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Family Functioning Following a Natural Disaster
In the last section, we discussed how to talk about a natural disaster crisis with children after the disaster has occurred using the Thirteen Points for Effective Discussion.
In this section, we will discuss struggling regarding sharing the trauma story with a loved one and stopping flashbacks.
Would you agree that family members of your client who experienced the trauma are often left out of the loop regarding the progress your client is making towards resolving the trauma? Julie, who lost her house in a hurricane, and was mentioned in a previous section, stated, "my mother says she feels a distance from me and that I never share anything with her." Julie was nervous that this would hurt her relationship with her mother. I suggested she follow the seven tips below to more effectively share her experience with her mother.
1. Sharing in steps: First I told Julie "It is important to not assume that your mother is getting all she needs because you are trying. Remember that sharing with her as much as you can is just a step for her, just like it is for you."
2. Basic Information: I stated to Julie, "Offer your mother basic information without overwhelming her with details that could upset her. Offer up the facts of the incidents. For example, instead of Julie saying to her mother "I saw blood, limbs, decapitation, and so on" she can share with her mom "I saw people hurt very badly."
3. Share feelings: I then stated to Julie, "include your feelings and reactions and what the event meant to you when describing the disaster to your mother."
4. Share Reactions: Encourage your client to share with their loved one as much as your client can about the reactions that your client continues to have. For example, Julie shared with her mother that she was experiencing flashbacks and nightmares. I told Julie to include in the discussion how these reactions make her feel.
5. Affect on relationship: In Julie’s discussion with her mother, I encouraged Julie to describe how her reactions affect her relationship with her mother.
6. Efforts to get better: I shared with Julie, "tell your mother how you are working to get better. Make sure to explain to her how she can help you and encourage her to continue to be patient."
7. Asking for feedback: Finally I told Julie, "In your conversation, learn more about how your behavior affects your mother by directly asking her. See if there are any actions you can take to help your mom."
Do you have a client, like Julie, who is struggling regarding sharing their trauma story with a loved one that can use these tips?
We will now transition and begin to discuss three exercises your client can use to stop their flashbacks of traumatic memories. They are Timeline Mantra, Digital Mantra, and BEMADS protocol.
Julie, who was dealing with trauma after a hurricane destroyed her home was having a flashbacks. She was speaking as if the hurricane was happening right now. I stated, "Stop, Julie. It is not happening now. What you perceive at this moment is a memory of what happened to you years ago. You are remembering when you were in the hurricane years ago." Here are three exercises that I shared with Julie to help her control and stop her flashbacks.
Exercise 1: Timeline Mantra
By a timeline mantra I mean separating what is a memory and what is happening in the present. While this may seem like a simple exercise, I find it is extremely effective. During one of our sessions, I stated, "the flashback is a memory and not a repeat of your trauma. It is important to remind yourself that it is a memory. You can do this by using these clear words and stating them in your head repeatedly, saying them out loud, listen from a digital recorder, or writing them on a piece of paper." Encourage your client to plan out a few ways for him or her to get the message across. I find this has the effect of reprogramming the neural pathways to the memory in the client’s brain by repeating, for example, "this is a memory and is not happening now." Thus this creates a timeline for Julie regarding what is a memory and what is happening in the present.
Exercise 2: Digital Mantra
By digital I mean adding numbers to the mantra, for example the phrase "Three years ago.". I explained to Julie, "If it is more effective for you, you can add to the simple mantra, in the timeline mantra, that accurately expresses the truth of your situation." Julie added to her mantra and she ended up with "I am remembering what happened to me over 3 years ago. It hasn’t happened since and it’s not happening now. It was terrible and it is terrible to remember. And I am grateful it is a memory and no longer really happening." It is important that your client does not include extreme details about their trauma because that could intensify their flashback. This is called a digital mantra because the specific number of years, 3, is mentioned.
Exercise 3: BEMADS Protocol
I shared the following exercise with Julie during one of our sessions to help her with her flashbacks. Clients can use this technique
1. in the moment of experiencing a flashback when they need to reduce or stop it,
2. are anticipating a situation that could trigger a flashback,
3. or as part of their morning routine. Here are the steps for the protocol: BEMADS is an acronym that stands for body, emotions, memory, attention, date, and safe. Here is how I used this technique with Julie.
I suggested Julie focus on her internal senses and name the sensations she was feeling.
I suggested Julie identify what she is feeling emotionally.
I suggested had Julie remind herself that this is a reaction to a memory and not an actual event that is happening now.
I encouraged Julie to focus her attention on external forces. By external forces I mean, I asked her to, specifically identify at least three things she can sense.
I suggested Julie affirm today’s date including the year, month, and day. She stated, "The day, the month, the date, and the year."
Finally, I had Julie evaluate whether or not she was safe in this moment in my office. When Julie affirmed that she was safe, she could reassure herself she was not currently in danger and she is simply having a flashback.
Do you have a client like Julie who is experiencing flashbacks, whether from a natural disaster, combat, etc. that could benefit from the BEMADS technique?
In this section we will discuss struggling regarding sharing the trauma story with a loved one and stopping flashbacks.
In the next section we will discuss the upsides and downsides of self-blame and discuss three exercises your trauma client can use to forgive himself. These exercises are Freeze Response, In Someone Else’s Shoes, and Talk to Others.
Peer-Reviewed Journal Article References:
Garfin, D. R., Silver, R. C., Gil-Rivas, V., Guzmán, J., Murphy, J. M., Cova, F., Rincón, P. P., Squicciarini, A. M., George, M., & Guzmán, M. P. (2014). Children’s reactions to the 2010 Chilean earthquake: The role of trauma exposure, family context, and school-based mental health programming. Psychological Trauma: Theory, Research, Practice, and Policy, 6(5), 563–573.
Hafstad, G. S., Gil-Rivas, V., Kilmer, R. P., & Raeder, S. (2010). Parental adjustment, family functioning, and posttraumatic growth among Norwegian children and adolescents following a natural disaster. American Journal of Orthopsychiatry, 80(2), 248–257.
Pfefferbaum, B., Houston, J. B., Reyes, G., Steinberg, A. M., Pynoos, R. S., Fairbank, J. A., Brymer, M. J., & Maida, C. A. (2010). Building national capacity for child and family disaster mental health research. Professional Psychology: Research and Practice, 41(1), 26–33.
What are seven tips your client facing trauma from a natural disaster can use to share their experience with a loved one? To select and enter your answer go to .