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The Trauma Response Cycle

The predictable consequences of trauma interact with the subjective experiences, interpretations, personality and coping skills of the survivor and their socio-economic context.

This model is a simple representation of very complex dynamics. There is no time scale for each phase or for the whole cycle. Several cycles may operate at once at different time scales. People often go round the cycle many times before moving beyond their trauma. It will not fit every experience - it is a map to be used as a guide when people feel lost or as an example of a method to help them draw their own maps of recovery.

Pre-Incident Beliefs

The fixed or mistaken beliefs about themselves and the world, usually fixed in childhood, that are likely to be challenged by disaster. People are thrown into crisis when disaster challenges core beliefs, the linchpin for their stability. Not everyone is thrown into crisis even if the incident is traumatic - it depends on the strength and variety of their coping skills and the personal significance of their losses.

The Critical Incident

Can challenge all aspects of a person - physical, emotional, and spiritual - and can affect their family, social and economic context and behaviour. It is defined here as a betrayal - 'It shouldn't have happened like this, why me? Why did they let it happen?'

'The Void'

The world feels as if it is turned upside down, nothing makes sense, people are in shock and the feelings underneath are intense. Others may try to 'move people on' or be over-protective. Strategies for dealing with the emptiness and confusion include distraction, avoidance, keeping frenetically busy and alcohol. Offers of help may be rejected, but some are at their most receptive to help, if it is given sensitively. They need 'permission' and safe places to 'gather their thoughts and feelings' and make sense of things to reduce the risk of unhelpful coping or activity. Methods include: listening, quality presence alongside the distress, practical support, mobilising local support and self-help, finding a place for reflection, group support, getting the facts straight, supportive rituals. When the shock and numbness subside strong feelings begin to be felt, as:

The Full Impact Emerges

In terms of intense feelings and the impact on all aspects of health, relationships and life. Help can be given to reduce the risk of reactive reactions and actions that may cause further problems. The choices made will influence which of the next two phases are chosen.

'The Whirlpool'

Life is defined by and stuck in the critical incident. F eelings may be turned into actions against self or others. A path of unhealthy coping may be taken that creates more stress as an avoidance of the primary distress. Guilt can be turned to blaming and scapegoating, anger to bitterness and revenge, sadness to self-pity and depression. These routes can have an impact on family, health, work and society, creating secondary trauma. Some will fall into a downward spiral which is difficult to leave unaided, some will choose suicide or develop full-blown or complex PTSD. Medical treatments may be needed at this point. Families and friends will need good support. But going into this 'pit' can also be a turning point that leads to growth. Re- emergence from the whirlpool may be un-grounded and premature. It needs to be well supported.

Healthy Coping

Reality is accepted - that what has happened cannot be changed and there may always be pain, but there is choice about perceptions and what is done with the experience. Control of one's life is resumed. Life now has more colour and it may be possible to love, trust and have fun again. Distress is transformed into positive social or political actions, learning, creative expression or personal growth. There may be an aspiration to explore forgiveness and other life issues.

Revisiting The Critical Incident

Reminders of the incident can occur at any time. They may re-activate emotions and physical sensations as if the incident is still happening - one of the most characteristic symptoms of trauma. Reminders include physical or symbolic reminders such as location, sounds, smells, sights, tastes, TV programmes, people and dates. Anniversaries and festivals remind what has been lost. The task: to identify triggers, prepare, manage and review them. The aim: to make reminders less troublesome by defusing their emotional charge and stimulating the brain to store them as memory. They may plunge the person into another cycle of the process.

Moving Beyond The Incident (Integration)

The incident is no longer the main focus of life, with room for new interests. New dimensions of life and living have been discovered and realities about what the world really is, not what it 'should be', are accepted. There is often a change of direction, values or lifestyle. Some people experience transformation at a higher, spiritual level.

View an illustration of the Trauma Response Cycle.

The Post-Crisis Journey is framed as a multi-dimensional, holistic and often irrational journey, rather than a linear progression from impact to recovery. There is NO TIME SCALE. It can operate on many levels, with small-scale daily circuits contributing to larger movements. All aspects of a person and their context are involved, not just symptoms and emotional responses. It is seen as a journey with many spirals up and down. Some never leave their disaster 'world view'. Some opt out of the journey completely but some achieve transformation of their experience. The lives of these people are no longer lived only in relation to the disaster event. Their move into other frames of reference is accompanied by the person being able to store their experience as a past memory which was an important, never to be forgotten experience from which they can draw and learn at any time. Their future lives are enriched by their journey as much as the trauma itself..

The journey depends on:

© Elizabeth Capewell, CCME, 1999 revised 2005

 

 

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