• Denisa Millette

Understanding Stress Responses of Trauma Survivors

Under stress we can all lose our ability to stay calm, rational and in control of our responses. Adults and children with a history of adverse childhood experiences (neglect, abuse, abandonment, domestic violence, etc.) are often extra sensitive to stress. Their stress response is a survival response.  It is a natural biological response to threat whether real or perceived. It prepares the body to fight or flee. If we can’t fight or flee, we freeze and shut down. These unconscious responses are often triggered without the person knowing. They stop them from being overwhelmed.


Many survivors live on high alert at all times because their fight-flight-freeze response was repeatedly reactivated and never turned off. They can be triggered by what seem like every day life challenges.


When triggered, a trauma survivor immediately goes into a fear-based stress response, just like during the original trauma. Many people re-experience aspects of the original trauma, as if it is occurring in the present. When the triggers aren’t obvious to the person, or others, the triggered person can seem to overreact for no apparent reason.


What happens when a person is triggered or overwhelmed?


When a person is triggered and overwhelmed, their nervous system goes onto over-active mode and they become hyper-aroused. They can be agitated, irritable, angry and may start shaking, sweating, and yelling. However, they can also become hypo-aroused, emotional numb or “shut down.” They might zone out, and become quiet. Many trauma survivors often move between these two trauma responses.


Supporting a trauma survivor is a very vital and often challenging role as they often struggle to just feel okay from day to day. Some have never felt okay or safe, emotionally or physically. Many experience guilt, shame, and blame themselves on daily basis. Many others are angry or distressed, suffer from insomnia and nightmares, and can be agitated and shut down at different times. Some survivors struggle with seeking help, feeling safe and trusting enough.


Trauma survivors are often seen as difficult to get along or attention seeking. However, we must realize that survivors have shown enormous strength, courage and resilience to have survived. The ways survivors cope and react make sense in the context of their trauma because what happened to them was wrong. Rather than asking, “What’s wrong with you?” we should always ask, “What happened to you?”


How can you support someone who have been triggered or overwhelmed?


BE EMPATHETIC AND NONJUDGMENTAL


When someone says or does something you perceive as weird or irrational, try not to judge or discount their feelings. Whether or not you think those feelings are justified, they’re real to the other person. Pay attention to them. Keep in mind that whatever the person is going through, it may be the most important thing in their life at the moment. Recognize that being hyper- or hypo-aroused is a fear/distress response.


Try and identify that a person is becoming overwhelmed early. Notice if they go quiet, or become easily angry, agitated or argumentative.


RESPECT PERSONAL SPACE


If possible, stand 1.5 to 3 feet away from a person who’s escalating. Allowing personal space tends to decrease a person’s anxiety and can help you prevent acting-out behavior. If you must enter someone’s personal space to provide care, explain your actions so the person feels less confused and less frightened.


USE NONTHREATENING NON-VERBALS


The more a person loses control, the less they hear your words—and the more they react to your nonverbal communication. Be mindful of your gestures, facial expressions, movements, and tone of voice. Keeping your tone and body language neutral will go a long way toward defusing a situation.


AVOID OVERREACTING


Remain calm, rational, and professional. While you can’t control the person’s behavior, how you respond to their behavior will have a direct effect on whether the situation escalates or defuses. Positive thoughts like “I can handle this” and “I know what to do” will help you maintain your own rationality and calm the person down.


Find ways to settle your nervous system if you are impacted. Control your own responses. It may help you to sit with your feet on the ground. Feel your feet connect to the floor. Take some calming deep breaths. Close your eyes and focus on the other sounds around you. Get a drink of water, etc.


FOCUS ON FEELINGS


Facts are important, but how a person feels is the heart of the matter. Yet some people have trouble identifying how they feel about what’s happening to them. Watch and listen carefully for the person’s real message. Try saying something like “That must be scary.” Supportive words like these will let the person know that you understand what’s happening—and you may get a positive response.


IGNORE CHALLENGING QUESTIONS


Answering challenging questions often results in a power struggle. When a person challenges your authority, redirect their attention to the issue at hand. Ignore the challenge, but not the person. Bring their focus back to how you can work together to solve the problem.


SET LIMITS


If a person’s behavior is belligerent, defensive, or disruptive, give them clear, simple, and enforceable limits. Offer concise and respectful choices and consequences. A person who’s upset may not be able to focus on everything you say. Be clear, speak simply, and offer the positive choice first.


CHOOSE WISELY WHAT YOU INSIST UPON


It’s important to be thoughtful in deciding which rules are negotiable and which are not. If you can offer a person options and flexibility, you may be able to avoid unnecessary altercations.


ALLOW SILENCE FOR REFLECTION


We’ve all experienced awkward silences. While it may seem counter-intuitive to let moments of silence occur, sometimes it’s the best choice. It can give a person a chance to reflect on what’s happening, and how he or she needs to proceed. Silence can be a powerful communication tool.


ALLOW TIME FOR DECISIONS


When a person is upset, they may not be able to think clearly. Give them a few moments to think through what you’ve said. A person’s stress rises when they feel rushed. Allowing time brings calm.


BE FAMILIAR WITH TRIGGERS


When a traumatic event is triggered, the narrative memory is compromised – what remains is a memory made up of images, feelings, and sensations – the survivor experiences the event as if it was happening again – in a real time. Most common triggers are memories of what happened and anything that makes them think about the trauma: hearing someone talk about it; a sound or smell; the person or place involved with the trauma, someone who is like the person who did the trauma; TV, songs or movies that mention a similar trauma; or anything else that reminds them of what happened.


Resources:


Blue Knot Foundation, International Training Trauma Institute, and National Center of Trauma Informed Care

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