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Family Medicine - Emotional Trauma: Recovery and Grief Dr.

Lerma Taylan

Emotional Trauma: Recovery and Grief

Emotional Trauma:
- damage or injury to the psyche after living through an extremely frightening or distressing event and may result in
challenges in functioning or coping normally after the event (Cascade Behavioral Health)
- it is not the objective facts of the event alone that determine how traumatic an event is; it is also the subjective
emotional experience of the event
- the more terror and helpless one feels, the more likely is that an individual will be traumatized

Potentially Traumatic Event


events that are both powerful and upsetting that intrude into the daily life
can be caused by a singular occasion, or from ongoing, restless stresses
involve major threat to one's psychological and physical well-being
may be life-threatening to ones own life or the life of a loved one
more prone to leave an individual with longer-lasting emotional and psychological trauma if :
o the individual was unprepared for the event
o the event occurred out of the blue
o the person is powerless to prevent the event
o the event occurred repeatedly
o if the event involved extreme cruelty
o if the event occurred during the childhood years

Examples:
o Natural disasters
o Interpersonal violence
o involvement in serious car accident or work place accident
o Acts of violence
o break-up or Divorce in a significant relationship
o Significant humiliating experience
o Surgery
o Falls/ Injuries due to sport
o Sudden, unexpected death of a loved one
o Diagnosis of a life-threatening or disabling condition

Signs and Symptoms


COGNITIVE
o Intrusive thoughts of event that may occur out of blue
o nightmares
o Visual images of the event
o Loss of memory and concentration ability
o Disorientation
o Confusion
o Mood swings

BEHAVIORAL
o Avoidance of activities or places that trigger memories of event
o Social Isolation and withdrawal
o Lack of interest in previously-enjoyable activities

PHYSICAL
o Easily startled
o Tremendous fatigue and exhaustion
o Tachycardia
o Edginess
o Insomnia
o Chronic muscle patterns
o Sexual dysfunction
o Changes in sleeping and eating pattern
o Vague complains of aches and pains throughout body
Extreme alertness

PSYCHOLOGICAL:
o Overwhelming fear
o Obsessive and compulsive behavior
o Detachment from other people and emotions
o Emotional numbing
o Depression
o Guilt
o Shame

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Family Medicine - Emotional Trauma: Recovery and Grief Dr. Lerma Taylan

o Emotional shock
o Disbelief
o Irritability
o Anger
o Anxiety
o Panic Attack

Effects of Untreated Psychological/Emotional


Trauma
Substance abuse
Alcoholism
Sexual problem
Inability to maintain healthy close relationship
Hostility
Constant arguments with love once
Social withdrawal
Constant feeling of being threatened
Self-destructive behavior
Impulsive behavior
Uncontrollable reactive thoughts
Inability to make healthy occupational or lifestyle choices
Dissociative symptoms
Feeling of depression, shame, hopelessness or despair
Feeling of ineffective
Feeling as though one is permanently damaged
Loss of former belief system
Compulsive behavioral pattern

2 plane or areas by which family and patient react


and adjust:
EMOTIONAL PLANE COGNITIVE PLANE
PHASE I PHASE I-
Denial, disbelief and Tension and confusion with
anxiety probable lack of capacity for
protest diffuse directly problem solving
over unfairness threat sets in motion
(minutes to hours) tension reduction
mechanism
PHASE II PHASE II- repeated failure in
Emotional upheaval deriving the diagnosis may
-characterized by lead to exacerbation of
strong emotions such tension and increase distress
as anxiety, anger & -resort to prayers
depression depends on -still earn capacity to
disrupted roles & problem solve
channels (period of
weeks)
PHASE III PHASE III- increasing
accommodation assessment and receptivity of
- the patient and the family to new approach for
family learn to relief of distress
accommodate and *some go doctor shopping
accept the diagnosis *some are willing and
- this is very capable for active
important for the participation
implementation of *time for real opportunity
therapeutic plans for the physician and other
health workers to assist
family in realigning roles and
expectations, learn new skills
and make adjustment
*willing to accept
responsibility
PHASE IV-
Acceptance of diagnosis
- enable them to mobilize
resources and recognize the
family
*quality of family
reorganization
*if there is no movement

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Family Medicine - Emotional Trauma: Recovery and Grief Dr. Lerma Taylan

towards this phase, family will


be inefficient in achieving
healthy adaptation to the
crisis and reorganize at more
dysfunctional level

Trauma Recovery
The first goal of trauma recovery should and must be to improve your quality of life on a daily basis. (Rothschild,
2010)
- it is the ability to live in the present without being overwhelmed by the thoughts and feelings of the past

Herman's Stages of Recovery


STAGE I - Stability
STAGE II - Remembrance and Mourning
STAGE III - Reconnecting

STAGE I Stability
Getting a road map of the healing process
Setting treatment goals and learning helpful process to reach those goals
Establishing safety and stability
Tapping into and developing one's own inner strength
Learning to regulate one's emotions
Develop and strengthening skills for managing painful and unwanted experiences and minimizing unhelpful
responses to them

STAGE II Remembrance and Mourning


Reviewing and discussing memories
Working through grief about unwanted or abusive experiences and their negative effect on one's life
Mourning or working through grief about good experiences that one did not have, but that all people deserve
Use Eye Movement Desensitization and Reprocessing (EMDR)

STAGE III Reconnecting


Reconnecting with people, meaningful activities and other aspects of life

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