Helping people with trauma after a disaster - 2
A guest blog by Frank Cole, a UK Trauma Healing facilitator
Dr Frank Cole, a retired GP, has been leading Trauma Healing Institute training courses for 15 years in UK, South Sudan, Ethiopia, Cameroon and elsewhere. Based on his experience, he provides additional material to the Trauma Healing Institute (THI) document ‘Helping People after a Disaster’ as featured in a previous blog.
The ‘Helping People after a Disaster’ document gives an overview of the traumatic response to a crisis and an outline of how sufferers can be helped.
Trauma healing materials have so far focussed on the help that can be given when sufferers are on their way to recovery and can cope with reflecting on their experiences. This is months and can be years after their crisis. Not much material has yet been produced that can help with the practical care in the immediate aftermath of a traumatic crisis. This article seeks to address this. Some of this is more relevant if you are using church facilities as a shelter for those that have experienced trauma. Please report your experiences and comments.
Trauma healing ministry in a crisis cannot be done independently. It is only one part of a package of care. In fact, it needs to be blended into everything else that is done. All care givers and care giving described in this article have a role to play in the recovery from trauma.
Much of this ministry is practical and can be provided even across language barriers. Smiles and a gracious, caring attitude speak volumes. Prayers are addressed to God but God’s Spirit ministers into the lives of those we pray over even if they do not understand the language used.
Personal and Immediate Care
1. Do your best to satisfy practical needs (perhaps in association with statutory or other secular or charitable organisations):
Food and drink.
Change of clothes.
Female hygiene products (refugees are mainly women)
Have plenty of tissues available.
Make available the means to recharge the batteries of phones and digital devices.
Have good internet access available as needed.
And provide all these with a smile and a welcome. People need to be affirmed.
2. Provide hugs or a touch on the arm, whatever is culturally appropriate. Bear in mind that physical touch can have a powerful affirmatory role but must be used with care.
3. Pray with people, quote or read scripture if appropriate but do not ask for or expect active participation (even saying ‘Amen’ may be too much).
4. Talk to them generally – keep it pleasant and lightweight – just hearing a friendly voice is comforting and may be all they need at an early stage. They may not respond verbally because they are too stressed, or you do not have a common language. That is OK. Do not ask searching questions about their experiences but invite them to talk if they wish.
5. If they wish to talk about their experiences, there are only two questions to use:
How did you feel?
Do not ask for details. You do not need to understand. You must not even try to understand for your own sake if nothing else, as you will be traumatised. Just get them to talk, for as they talk they are talking to themselves and talking is a tool God has given humanity to help us get started on the Journey of recovery and healing.
6. Later on when they have shared more deeply ask, 'What was the hardest part for you?' This is not counselling. It is not intended to be. It is facilitating – helping sufferers express themselves so they gain a measure of control over their experiences. They will need to do this repeatedly and each time it enables them to progress on the Journey of recovery and healing. It is only some months later when they are well on their way on the Journey that they will benefit from a formal trauma healing group.
7. As soon as they are able and ready, get them involved in their own care. Let them take responsibility. They may be particularly helpful in welcoming newcomers.
8. People need a place to gather. Those who are best equipped to help people in a crisis are their fellow sufferers so ensure there is a place to meet relatives and friends, pass on news, share stories, help each other settle into their new environment, etc. They may not know how to unburden themselves from their memories of loss and the troubles they have been through, but fellow sufferers are best placed to understand. Talking together eases loneliness. And there will be less of a language barrier. Groups may get going spontaneously, but if not, do what you can to encourage this.
9. Give them opportunities to get news but use caution. Not everyone will want to watch or listen to non-stop news, though news needs to be available for those who do want it. Try to ensure people have access to a mobile phone and the internet so they can keep in touch with their family and friends. This also helps them to recover their sense of control.
10. They must not be neglected. They need the same practical help as adults. Learn their names and speak to them directly, though without excluding parents or other responsible adults.
11. They need opportunities to play with toys and use paint, pen and paper to draw and colour. They need books and electronic devices to read, study and play that are relevant to them and their experience. They may be better able to express their inner griefs and fears in play activities, as they are unlikely to have the vocabulary to express in words their experiences and fears. Having carers available who are familiar with how to facilitate this, would be a blessing.
12. They must be given explanations about what is going on that are relevant to their ability to understand. Do not ignore this. Otherwise, they will invent their own story to explain what has and is happening and that can have deep and significant effects on their personal development for years to come. Encourage parents and their community leaders to talk with their children.
13. Teenagers need to be treated more like adults. Give them responsibilities. Involve them in activities. Train your own teenagers to get alongside them.
Caring for the caregivers
14. Those who are involved in providing this care are themselves going to be traumatised. Listening, seeing and absorbing emotions such as fear and anxiety all cause secondary trauma. They could have nightmares, stomach aches, headaches, be irritable and anxious and have other stress symptoms. They need regular, even daily, debriefing. Again, the best people to help are themselves. They cannot share all they experience with family and friends who are not involved because that will traumatise them and the cycle of harm will spread wider, so they too need to meet in groups for mutual support. If this is organised formally, consider going into twos or threes to discuss how the day/session has gone. Swap stories. Weep together. Laugh together. Hug. Pray for each other. This is a healing process. Have someone share out tissues, cups of tea, biscuits, etc.
15. Regularly gather everyone together. Pray over them and read Scripture. Commend them to God's care and encourage them to consciously bring the hurts of the day, the memories and the pains they have experienced to Jesus. It can help to do this in a ceremony such as having a stone for everyone to pick up and bring forward and place at the foot of a cross while saying something like, ‘I hand over to you, Jesus, the hurt and pain I have experienced today and leave them with you.’ This is taking Jesus at his word, ‘Come to me, all you who are weary and burdened, and I will give you rest’ (Matthew 11:28). The ceremony enhances their decision. You may need to do this frequently. In time carers will learn to take their hurts to Jesus as new traumatic experiences occur in the middle of their ministry, without needing a ceremony. This takes away the pain of the memories but not the memories themselves. However, the memories do fade over time as they are no longer stimulated by the associated emotional response. We are not to carry such burdens. Jesus does that. This is all part of our salvation!
16. Have a regular, perhaps weekly, gathering of carers for further debriefing, spiritual nurture and training to help develop skills and self-confidence. This should include training in listening skills, pastoral praying, an appreciation of the Journey of recovery and healing and the help that is needed at different stages, recognising personal and communal limitations and how to access other resources. See https://traumahealinginstitute.org/resources for resources you can use or adapt to help develop your team’s knowledge and skills.
Looking after care givers will enhance their attitude, interest and ability to relate to the refugees in their care. And that will speak powerfully of God’s gracious care even in the most stressful of times and across language and cultural barriers.
17. Do not take on too much frontline care yourself, though your presence when able will be an encouragement to the team. You need to protect yourself from secondary trauma and your main responsibility is caring for caregivers, overseeing and planning and keeping in touch with other caregiving agencies in your locality. Appoint a small leadership team to oversee this ministry. If your church community is too small to cope with all of this just do what you can – every little helps – or liaise with other churches and work in partnership.
18. Have someone take responsibility for practical resources, cleaning and hygiene. Develop a scheme for keeping records of contacts, for both individual carers and management. Liaise with other groups and agencies.
19. Develop a whole-church ministry with prayer support, child minding facilities for frontline carers, practical helpers, befrienders, receptionists, those who care for the carers, children’s carers, teenage carers etc. Even children can be helpful in befriending, especially with the elderly and of course, other children.
20. Prioritise the care of carers. Watch out for those who are feeling the pressure of the ministry and need to step back.
21. When planning what to do, bear in mind the ‘T’ features of Crisis Care 101:
a. Talk – those who have been traumatised need to talk about their experiences but may need help in discovering how best to express themselves.
b. Time – there are no ‘quick fix’ answers. This is a journey with ups and downs, side turnings and blocked roads that all need to be negotiated.
c. Tears – emotions need to be expressed.
d. Tea – cups of tea are an English way of expressing compassion, empathy and sharing that helps barriers to come down. Each culture will have a similar activity.
e. Touch – physical contact needs to be used with discretion, but it is a powerful means of expressing empathy, compassion and care.
It has been said that ‘trauma is perhaps the greatest mission field of the twenty-first century' so do not be surprised if there is a gradual turning to God by new believers and previous believers rediscovering their faith. The Psalms are likely to be helpful in Sunday sermons, especially the Lament Psalms as they are about going through bad experiences that cause trauma and are written by sufferers. They are remarkably relevant to these modern day crises but need to be seen in their poetic structure and with an understanding of how trauma damages us in our whole being especially emotionally and spiritually.
You can contact Frank Cole by email here.
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