By Tony Garascia

The Nature of Stress and Trauma

Stress is an everyday part of life. Stress comes in all shapes and sizes, from the relatively small stress of making sure our children have their homework done to the much larger issues surrounding watching a parent who is in the military deploy to a combat zone. While we all are used to dealing with stress as an everyday thing, sometimes the little stresses mount up and become more traumatic to family members. When that happens, it is time to take notice and perhaps reach out and seek help.

Those in the counseling business distinguish between “big T” and “little T”, where “T” stands for trauma. “Big T” includes things such as watching a horrific event like a major injury, death, or receiving horrible news of a loved one’s death. This type of trauma is characterized as an intrusive event, or series of events, that threatens a person’s emotional and physical safety and which overwhelms a person’s ability to cope and survive.
On the other hand, “little T” trauma is not life threatening but is often sustained over time and represents those events that threaten the emotional and physical safety of the individual. Watching parents argue about financial matters, being regularly bullied and teased at school, being yelled at repeatedly by a parent for not performing well enough are just a few examples of how “little T” can have a lasting effect on the person.

Then there are the stresses and traumas that fall in between “little T” and “big T.” The May 2001 issue of Health Day News reported a 10% increase in hospitalizations in children aged 9-17 whose parent was being deployed to Afghanistan. What this indicates is that stress creates its own pathway of emotional havoc, and it is helpful if parents can be on the lookout for signs of distressed family members.

The reason why this type of stress is so harmful to the person is because of the way that we remember stressful events. Trauma is often remembered through
• Body memory/sensations
• Intrusive images of original event
• Negative thoughts and beliefs about the event: “What is wrong with me, I deserved it”
• Feelings associated with the event: fear, panic, etc.
In addition, when the brain tries to process a traumatic memory, it forges a connection between the memory of the event and the “fight or flight” center of the brain, the amygdala. Every time the event is remembered, the “fight-flight” response is triggered. Since memory is dynamic, can be triggered by recalling similar smells, actions, sounds, and body postures associated with the traumatic event. This helps explain why some adults are so avoidant of conflict, because in their childhood they have distinct memories of their parents yelling and fighting in a way that created fear and trauma.

There is also the concept of secondary victimization, meaning that just hearing about a traumatic event can cause serious stress and symptoms in an individual. Research on the effects of the 9/11 attacks in 2001 indicate that 60% of Americans reported watching the events on TV as they occurred, with less than 1% reporting watching no TV coverage that week. On one survey, 44% respondents reported one or more substantial symptoms of stress. Other studies documented acute stress reactions, symptoms of PTSD, panic attacks, symptoms of depression and increases in substance/alcohol abuse.

How Families Can Cope

When confronted with serious stress or traumatic events it is important to understand that there are three basic responses people take in dealing with trauma.
1. Denial Legacy: It’s over and done with, we don’t talk about it. This legacy usually leads
to the second response, pathology legacy.
2. Pathology Legacy: people in the family re-experience stress related symptoms well after
event is experienced. The Pathology Legacy is built on the premise that pain that is not
processed is pain that is re-experienced and passed on to others.
3. Developmental Legacy: In this third, and healthier, option the stress event is confronted
and integrated into the family story with the belief that the past can be tapped as a
potential resource for the future. Here, there is a belief that somehow the family will
continue to promote a sense of resiliency and find the necessary resources to make this
happen.

A Model of Coping

Families wanting to cope more effectively with the stresses facing them can fall back on the F.A.C.E.S. model developed by Garland, Butler, and Spiegel. This model takes a developmental perspective and treats everyone in the family as capable of becoming stronger through adversity. Facing the situation rather than fleeing. This involves acknowledging that a stressful, possibly traumatic, event has happened and that the reality needs to be addressed and talked about. Tip: Teach your children to talk about their daily setbacks and stressors. Encourage them to face their fears.

Altering worldview/selfview. Sometimes an event happens that causes us to look more deeply at our beliefs about how things should work. The death of a loved one, for instance, might force us to look at our belief that life should be fair. The pain of the event can cause us to re-examine and change some beliefs about our world and self, while shoring up and making more firm other beliefs. Tip: Be open to talking to your child about “why bad things happen to good people.” Help them examine their own beliefs about transitions and upsetting events.

Coping actively through seeking out those who can help us. Counseling, financial advice, legal advice, or the solace and comfort of friends, helps people cope actively with the crisis they are facing. Tip: Know when to ask for help from a school counselor, pastor, or mental health therapist.

Expressing Emotion is important since our affect is often the lead agent in coping and adapting to a stressful situation. Allowing someone to express grief and strong emotion is often the first step towards a resilient way of coping. Tip: Teach children to not be afraid of their own sadness and anger by having them talk about their feelings and expressing their frustration in appropriate ways.

Social Support such as reaching out to neighbours, friends, and community resources is helpful. “Tending and Befriending” is a healthy way to cope with stressful situations. This also includes integrating one’s spiritual language into the language of coping. One of the first things that our country did on the evening of 9/11 was shown in the thousands of prayer services that were held all throughout the country. Tip: Become connected to your school, church, and other social organizations that offer an opportunity to you and your family to gather and “tend and befriend” with others in the community.

What To Look For and Knowing When to Seek Help.

The following represent a partial list of behaviors in children and adults that might be a sign that stress is moving into a danger zone for that individual. Any four or more of these behaviors might warrant a call to your doctor or mental health facility.
• Falling grades
• Crying or outbursts beyond normal
• Noticeable weight gain or loss
• Noticeable change in sleep patterns, sleeping too much or not enough.
• Clear signs of depression
• Lack of interest in things normally of interest
• Increased anxiety
• Increased startle response
• Outbursts of anger at work, for adults.
• Outbursts of anger or fighting at school.
• Isolation from others
• Increased use of substances like alcohol, marijuana, or other substances (for both
adolescents and adults).

Anthony J. Garascia, M.A., M.S., LCSW is Clinical Director of the Samaritan Counseling
Center, South Bend, Indiana.