hosted by F. Michael Montgomery, LCSW, LMFT
LCS 6184, MFC 15488
Therapy for the heart, mind, body and spirit in a safe and healing setting
This Inner-healing web site is a resource center for the support and promotion of personal growth and healing.
My desire is to support people in their own healing through the compassionate and courageous work of their hearts.
Coping with Traumatic Stress Reactions
A National Center for PTSD Fact Sheet
The Importance of Active Coping
When people take direct action to cope with their stress reactions and trauma-related problems, they put themselves in a position of power and start to feel less helpless.
• Active coping means recognizing and accepting the impact of trauma on your life and taking direct coping action to improve things.
• It means actively coping even when there is no crisis; coping is an attitude and a habit that must be strengthened.
Understanding the Recovery Process
Knowing how recovery happens puts you in more control of the recovery process.
• Recovery is an ongoing, daily, gradual process. It doesn’t happen through being suddenly "cured."
• Some amount of continuing reaction to the traumatic event(s) is normal and reflects a normal body and mind. Healing doesn’t mean forgetting traumatic war experiences or having no emotional pain when thinking about them.
• Healing may mean fewer symptoms and symptoms that are less disturbing, greater confidence in your ability to cope with your memories and reactions, or an improved ability to manage your emotions.
Coping with Traumatic Stress Reactions: Behaviors that DON’T Help
• Using drugs and alcohol to reduce anxiety, relax, stop thinking about war experiences, or go to sleep. Alcohol and drug use cause more problems than they cure.
• Keeping away from other people. Social isolation means loss of support, friendship, and closeness with others, and more time to worry or feel hopeless and alone.
• Dropping out of pleasurable or recreational activities. This leads to fewer opportunities to feel good and feel a sense of achievement.
• Using anger to control others. Anger helps keep other people away and may keep bad emotions away temporarily, but it also keeps away positive connections and help from loved ones.
• Trying to constantly avoid people, places, or thoughts that are reminders of the traumatic event. Avoiding thoughts about the trauma or treatment doesn’t keep away distress, and it prevents you from making progress on coping with stress reactions.
• Working all the time to try to avoid distressing memories of the trauma (the workaholic).
Coping with Traumatic Stress Reactions: Behaviors that CAN Help
There are many ways you can cope with posttraumatic stress. Here are some things you can do if you have any of the following symptoms:
Unwanted distressing memories, images, or thoughts
• Remind yourself that they are just that—memories.
• Remind yourself that it’s natural to have some memories of the traumatic event(s).
• Talk about them to someone you trust.
• Remember that, although reminders of trauma can feel overwhelming, they often lessen with time.
Sudden feelings of anxiety or panic
These are a common part of traumatic stress reactions and include sensations of your heart pounding and feeling lightheaded or spacey (usually caused by rapid breathing). If this happens, remember that:
• These reactions are not dangerous. If you had them while exercising, they probably would not worry you.
• It is the addition of inaccurate frightening thoughts (e.g., I’m going to die, I’m having a heart attack, I will lose control) that makes them especially upsetting.
• Slowing down your breathing may help.
• The sensations will pass soon and you can go about your business after they decrease.
Each time you think in these positive ways about your arousal/anxious reactions, you will be helping them to happen less frequently. Practice will make it easier to cope.
Feeling like the trauma is happening again (flashbacks)
• Keep your eyes open. Look around you and notice where you are.
• Talk to yourself. Remind yourself where you are, what year you’re in, and that you are safe. The trauma happened in the past, and you are in the present.
• Get up and move around. Have a drink of water and wash your hands.
• Call someone you trust and tell them what is happening.
• Remind yourself that this is a common traumatic stress reaction.
• Tell your counselor or doctor about the flashback(s).
Trauma-related dreams and nightmares
• If you awaken from a nightmare in a panic, remind yourself that you are reacting to a dream and that’s why you are anxious/aroused—not because there is real danger now.
• Consider getting up out of bed, regrouping, and orienting yourself.
• Engage in a pleasant, calming activity (e.g., listen to soothing music).
• Talk to someone if possible.
• Talk to your doctor about your nightmares; certain medications can be helpful.
Difficulty falling or staying asleep
• Keep to a regular bedtime schedule.
• Avoid strenuous exercise for the few hours just before going to bed.
• Avoid using your sleeping area for anything other than sleeping or sexual intimacies.
• Avoid alcohol, tobacco, and caffeine. These harm your ability to sleep.
• Do not lie in bed thinking or worrying. Get up and enjoy something soothing or pleasant; read a calming book, drink a glass of warm milk, or do a quiet hobby.
Irritability, anger, and rage
• Take a "time out" to cool off or think things over. Walk away from the situation.
• Get in the habit of exercising daily. Exercise reduces body tension and helps get the anger out in a positive and productive way.
• Remember that staying angry doesn’t work. It actually increases your stress and can cause health problems.
• Talk to your counselor or doctor about your anger. Take classes in anger management.
• If you blow up at family members or friends, find time as soon as you can to talk to them about it. Let them know how you feel and what you are doing to cope with your reactions.
• Slow down. Give yourself time to focus on what it is you need to learn or do.
• Write things down. Making "to do" lists may be helpful.
• Break tasks down into small do-able chunks.
• Plan a realistic number of events or tasks for each day.
• You may be depressed; many people who are depressed have trouble concentrating. Again, this is something you can discuss with your counselor, doctor, or someone close to you.
Having difficulty feeling or expressing positive emotions
• Remember that this is a common reaction to trauma, that you are not doing this on purpose, and that you should not feel guilty for something you do not want to happen and cannot control.
• Make sure to regularly participate in activities that you enjoy or used to enjoy. Sometimes, these activities can rekindle feelings of pleasure.
• Take steps to communicate your caring to loved ones in little ways: write a card, leave a small gift, or phone someone and say hello.
A Final Word
Experiment with these ways of coping to find which ones are helpful to you. Practice them; like other skills, they work better with practice. Talk to your counselor or doctor about them. Reach out to people that can help — in your family and your community. You’re not alone.
National Center for PTSD
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F. Michael Montgomery, LCSW, LMFT