30
from. Such trauma might be children observing domestic violence, a
couple going through a bitter divorce, a person nearing retirement but
losing his/her job, etc. Not that these aren't bad experiences, but the
point is that most people are not crushed by similar experiences; some
even become stronger ("what doesn't kill me, makes me stronger").
Thus, the important question is: What makes some of us prone to
serious disruption by trauma while others have the means to handle
it? (While we are considering cognitive factors, we should keep in mind
that some intense fear responses seem to be permanent while others
fade--see conditioning in the next section.)
Peterson and Moon (1999) agree that a catastrophe, such as
combat, auto accident, cancer, rape, divorce, death of a loved one,
etc., and a mental state, including various ways of coping or
catastrophizing, combine to produce an individual's unique emotional
reaction to a crisis. It should be helpful to distinguish (a) the inevitable
stress and disappointment accompanying a traumatic event from (b)
the victim's unhealthy cognitive or physiological reactions which
exacerbate the emotional stress reactions. It seems likely that the
bigger and more threatening you perceive the catastrophe to be and
the less control you feel you have over its consequences, the more
upsetting the situation is likely to seem to you. These are similar to
the psychological/cognitive conditions that give rise to depression,
pessimism, low self-esteem, anger, and other emotions (see later
chapters).
Peterson and Moon give some advice about avoiding or coping with
catastrophes: (1) guard against unjustified optimism--instead of
thinking "Oh, I'll be safe," we can, for example, prevent or reduce auto
accidents by recognizing and acting to avoid the true risks of drinking,
speeding, tailgating, road rage, sleepiness, cell phones, neglecting
seat belts, children fighting, and believing you are a super driver at
high speeds. (2) One can shift one's thinking from pessimism to
administered programs (Fresco, Craighead, Sampson & Koons, 1997)
for thinking in less catastrophic ways which might also result in
reduced trauma reactions. (3) As discussed above, after a catastrophe,
debriefing can reduce the chances of PTSD developing in the most
vulnerable 25%. Support groups usually help. Also, specific cognitive-
behavioral programs have been written, e.g. for rape survivors (Foa,
Hearst-Ikeda & Perry, 1995), to reduce the long-term emotional
trauma. (4) Finally, chronic anxiety, such as in stress or panic
reactions or PTSD, and overly helpless, depressive, or pessimistic
thoughts can be treated with Insight therapy, Cognitive or Rational-
techniques, such as positive reappraisal, distancing, and some of the
techniques used with chronic pain, seem to also be effective. So, our
response directly to trauma can be reduced. And, we can also have
some control over the intensity of our long-term unwanted reactions to
trauma.
