Secondary Survivors
Paula R. Smith
Critical Incident Responder, Acworth, Georgia
Compassion fatigue, unwelcome grief, unwanted trauma, fear, and PTSD/STSD enter our homes and lives via the nightly news. As reporters interviewed survivors and their families, we were moved to respond with gifts and sympathy, realizing how vulnerable we are. In order to remain the “salt of the earth,” we must prepare, educate, and discipline ourselves to respond more effectively in our present world situation. What do we do? How do we remain calm and recover from our own tragedies? The Bible is full of examples of traumatic grief, disasters, and tragedy and how to thrive in spite of them with God’s assistance. We need to resolve the “issues” of our own lives so we can be available to be the arms and hands and feet of the church. The whole world is watching and in need of God’s strength, direction, and love.
The capacity for compassion and empathy seems to be at the core of our ability to do the work and at the core of our ability to be wounded by the work. – Charles Figley, Ph.D., Florida State University
The World Trade Center disaster is no longer the lead story for the nightly news. Americans have moved on to Olympic scandals, Enron, the Middle and Far East, and the constant possibility of continued world conflict. The exception to this procession are the secondary survivors—families of disaster employees, debriefers, and disaster workers who continue excavating, searching, and coping with reexposure and constant sensory reminders. Each and every day, they are completely entwined in grief and trauma while the rest of the world is encouraging and even insisting that everyone “move on.” As clergy, professional counselors, and Christian friends, we are being called on to expand our expertise to assist these primary and secondary survivors.
Office paper and paper clips (among other things) awaken my memories of one walk to Ground Zero the week following the WTC disaster. I cannot comprehend the family’s and disaster worker’s daily struggle with sensory references since I struggle with the mere sight of a paperclip on the sidewalk miles and moments away. Regular sounds, smells, sights, and even vibrations in the present can bring troubling, disarming visions, odors, and noises from past traumatic experiences to today’s surface. Grief and other uncomfortable emotions can also emerge from entirely different painful events, causing the past and present to melt into a tangled, inarticulate mass. It is impossible to impose order on all this chaos, but that is exactly what we all attempt to do, causing further frustration and adrenaline-insulin imbalances. Physiological disturbances caused by the original traumatic event can perpetually duplicate that trauma throughout the rest of our lives without invitation or permission.
The whole country suffered with compassion fatigue for at least the first 90 days following the 9/11 tragedy. This was due to constant media exposure (which lowers our immune system), our compassion gene, and also because of our own past woundedness and need to avoid future pain. A loving father God, who fearfully and wonderfully created us, placed this gene into our DNA. This trait actually surfaces in personality and psychological tests and can motivate or paralyze us, but it will always capture our attention. Our bodies make a choice to run to, run from, or freeze when threatened. It is one of the reasons we continue to be vulnerable to Post-Traumatic Stress Disorder (PTSD) and Secondary-Traumatic Stress Disorder (STSD).
PTSD and STSD can affect the disaster survivor, the person standing next to the survivor or victim, significant others of the survivor (or victim), and persons standing next to the survivor’s (or victim’s) significant others. We were all standing too close via the nightly news and constant update coverage, viewing sights that otherwise would have been worlds away. Some were moved to respond with gifts of blood, money, written thanks, and notes of encouragement. Others turned off the TV and continued with their busy lives. And then there were those who became paralyzed and frozen in the moment by choice or compulsion. Families, neighbors, and those vicariously standing too close can be secondary survivors. Of course, there are other variables. Prior life experiences, defense mechanisms, coping skills, and support systems will alter symptoms and length of exposure effects.
Compassion fatigue affects clergy, emergency workers, counselors, social workers, crime victims, war survivors, and all involved in the helping professions and their families. As little assistance as members of the helping professions receive, their families receive less. They are sometimes forgotten because they were only standing too close. Family members should be encouraged to follow similar standards that are now in place for disaster professionals. Debriefings, support groups, peer support, counseling, and medical assistance are a few standards in place for emergency personnel. Families and those who work in helping professions should be encouraged and allowed to take care of themselves often and continually.
How can we assist and support our neighbors and brothers and sisters in Christ? How can we counsel and be lifelines to those paralyzed by their traumatic experiences? First, we must be absolutely sure and have no doubt that we ourselves have resolved the questions that survivors have about God and suffering. How can we help a hurting, dying world if we struggle with their same question of “How can a loving God let something like this happen?” We must be prepared to pray and project the confidence that the primary survivors and families of victims need in traumatic events. We must already have that total confidence in a “very present help” (Ps. 46:1b).
There are other things that professionals and friends can do to assist the families of survivors (or victims) and helping professions:
• Encourage, but do not pressure them to talk about their own emotions, reactions, and feelings.
• Help to educate them with things you have learned.
• Offer unconditional love and support..
• Assist them in reestablishing their normal routine.
• Validate their stress, fears, and grief. Their reactions are normal; the event was the abnormal element.
• Walk them around, get them moving. Even a short walk with some fresh air can provide a whole new outlook.
• Pray hard and constant, with and for them.
• Hugs are good, but ask first, just in case this is uncomfortable.
• Ask them what they need. Treat them as the expert they are now.
• Be prepared to ask for help yourself if it begins to feel overwhelming. Trauma’s wake is contagious.
This article is not meant to be an assessment tool or offer diagnostic criteria. Education and information are primary interventions. This is your introductory course. One resiliency factor that can be addressed before trauma and crisis is balancing the information that is retrieved in the microseconds the following the crisis. Knowing now who are in Christ, what we are promised in the big picture, not just the moment, and breathing in peaceful truth instead of confusion and lies will provide some of the necessary faith-full substance. When trauma explodes, up to 70% of your brain-bound oxygen is diverted into your muscles to propel you somewhere else. Don’t forget to breath deeply and slowly to restore your ability to think and make beneficial decisions.
Preparing yourself for crisis and trauma is a necessary “habit.” In Ephesians, we are instructed to buckle the belt of truth (preventing exposure and penetration) along with the breastplate of righteousness, shield of faith, salvation helmet, peace shoes, and word sword – a complete “habit” or seamless covering of our physical, mental, and spiritual being (6:11-17). As Christians, we are instructed to put these articles on now, not just when, because when will come. One of the lies that continually is perpetuated and believed is that we will be immune to all tragedies. We are only promised God’s strength, love, peace, and presence. Prepare now for when. Fill your mind, body and spirit with the Word now, so it can easily flow out every pore in the next traumatic event. Counseling and support by your living example speaks volumes to victims.
Take care of yourselves when trauma occurs. Learn what to do and do it. Take a class, read some trauma material, consuls with experts and past victorious survivors of traumatic events (including Paul, David, and Job). Caregivers (professionals and families) have a tendency to be uncomfortable with the reverse role. You cannot bear another’s burden if vicarious trauma (or your own) has immobilized you. Get into the daily ritual of caring for yourself, sharpening your own saw, and then continue in difficult times. Develop and maintain a thankful attitude, evening the midst of tragedy. Wait for the authentic peace of God. Deal with present hurts and emotional turmoil as they surface and decide now to not allow those feelings to continually trespass. Take care of yourselves as long as it takes. There is no expiration date on self-care. If the back of your hand is Velcro-ed to your forehead while your exhaustion whines, I had a hard day, I deserve a hot fudge sundae for dinner, your mouth is lying and your primary care physician can surgically remove that Velcro. You deserve a healthy salad and balanced grains, three liters of water, a brisk walk, and a good night’s sleep, or perhaps a power-nap. Schedule these items in your appointment book to keep focused on self-care.
Another way caregivers can benefit is by continuing to take care of themselves and allowing other caregivers to do the same. Supportive empathy and tolerance are necessary. Some caregivers will need to retire (briefly or permanently) from this role. We as part of the Christian caregiver family must allow them to make that choice for themselves. I do not mean that they are allowed to gently disappear from our midst, but they should be allowed to change their functions, if necessary, without stigmas. Some professionals and their families will need a hand accepting assistance when unhealthy reactions occur and persist. Trauma work is not for everyone and is no more lofty than the important job of vacuuming the church building, childcare, or serving meals. One of the things that I specifically pray about is the spiritual and emotional health of the responders and for the general public to allow them to be human rather than only heroes. Falling from tall pedestals is incredibly painful and requires a lot of spiritual rehabilitation. It is stubborn pressure to be a hero every day and have to live up to that reputation, when you know you are as vulnerable as the people you have just rescued. Each of us must be allowed to grief all the way to hope.
And now for the empirical data from the source—Jesus is our perfect example in all life situations. He was always a participant in life, not just a spectator. He knew who he was; there was no doubt. He cared for his human self, could soothe himself and others in distress, and successfully managed daily stress. He knew the Word and could recall its comforting conciseness. He was an effective time manager. He frequently practiced his faith, walking on water, healing a traumatized world, and encouraging others to do the same with their God-given DNA uniqueness.
My final advice to families and caregivers would stem from my own personal experience. God’s grace (empowering presence) continues to fill in the gaps where my lack is abundant. His words continue in my heart. “Don’t look at the waves, Keep our eyes on me.” His final command is crystal clear to me. “Go everywhere, tell everyone about the real me, with love, by your life example, and don’t worry, I’ll always be right there with you.”
REPRINTED WITH PERMISSION FROM MARRIAGE & FAMILY: A CHRISTIAN JOURNAL, Vol. 5, Issue 4, 2002. Permission given by George Ohlschlager of the American Association of Christian Counselors.