By John Lee, LMHC, Post Traumatic Stress / Trauma Topic Expert Contributor

Click here to contact John and/or see his GoodTherapy.org Profile

My heart goes out to the people in Haiti and to their loved ones here in America. I practice in South Florida and have been called upon to provide critical incident stress debriefing to people who have been affected by the earthquake. I’ve spoken with people who were there and now back here, people who do not know the status of their loved ones, and people who have lost multiple family members.

Just like I remember what I was doing when President Kennedy was assassinated or what I was doing when other disasters hit, I will always remember what I was doing when I received my first call last Wednesday afternoon. The terror in people’s eyes! Not wanting to believe what just happened! Not knowing if…..! Not being able to call…! Calling cell phones and not hearing the ring or voice mail! Terror! Absolute Terror!

I am sharing this experience because I need to provide more information on what to expect when trauma strikes. It is normal to have a reaction to tragedy or trauma. Trauma can happen to anyone. Normal everyday people have normal reactions to trauma! Accepting that it is OK to experience this kind of shock is very, very hard. It is very important for people to have an understanding of some of the normal reactions to really bad events which normal people experience.

Sometimes these reactions happen right away and sometimes they might happen a few days later. Less than 24 hours after the earthquake, what I saw from victims was shock, desperation, wanting answers, and wishing we could wake up from a really bad nightmare. Not only do people have reactions to the event but also events like this can bring up other memories of “Trauma” from years ago. For example, someone can have a nightmare two days later of another horrible event.

People try their best to deal with the emotional part of trauma on their own. However, sometimes the “Normal reactions” are just too much to bear. It doesn’t mean you are going crazy or becoming mentally ill! It just means there is help out there to assist with the normal recovery process. It is especially important to seek help to prevent later issues like Post Traumatic Stress Disorder or severe depression.

The following are normal reactions to Traumatic Events.

Many people experience Physical, Cognitive or Thinking, Emotional, Behavioral and Spiritual reactions. Physical reactions may include extreme tiredness, nausea, fainting, vomiting, chest pain, high blood pressure, difficulty breathing and heart attacks.

Cognitive or thinking reactions include not being able to think, not being able to make a decision, nightmares, memory loss, becoming fearful, feeling lost, forgetfulness. Many confuse some reactions to psychosis. Some people may experience seeing things or loud intrusive thoughts. Seeing things and voices are part of psychosis. However, when the thoughts or hallucinations are trauma related it becomes a very treatable issue. This is why it is so important to know this is a reaction. If you experience these frightening reactions say to yourself, “Stop!” This is a reaction!” I can get help and I will be OK! “This will pass!” Again, there is a big difference between psychotic voices and hallucinations and intrusive thoughts or images that are trauma related.

Emotional reactions include guilt, depression, anger, and fear. Don’t feel bad if you need to scream out or cry; it is OK. Express your feelings. If you feel you will lose control, talk to a friend or reach out to a professional. Constantly remember, “What I am experiencing are normal reactions to a horrible event.”

Behavioral reactions include: not being able to sleep, inability to sit still, getting into “If I woulda, coulda, shoulda things would have been different,” giving up or neglecting personal hygiene, not wanting to go to work, avoiding people, places and things. Often there is a tendency to drink alcohol or use street drugs to kill the pain or get some relief. However, drinking takes away judgment and often people take out their loss on others. Many domestic cases of violence are related to reactions from trauma and alcohol and drug use. You might find yourself taking out your anger on an innocent bystander. Again, if you are experiencing loss of control or uncontrollable anger, get help!

Often people could feel suicidal or homicidal. Feeling “I wish I could just die” is a normal symptom of depression and sometimes a normal reaction to trauma. Are you experiencing these kinds of thoughts? Then stop what you are doing and get help. Right now!

Other less severe behavioral reactions include feeling paralyzed like you can’t move. Often there is a tendency to stay away from people. This is the time when people need to be around others. Helping others is a great way to distract yourself from the tragedy. This is the time to be a friend for somebody who needs a friend.

Spiritual reactions include anger at God, asking yourself “If there is a God, how could this happen!” Another spiritual reaction is stopping your normal religious practice.

It is important not to suppress your feelings. This is not the time to pretend everything is OK. Don’t say things like “I am OK!” “I can handle it!” Trauma is huge! Please give yourself permission to get the emotional help you need to recover.

If you don’t feel like eating, make yourself eat! Drink plenty of water. Take vitamins. Force yourself to eat a nutritious balanced diet, even if you don’t want to. Not wanting to eat can be a normal reaction to trauma.

Go for a long walk. While walking, don’t go over the trauma in your head. During the first 4 steps, take in a slow deep breath. The next 4 steps hold your breath, and the next 8 steps exhale pulling your navel towards your spine. Do this cycle of breathing for 8 times. And, practice it at least 8 times per day. If traumatic thoughts come into your mind, refocus on your breathing.

Many people find getting back to work is helpful. While working, if your thoughts become distracted on the trauma, refocus on your work. Ever see the movie “Karate Kid?” “Wax on. Wax off.” The character concentrated on applying the wax and removing the wax. He became totally focused.

Some people find journaling or writing is good to stop recurring thoughts. If you can’t get to sleep because you keep going over and over the trauma, write it down and tell yourself, “I have it written down; I can go back to it in the morning. I don’t have to do it now.”

One thing I feel is the most important thing to do for yourself. If you love someone, call them up right now and tell them you love them!

Remember, everything I wrote about is a possible normal reaction to trauma. It is important to experience the reactions and not to suppress them. Stuffing the feelings is what could later turn into problems like PTSD. Give yourself permission to seek help. Work through the different stages of grief. What do you tell someone who lost many family members? What do you tell someone who actually saw the devastation? Answer? Listen to them and provide an open ear and an open heart. What happened in Haiti could happen anywhere, which is why I wrote, “If there is someone you love, Call them up Right Now and tell them you Love Them!”

©Copyright 2010 by John Lee, LMHC. All Rights Reserved. Permission to publish granted to GoodTherapy.org. The following article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry. Click here to contact John and/or see his GoodTherapy.org Profile