Moving On After Trauma; A Guide for Survivors, Family and Friends

Help Guide to Moving On After Trauma

If you are concerned about someone badly effected by a trauma, you could use this guide to help them in Moving On After Trauma (the book with this title is available from Amazon.co.uk). Having someone spend 10-15 minutes a week going through a self-help book with the person effected can make a world of difference. Social support is the biggest predictor of how people manage post-traumatic stress symptoms. You may well do as much as any therapist and you do not have to be a therapist. Try the following weekly brief chats:

Week 1: What's Happening To Me?, Chapter One

1. How did you get on reading Chapter One? Did it make you feel understood?
   
   
2. Did you complete the Trauma Screening Questionnaire (TSQ) on page 10?
   
   
3. How many 'yes's' did you put? (More than 6 is probable PTSD)
   
   
4. Did you tell the brief story of what happened by completing the thumbnail sketch on page 21?
   
   

Week 2: Making sense of my reaction?, Chapter Two

1. Does it sound right thinking of yourself as having developed an oversensitive alarm that keeps overreacting?
   
   
2. Does it sound right thinking of yourself as now living in a bubble?
   
   
3. Does it sound right thinking of yourself as like a lemonade bottle without the top on, no fizz?
   
   
4. Did you find one or more characters in the book sounded like you?
   
   
5. How do you feel about trying to follow in their footsteps to recovery?
   
   

Week 3: Resetting the Alarm, Chapter Five

1. Did the idea of gradually daring yourself to do things make sense?
   
   
2. Did you come up with any little 'dares'?
   
   
3. Have you done any dares yet?
   
   
4. How will you reset your alarm without beginning to do some dares?
   
   
5. Have you read any more about the characters in the book who seemed like you?
   
   

Week 4: Better Ways of Handling the Memory, Chapter Six

1. What did you think of the idea that blocking the memory doesn't actually work?
   
   
2. How did you feel about the idea of creating space for the normal things in life by pigeon holing the memory to be sorted out in a special way at a special time?
   
   
3. What way did you think you might try for sorting out the memory in the day so it doesn’t disturb your sleep at night?
   
   
4. Did you try any special ways of dealing with the memory?
   
   
5. You have already made a start confronting the memory of the incident, which is like a 'bully' by doing the Thumbnail Sketch. There seem to be different ways getting the 'bully' to back down such as writing a page a day about the incident and its effects, for 2-3 weeks, after which time you become bored with it instead of re-experiencing it. Could you have a go at that? If the answer is 'no', what about writing about it just once and reading it over out loud 3 times a day? If the answer is still 'no', has your way of handling the memory up to now worked? If the answer is 'no' can you be absolutely sure that trying a different way might not work?
   
   

Week 5: Resetting the Alarm, and Better Ways of Handling the Memory, Chapters Five and Six

1. Are there still things you avoid that you did before?
   
   
2. Which would be the easiest of the avoided things to have a go at?
   
   
3. What could you say to yourself to make it easier to cope with the dares e.g play music, sing? When you tried what you have been avoiding did you spell out the similarities and differences to the incident?
   
   
4. How have you gone on in your special time confronting the bully? Keeping on confronting him/her means he/she backs down. Did it make sense that in writing or talking about it you are coming up with an updated version of it for the mind to work on rather than the old version (which is often fantasy of something worse happening that didn’t actually happen).
   
   
5. Have you read any more about the characters who seemed like you?
   
   

Week 6: Restoring Relationships and Managing Mood, Chapters Five through Eight

1. How are the dares going?
   
   
2. Are there further dares you could try?
   
   
3. How is it going at the special time confronting the bully?
   
   
4. Could you invest a little more in relationships?
   
   
5. Could you invest in small doses in doing some things to give you a sense of achievement or pleasure?
   
   
6. How did you go trying to come up with more objective 2nd thoughts when your mood dips?
   
   
7. Did you use the MOOD record, page 95?
   
   
8. After you had come up with the more objective seconds thoughts did you get on and do things instead of agonise?
   
   

If you are a therapist you could assign reading of Moving On After Trauma as a homework assignment. Structuring sessions and assigning and reviewing homework are the biggest predictors of the outcome of cognitive behaviour therapy. Detailed protocols of CBT for PTSD are given in the authors Counselling for PTSD 3rd Edition (2006) Sage Publications. If you are one of the new breed of Graduate Mental Health Workers dedicated to low intensity work you could provide the 6 chats above using telephone and/or e-mail.