incidents cause us to experience extreme fear, terror, confusion and helplessness. How our body and mind deals with those sudden and intense feelings after a traumatic incident is a trauma reaction.
The definition of a traumatic incident is one where you felt certain that you were about to die or sustain serious injury, or one where you were confronted with the death of another person.
We might expect survivors of an earthquake to have a trauma reaction but survivors of a fatal car crash, or people caught up in a violent crime are also likely to experience a trauma reaction.
Much less understood is that for some people, opening your front door to find a police officer telling you that your husband or wife has died, can also affect people as trauma.
We all respond differently and we don’t get to choose what our trauma response will be.
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Common forms of trauma reaction
Traumatic events shatter our expectations about ourselves and about our world. We can say logically that while we knew this kind of thing happened to other people, we didn’t expect it to happen to us but it did so we’ll just get on with it. However, our body and mind take longer to adjust. In the same way that if you break your arm, accepting that arms can break is not enough to heal the bone. Your arm will take its own time to do what bones do.
While our inner workings are making sense of the trauma, common symptoms are that we relive the traumatic event or that we feel numb to all emotions or over-sensitive to everything.
Other common effects are to get extremely concerned about safety, be easily startled, get irritable, have nightmares, feel distant towards those around you or to struggle with sleep and concentration.
It is worth remembering that if you recognise some of these symptoms, you might be experiencing a trauma reaction but if you experience a trauma, you will not automatically get all or any of these symptoms.
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What to do
Really pace things
Do what you can and leave out what you can’t
Educate your peer group
Learn to be kind to yourself
Listen to your body
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Trauma reactions over time
Trauma reactions that haven’t been able to heal can develop into many different symptoms such as depression, anxiety, chronic pain and immune system disorders.
For some people a trauma reaction lasts for years while for others it lasts only a few days. As this is about the death of your partner, the grief will make symptoms last a bit longer.
If your symptoms are affecting your ability to hold down your job, drive your car or engage with close friends and family then you should see a doctor.
If your symptoms start to get worse rather than better then you should seek out a trauma specialist as soon as you can.
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Overcoming Traumatic Stress. A self-help guide using cognitive behavioral techniques. By Claudia Herbert & Ann Wetmore (1999, 2008). Published by Robinson & Constable Ltd,. London. (Newly revised edition to be released 2017)
Understanding your reactions to trauma. A guide for survivors of trauma and their families. (1996, 2002, currently in revision. Expected release 2017). Published by Merkaba Publishing, Witney.
Find a psychotherapist
Find an EMDR consultant
Understanding reactions to traumatic events
A very short, simple leaflet produced by North Bristol NHS
Coping with the effects of a traumatic event
A more detailed leaflet from Lancashire NHS
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First published in Issue 13 of Widows and Widowers magazine
Image by iStock.com/alexkich