In addition to being a co-owner of Lumi Café with his wife Mary, Steve Farmilant is a clinical psychologist with experience in treating trauma-related issues. He offered to write this article to help those who might still be experiencing internal reactions to the tragic event that occurred at the Amphitheater this summer.
The attack of Salman Rushdie on August 12th sent shock waves through the Chautauqua Institution community. The Institution has always been a place of peace and refuge for its visitors, which made the brutal assault all the more horrifying. Although many of us have returned to a place of psychological well-being since then, there are visitors and residents of the grounds who are still experiencing trauma-related anxiety.
Trauma reactions occur when an experience is so complex and overwhelming that it cannot be processed well enough to understand all the nuance involved. The feeling of being trapped in an inescapable situation is basic to this. The mind and body then re-create the experience for the purpose of finally finding a way to make sense of the event, which would provide the individual with a sense of control and freedom. The ironic paradox here is that the inescapability cannot be processed directly. If some escape is found, it doesn’t count, because that sense of inescapability is by definition inescapable.
Trauma is as physiological and psychological reaction to a terrible event that is either witnessed or experienced personally. Common examples include being in a car accident, being mugged, or seeing someone shot or stabbed. Other well-known experiences include being in combat or being assaulted.
The mind and body consequences of experiencing trauma can be different for everyone. Intensity and duration of symptoms, length of time before symptoms are expressed, and need for therapeutic or medical intervention are a few of the variables that make the course of a trauma response unpredictable.
According to the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), diagnosis of trauma-related illness includes a constellation of symptoms: avoidance of reminders to the event (such as refusing to discuss it), intrusive re-experiencing of the event (unwanted thoughts, flashbacks, or dreams), and increases in arousal (startle response, sleep disturbance, and hypervigilance). This cluster of symptoms, when present longer than one month after the traumatic event is called Posttraumstic Stress Disorder (PTSD). If the symptoms abate before one month, the condition is diagnosed as Adjustment Disorder.
Treatment of these symptoms includes some combination of psychotherapy and medical intervention. Although trauma is akin to an anxiety disorder, antidepressant medication does help manage the physical and emotional symptoms. Therapeutic help can come in the form of Eye Movement Desensitization and Reprocessing (EMDR), talk therapy to process thoughts and feelings associated with the event, and cognitive-behavior exercises.
Physiological symptoms can be relieved by progressive relaxation exercises, meditation, and a technique known as 4-7-8 breathing. This involves four or five repetitions of breathing in deeply through the nose for four seconds, holding the breath for seven seconds, and breathing out through pursed lips for eight seconds. The last few seconds of the exhalation will require forcing out the last few bits of air. This exercise can reset the entire central nervous system and bring a sense of calm, at which point the cognitive exercise will be more effective.
Cognitive interventions are developed by identifying the “automatic thought” associated with the trauma. These thoughts can be identified by a “fill in the blank” exercise: I am ___________. I feel __________. I wish I could __________. I should have ___________. Once the automatic thought is identified, a logical argument can be made. For instance, the thought “I am helpless” can be argued by saying “I have many resources”. “I feel guilty” can be argued with a statement such as “I didn’t cause it”.
The exercises and information listed above should begin to help anyone still experiencing residual trauma effects from the attack we experienced this season. If they are not sufficient to return to a sense of comfort after the heinous attack on Mr. Rushdie, I would encourage a consultation with a psychologist or psychiatrist for further treatment.