Learn the best ways to cope with trauma.
There's a silver lining to our day-to-day stress. It's so familiar to us—the irritation of traffic and adrenaline of deadlines—that we, hopefully, have learned how to cope. Ideally, we've got a healthy outlet, a favorite walk or a trusted friend to relieve the accumulation of life's little pressures.
But what about the really hard stuff—the realization of fears we rarely dare to voice, if at all? When the scan comes back with bad news, or a loved one suffers a devastating accident; then what? How does one cope with the kind of trauma that levels life in an instant?
According to experts in extreme stress, some strategies work much better than others. A key objective for anyone in stress is managing his or her "fight-or-flight" response—the evolutionary instinct that readies our bodies for danger with the energy and focus to battle a predator or run away. Unlike animals, whose response to danger subsides once the threat does, humans have the capacity to recall the trauma and fear for the future, says Steven Southwick, co-author of "Resilience: The Science of Mastering Life's Greatest Challenges" and professor of psychiatry, post-traumatic stress disorder and resilience at the Yale Medical School and the Yale Child Study Center. "We can keep ourselves stressed 24/7, and unfortunately stress can cause all sorts of problems," including, for example, injuring the very part of the brain that turns off the stress response, Southwick says.
According to David Spiegel, associate chair of psychiatry and behavioral sciences at Stanford University School of Medicine and director of its Center on Stress and Health, people in extreme stress should keep these key points in mind:
1. Make a prioritized checklist of what needs to be addressed and tackle each item sequentially;
2. Don't be afraid to ask people for help;
3. Know your limits, and guard them;
4. Rest—take breaks, get lots of sleep, and "practice self-soothing";
5. Maintain a healthy diet and exercise routine.
In addition, the following strategies can provide comfort and relief:
1. Express your feelings. "Don't fight your emotions. Think of them as your friend, not your enemy," says Spiegel. There's a misconception among some that containing one's emotions contains the problem or that they "need to be strong" for their families by putting up a stoic front, Spiegel says. That not only doesn't work—it backfires. People end up "wasting energy fighting themselves," he says. Plus, releasing emotions brings people together, which is precisely what's needed in times of trauma.
2. Find social support. "People who are socially isolated have a two-fold elevation in all-cause mortality," Spiegel says, calling social isolation as much of a risk to one's health as smoking or high cholesterol. "And yet, when people get sick or in trouble, they often lose social support rather than gain it," he says. Spiegel, who runs support groups for women diagnosed with breast cancer, says such groups provide an opportunity to share experiences and advice. Everywhere else in life, that woman may feel like an outsider, the one with a "death sentence." But in the support group, "you belong."
Due to his research, Southwick has become so convinced of the power of social support that he now works with his patients to draw a diagram of their social networks, examining each individual involved to ensure that they are trusted and reliable. "Strength comes from social networks," he says. "We're all social beings.
3. Find a way to relax. Whether it's prayer, meditation or deep relaxation techniques, these acts offer a powerful antidote to stress. "You really can't be tense and relaxed at the same time. They're opposites," says Carol Goldberg, psychologist and host and producer of the New York-area TV show "Dr. Carol Goldberg and Company." She suggests, for example, visualizing a calming scene, repeating a soothing mantra or deep breathing from the diaphragm to boost oxygen supply and help rid yourself of carbon dioxide. "It's something that you always have within you. You don't have to get any equipment ... You can just close your eyes, and take some deep breaths."
4. Face your fears. "Most of us have a very difficult time doing that because it's unpleasant," Southwick says. However, "if you want to be resilient, sooner or later, you're going to have to face those things, or some of those things." In fact, "avoidance is at the heart of all anxiety disorders," he says. When veterans address post-traumatic stress disorder with a therapist, they expose themselves to theirs to try to make peace with them.
The trick is to reframe fear and face it before it devolves into a state of panic, which shuts down the part of the brain responsible for rational thinking. To conquer fear, you have to learn about it and understand it. And then, "when you do approach the fear, try to do it with someone who you really trust."
5. Find a role model. "We tend to learn through imitation," Southwick says. Look to others who successfully negotiate challenges, ask them about their coping skills, and try them out yourself. For example, if that person calls a friend during times of stress, you might consider that tactic.
For his part, Southwick has found role models in the research for his book. A young woman with spina bifida who won a gold medal for swimming in the Paralympics is one of them. She not only excelled in college, graduating with honors, but she swam an average of 26 miles a week. These days, when Southwick goes swimming, he often thinks of her as he's wrapping up his mile of laps, and says to himself: "What, are you kidding? Twenty-six miles a week ... I keep going."
Source: http://health.usnews.com/health-news/health-wellness/articles/2013/03/21/how-to-handle-extreme-stress
Putting pen to paper, or fingers to keyboard, can really pay off.
Whether you put pen to paper or type on a computer, writing about stressful experiences or emotionally charged issues in your life can be good for your health and emotional well-being. In fact, expressive writing, which basically involves pouring your heart and mind into words, without worrying about spelling, punctuation, grammar and other writing conventions, is good medicine: In recent years, research has found that it improves symptoms of irritable bowel syndrome or IBS, asthma and rheumatoid arthritis; helps with recovery from childhood sexual abuse and postpartum depression; and improves the state of mind in those with Parkinson's, cancer and many other health conditions.
It can even promote faster wound healing. In a 2013 study, researchers at the University of Auckland in New Zealand had 49 healthy adults, ages 64 to 97, spend 20 minutes a day for three consecutive days writing about upsetting events in their lives (expressive writing) or their daily activities (time management): Two weeks later, the researchers gave participants small puncture wounds on the inside of their upper arms then monitored their healing. Eleven days after the wound infliction, 80 percent more of those in the expressive writing group had fully healed compared with those in the other group.
The Magic Behind the Act
"Writing about an emotionally charged subject or an unresolved trauma helps you put the event into perspective and give some structure and organization to those anxious feelings, which ultimately helps you get through it," notes James Pennebaker, a professor of psychology at The University of Texas–Austin and co-author of the new book "Opening Up by Writing it Down: How Expressive Writing Improves Health and Eases Emotional Pain." "This can help people sleep better, feel and think better, and have richer social lives, all of which can bolster immune function and improve health."
Not surprisingly, writing about emotionally charged subjects also can improve mental health, including symptoms of depression, anxiety, major depressive disorder and even post-traumatic stress disorder among veterans. What's more, in a 2014 study involving 149 women in a residential treatment program for substance abuse disorders, researchers from the VA Connecticut Healthcare System in West Haven, Connecticut, found that those who engaged in four 20-minute writing sessions (about emotional topics) on consecutive days had greater reductions in the severity of their post-traumatic symptoms, depression and anxiety after two weeks than participants who wrote about neutral topics.
The mechanisms behind these emotional benefits aren't entirely understood. One theory is that describing your feelings with words may be somewhat cathartic, releasing pent-up feelings that may be dragging you down. Another is that the act of writing can help you organize disorganized thoughts into more cohesive ones that give meaning to an upsetting or traumatic experience. It also may be that the process of writing enables people to learn to better regulate their emotions because they gain a sense of control over upsetting experiences life throws at them.
Meanwhile, a pair of studies published in the April 2016 journal Emotion found that expressive writing helps people distance themselves from a distressing life experience, which in turn makes them less emotionally reactive to it. "We think the process of creating a coherent story out of disorganized emotional memories facilitates self-distancing because this process requires people to adopt other people's perspectives and focus on broader contexts," explains lead author Jiyoung Park, an assistant professor of psychological and brain sciences at the University of Massachusetts–Amherst.
Feeling Is Believing
For as long as she can remember, Erin Morris had anxiety that would interfere with her ability to make decisions. In the fall of 2015, she started writing about whatever was on her mind for 15 minutes in the morning. "The important part for me is to not stop and judge myself or my writing but to let it flow and express everything that is in my head," says Morris, 36, a graphic designer who splits her time between Costa Rica and Columbia, South Carolina. Besides easing her anxiety, the writing habit has brought a considerable improvement in her previous sleep troubles, greater energy and "mental clarity when it comes to making decisions and dealing with complicated relationships," Morris reports.
Clint Evans, who spends up to 15 minutes writing in his journal in the morning and the evening, can relate to these perks. "Expressive writing reduces my stress and helps me sleep better," says Evans, 36, a business consultant and content service provider in Austin, Texas. "I feel release when writing in my journal – my mind stops racing and slows to a calm." The writing practice helps him fall asleep faster and sleep more soundly.
Most of the research has explored the benefits of writing about one's deepest thoughts and feelings about a stressful event using the first-person point of view (the "I" voice). A 2013 study from the University of Iowa suggests that assuming a distant, third-person perspective (using "he" or "she") may be even more beneficial because it's associated with less intrusive thinking and fewer physical symptoms. "Taking an observer's vantage may be vital to maintaining composure and making progress when trying to sort through a distressing or angering event or moment in life," explains lead author Matthew Andersson, now an assistant professor of sociology at Baylor University in Waco, Texas. "It's a short leap from picturing a difficult personal event from an observer's perspective to actually using a third-person pronoun, as if you're looking at a completely different person going through what you did."
Of course, "these potential pathways aren't mutually exclusive," Andersson notes, and there may be cumulative benefits. Whatever the mechanisms may be and whatever voice you choose to use, engaging in expressive writing can yield major benefits. "The beauty of this intervention is that it's cost-effective, low risk and [offers a] high payoff," notes Katherine Krpan, a psychologist who investigated the effects of expressive writing on major depressive disorder while at the University of Michigan. "People seem to like the idea of a non-pharmacological intervention. You can also do it wherever you are."
How to Write Yourself Well
To harness the power of expressive writing, Pennebaker recommends choosing a time and place where you're unlikely to be uninterrupted. Vow to write continuously about something that's upsetting you for at least 15 minutes on four consecutive days. Don't worry about spelling, grammar, punctuation, verb agreement or other writing conventions; simply pour your deepest, most honest feelings onto paper or a computer screen. "It can be related to something you're dreaming, thinking or worrying about a lot, an issue or memory that's affecting your life in an unhealthy way, or a subject you've been avoiding for days, weeks or years," Pennebaker says.
Try it for at least a few weeks and see if it helps. If it does, stick with it. Ultimately, what you do with your expressive writing is entirely up to you: You can save it for future reference, throw it away, burn it or shred it, Pennebaker says. The important thing to remember is that it's meant to be for your personal benefit and your eyes only.
