Understanding triggers and responses
The potential consideration
People leaving countries due to conflict are likely to have experienced trauma directly or indirectly and lived through significant stress whilst trying to find a way of keeping themselves and their families safe. Being hosted in a safe country is an amazing gift to receive but for the person it may not mean that they are able to relax and feel relieved. It can take time to adapt to this new life and feel truly safe. As a host it can be difficult to know how to support someone through this process. This article aims to explain why people may continue to feel at threat and how those around them can offer a containing environment whilst also caring for themselves in the process.
The psychology facts
When thinking about trauma it is helpful to think about the different ways that life events can impact upon our wellbeing. Trauma is conceptually split into 2 types both of which can have significant impacts upon wellbeing and both of which may be present in people fleeing their homes due to war. “Big T trauma” refers to distressing events that we are involved in or witness that pose a risk to the life or body-integrity of ourselves or someone else. This is the type of trauma associated with Post Traumatic Stress Disorder. “Little t trauma” refers to distressing events that do not necessarily have the perceived risks of big T trauma but have a significant impact upon a person’s wellbeing due to the risk they pose to factors that are important to a person. When we think about the situations a refugee might have experienced they may have experienced both types of trauma. A person may have experienced life threat to themselves or others alongside witnessing war but also be experiencing the loss of their home, communities and livelihood.
Trauma of both sorts can fundamentally change the way we see the world, can make us feel helpless or out of control and have a significant impact upon our emotional wellbeing. In addition to these understandable difficulties, the way that our brain processes and makes sense of trauma is different to the way in which other experiences are stored in our memory and this can cause significant difficulties. The reason for this is that during a traumatic experience our brains function to survive and therefore the focus is on action to remain safe rather than making sense of what is going on. Sometimes after the event our brains might go back and do the processing but sometimes they don’t and therefore memories become fixed in the moment. This is compounded by the fact that our brain naturally doesn’t want to go back and look at something painful. For people leaving their homes due to war there are additional complications in relation to processing due to the sheer number of traumas they may experience and that it is likely to take a significant amount of time before they reach a sufficiently safe place for them to feel able to explore these experiences. This may mean that as they become settled into their new homes some refugees may be living with significant impacts due to trauma, below is a brief overview of the impact that trauma can have.
The impact of trauma:
Memories of traumatic events are stored differently meaning that they are vivid, distressing and fixed in that moment. Unlike other memories which feel like they exist in the past and are perhaps more vague trauma memories may feel like you are right back in that moment of threat seeing, feeling and thinking all the same things you did in that moment.
Trauma memories that are not processed can leave the person feeling that they are at constant threat this means that they may be hypervigilant, easily startled, struggle to relax, have difficulties concentrating and feel strong emotional responses… essentially all the things you would expect to experience whilst living under threat.
Trauma memories are easily triggered, the brain is hyperaware of any factors in our experience or environment that are reminiscent of the trauma so triggers could be small or difficult to anticipate but take the brain straight back into that moment of trauma.
Flashbacks occur in trauma, this is where a person experiences sudden involuntary reliving of a traumatic event usually due to a trigger. People experiencing flashbacks may experience significant distress, physical responses or may act out their actions from the moment
Night time can be difficult for people experiencing trauma as they may experience distressing nightmares and are often more susceptible to flashbacks when falling asleep or waking up.
Experiencing the symptoms of a trauma response can be incredibly distressing for the person experiencing them and can also be distressing for those around them. This is why it is important to consider that these responses are an understandable response to past stress and trauma. It is our brain and body trying to keep us safe and prevent them from experiencing trauma again. People who are living with these experiences will not only benefit from validation and support from those around them but may also need to seek professional support if symptoms persist, in order for them to have the space and expert help to process what they have lived through and find a meaningful way forwards.
Tips for managing this as a host
Having someone who experiences hyper-vigilance or flashbacks living in your home can be difficult, you might feel a range of emotions due to witnessing someone’s responses or you yourself might feel hyper-vigilant or that you are walking on eggshells trying not to cause distress. Here are some tips for caring for yourself during this process:
Make time for self-care. When someone is living in your house it can be intense especially as you get to know each other. Make sure that you are doing the things that keep you well whether that is spending time outside, exercising, engaging in hobbies or faith, we are all different but make sure that you are making time to do the things that matter to you.
Remember we are not responsible for other’s emotions. It is great to be mindful of other’s needs, but it is not always possible to ensure that other people are happy. Particularly in relation to trauma, the responses you might see are due to someone else making sense of their experience so don’t criticise yourself if you accidentally startle someone or notice they are distressed, you can only do what is in your power.
Don’t put your life on hold. Your needs matter too so if you want to watch the news or a war movie but know this is triggering for your guest it doesn’t mean you can’t do this. Instead use communication and boundaries to negotiate this, perhaps making the guest aware so that they are able to avoid this if they would prefer.
Remember your role. Being a host who is warm and welcoming is an amazing gift to offer, if someone is experiencing trauma responses however it is important that they receive professional support. Don’t feel responsible to try and work through their trauma or talk through it with them in detail as this can cause more distress for them and open you up to vicarious trauma. Instead, be validating of their difficulties, signpost them to support services and support them with a safe place to live.
Look out for signs of vicarious trauma in yourself. We will be posting an article on this later in the series.
Tips for supporting your guest
Whilst it is not your responsibility to support someone through post-traumatic responses, there are some things you can do to make someone’s journey easier:
Normalise and validate their experiences. If someone shares that they are struggling express to them that this is entirely understandable and encourage them to seek support from the appropriate services.
Don’t ask someone for information that they don’t volunteer. Allow someone to share the bits of their experience that they want to but be mindful of intrusive questions that could lead to distress.
Allow someone space. If someone appears far away or is moving unusually, they may be experiencing a flashback. Allow them space and don’t raise your voice or touch them as this could be distressing. Once they reconnect with the present moment you could help them to orientate themselves if needed or support them to feel more grounded by making them a drink, offering them something to smell or touch or simply reminding them they are safe.
Try to be mindful of potential triggers and communicate to reduce impact. Depending upon your relationship with your guest you may have discussed their triggers but if not it might just be a case of giving your guest a heads up if you are doing something that you think may have the potential to cause distress. Common triggers could be things such as the news (be mindful or discuss with the person if they are happy for the radio or TV to be on in the background or newspapers lying around), loud noises (such as fireworks), planes flying overhead or large vehicles passing, weapons (in the house, as part of hobbies or toys), violent video games or movies etc.
Consider personal space. We all have different norms and needs in relation to personal space but for people who have experienced trauma this is particularly important, allow the person plenty of personal space, try to avoid following them closely behind, looking over their shoulder or touching them when they don’t expect it. As a rule, follow their example in relation to personal space and physical contact, it might be your norm to offer a hug if you see someone distressed but others might find this intrusive or culturally inappropriate so get to know your guest and follow their lead.
Discuss with your guest if there are things that can help them to feel safe e.g. having a lock on their room, sitting in a particular position, calming images or furnishings etc.
Signpost to resources. We would not advocate for a host to play therapist, but there are lots of self-help resources that are freely accessible and may help your guest manage trauma symptoms while they are waiting to access professional help. Here is a great PDF about managing flashbacks.
Dr Nicola Griffiths