Emotional and Psychological Trauma情绪和心理创伤自救

资料来源：锡德兰研究所

作者：劳伦斯·罗宾逊（Lawrence Robinson），梅林达·史密斯（Melinda Smith），麻省理工学院和珍妮·西格尔（Jeanne Segal）博士。

翻译并综合管状病毒流行写作：Shadow影

Translated by incoorperating overall COVID-19 Situation by Shadow

When bad things happen, it can take a while to get over the pain and feel safe again. But with these self-help strategies and support, you can speed up your recovery.

If you’ve experienced an extremely stressful or disturbing event that’s left you feeling helpless and emotionally out of control, you may have been traumatized. Psychological trauma can leave you struggling with upsetting emotions, memories, and anxiety that won’t go away. It can also leave you feeling numb, disconnected, and unable to trust other people. When bad things happen, it can take a while to get over the pain and feel safe again. But with these self-help strategies and support, you can speed up your recovery. Whether the trauma happened years ago or yesterday, you can make healing changes and move on with your life.

What is emotional and psychological trauma?

Emotional and psychological trauma is the result of extraordinarily stressful events that shatter your sense of security, making you feel helpless in a dangerous world. Traumatic experiences often involve a threat to life or safety, but any situation that leaves you feeling overwhelmed and isolated can result in trauma, even if it doesn’t involve physical harm. It’s not the objective circumstances that determine whether an event is traumatic, but your subjective emotional experience of the event. The more frightened and helpless you feel, the more likely you are to be traumatized.

Emotional and psychological trauma can be caused by:

·One-time events, such as an accident, injury, or a violent attack, especially if it was unexpected or happened in childhood.

·Ongoing, relentless stress, such as living in a crime-ridden neighborhood, battling a life-threatening illness or experiencing traumatic events that occur repeatedly, such as bullying, domestic violence, or childhood neglect.

·Commonly overlooked causes, such as surgery (especially in the first 3 years of life), the sudden death of someone close, the breakup of a significant relationship, or a humiliating or deeply disappointing experience, especially if someone was deliberately cruel.

Coping with the trauma of a natural or manmade disaster can present unique challenges—even if you weren’t directly involved in the event. In fact, while it’s highly unlikely any of us will ever be the direct victims of a terrorist attack, plane crash, or mass shooting, for example, we’re all regularly bombarded by horrific images on social media and news sources of those people who have been. Viewing these images over and over can overwhelm your nervous system and create traumatic stress.

Childhood trauma and the risk of future trauma

While traumatic events can happen to anyone, you’re more likely to be traumatized by an event if you’re already under a heavy stress load, have recently suffered a series of losses, or have been traumatized before—especially if the earlier trauma occurred in childhood. Childhood trauma can result from anything that disrupts a child’s sense of safety, including:

·An unstable or unsafe environment

·Separation from a parent

·Serious illness

·Intrusive medical procedures

·Sexual, physical, or verbal abuse

·Domestic violence

·Neglect

Experiencing trauma in childhood can result in a severe and long-lasting effect. When childhood trauma is not resolved, a sense of fear and helplessness carries over into adulthood, setting the stage for further trauma. However, even if your trauma happened many years ago, there are steps you can take to overcome the pain, learn to trust and connect to others again, and regain your sense of emotional balance.

Symptoms of psychological trauma

We all react to trauma in different ways, experiencing a wide range of physical and emotional reactions. There is no “right” or “wrong” way to think, feel, or respond, so don’t judge your own reactions or those of other people. Your responses are NORMAL reactions to ABNORMAL events.

Emotional & psychological symptoms:

· Shock, denial, or disbelief

· Confusion, difficulty concentrating

· Anger, irritability, mood swings

· Anxiety and fear

· Guilt, shame, self-blame

· Withdrawing from others

· Feeling sad or hopeless

· Feeling disconnected or numb

Physical symptoms:

· Insomnia or nightmares

· Fatigue

· Being startled easily

· Difficulty concentrating

· Racing heartbeat

· Edginess and agitation

· Aches and pains

· Muscle tension

Healing from trauma

Trauma symptoms typically last from a few days to a few months, gradually fading as you process the unsettling event. But even when you’re feeling better, you may be troubled from time to time by painful memories or emotions—especially in response to triggers such as an anniversary of the event or something that reminds you of the trauma.

If your psychological trauma symptoms don’t ease up—or if they become even worse—and you find that you’re unable to move on from the event for a prolonged period of time, you may be experiencing Post-Traumatic Stress Disorder (PTSD). While emotional trauma is a normal response to a disturbing event, it becomes PTSD when your nervous system gets “stuck” and you remain in psychological shock, unable to make sense of what happened or process your emotions.

Whether or not a traumatic event involves death, you as a survivor must cope with the loss, at least temporarily, of your sense of safety. The natural reaction to this loss is grief. Like people who have lost a loved one, you need to go through a grieving process. The following tips can help you cope with the sense of grief, heal from the trauma, and move on with your life.

Trauma recovery tip 1: Get moving

Trauma disrupts your body’s natural equilibrium, freezing you in a state of hyperarousal and fear. As well as burning off adrenaline and releasing endorphins, exercise and movement can actually help repair your nervous system.

Try to exercise for 30 minutes or more on most days. Or if it’s easier, three 10-minute spurts of exercise per day are just as good.

Allow yourself to feel what you feel when you feel it. Acknowledge your feelings about the trauma as they arise and accept them. HelpGuide’s Emotional Intelligence Toolkit can help.

Tip 4: Take care of your health Exercise that is rhythmic and engages both your arms and legs—such as walking, running, swimming, basketball, or even dancing—works best.

Add a mindfulness element. Instead of focusing on your thoughts or distracting yourself while you exercise, really focus on your body and how it feels as you move. Notice the sensation of your feet hitting the ground, for example, or the rhythm of your breathing, or the feeling of wind on your skin. Rock climbing, boxing, weight training, or martial arts can make this easier—after all, you need to focus on your body movements during these activities in order to avoid injury.

Tip 2: Don’t isolate

Following a trauma, you may want to withdraw from others, but isolation only makes things worse. Connecting to others face to face will help you heal, so make an effort to maintain your relationships and avoid spending too much time alone.

You don’t have to talk about the trauma. Connecting with others doesn’t have to involve talking about the trauma. In fact, for some people, that can just make things worse. Comfort comes from feeling engaged and accepted by others.

Ask for support. While you don’t have to talk about the trauma itself, it is important that you have someone to share your feelings with face to face, someone who will listen attentively without judging you. Turn to a trusted family member, friend, counselor, or clergyman.

Participate in social activities, even if you don’t feel like it. Do “normal” activities with other people, activities that have nothing to do with the traumatic experience.

Reconnect with old friends. If you’ve retreated from relationships that were once important to you, make the effort to reconnect.

Join a support group for trauma survivors. Connecting with others who are facing the same problems can help reduce your sense of isolation, and hearing how others cope can help inspire you in your own recovery.

Volunteer. As well as helping others, volunteering can be a great way to challenge the sense of helplessness that often accompanies trauma. Remind yourself of your strengths and reclaim your sense of power by helping others.

Make new friends. If you live alone or far from family and friends, it’s important to reach out and make new friends. Take a class or join a club to meet people with similar interests, connect to an alumni association, or reach out to neighbors or work colleagues.

If connecting to others is difficult…

Many people who have experienced trauma feel disconnected, withdrawn and find it difficult to connect with other people. If that describes you, there are some actions you can take before you next meet with a friend:

Exercise or move. Jump up and down, swing your arms and legs, or just flail around. Your head will feel clearer and you’ll find it easier to connect.

Vocal toning. As strange as it sounds, vocal toning is a great way to open up to social engagement. Sit up straight and simply make “mmmm” sounds. Change the pitch and volume until you experience a pleasant vibration in your face.

Tip 3: Self-regulate your nervous system

No matter how agitated, anxious, or out of control you feel, it’s important to know that you can change your arousal system and calm yourself. Not only will it help relieve the anxiety associated with trauma, but it will also engender a greater sense of control.

Mindful breathing. If you are feeling disoriented, confused, or upset, practicing mindful breathing is a quick way to calm yourself. Simply take 60 breaths, focusing your attention on each ‘out’ breath.

Sensory input. Does a specific sight, smell or taste quickly make you feel calm? Or maybe petting an animal or listening to music works to quickly soothe you? Everyone responds to sensory input a little differently, so experiment with different quick stress relief techniques to find what works best for you.

Staying grounded. To feel in the present and more grounded, sit on a chair. Feel your feet on the ground and your back against the chair. Look around you and pick six objects that have red or blue in them. Notice how your breathing gets deeper and calmer.

It’s true: having a healthy body can increase your ability to cope with the stress of trauma.

Get plenty of sleep. After a traumatic experience, worry or fear may disturb your sleep patterns. But a lack of quality sleep can exacerbate your trauma symptoms and make it harder to maintain your emotional balance. Go to sleep and get up at the same time each day and aim for 7 to 9 hours of sleep each night.

Avoid alcohol and drugs. Their use can worsen your trauma symptoms and increase feelings of depression, anxiety, and isolation.

Eat a well-balanced diet. Eating small, well-balanced meals throughout the day will help you keep your energy up and minimize mood swings. Avoid sugary and fried foods and eat plenty of omega-3 fats—such as salmon, walnuts, soybeans, and flaxseeds—to give your mood a boost.

Reduce stress. Try relaxation techniques such as meditation, yoga, or deep breathing exercises. Schedule time for activities that bring you joy such as your favorite hobbies.

When to seek professional therapy for trauma

Recovering from trauma takes time, and everyone heals at their own pace. But if months have passed and your symptoms aren’t letting up, you may need professional help from a trauma expert.

Seek help for trauma if you’re:

·Having trouble functioning at home or work

·Suffering from severe fear, anxiety, or depression

·Unable to form close, satisfying relationships

·Experiencing terrifying memories, nightmares, or flashbacks

·Avoiding more and more anything that reminds you of the trauma

·Emotionally numb and disconnected from others

·Using alcohol or drugs to feel better

Working through trauma can be scary, painful, and potentially re-traumatizing, so this healing work is best undertaken with the help of an experienced trauma specialist. Finding the right therapist may take some time. It’s very important that the therapist you choose has experience treating trauma. But the quality of the relationship with your therapist is equally important. Choose a trauma specialist you feel comfortable with. If you don’t feel safe, respected, or understood, find another therapist.

Ask yourself:

·Did you feel comfortable discussing your problems with the therapist?

·Did you feel like the therapist understood what you were talking about?

·Were your concerns taken seriously or were they minimized or dismissed?

·Were you treated with compassion and respect?

·Do you believe that you could grow to trust the therapist?

Treatment for trauma

In order to heal from psychological and emotional trauma, you’ll need to resolve the unpleasant feelings and memories you’ve long avoided, discharge pent-up “fight-or-flight” energy, learn to regulate strong emotions, and rebuild your ability to trust other people. A trauma specialist may use a variety of different therapy approaches in your treatment.

Somatic experiencing focuses on bodily sensations, rather than thoughts and memories about the traumatic event. By concentrating on what’s happening in your body, you can release pent-up trauma-related energy through shaking, crying, and other forms of physical release.

Cognitive-behavioral therapy helps you process and evaluate your thoughts and feelings about a trauma.

EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation that can “unfreeze” traumatic memories.

Helping a loved one deal with trauma

When a loved one has suffered trauma, your support can play a crucial role in their recovery.

Be patient and understanding. Healing from trauma takes time. Be patient with the pace of recovery and remember that everyone’s response to trauma is different. Don’t judge your loved one’s reaction against your own response or anyone else’s.

Offer practical support to help your loved one get back into a normal routine. That may mean helping with collecting groceries or doing housework, for example, or simply being available to talk or listen.

Don’t pressure your loved one into talking but be available if they want to talk. Some trauma survivors find it difficult to talk about what happened. Don’t force your loved one to open up but let them know you are there to listen if they want to talk, or available to just hang out if they don’t.

Help your loved one to socialize and relax. Encourage them to participate in physical exercise, seek out friends, and pursue hobbies and other activities that bring them pleasure. Take a fitness class together or set a regular lunch date with friends.

Don’t take the trauma symptoms personally. Your loved one may become angry, irritable, withdrawn, or emotionally distant. Remember that this is a result of the trauma and may not have anything to do with you or your relationship.

To help a child recover from trauma, it’s important to communicate openly. Let them know that it’s normal to feel scared or upset. Your child may also look to you for cues on how they should respond to trauma, so let them see you dealing with your symptoms in a positive way.

How children react to emotional and psychological trauma

Some common reactions to trauma and ways to help your child deal with them:

·Regression. Many children need to return to an earlier stage where they felt safer. Younger children may wet the bed or want a bottle; older children may fear being alone. It’s important to be understanding, patient and comforting if your child responds this way.

·Thinking the event is their fault. Children younger than 8 tend to think that if something goes wrong, it must be their fault. Be sure your child understands that he or she did not cause the event.

·Sleep disorders. Some children have difficulty falling asleep; others wake frequently or have troubling dreams. Give your child a stuffed animal, soft blanket, or flashlight to take to bed. Try spending extra time together in the evening, doing quiet activities or reading. Be patient. It may take a while before your child can sleep through the night again.

·Feeling helpless. Being active in a campaign to prevent an event from happening again, writing thank you letters to people who have helped, and caring for others can bring a sense of hope and control to everyone in the family.

Source: Sidran Institute

Get more help

What is Psychological Trauma? – Includes the causes, symptoms, treatments, and effects. (Sidran Institute)

What is Child Trauma? — Different types of childhood trauma and the treatments available. (The National Child Traumatic Stress Network)

Eye Movement Desensitization and Reprocessing (EMDR) Therapy – Covers the eight phases of EMDR therapy involved in the treatment of trauma. (American Psychological Association)

Authors: Lawrence Robinson, Melinda Smith, M.A., and Jeanne Segal, Ph.D. Last updated: October 2019.

情绪和心理创伤

资料来源：锡德兰研究所

作者：劳伦斯·罗宾逊（Lawrence Robinson），梅林达·史密斯（Melinda Smith），麻省理工学院和珍妮·西格尔（Jeanne Segal）博士。

翻译并综合管状病毒流行写作：Shadow影

什么是情绪和心理创伤？

情绪和心理创伤是异常压力的事件造成的结果，这些事件破坏了人的安全感以致你在危险的世界中感到无助。创伤经历通常是那些会威胁生命或安全的事件，以及任何使人感到不知所措和与世隔绝的情况即使并不涉及身体伤害。决定事件是否具有创伤性的不是客观环境，而是人的主观情感体验。人越感到恐惧和无助，遭受创伤的可能性就越大。

引起情绪和心理创伤的原因之一就是与威胁生命的疾病作斗争及目睹亲人和这种疾病作斗争或因各种原因失去所爱的人，亲密关系的破裂，遭受或目睹暴力事件，大量恐怖新闻的袭击，或经历反复发生的创伤事件。

应对自然或人为灾难的创伤可能会带来独特的挑战，即使没有直接参与该事件。即使我们大多数人极不可能成为恐怖事件的直接受害者，但如果遭到社交媒体和恐怖新闻的大量袭击，也可能会使您的神经系统不堪重负，并产生创伤性压力。

童年创伤和未来创伤的风险

任何人都可能发生创伤性事件，但是如果您已经承受了沉重的压力，已经遭受了一系列损失或曾经遭受过创伤，那么更有可能遭受突发事件的创伤，特别是童年遭受过创伤的人。比方自小就生活在不稳定或不安全的环境，与父母分离，有过严重疾病，被忽略，虐待或家暴。

儿童时期遭受创伤可能会有严重而持久的影响， 有时恐惧和无助感会持续到成年，以后更容易受创伤。但是，如果事过多年，您采取一些步骤来克服痛苦，学会再次信任并与他人建立联系，也能重新获得情绪上的平衡感。

心理创伤的症状

我们所有人都以不同的方式对创伤做出各种各样的身体和情感反应。比方身体上会感觉麻木，失眠或噩梦，极度疲劳，容易受惊，难以集中注意力，心跳加速，疼痛或各种疾病产生。情绪上会感到 震惊，否定或怀疑，困惑，难以集中，愤怒，烦躁，情绪波动，焦虑与恐惧，内疚，羞耻，自责，社交恐惧，悲伤或绝望。

创伤治愈

创伤症状通常持续几天至几个月，过后逐渐消失。但是，即使您感觉好些，也可能会不时地因痛苦的回忆或情绪而感到困扰。如果您的心理创伤症状没有缓解，甚至变得更糟，并且发现自己无法在很长一段时间内正常面对生活，那么您可能正在经历创伤后应激障碍。

情绪创伤是对令人不安的事件的正常反应，但当您的神经系统被“卡住”心理处于休克状态，无法理解发生的事情或无法处理您的情绪时，情绪创伤就会变成创伤后应激障碍。

无论创伤事件是否涉及死亡，作为幸存者的您都必须（至少暂时）应对您失去安全感的情况。就像失去亲人的人一样的悲伤需要恢复的过程。建议如下：

1：运动起来

创伤会破坏您身体的自然平衡，使您陷入极度兴奋和恐惧的状态。运动除了燃烧肾上腺素和释放内啡肽外，还可以帮助您修复神经系统。每天尝试运动30分钟或更长，例如散步，跑步，游泳，篮球，或跳舞。运动时不要专注于某种思想，而应专注于自己的身体以及运动时的感觉。攀岩，拳击，举重训练或武术可以更容易达到这个目的，因为在这些活动中，您必须专注于身体运动才能避免受伤。宅家状态可以尝试跳绳，做体操等可以独立操作而且不需要太大空间的运动。

2：社交

遭受创伤后，您可能希望从社交圈子中退出来，但这只会使事情变得更糟。与他人的交流将帮助您恢复健康，因此请努力维持自己的关系并避免独处。宅家可以通过社交媒体和朋友保持联系来达到这个目的。与他人交流并不需要谈论创伤，因为有时会越谈越受伤。舒适感来自于他人的参与和接受。

最重要的是您需要有一个能分享您的感受的人，一个愿意专心聆听而又不随意判断您的人，这个人可以是可信赖的家庭成员或朋友。或者尝试重新与一度中断联系的老朋友联系。宅家可以在家族群或好友群或通过朋友圈实现，视频也是很好的选择。

可以适当参与与创伤经历无关的社会活动。宅家下可以通过加入一些有共同兴趣爱好的社交媒体群实现。

加入创伤幸存者支持小组，与面临相同问题的其他人联系可以帮助减少您的孤立感并有助康复。这个也可以通过社交媒体实现。

成为志愿者。志愿服务在帮助照顾他人过程中可以减少创伤带来的无助感。作志愿者要利用自己的优势，并通过帮助他人来恢复自己的力量意识。作为妈妈，照顾好孩子或宠物。作为晚辈，常常和长辈聊天，关心他们的身心健康。作为老师，开展网络教学帮助学生解惑。去安慰那些比你更痛苦的人，帮助他们想办法解决问题。筹集募捐支援医疗前线。或者仅仅是告诉他人如何避免病毒感染如何保护自己安全都行。但是不要沉迷于散布谣言和恐怖新闻。

结交新朋友也很重要。隔离状态参加网络学习课程或加入社交媒体俱乐部，结识志趣相投的人，校友，邻居或同事如果有群也可以多聊聊。

如果还是很难与他人建立联系……那么您可以在下次与朋友微信聊天之前采取一些措施：锻炼或移动。上下跳跃，挥动手臂和双腿。这样您的头部会更清晰，并且联系起来更容易。

3：自我调节

无论您感到多么烦躁，焦虑或失控，重要的是要让自己平静下来。它不仅有助于减轻与创伤有关的焦虑，而且还可以增强控制感。

正念的呼吸。如果您感到迷失方向，困惑或沮丧，那么练习正念呼吸是使自己平静的快速方法。只需呼吸60次，然后将注意力集中在每次呼出和呼吸上即可。

让感官愉悦，如果有特定的图像，气味或味道会让您镇定，或者抚摸动物或听音乐可以慰藉您，那么就增加这种感觉的输入。

宅家可以做一些可以与家人互动的活动比如打牌，一起做家务，猜谜语，赏月，讲故事。或者独自做自己兴趣爱好的让您身心愉悦又有收获的一举两得的事，比方画画，唱歌，打游戏，写文章，学做菜，养花养草养小宠物，网购喜欢之物，整理房间等。

4：照顾好自己

健康的身体和充足的睡眠可以提高您应对创伤压力的能力。历经创伤后，担心或恐惧可能会干扰您的睡眠方式。缺乏优质的睡眠会加剧您的创伤症状，并使您难以保持情绪平衡。坚持每天在同一时间入睡和起床，并保证每天7至9个小时的睡眠。

避免饮酒，抽烟或吸毒，这只能让创伤症状恶化，并增加抑郁，焦虑和孤立感。

饮食要均衡，这会帮助您保持精力充沛，减少情绪波动。避免吃含糖高和油炸的食物，增加omega-3脂肪（例如鱼，核桃，大豆和亚麻籽）的摄入以愉悦心情。

减轻压力也可以尝试放松技巧，例如冥想，瑜伽或深呼吸练习。

创伤治疗

为了从心理和情感上的创伤中恢复过来，您需要忘掉您长期以来一直避免的不愉快的感觉和记忆，释放压抑的能量，学会调节强烈的情绪并重建自己的能力信任他人。

身体体验的重点是身体感觉，而不是对创伤事件的想法和记忆。通过专注于体内发生的事情，您可以通过哭泣，温泉浴等身体释放与创伤相关的能量以“解冻”创伤性记忆。

帮助亲人解决创伤

当亲人遭受创伤时，您的支持可以在他们的康复中发挥关键作用。

从创伤中恢复需要时间。要抱着理解和耐心的态度，由于每个人创伤修复速度不同，所以不要根据自己或他人的反应来判断亲人的反应。

提供实际支持比方，分担家务，交谈或聆听，或者提供物质帮助，送礼物。

不要强迫您所爱的人说话，但如果他们想说话，您要回复。一些创伤幸存者很难表达自己。不要强迫您所爱的人说什么，但要让他们知道您时刻会陪他们聊天的。他们自行决定做什么。

帮助您所爱的人社交和放松。鼓励他们参加体育锻炼，寻找朋友，发展爱好，或陪他们参加活动，哪怕只是简单的聚餐。

您所爱的人可能会生气，易怒，孤僻或在情感上遥远， 但这是创的结果，与您无关。

为了帮助孩子从创伤中恢复过来，交流很重要。让他们知道感到害怕或沮丧是正常的。让他们看到您以积极的方式处理各种突发事件和创伤如果他们需要了解原因。

儿童如何应对情绪和心理创伤

1）回归。许多孩子需要回到他们觉得更安全的早期阶段。年龄较小的孩子可能会弄湿床或想要喝奶；大一点的可能会害怕孤独。如果您的孩子以这种方式做出反应，那么一定要有理解力，耐心和安慰。

2）认为事件是他们的错。 8岁以下的孩子倾向于认为如果出现问题，一定是他们的错。确保您的孩子了解他或她不是造成此事件的原因。

3）睡眠障碍。有些孩子难以入睡或者会半夜醒来或做噩梦。给您的孩子一个毛绒玩具，柔软的毯子或上床睡觉时开一盏小灯。尝试进行安静的活动或阅读。这个一定需要您的耐心，可能需要一段时间才能再次通宵入睡。

4）感到无助。积极参加活动以防止事件再次发生，给曾帮助过的人写感谢信，关爱他人可以给全家人带来希望和控制感。