One of the ways The Family Counselling Centre (TFCC) provides professional mental health services to those in need is by providing crisis interventions; such as trauma debriefs with employees and staff, families, and groups. Trauma is something we are frequently exposed to, either directly or indirectly. Trauma is an emotional response to a terrible event like an accident, crime or natural disaster. Trauma sets in immediately after the event, with shock and denial being typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people may have difficulty moving on with their lives. Mental health practitioners, such as those at TFCC can help these individuals find constructive ways of managing their emotions through trauma debriefing and individual counselling when necessary. The recent staff trauma debrief was held by Andrea Nettel; the Founding Director, and counsellor of TFCC.
Here are some examples of traumatic events:
- domestic or family violence, dating violence
- community violence
- sexual or physical abuse
- natural disaster such as a hurricane, flood, fire or earthquake
- a serious car accident
- sudden unexpected or violent death of someone close
- serious injury
- major surgery or life-threatening illness
- war or political violence
What is trauma debriefing?
The debriefing process is designed to enable the victim to re-experience the incident in a controlled and safe environment in order to make sense of and become reconciled to the traumatic incident. Trauma debriefing provides a safe, open, and non-judgmental space for trauma survivors, enabling each participant to share their initial reactions and emotions following a critical incident.
The recent staff trauma debrief held by Andrea focused on the trauma experienced by several employees of a nursing home, that had experienced an unexpected and violent death of one of the elderly patients. the debriefing began with a round of introductions. Each person was given a change to introduce themselves and identify their role in the incident. Some individuals recalled great details of the event and how they reacted and behaved while others gave their account of the event more vaguely. As each person shared the role that they played that day, more details of the event came to light. Specific details emerge from the group as some individuals provide core facts, and others fill in missing details. This is an important part of trauma healing, as incomplete knowledge may create misperceptions, while the introduction of missing facts helps correct these misperceptions and create a full understanding of the event for all of those involved. As these details come to light, Andrea focuses on each of the employees who are learning these details for the first time; asking them how they felt now knowing these details and how these details affect their perspective of the event.
As details of their experience are shared, they are able to be compiled together and create the full account of the event; each of the employees expressed different emotional reactions. One of the employees, a carer, shared how the trauma they were experiencing did not focus on the loss of the individual or the death of the person, but on how this death has challenged their sense of control. As a carer in a nursing home, these individuals have been trained to deal with deaths commonly associated with the effects of age and are of natural cause. However, in this case the death was not age related and thus, could not be dealt with in the same manor. Another employee agreed with this loss of control as they explained; carers usually spent the last hours of the residents lives with them, maintaining care and supervision over the individuals, until the families arrive. However, due to the sudden nature of this death there was no opportunity to provide any care for the departed. The supervisor on duty the day of the event, shared how they feels that they had failed in their job to provide care for the residents; and that this feeling of failure has been so great and has caused so much stress in their work life that they are experiencing difficulty in their marriage as a result. Other symptoms of trauma shared by the employees include emotion shifts; insomnia; intrusive thoughts; and anger.
Once all of the employees had the opportunity to share their experience and talk with one another, sharing their feelings and symptoms of trauma.
Andrea began to explain trauma, and the healing process of trauma from a psychological perspective. She began by explaining how everything they were experiencing is completely normal for their stage in trauma healing.
Andrea explained how the brain “separates” when exposed to great stress. These brain structure can be seen as the “thinking” and “survival” parts of the brain. Our prefrontal cortex, our “thinking brain”, manages the executive functioning skills of problem solving, organization, emotional regulation, critical thinking, and decision-making skills. But everything changes when we experience trauma. The thinking brain switches to our “survival brain”. Our survival brain reacts impulsivity in order to maintain self-preservation. The survival brain is trying to keep us alive, but it can be very selfish and impulsive in order to do so. Andrea goes on to explain that this is likely what causes our interpersonal problems at home or work after we experience a traumatic event.
Andrea went on to explain that as we heal from the trauma; we shift back from our survival brain to our thinking brain. She used the image of building blocks to represent our neuropathways that link our survival brain to our thinking brain. Explaining that as we heal and begin to use our executive functions again; we build our mental tower. As we build our tower, we have the control to evaluate our memories and our feelings that make up who we are, and we can arrange them and heal from the trauma in our own ways.
Deciding how we are going to build our tower and eventually reach normal functioning again. This imagery is very impowering for the victims of this trauma; reminding them that they are in control of their own lives and can rebuild their lives once again.
The nursing home employees felt relieved to know that they were all experiencing similar emotions and symptoms to one another and that these symptoms were normal for their stage in the healing process. They also showed gratitude towards Andrea for the opportunity to share freely that the debrief provided and for her insight on the topic of trauma. To conclude the debrief, Andrea provided each of the employees with pamphlets and the contact details for The Family Counselling Centre, for them to utilize for the purposes for individual counselling, if their symptoms do not improve over the next few weeks or, if they feel it necessary.
Report written By Christiane Viljoen, volunteer counsellor at The Family Counselling Centre.