Module 2 Stress and Coping

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Module 2 -Stress and Coping
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Into every life a little rain must fall ..

• But what happens when there is a flood?

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Learning Objectives

• Use the terminology of stress and coping
• Describe how people react to and cope with stress
• Describe common reactions to loss and grief
• Employ guidelines for the provision of
  psychological support

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Stress

• A state of physical and/or psychological arousal
• Often brought about by a perceived threat or
  challenge
• May be expressed differently by different
  cultures

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Stress Reaction Phases

• Acute phase
• Reaction phase
• Repair phase
• Reorientation phase

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Acute Phase

• Lasts minutes, hours or days
• Fight or flight response preparation for
  physical activity
• Narrowing of focus decreases ability to think
  properly
• Emotional reactions disbelief/consternation/fear/
  grief
• Rigid behavior irritability, anger, etc. affects
  communication
• Panic is rare but if present, requires immediate
  attention

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Reaction Phase

• Lasts one to six weeks
• Delayed reactions previously repressed or denied
  feelings will surface
• May be overwhelming, bringing feelings of
  powerlessness

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Reaction Phase Characteristic reactions

• Fear of returning to the site of the event
• Dreams or nightmares
• Anxiety, restlessness, insomnia
• Muscular tension, tremors and exaggerated startle
  response
• Increased irritability and isolation, depression
• Disturbing thoughts about survival, relief, guilt
  and grief
• Perceived images of how others suffered in the
  disaster, i.e. how they died, how they injured

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Repair Phase

• Lasts one to six months
• Reactions are less intense, and not so
  overwhelming
• Feelings of hurt continue, but are more
  manageable
• Renewed interest in everyday life
• Makes plans for the future

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Reorientation Phase

• Approximately six months after a distressing
  event and continuing
• Heightened stress reactions are substantially
  reduced
• Grief reaction may not be resolved but is
  accepted
• Most reactions will diminish gradually
• Assessing ongoing needs is important

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Coping with Stress

• Coping is a way to prevent, delay, avoid, or
  manage stress
• Coping mechanism categories
• Changing the source of stress
• Changing the view of the situation
• Tolerating the stressor until it passes or
  becomes less troublesome

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Examples of Coping

• Seeking help from others or offering to help
  others
• Using natural support systems
• Talking about their experiences and trying to
  make sense of what happened
• Hiding until the danger has passed
• Seeking information about the welfare of loved
  ones
• Gathering remaining belongings

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Examples of Coping (cont.)

• Beginning to repair the damage
• Burying or cremating the dead
• Following religious or cultural practices
• Setting goals and making plans
• Using defenses like denial
• Remaining fearful and alert to further danger
• Thinking long and hard about the event

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Activity 6 What if

• Activity Break into pairs. Imagine that there
  is flood in your community. Your family's income
  is based on farming, and you lose all your crops
  in the flood.
• Take 5 minutes to discuss three (or more)
  actions, thoughts, beliefs, personal
  characteristics or strengths or aspects of your
  culture that would help you to cope with the
  situation.

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Loss and Grief

• Loss is a common theme in most disaster settings
• Common reactions to loss
• Denial, numbness or shock
• Bargaining
• Depression
• Anger
• Acceptance
• Reorientation

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Loss and Grief Signs of Trouble

• Avoiding or minimizing emotions
• Using alcohol or drugs to self-medicate
• Using work or other distractions to avoid
  feelings
• Hostility and aggression toward others

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Activity 7 Another point of view

• Activity Break into small groups of 3-4 people
  discuss the situations and possible emotional
  responses of the following people
• A widow. Your home burned down, the cause is not
  yet determined.
• A parent. Your home burned down and you have
  lost all your work tools in the fire.
• A teenager. Your home burned down and your
  parents were injured in the fire while rescuing
  you and your sister.
• A recent immigrant to this country. Your home
  has burned down and it brings back memories of
  war in your homeland.

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Emotional Numbness or Extreme Agitation

• Immediate attention is needed
• Possible referral for professional care
• When referring
• Inform the person of your intention
• Recognize that the referral may cause a negative
  reaction

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Guiding Principles in Providing Psychological
Support

• First protect from danger
• Focus on physical and material care
• Be direct, active and remain calm
• Focus on the here and now situation
• Provide accurate information about the situation
• Assist with mobilization of resources

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Guiding Principles in Providing Psychological
Support (cont)

• Do not give false assurances
• Recognize the importance of taking action
• Reunite with family members
• Provide and ensure emotional support
• Focus on strengths and resilience
• Encourage self-reliance
• Respect feelings and cultures of others

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Activity 8 Guiding Principles

• Give an example of something specific you could
  say or do in each of the previously discussed
  principles.

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Crisis Intervention

• Observe safe practices by showing concern for
  your own safety
• Remain calm and appear relaxed, confident and
  non-threatening

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Crisis Intervention Steps

• Assess the situation
• Establish rapport
• Identify the main problem (s)
• Deal with feelings and emotions
• Generate and explore alternative coping
  strategies
• Formulate an action plan
• Follow up