Try to focus on what you can influence

Forest fires, war, threats and violence dominate the news every day. And not everyone can handle that equally well. Journalist Floor Bakhuys Roozeboom therefore entered into a conversation with crisis and trauma expert Andrea Walraven-Thissen: how do we increase our mental and emotional resilience in times of crisis?

A photo of a mother, daughter and son lying dead on the sidewalk, next to the trolleys they used to flee. A photo of a man shot and killed, lying on the sidewalk in front of his house, his hands tied behind his back. A photo of a dead woman’s hand, mud under her nails painted red.

When images of victims of the war in Ukraine came out last spring, many people were deeply moved. Some struggled to properly process the horrors on their screens. Many felt a sense of powerlessness. So many images, so much suffering, the feeling that there is nothing you can do. How do you deal with that? Andrea Walraven-Thissen, crisis counselor and trauma expert, shared a thread on Twitter with insights and practical tools for dealing with such horrific images. Her advice was widely shared and appreciated by many.

Just a few tweets, because I notice that many people suffer from all the terrible war images. First of all; it is very personal how images affect you and which images are difficult to get rid of. If you are tired, sick or otherwise not feeling well>— Andrea (@Walrathis) April 5, 2022

For some twitterers it may have been their first introduction to Andrea Walraven-Thissen, but in her own field and field she is an established name and a much sought-after expert when it comes to crisis management and trauma prevention. She grew up in Limburg, but has been living in Germany for eighteen years. From there she works in various countries as an expert in psychosocial assistance and is involved in extremely violent situations, such as attacks, major traffic accidents and suicide.

Whether it concerns seeing violent images in the media or experiencing a violent event yourself, according to Walraven-Thissen there is one common denominator: “It is almost never the intensity of an image or event itself that has the deepest psychological traces. Powerlessness has the most impact. If you want to prevent trauma, you have to give people back a sense of control.” A conversation about psychological resilience in times of crisis.

As a result of the images from Ukraine you talked about the circle of control , the circle of influence . Can you tell something about that?

“It is very personal how images affect you and which images you find difficult to get rid of. It is also very personal which events make such a deep impression that people continue to suffer from them for a long time. Some experience something horrible and keep psychologically nothing about it, others do. We now know that the extent to which someone has felt powerless and how long that state of powerlessness has continued play an important role. Breaking that state of powerlessness or at least that feeling of powerlessness is then crucial. You do that by shifting the focus back to your own circle of control : in other words, what someone does have influence over.”

How do you do that then?

“By providing a trade perspective. One of the first things my colleagues and I do when we get to the scene of an emergency is to give people back a sense of control. Often in the form of an assignment, a task with a beginning and an end. “Making coffee. Getting water. Holding an IV. Helping someone else. Answering questions they know the answer to.”

Why is that so important?

When a situation is overwhelming, giving someone back a sense of control is crucial. That’s what my colleagues and I always try to do in emergency situations.”

At what times are you called up?

“In the event of events, crises or emergencies that are estimated to exceed the normal mental capacity of people. Attacks, major accidents, disasters, missing persons. Sometimes I am on site to direct and advise on what is needed to I sometimes support international colleagues remotely. Sometimes I provide training to emergency services or agencies. And in Germany, my colleagues and I also drive as a uniformed service when the emergency services are called via 112. Just like in the Netherlands, I you have a button here in the control room for the police, fire brigade and ambulance, but in Germany you have an extra button for psychosocial support.such as in the event of an accident with several deaths or a suicide, then we come along to provide psychological first aid.”

How does it work when you arrive somewhere?

“When my colleagues and I arrive, we often find distressed people. They often express themselves in very different ways. Some people scream. Others cry. Some are very busy helping others. that is all very normal behavior and a healthy reaction to a violent event. The body and brain have then found an outlet for the strong emotions, allowing it to regulate itself. Simply put: reacting strongly to a violent event is normal. When my colleagues and I try to estimate who needs help the most, we look at the people you don’t hear, the people who turn all the way in, are pale and silent, stare and stop moving, those are the people we go to first.”

“ ‘Certain parts of the brain go offline, as it were’

“These people show signals that their brain is not able to process the situation properly for a while. In a simplified way, you could say: if the brain does not know how to handle a severe situation, the brain can go a bit ‘locked’ out of self-protection. parts of the brain then no longer work properly, they go ‘offline’, as it were. You also see that talking no longer goes well, that focusing no longer works. In an emergency situation, my colleagues and I try these people as soon as possible so we can stabilize them. Basically by pulling their heads out of the lock a little bit more carefully.”

How do you handle that?

“I once came to a house after a report where a family drama with a lot of violence had taken place. Numerous emergency services were on the spot. An entire arrest team had already gone through the house. When I made a round of the house and got to the attic, I found a child there, a girl. She had been sitting there all this time. Dead still, frozen. My first priority then is to get her out of that frozen state very gently. Not by asking about her emotions or comforting. Also I’m not going to ask at that point what happened.”

“What I do do is try very calmly to get someone back in. Take a lot of rest. Take a lot of time. Keep a little physical distance, so that someone feels safe. A very subtle look to see if you can find an entrance. In this case, the entrance turned out to be a guinea pig that was standing in a cage in the attic. I started talking not to the girl but to the guinea pig. And slowly I noticed that the girl found it interesting anyway. She looked, she listened. For example, I said I was curious about the name of the guinea pig, and the girl answered me.

That is an important moment, because when someone speaks for the first time or actively looks at you, that is the moment when you see the brain come ‘online’ again, as it were. In a brain that is in acute stress, the inner part, the emotional brain, is very active, but the outer part, which also includes speech, is inactive. So if you can get someone to speak again, you are literally pulling the brain out of that acute stress response. That’s why singing helps when you’re scared.”

You often see that people experience the same violent event, but react very differently to it and look back on it differently. How did that happen?

“Vulnerability plays a role. Just as you are more susceptible to illness if your physical resistance is lower, you can also be more psychologically vulnerable if your mental resistance is lower. For example because you are tired, have already been through a lot, are overwhelmed or want another That’s why you don’t feel comfortable in your own skin. Everyone also takes different baggage with them from their own life, which means that images and events land differently in everyone and evoke different emotions.”

“ ‘I have to actively break through the identification at that moment’

“Identification is often a factor. You see something in an image or event that you recognize and link it to your own life. For example, a deceased child in a photo is the same age as your own child. Or a piece of clothing someone is wearing resembles a clothing of your loved one. And so there can be other factors that make you strongly connect with an image or event. And these are different for everyone. For example, if I hear in an accident that a policeman keeps repeating that the child died wears the same shoes as his own child, then that is a signal to me.

I may feel the urge to put an arm around that person out of empathy and to show understanding for the fact that those shoes evoke so much emotion. But what I have to do at that moment is actively break through the identification. I do that by asking that person about their own child. What is your child’s name? How old is your child? Where is your child? What is it doing now? In doing so, I break the link between the child who died in an accident and my own child. By distracting the thought and by focusing on the reality: this is not your child. Your child is at home. Your child is safe. And then I say, for example: when you come home, you will give your child a big hug. With which I bring someone back to their own circle of control .”

In the twitter thread you shared, you wrote that you can also apply this principle to horrific images in the media.

“That’s right. Violent images can have a really strong mental impact. How well you mentally withstand violent images depends, among other things, on your mental toughness or vulnerability at that moment and, for example, also on the duration of the exposure. And here too. you see that identification often plays a role. If you are mentally more vulnerable, if the identification is very strong, or if the exposure continues for a long time, you can really start to notice this in the form of anxiety, depression or other psychological complaints.”

What should you do if you notice that?

“Actually you can then apply the same basic principles as I would to stabilize someone in a crisis situation. First of all: stop the exposure where possible. So in the case of heavy images in the media: stop scrolling, turn off your TV, lay down Put your phone away and consciously do something else Is there anything in the images that reminds you of something or someone in your own life Break the identification: remind yourself that you are not in that situation yourself, that it is not your loved one is in the picture or in the video. Go in your mind to the people you love, think about what they are doing, call them, or go to them and give them a hug Give yourself a simple command, such as taking a walk, petting the dog or making a cup of tea Bring your attention back to your own circle of control.”

You could also say: perhaps it is sometimes good if horrific images arouse intense emotions, because otherwise we would not allow the weight of certain events in the world to sink in sufficiently.

“Certainly. But just as in an emergency there is a difference between recognizing that a situation is serious and dangerous and going into total panic, there is also a difference between being swept by images and events and being completely paralyzed by them. the latter you are not helping anyone. If you have watched so many horrific images from Ukraine that you can no longer sleep and can hardly function at work, then you are not helping the victims on the spot either. That does not mean that you are completely must close for the suffering of others.

If you notice that the news and images from the war affect you a lot, then my advice as an expert is: give yourself a trading perspective and focus on your circle of control . Find out which goals you can support. Sign up as a volunteer. Actively do things to help. That is not only better for your own mental health than endlessly scrolling through those images. You also help others more. The point is: guarding your own mental toughness doesn’t make you indifferent. By taking good care of yourself, you can actually be better for others.”

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