ROB GORDON - CLINICAL PSYCHOLOGIST AND EXERT ON MASS TRAUMA:
25 years experience with 30 disasters in Australia and New Zealand including Black Saturday Bushfires, Queenland and Victoria floods.
Wednesday 11th October: Understanding the stresses of recovery in 2nd and 3rd years: protecting health, lifestyle and relationships.
During times of mass trauma there is not a significant increase in diagnosable psychological conditions. This is generally due to the processes individuals pass through during long recovery periods. Post-traumatic reactions play a more significant role.
Degraded Quality of Life
Things that give meaning and enjoyment to life are dropped in order deal with the issues we are facing. Relationships, interests and leisure slowly drift out of our lives resulting in Iife becoming ‘spartan’ and devoid of the things that really matter. We neglect ourselves in order to deal with the material problems we are facing ie get my home repaired/rebuilt.
Self-awareness and normality are missing and results in a loss of our “frame of reference” which disenables us to make strategic (thoughtful) decisions and assert ourselves. This is because our energy and focus is put into fixing our material loss and the things that give real meaning to our lives are neglected. We become egocentric: focus is on fixing the material problem ie need to get my home rebuilt, and there is no focus on self or family. An example of this: parents are so focused on getting information, understanding the situation and finding a way forward they do not give their children the attention they would normally receive. The children see the stress the parents are under and in order to protect the parents they put their own needs aside and instead seek attention and support from their peer group. Long term the family unit becomes less relevant to the children and the peer group more relevant. Couples relationships can undergo the same transformation. Focus on the problem at the expense of the relationship = couples become just friends.
By the time full recovery is achieved frustration, anger and loneliness come to the fore. Children may start to act up and the parents do not understand as it is all supposed to be over and good now.
There are generally 4 processes we go through at times of trauma and not always in sequence.
STAGE 1: EMERGENCY/SURVIVAL MODE
This is the fright or flight mode. Adrenaline is produced in large quantities and the right frontal lobe of the brain (visual part of brain) takes over. This leads to an inability to make good decisions as we lose context. We deal with imminent danger/risk and are unable to activate the left hemisphere of the brain. This results in a lack of strategising/planning and comprehension and explains why we can’t get the right words out or remember things – it is all action to deal with imminent risk/danger. This is referred to as ‘losing the feedback route’ – adrenaline keeps you going but the focus is singular and not comprehensive.
As long as we are feeling under threat we remain in the adrenaline mode and depending on circumstances we can swing in and out of this state numerous times.
STAGE 2: ENDURANCE MODE
The primary chemical reaction involves cortisol. This is a persisting chronic stress state. Results in lowered energy as endurance is needed to get through this period and the body is therefore conserving energy. The bodies self-maintenance process is hijacked. Cortisol normally feeds the bodies functions to enable it to replenish itself. In the endurance mode the cortisol is exploited to give energy just to do what we have to. Memory and concentration is undermined and metabolism changes (weight gain or loss) when high levels of cortisol are sustained over long periods.
The ‘creeping’ effect of the endurance mode results in what is referred to as ‘chaotic inefficiencies’ with interruption of severe emotional reactions at times. We forget what is ‘normal’ and are operating at a heightened level – forgetting how to come back down.
The Cortisol Mind
- inability to distinguish relevant from irrelevant
- become inefficient (can’t keep on task)
- ability to make important decisions, plans, strategies are disabled
- memory and concentration loss
This results in ‘inaction’ and lack of progress and feeds tension back into us. Emotion becomes a by-product of this state and is likely to boil over at times. Pre-existing stresses increase and despair, pessimism and bitterness increase.
Our sense of wellbeing is locked into things that we can’t solve ie do geologists know what is happening. We lock ‘recovery’ on something we have no control over and therefore lose our ability to bring about our personal recovery.
It is important at this stage to re-focus on the tangible things in life that we can change/control ie family, friends, leisure, interests.
STAGE 3: REGAIN SELF AND REPLENISH LOST RESERVES
By this stage our recovery is complete ie rebuilt. We are feeling exhausted but our ‘feedback route’ is now turned back on as our chemical levels normalise.
With all this change and long term lack of self-awareness the difficulty is re-engaging and working out “how do I make this the next stage of my life?”
Our priorities will change due to the experience. Our goals may have changed.
During the previous stage our focus was completely on solving the problem. We forget ourselves and now that recovery has happened we question who am I?, where am I going? what is important to me now?
4TH STAGE: RECOVERY FROM RECOVERY
The experience has changed us. Our focus returns to more tangible things and we focus on setting up our new future.
General: remaining in the adrenaline and/or cortisol stages for extended periods of time can and will effect health. It is important to get out of both of these cycles – even if it is only for short periods of time ie get out of town for a weekend, make time to socialise, spend time playing with children, exercise etc. This also has the benefit of allowing us the space to re-focus on ourselves, our families and our friends.