Recently, public attention has been focused on the reactions people have to trauma. Many studies have been done, and many efforts have been made to reduce the possibility of developing a dysfunctional response, which may eventually develop into a full blown psychiatric disorder known as Post Traumatic Stress Disorder (PTSD).

For the past several years, teams of psychologists and counselors have been deployed to areas where natural or violent incidents have occurred in order to intervene with survivors of these traumatic events. Yet, much of this has been done without any real understanding of the process of surviving trauma, and with all of their good intentions, may have actually increased their likelihood of the development of PTSD.

Historically, the interventions that have been tried with survivors have often resulted in increasing the delayed anxiety and nightmare symptomology, over the years, doctors have routinely dispensed barbiturates or benzodiazepines to assist people getting through the initial days immediately following the traumatic incidents. This has, unfortunately resulted in increasing the likelihood of developing a delayed stress reaction, psychologists armed with this knowledge then swooped down on populations surviving major trauma in an effort to help them process their feelings. However, this too failed to produce the results which they worked diligently, often with no remuneration, to accomplish.

While at this time there are no guaranteed steps to use to avoid development of the debilitating disorder, there are certain measures that can be taken to reduce the risk, or even decrease the symptomology. What we know now is that getting a trauma survivor to talk in depth about the event without time to process and assimilate the experience actually increases the likelihood of development of PTSD symptoms. This information is crucial for the support systems of these survivors to be armed with in their efforts to provide support. Now armed with this information, helpers can intervene with responses that are actually able to assist with the resolution of the trauma. It is important, in working with survivors immediately after a traumatic event, to help them re-establish a sense of control. Simple questioning which do not require in-depth responses are helpful. Ask "What name would you like for me to call you?", "could I get you a glass of water?" or "Where would you like to sit?"

DO NOT ask them to immediately begin describing the events as this can actually increase the likelihood of developing PTSD. DO tell them that their reactions are a natural response to a traumatic event. They should be reassured that while the traumatic experience creates a sense of chaos in their lives, they are not actually "crazy". If the person is going to be involved in a criminal investigation, then informing them of what will be expected of them, and providing them with the details of the course of events which will follow will assist them in feeling more in control.

Further, education about PTSD can help to alleviate fear of "going crazy" if they understand that their responses are normal, and frequently experienced by survivors of trauma. They need to understand that the reactions they have, while intense, are NOT evidence of them "going crazy", but instead indicate that they are responding normally to an abnormal event. They also need to be reassured that their is no shame in seeking psychological help from time to time, especially in periods of high stress. Treatment can actually quickly reduce traumatic stress symptoms and prevent decay of the survivors functioning.

Certain self care measures may decrease the likelihood of development of PTSD. Shortly after a traumatic even has occurred, it is important for the survivor to take the time to restore a sense of control and meaning to their lives. For the first days immediately after the event, they should be encouraged to NOT discuss the event details, but instead to make contact with family and friends in some kind of normal setting which will restore a sense that life can go on even in the face of such a horrible experience. This will also allow them to re-establish a sense of being connected to other people in an important way. Spending non-stressful time, in the company of people who care about the survivor will provide a sense of purpose and meaning to life which at this point may be in serious question for the survivor.

Societal response to a traumatic event is frequently to make efforts to get the survivor to medicate the feelings of shock and despair which are the initial responses to the event, it is critical to NOT medicate with drugs, (either prescribed or not) or with alcohol. Diving back full force into a heavy work or personal responsibility schedule will also increase the possibility of developing PTSD later on.

The stages of trauma resolution are similar to the stages of grief. When trauma can be resolved in a healthy way shortly after the traumatic incident, the possibility of developing PTSD symptoms is minimized. Each of the stages has a predictable and negotiable chain of responses. Navigating these successfully will frequently ease the emotional burden of the traumatic events.

Because shock is the first response to any type of trauma, the numbing may feel confusing, even shameful at first. Yet it, too, is a normal response to an abnormal occurrence. This numbing may also cause the survivor to fall into the belief that they are "handling things" and not be in need to the preventative or self care measures recommended. Education about the stages of recovery from a traumatic event will often help the survivor recognize what is happening and not fall into the trap of believing that they can "handle it" because their feelings are not problematic at first. While it is true that some people do seem to have an innate ability to manage trauma without developing PTSD symptoms, there is no guarantee that it will be them.

Paradoxically, it may be that the fact that the survivor has survived other traumas without developing PTSD symptoms actually increases the likelihood of the development of PTSD this time. it is as if people have a limited number of traumas they can handle in a lifespan, and when something happens to a person who has prior trauma as a child, with no ill effects, an adult trauma is actually more likely to trigger a PTSD type response. This means that if a person has had childhood trauma, they are more likely to develop PTSD as an adult if they are again exposed to a traumatic event.

Then, as feelings begin to be freed, the pain is often overwhelming, uncontrollable crying, or shaking, or fits of rage are not uncommon to survivors working through the next stages of the process. Anger tends to be right on the surface just underneath the shock and denial, sometimes this response takes the form of lashing out at those closest to the survivor, and damaging those relationships which are most needed for support. Finding healthy outlets for the anger is crucial to moving into the next phase of the healing. When the trauma has a violent, or criminal component, the rage is often incapacitating, without an outlet: the anger can take over the person's life. Anger outlets such as hitting a punching bag, tearing up newspaper, hitting the bed with a tennis racket, are just a few of the creative solutions survivors have developed to release these overwhelming feelings of rage.

Tears and intense sadness will often follow quickly on the heels of the anger outbursts, once the anger is released, the sadness, despair, and pain of what occurred becomes prominent. The crying may become debilitating at times, but there IS an end to the pain. When the horror of what occurred can be processed fully, the ability reconnect with the things that really matter to the survivor's previous sense of self can be restored. The grief can be overwhelming, and the pain can feel as if it will never end. But, the pain will end. and it will not make person "crazy". The pain itself can be worked through a layer at time. Frequently this processing of the pain takes large amounts of time to work through. That doesn't invalidate the point that it will eventually come to a completion and no longer take over the person's life.

Melody Brooke, MA, LPC, LMFT is an author, speaker, workshop presenter and counselor. Melody holds an MA in Counseling and Guidance from Texas Woman's University. She is also a Certified Radix Practitioner, Right Use of Power Teacher and InterPlay Teacher. Melody's 19 years work with individuals, couples and families provides her with a unique approach to solving clients' problems. Her life-altering book, "Cycles of the Heart: A way out of the egocentrism of everyday life", is based on her experience helping people resolve their relationship difficulties with themselves and others. To find out more go to Melody's Homepage