Survivor Reactions

Surviving a traumatic event

Most traumatic events have a degree of randomness about the way they occur. Natural disasters, transport accidents, criminal incidents and other events occur without a particular relationship to the individuals involved.

When some people die or are injured, survival may depend on being prepared, past training, experience or fast reactions. For most people however, survival can depend on just where they happened to be in relation to the danger. Surviving and being physically unharmed does not mean a person is unharmed emotionally. Survival is often associated with complex emotional reactions which cause distress and make it hard to resume life after the event. What are common survivor reactions?

A number of common emotional responses have been observed among survivors of traumatic events:

• guilt and blame: feelings of guilt and self-blame that somehow their survival is at the expense of those who died or were injured
• unworthiness: the feeling that people should be spared because they are special, good, worthy or have some special gift - but that doesn’t apply for themselves
• I should not have survived: the feeling that the survivor should have died along with the others and should not be alive, so they are unable to resume their old life
• loss of connection to the old life: a dramatic, unusual event does not fit into the life the person was living previously and the person does not feel able to go back to ordinary every day concerns when so many other lives are permanently altered
• disorientation: the feeling of not knowing what it all means, what occurred is outside anything that ever happened before.

Positive post-traumatic growth

Some people find that the experience of survival has a dramatic positive effect:

• life is given new meaning, perhaps with strong humanitarian or spiritual values;
• everyday things are appreciated and no longer taken for granted;
• renewed sense of purpose to make the best use of the time available;
• increased appreciation and values for relationships with family and friends;
• increased value for community.

Why do feelings of guilt and unworthiness develop?

Normal social life assumes everyone is of value and everyone cares to some extent for others, even those they do not know. There is a basic sense of commonality between people and a bond of empathy so that when something happens to unknown people sympathy is evoked. These feelings connect the members of a community so they take care of each other by being considerate, polite and abiding by social rules. As long as things are normal this bond is in the background.

When something goes wrong, the bond people feel for each other comes into the foreground. They rush to help anyone in need regardless of whether they know them. They are caring and concerned, showing the underlying emotional involvement with other people that holds society together. The general social bond remains in the background; but when people have seen others die, tried to help them, or someone was injured (when they might not have been), this bond becomes emotionally energised and can feel as strong as what they usually feel to those closest to them. People feel strongly attached to the people involved in the event and may not full understand this reaction. When those they feel emotionally connected with are hurt or die people naturally feel guilt and unworthiness: that they should have suffered instead.

Why do people feel a lost connection to life?

Close involvement with death and injury can evoke significant and overwhelming emotional reactions. They swamp normal patterns and people find it hard to go back to routine tasks and no longer have the same motivation. heses emotions are unfamiliar, strong and demand attention, but the person may have no way of continuing involvement with the event. The old life no longer has the same importance yet there is no way of expressing the complex feelings that may be occurring This can lead to a sense of lost connection with the old life and disorientation in the direction of life.

Who experiences survivor reactions?

Any survivor of a traumatic incident can experience guilt, unworthiness or disorientation: including helpers, witnesses, emergency first responders, families and healthcare providers.

When should people seek help for survivor reactions?

Survivor reactions are a normal consequence of being involved in a tragic event. However, if they do not resolve, or if the person has experienced other mental health conditions, considerable distress may result and for some people this can lead to mental health problems. Early support from trained professionals can prevent complications and ease the recovery journey.

Professional help should be sought when:

• reactions are interfering with normal life and relationships.
• the event does not seem to fade and the feelings are not subsiding
• loss of interest in previously enjoyable or meaningful activities
• isolating themselves
• difficulties with sleep, eating, mood, relationships, work or leisure
• thoughts of self-punishment, self-harm or taking risks

Close involvement with death and injury can evoke significant and overwhelming emotional reactions. They swamp normal patterns and people find it hard to go back to routine tasks and no longer have the same motivation. Theses emotions are unfamiliar, strong and demand attention, but the person may have no way of continuing involvement with the event. The old life no longer has the same importance yet there is no way of expressing the complex feelings that may be occurring This can lead to a sense of lost connection with the old life and disorientation in the direction of life.

Helping people with survivor reactions?

The following advice can be provided to people that are experiencing survivor reactions:

• Talk to supportive people who will not express judgement. Explaining your emotions may help you to step back and get things into perspective.
• Don't try to talk yourself out of the reactions, being logical about what happened is often not enough to take them away, but it is important to compare the reality with your beliefs.
• Remind yourself you are human. All anyone can do in an emergency is what the situation allows.
• Try not to compare yourself with others - everyone is different - instead try to evaluate your situation on its own merits.
• Don't try to ‘work off’ guilt by setting high standards of achievement, it rarely eases feelings of unworthiness. Instead try to confront what is driving the feelings.
• Traumatic events often bring people face to face with death and the great mysteries of human existence. Understand and accept this is a journey of learning rather solving a problem or finding the explanation.

Where can people seek help for survivor reactions?

• Mental health specialist, such as a psychiatrist, psychologist or social worker, with experience in treatment of PTSD

• Community health centre

• Australian Centre for Post-traumatic Mental Health Tel. (03) 9035 5599

General telephone counselling services can provide advice:

• Lifeline 13 11 14

• GriefLine 1300 845 745

• BeyondBlue 1300 224 636