It has been one month since the Boston µarathon bombings, and the media frenzy has quieted to a dull rumble. Then last week, another headline: "Three Missing Girls Found Alive." And the process repeats. Media blitz and, shortly after, silence.
When the media spotlight dims and the public goes back to life as usual, what happens to the victims and their families whose sense of safety has been shattered? Tragedies like the Boston Marathon bombings and the kidnappings of Amanda Berry, Gina DeJesus and Michelle Knight have a short news life, but their real-life effects are long-lasting.
The Anatomy of a Traumatic Stress Reaction
People react differently to trauma. Some -- in fact, most -- rebound quickly, while others adjust over a longer period of time. In general, more severe trauma, such as physical or sexual abuse, has more long-lasting psychological effects than other forms of trauma, such as neglect.
In the weeks following a traumatic event, some people develop acute stress disorders. Many of those people go on to struggle with post traumatic stress disorder (PTSD), a type of anxiety disorder that is characterized by nightmares, frightening thoughts, difficulty sleeping or making decisions, and avoiding reminders of the traumatic event. People who experience trauma are also at heightened risk of substance abuse and other high-risk behaviors.
Trauma recovery can be a long-term process. Research shows that traumatic events can actually change the structure and chemistry of the brain. Particularly for children and adolescents, trauma can have a significant impact on physical and emotional development.
Fortunately, PTSD is highly treatable. There are a number of therapies that are proving highly effective to help people process traumatic experiences in a safe way, including Eye Movement Desensitization and Reprocessing and Somatic Experiencing. Those who have difficulty expressing their feelings verbally may benefit from art therapy, animal-assisted therapy, journaling or other alternative approaches. The stress response can also be counteracted with body-centered therapies, such as massage therapy, acupuncture, yoga and meditation. Sometimes the biggest hurdle is allaying the survivor's fears about trauma therapy.
Building Resilience: A Family Affair
The differences in recovery after trauma vary from person to person and have been explained by the concept of resilience. The brain has ways of coping with and reversing the effects of psychological and physical maltreatment, but a number of factors influence how well and how quickly people bounce back. One of those factors is the individual's support system.
Although the media tends to zero in on the trauma survivors themselves, traumatic events send shockwaves through the entire family system. It can be difficult for family members to provide needed support to the trauma survivor when they are victims in their own right.
It is often a case of conflicting needs. Trauma survivors need to recover at their own pace, but family members may want to regain a sense of normalcy as quickly as possible. When confronted with physical violence or abuse, it can be so agonizing to accept that a loved one experienced something so painful that family members look the other way, even in the face of obvious signs of PTSD or other mental health issues. Some may feel guilty that they couldn't prevent the trauma from happening, even if it was entirely out of their control.
A New "Normal"
So what can loved ones do to support someone who has been traumatized? One of the best ways is to take care of themselves. It isn't uncommon for loved ones to become depressed or anxious or to feel sick or burnt out while supporting someone recovering from trauma. No one can be expected to have all the answers or do or say the right thing every time. By eating well, exercising and taking time to rest and recharge, family members build their reserves. Just as the trauma survivor leans on family for support, family members need a support system of their own.
Family members should also get educated about the signs of PTSD and nurture a close relationship with their traumatized loved one so that they can recognize the need for intervention should it arise. Trauma survivors may become uncharacteristically angry or argumentative, or withdraw from family members and friends. These reactions may change from day to day.
Rather than trying to follow any particular roadmap to recovery, family members best serve trauma survivors by acknowledging and accepting their feelings, even if they seem unusual or extreme, and allowing them to set the pace for the healing process. The process is smoothest when the entire family works together to establish a new normal. From keeping a consistent daily routine to doing activities as a family, there are many ways to create a home environment that feels safe and predictable.
Once a traumatic event occurs it will always be part of the survivor's life experience, but it doesn't have to define them. The healing process takes time but with support and treatment, it is remarkable how much recovery can occur -- for both the trauma survivor and their family -- even in the most tragic circumstances.
David Sack, M.D., is board-certified in psychiatry, addiction psychiatry and addiction medicine. He is CEO of Elements Behavioral Health, a network of mental health and addiction treatment centers that includes the Promises, The Ranch, Right Step, The Recovery Place, The Sexual Recovery Institute, Malibu Vista, and Spirit Lodge.
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