1. Human Preparedness : Understanding Trauma Dr. David Yonas, Ph.D.

2. Agenda  Bio  Trauma Definition  Stages  Relief  Helping After Trauma  Trauma Recovery General Help  Coping Strategies  Goal of the Crisis Professional  Leadership Stress Management  Resilient People

3. Bio  Dr. David Yonas Ph.D., LMFT, LPCC Volunteer for the Red Cross since 2000 serving as a supervisor and coordinator in both pre and post- disaster events Author and professor at KSU and The University of Akron and The American Red Cross Current focus with veterans and military families during deployment and returning home

4. Trauma Definition & Common Emotional Reactions  Physical Trauma: The body’s response to injury and threat  Mental Trauma: Includes frightening thoughts and painful feelings. It can produce strong feelings as well as extreme behavior such as intense fear or helplessness, withdrawal or detachment, lack of concentration, irritability, sleep disturbance, aggression, hyper vigilance or flashbacks. Common Reactions  Shock  Confusion  Fear or worry  Grief  Anger  Guilt  Shame and surprise  Helplessness  Sadness  Isolation or alienation  Hopelessness and despair

5. Trauma Stages Stage One: Circuit Breaking The juice turns off. Intellectually, you lose from 50 to 90 percent of brain capacity, which is why you should never make a decision when you're "in the trauma zone." Emotionally you don't feel anything. Spiritually you're disconnected, you have a spiritual crisis or it doesn't mean anything to you at all. Physically all your systems shut down and you run on basics. What is so intriguing is that physical symptoms that were previously prominent often disappear during this time. Back pain, migraines, arthritis, even acne often clear up. Then, when recovery from trauma is complete, the physical symptoms return. When the system starts to recover and can handle a bit more stimulation and energy—and the human system is destined to try to recover, to seek equilibrium—feelings begin to return. Stage Two: Return of Feelings Most people have not experienced so much primary trauma that they must see a professional counselor; they can work through their feelings by involving the people they are close to. They do it by telling their story—a hundred times. They need to talk talk talk, that is the means by which they begin to dispel the feelings of distress attached to their memories. The more that feelings can be encouraged, the better. The more you feel the more you heal. The expression of feelings can take many forms. For most people it may be easiest to talk. But others may need to write. However they tell their stories, the rest of us have an obligation to listen.

6. Stages of Trauma Relief  Overwhelming Feelings : Victims are often overwhelmed by feelings and “tied up in knots”. Validate their feelings by hearing their stories, but try not to let the feeling guide the relief  Thoughts: Shift to functioning and a sense of control by consider alternative meanings given to the event; problem-solve on an hour-to-hour, day-to-day basis  Actions: Establish routine acts such as eat, rest, and cleaning; help someone else, interact with friends, family; share plans and use existing resources at hand.

7. Helping After Trauma  Protect: From further harm, traumatic sights and sounds, from onlookers and media  Directing: Be firm in directing others away from the event site and away from injured survivors  Together: Keep people together with family and friends

8. Trauma Recovery Help Identify those who:  Refuse to go places that remind them of the event  Seem numb emotionally  Show little reaction to the event  Behave dangerously In general, helpers should:  Listen  Accept/do not argue about their feelings  Help them cope with the reality of their experiences Monitor Healing:  Do not ignore severe reactions  Attend to sudden changes in behaviors, speech, language use, or feeling/emotion states  Support  Be with them when possible

9. Coping Strategies Lessening Emotional Shock  Calm and uncluttered surroundings that convey order and safety  A return to routine  Practical, functional help from people In general, helpers should:  Listen  Accept/do not argue about their feelings  Help them cope with the reality of their experiences Monitor Healing:  Do not ignore severe reactions  Attend to sudden changes in behaviors, speech, language use, or feeling/emotion states  Support  Be with them when possible

10. Goals of the Crisis Professional Phase I: Initial Establish that there is support Insure safety Address immediate needs Normalize and validate experiences Educate Nurture hope Collaboratively generate goals: motivate change Phase II: Skills Building Address Target issues Teach coping skills Address adherence issues Maintain or develop relationships Structure with routines Emphasize values, ethics, good deeds View functioning as a process

11. Leadership Stress Management Leadership is paramount in maintaining organized, efficient work and recovery. Avoid jurisdictional issues between offices. In order to take care of others, you must first take care of yourself. Management Plan:  Reduce stress by example  Establish a work/rest schedule  Breaks  Rest Area  Drink and eat on a regular schedule  Identify a trusted co-worker who can evaluate your level of effectiveness and consult with him/her and provide similar service the them.  Compliments serve as motivators and stress moderators.

12. Resilient People Feel special and appreciatedSet realistic goals and expectations for themselves Solve problems and meet challenges Foster growth Have a sense of own strengths and weaknesses Practice good interpersonal skills Focus on aspects of life they can control or influence Are empathetic Listen and communicateAccept people for who they are Develop responsibility, compassion and a social conscience, contribute Change “negative scripts” (thoughts and behavior patterns)

13. Question and Answer Session