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Thursday, January 21, 2010

Managing Your Stress and Overcoming Trauma: The Psychological Effects of Overexposure to News About Disaster

What Many Psychotherapists Saw After the 9/11 World Trade Center Attack:
After the 9/11 World Trade Center attack, many psychotherapists in NYC began to see the damaging psychological effects of overexposure to broadcast news stories about 9/11. This included seeing people who were not directly affected by the attack (people who were not anywhere near the World Trade Center that day and who were fortunate not to have lost anyone). These people were coming into psychotherapists' offices feeling emotionally overwhelmed by the tragedy. For many people, it was triggering their own personal history of psychological trauma. Even people who grew up in relatively healthy homes as children, felt overwhelmed. Although most psychotherapists were already aware that overexposure to broadcast news about tragic events can cause damaging psychological stress, NYC psychotherapists (and I include myself) were reminded that it's healthier to limit your exposure to the graphic images on broadcast news about disaster.

The Earthquake Disaster in Haiti:
All of this comes to mind again following the earthquate disaster in Haiti. Even among people who don't have friends or relatives in Haiti, there are many people who are glued to their TV sets watching broadcast news stories and feeling emotionally overwhelmed. What's going on in Haiti is certainly horrific beyond most of our imaginations. It's easy to see, especially if you have friends or relatives in Haiti, why the news stories would be so compelling. However, watching these recurring images of disaster can cause traumatic stress and psychological impairment without your even realizing it. At the end of this post, I'll give some tips for how to cope with feelings that you might be experiencing and how to manage your stress.

At this point, it's too soon for me to present examples of the current situation from my psychotherapy private practice in NYC of recent events without violating confidentiality, so I will present a composite of a case from after the 9/11 World Trade Center attack. While I realize that the disaster in Haiti is on a more massive scale with more far reaching and longer lasting effects, my objective is to demonstrate how, even when someone is not directly affected by a disaster, overexposure to broadcast news about the disaster can have adverse psychological effects. As always in my composite vignettes, there is no identifying information about any one particular client.

Susan - After the 9/11 World Trade Center Attack:
Susan was a woman in her mid-30s. She moved to NYC from the Midwest in 2002, a few months after 9/11. She was not in NY on 9/11 and she did not know anyone who was directly affected by the tragedy. However, after the 9/11 attack, like many people, she felt compelled to watch hour after hour of broadcast news about the tragedy. Much of the news and many of the images that she watched were repetitive, but she was glued to her TV set.

Susan moved to NYC for a career opportunity. By the time she came to see me, she was expressing common symptoms of acute stress: anxiety, insomnia, nightmares, irritability from lack of sleep, an overwhelming feeling of fear and foreboding, as well as depression. At that point, there wasn't anything else going on in her life that would account for how she felt. She was happy in her relationship, she had a good emotional support system, she really liked her new job, and she was doing well financially. Yet, she felt like she was falling apart.

Susan's nightmares were anxiety dreams that combined the recurring images that she watched on TV with scenes from her childhood in a very chaotic and emotionally abusive household. Susan was the oldest of four children. She and siblings grew up with alcoholic parents who gambled and were often violent with each other (although not with the Susan or the other children). Life was not only chaotic but unpredictable. Susan grew up watching violence between her parents and feeling helpless to do anything about it. As the oldest, she felt that she should be able to do something to help her family but, of course, this wasn't realistic because she was only a child. Even though both parents earned good incomes, the family was often on the brink of financial disaster due to the parents' excessive drinking and gambling. At various times, her parents couldn't pay the mortgage because of their gambling debts and they often feared they would lose their home. Susan talked about always feeling that the rug could be pulled out from under her at any time.

Susan was surprised that her dreams about 9/11 included violent scenes from her childhood because she had attended psychotherapy (talk therapy) back home for several years in her early to mid-20s to address her childhood trauma. She felt that she had developed insight into her family history and how it affected her--until she began having nightmares about it again. As she and I continued to talk about her current emotional reactions, she began to realize that the graphic news stories that she had been watching triggered traumatic emotions about her childhood. What had appeared to be resolved in her prior talk therapy was not resolved. She had learned to manage her life in her prior psychotherapy, which was important, but the underlying emotions were still there under the surface and were being triggered. After 9/11, she began to feel those same helpless feelings that she felt as a child--that something bad could happen at any time and she would be powerless to do anything about it. The relentless TV images from 9/11 triggered and reinforced these feelings in her.

Gradually, we worked together using EMDR and clinical hypnosis, which is often more effective than regular talk therapy for overcoming trauma, to help Susan overcome her current fears and process the unresolved childhood trauma that was being triggered. She learned coping strategies in psychotherapy to calm herself and deal with her stress. In addition to learning to meditate and learning other stress management techniques, Susan took a break from the daily stories and images of disaster on broadcast news. She kept abreast of what was going on by reading the newspaper and she was more selective about which stories she delved into.

Susan learned that the compelling desire that she had to watch hours of "bad" news on TV was linked to the unresolved trauma from her childhood. If her mind could "talk" to her, it would have said, "Here's a story about chaos, fear and confusion that's familiar to me. I feel helpless, but I have to watch it so I'll know how it turns out." By the end of treatment, Susan learned to manage her stress, she overcame the underlying childhood trauma so that it was no longer there to be triggered, and she returned to the high level of emotional functioning that she was experiencing prior to 9/11.

The Mind-Body Connection as it Relates to Trauma:
During the last 15-20 years, psychotherapists and mental health researchers have been learning more about the mind-body connection as it relates to trauma. One of the things that they have learned is that violent and disturbing images can trigger underlying feelings about earlier trauma, even for people who are not directly affected by the current stories and even for people who have had a fair amount of regular talk therapy to deal with the effects of childhood trauma. For most people, it doesn't matter how long ago the trauma occurred because the unconscious mind doesn't make distinctions about time. And, as time goes on, we are continuing to learn more about how the mind works and the mind-body connection.

Here are some tips to deal with the stress of the news about the disaster in Haiti and other traumatic news stories:

Limit your exposure to TV news stories:
Watching recurrent images of disaster can have adverse emotional effects on you. These stories and images have a way of sticking in your mind and causing you a lot of stress. For a while, depending upon how you're feeling, you might need to take a break from the news. If you have friends or family members in Haiti, it's understandable that you want to keep informed. However, watching endless replays of the same stories will only increase your stress and anxiety.

Maintain your normal routines and manage your stress:
Even if you're waiting to hear about loved ones in Haiti, as much as possible, it's best to maintain your normal routines, especially if you have children. Eating nutritious meals, going on with your regular daily routines, maintaining a healthy sleep regime, getting support from your emotional support system, and going for walks are all good ways to help reduce the effects of stress.

Keep things in perspective:
Try not to let your thoughts run away from you. I understand this is easier said than done, especially if you're waiting to hear about loved ones. But excessive worry and rumination about what's happening, what could happen and what might happen will only exhaust you. If you find yourself doing this, once again, talk to people in your support system who have a calming influence on you. If you consider yourself to be a spiritual or religious person, try to find solace in your spirituality.

Rather than feeling helpless, learn what you can do and find constructive ways to channel your energy:
Whether you're directly affected by the disaster or not, rather than feeling helpless, find constructive things that you can do. One of the most debilitating aspects of any disaster, even for those of us watching it from afar, is the feeling of helplessness in the face of overwhelming events. If you feel that you want to do something constructive about what's going on in Haiti, you can find out about the many reputable organizations involved in the disaster relief effort and make a contribution, if possible. If you're not sure which charitable organization to contribute to and you want to avoid getting caught in a scam, you can go to Charity Navigator's web site (http://www.charitynavigator.org/) and read about the various reputable charitable organizations.

Once again, I want to stress how important it is, even if you volunteer your time and money to some aspect of the disaster relief effort in Haiti, to stay involved in your own life and with the people who are close to you.

Maintain a positive attitude:
As much as possible, strive to maintain a positive attitude. Remember, as tragic as events are, there have also been stories about compassion, hope and survival. During other disasters, there have been many examples of people who have been emotionally resilient. This is not to minimize the tragedy in Haiti. However, it's important to remember that, in the long run, many people who experience tragedy talk about how it has given them a new appreciation for life, their loved ones, and the importance of living every day to its fullest. For those not directly affected by the disaster in Haiti, it can increase their gratitude about what they do have in their lives.

When stress management techniques and mutual support are not enough:
If you find that, after using these tips you're still feeling emotionally overwhelmed, you could benefit from seeing a licensed mental health professional in your area who knows how to work with trauma. Licensed psychotherapists are professionals who have completed their undergraduate and graduate education in the mental health field and who have demonstrated expertise so that they are licensed by the State.

Finding someone who also has advanced postgraduate mental health training is most beneficial.

To find someone, you can contact your insurance carrier or, even better, you can seek recommendations from people that you trust who have seen or who are seeing a licensed mental health professional.

To find out more about clinical hypnosis and hypnotherapists in your area, you can visit the ASCH website: http://www.asch.net/

To find out more about EMDR and EMDR psychotherapists in your area, you can visit the EMDRIA website: http://www.emdria.org/.

I am a licensed psychotherapist, hypnotherapist and EMDR therapist in NYC.

To find out more about me, visit my website: http://www.josephine-ferraro.com.

To set up a consultation, call me at (212) 726-1006.