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Section 8
Crisis and Disaster Counseling

Question 8 | Test | Table of Contents

In the last section, we discussed the upsides and downsides of self-blame and discuss three exercises your trauma client can use to forgive himself. These exercises are Freeze Response, In Someone Else’s Shoes, and Talk to Others.

In this section, we will discuss how your client can monitor and control their sensations surrounding their natural disaster trauma.

Like many clients, not only those who have experienced loss through a natural disaster, like a hurricane or earthquake, Tom was having difficulty knowing what he was feeling. The following is a conversation I had with Tom about describing and tracking his sensations. I stated to Tom, "Tom, I noticed when asked how you are doing, you usually offer a vague response such as ‘okay’ or ‘not so good’. For the purposes of this session, I would like to encourage you to really think about what your body is telling you that made you respond with the answer of, for example, ‘not so good’." I then went on to state, "The way you distinguish bodily sensation from emotion; and emotions from thoughts is your ability to locate the sensation in your body and experience it in a physical way. You can identify a sensation by asking yourself when I feel a certain emotion- such as anxiety- how do I know that I am feeling that emotion?"

Describing and Tracking Sensation Exercise:
I used the following exercise with Tom to help him better identify his sensations.
Have your client find a comfortable place and position to sit. Let your client know that if at any time their sensation is too intense, they can slow down or stop all together. Have your client bring in an object that brings them comfort and is special. Tom carried a photo of his mother who had passed due to cancer several years before. Since he described himself as having a positive supportive childhood, mainly due to the parenting provided by his mother; looking at this photo brought him comfort. I then had Tom tune into the sensation he experienced as he looked at the photo of his mother. To facilitate Tom getting into this positive feeling mode, I started with relaxation by stating "feel how the chair holds your weight. Notice your clothing on your skin. Notice how your feet are grounded. Try to feel a sense of groundedness within your whole body. Can you describe how you feel when you look at the photo of your mother?"

I had Tom shift his focus on the safety object i.e. the photo of his mother and then on to his body. Once Tom moved back and forth between the photo and his body, I had him further focus on shifting to an inner sense of where the comfort of the object is experienced in their body.

Once Tom felt comfortable with this part of the exercise, I added the following to the exercise. I stated to Tom, "I would like for you to remember a time sometime in the past few days that you felt most like yourself." I encouraged Tom to notice what bodily experiences he feels while he recalls the memory. Again, have your client shift back and forth between the memory of when he felt most like himself and the current sensations he or she is feeling. Encourage your client to continue this pattern of recalling a memory and experiencing the current sensations. Gradually have your client recall memories of when they felt most like themselves further and further back in time: in the last week or two, last month, etc. When your client has gone through these steps successfully, have them open their eyes and return to the room. Have them look at the object in front of them and again return to shifting back and forth between observing the object and observing their internal experiences.

Tracking Your Rhythms of Expansion and Contraction Exercise:
For many clients facing trauma, like Tom, the traumatic situation lingers and the connection of new situations with the traumatic one stays. The key to dissolving the constriction of the traumatized event is to stay with the sensation until it begins to change. When your client contacts the sensation of the traumatic situation, it will begin to change. The sensation will most likely go through an expansion and contraction, and will oscillate between being worse and getting better. I have found, once my client learns how to control this oscillation between the trauma, they will begin to feel that their emotional pain is more manageable and finite. To begin the exercise, I stated to Tom, "I want you to remember an experience when you felt mildly uncomfortable. Imagine you are driving in your car, looking forward to getting home, when you have to come to a stop when the cars in front of you slow down. You are unable to see the cause of the jam. Now I want you to focus on what you are experiencing with your sensations. Pay attention to where your body feels irritated and continue to focus on the sensation until it shifts."

Do you have a client like Tom who is facing trauma after a natural disaster and can benefit from learning to understand and control their sensations?

Experiencing your Present Environment Exercise:

The following exercise I have found to be effective with clients who are facing trauma after a natural disaster, like Julie whose home was destroyed in a hurricane. It will help the client be able to be present, to see, hear, smell, and perceive their immediate environment fully.

I began the exercise by stating to Julie, "As you return to the outer world, allow your eyes to take in the information. It is normal for the nervous system to take in all the information out of interest, curiosity, and exploration. Trauma limits the exploratory, curious, searching, and looking of your senses. If there is someone else around as you return from your internal exercises, you may want to make contact with that person. This is natural to want to reach out and make contact with the environment when you are not in a traumatized lock-down." Julie found this exercise helpful when she began to lock-down when she was work. She was able to take five minutes to take a complete sensory inventory of her surroundings to ground herself.

In this section we have discussed how your client can monitor and control their sensations surrounding their natural disaster trauma.

Source: Rothschild
Reviewed 2023

Update
Lessons Learned from Natural Disasters around Digital Health
Technologies and Delivering Quality Healthcare

Lokmic-Tomkins, Z., Bhandari, D., Bain, C., Borda, A., Kariotis, T. C., & Reser, D. (2023). Lessons Learned from Natural Disasters around Digital Health Technologies and Delivering Quality Healthcare. International journal of environmental research and public health, 20(5), 4542. https://doi.org/10.3390/ijerph20054542


Peer-Reviewed Journal Article References:
Everett, A., Sugarman, O., Wennerstrom, A., Pollock, M., True, G., Haywood, C., Meyers, D., Raines, A., Wells, K., Johnson, A., Arevian, A. C., Sato, J., & Springgate, B. (2019). Community-informed strategies to address trauma and enhance resilience in climate-affected communities. Traumatology. Advance online publication. 

Fox, J., Gupta, R., & Mitchell, G. (2018). Considering developmental concepts from attachment theory to inform graduate student training in global trauma and disaster psychology. International Perspectives in Psychology: Research, Practice, Consultation, 7(3), 189–201.

Grolnick, W. S., Schonfeld, D. J., Schreiber, M., Cohen, J., Cole, V., Jaycox, L., Lochman, J., Pfefferbaum, B., Ruggiero, K., Wells, K., Wong, M., & Zatzick, D. (2018). Improving adjustment and resilience in children following a disaster: Addressing research challenges. American Psychologist, 73(3), 215–229. 

Hansel, T. C., Osofsky, H. J., Steinberg, A. M., Brymer, M. J., Landis, R., Riise, K. S., Gilkey, S., Osofsky, J. D., & Speier, A. (2011). Louisiana Spirit Specialized Crisis Counseling: Counselor perceptions of training and services. Psychological Trauma: Theory, Research, Practice, and Policy, 3(3), 276–282.

Kenny, M. C., & Kasian, E. (2011). Review of Crisis and disaster counseling: Lessons learned from Hurricane Katrina and other disasters [Review of the book Crisis and disaster counseling: Lessons learned from hurricane katrina and other disasters, by P. Dass-Brailsford, Eds.]. Psychological Trauma: Theory, Research, Practice, and Policy, 3(3), 309–310.

Morris, A. J. F. (2011). Psychic aftershocks: Crisis counseling and disaster relief policy. History of Psychology, 14(3), 264–286.

QUESTION 8
What two things does your client shift their focus on in the Describing and Tracking Sensation Exercise? To select and enter your answer go to Test.

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