Signs that indicate you should seek help from a therapist

What you need to know:

  • In the first few days, it’s best simply to talk to family, work colleagues and friends.

As we take stock after a truly terrible week, many people are asking how those who were affected — including the rescuers, medics and journalists — can be helped to recover psychologically from their experiences.

In the first few days, it’s best simply to talk to family, work colleagues and friends. Well-meaning organisations often offer counselling immediately after or even during events like this, thinking to prevent future problems.

But there’s no evidence that this does any good at all. And strong suggestions that it can create problems where none exist.

However, “debriefings” for workgroups can be very helpful, providing they are not held too soon. A good timing in our case would be early this coming week.

So if you’re an employer whose organisation was affected, for example, you might like to consider asking a psychologist to lead such a discussion for your staff. After which specific individuals can be followed up as and when needed. 

If you or one of your family were involved, the best approach is to monitor yourself over the next few weeks. If you begin to feel that your recovery is stalling, then that’s the signal that you should consider getting some professional help.

But what sort of issues might you be facing? Think back over the events of the last week. You may have experienced real fear, perhaps considerable pain, and recurring anxieties at all sorts of levels.

In addition to any physical injuries you may have sustained, you may also have suffered real distress from “fight or flight” reactions, for example panic, high heart or breathing rate, sweating, pallor, intestinal distress and so on.

RUNNING ON ADRENALINE

During the actual attack, you might have been “running on adrenaline” and may not even have noticed your fears or physical symptoms — even injuries — at the time. You might have had to behave very bravely in defence of your own life, your family or even complete strangers.

You might have experienced a heightened sense of awareness, even confidence or euphoria as the situation unfolded, and especially as you escaped. Or you might have been completely disabled by fear.

It’s possible you were calm and competent throughout. Or agitated or panicking. Everyone is affected differently, depending on their own unique circumstances, background or training.

Your psychological reactions after the event — and over the the next few days, weeks months and even years — may also vary enormously, from mild to incapacitating, depending on your particular circumstances.

To your surprise, you might find that you recover quickly. People are astonishingly resilient and, after grieving for lost loved ones, you will probably go on swell despite all you have experienced. You may even feel stronger for it.

But you also might become depressed, or have panic attacks, anxiety, nightmares or sustained grief. Or feel guilty for having escaped while others suffered or died.

And yet, it’s still likely that all the help you need will be family support: kind words, someone willing to listen, prayer. But it’s also possible that your distress might become debilitating.

And become full blown Post Traumatic Stress Disorder (PTSD).

Maybe soon, maybe even years later. You might well appear quite normal, even to yourself, but somehow you’re not. Your joy in life destroyed.

Your peace shattered. You may suffer poor concentration, emotional outbursts, health problems — or lose your job. You might feel very much alone. Cut off from life. Or be angry or sad all the time.

You may have a hyper-alert nervous system, or be detached, or have intrusive thoughts or flashbacks. You may start drinking heavily. I’m afraid the list of possible problems is very long.

So everyone who has been touched by the tragic events of this week should watch themselves and their loved ones for possible problems. And no one should feel any shame at whatever difficulties they experience.

Children and women are likely to have the worst symptoms, as is anyone who already had a lot of stress in their life.

We must all grieve, and most of us will gradually recover with help from family, community, religious leaders and friends. But those who don’t will need psychological support to prevent their memories of this week from getting stronger rather than fading away.

Sadly, psychologists have had a lot of experience of PTSD. From wars, via 9/11 to individual acts of violence. At its simplest, they simply provide the best kind of listening ear — understanding and empathetic.

Not very different from an incredibly patient family member — especially older therapists with many years of experience. But, in more difficult cases, they also have very effective tools to deal with PTSD.

Cognitive behavioural therapy. Graded exposure. Cognitive restructuring. Memory reframing. Nightmare control. Group techniques. So do get help if you need it.