Responding to Trauma

In the NAMI Peer-to-Peer nine-week education course, the mentors introduce the participants to the "Stages of Emotional Response to Trauma" and ask each of the students to assess where he or she is along this continuum.  It is true that the diagnosis of schizophrenia is a trauma.  My hospitalization in 1987 when I had my breakdown split my life into before and after.  There was no turning back.  Things couldn't go on the way they had.  I adapted as best I could because resilience didn't come easy. 

In the first week of Peer-to-Peer, the mentors suggest that when we are labeled and treated for a mental illness, the events leading up to the diagnosis hit us with "the full force of a tornado through our lives," leaving us confused, bewildered, uncertain, and frightened.  Unlike tornado survivors, though, we are expected to take our medication and get on with our lives, as if nothing has happened.  Or, as is also the case, "we have been given the message that we are so damaged by our illness that we are nearly incapable of anything anymore."  We collapse "under the weight of the shame, the regret, and the lowered expectations of the people closest to us- who are as helpless as we are in the beginning to make things better."

If you are newly diagnosed, or even if you've been in recovery awhile, I want to revisit the stages of emotional response to trauma.  A course like Peer-to-Peer is good for newbies as well as old hands alike.  It holds that trauma is an integral part of the mental illness experience, and gives techniques for understanding and managing the impact of trauma on our lives.

Here now I will define and delve into each stage of emotional response:

1.  Catastrophic Event:

     Crisis

     Chaos

     Shock

     Denial

     Normalizing

     Hoping Against Hope

Providers often use the word Crisis to describe an acute episode.  We marshal reserves of courage to deal with the event.  Chaos is how we describe our minds and our lives.  Things are out of balance and we've lost our equilibrium.  Shock takes many forms, including disbelief or numbness.   We often have no words to express how we feel about what happened, because the episode came on suddenly and left us shell-shocked.  The next, Denial, may be protective.  We are aware that something traumatic occurred, but it is too painful to process right now.  Normalizing comes on in many forms, such as resistance, "I'm perfectly okay and don't need any help," to despair, "I'm so not normal I'm beyond help."  The Catastrophic Event stage closes out with Hoping Against Hope, which keeps us afloat in times of great hardship.  We hope against hope that we aren't going to be sick all our lives.  We have gone through the worst and begin to hope that things can get better.