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“I keep seeing his drooping lip and the look of fear in his face when they were putting him on the stretcher in our bedroom,” said 63-year-old Evelyn during her first psychotherapy session about the night her husband suddenly had a stroke two years before. “It was so shocking and upsetting. I don’t want to remember it, but it plays in my mind sometimes — like I’m rewatching the same horror movie.”
No one forgets moments of great danger. In fact, our memories of such crises can have a clarity and power that haunt us. In the course of their duties, family caregivers like Evelyn may be exposed to many haunting scenes — sudden medical events; bedside vigils in hospital emergency rooms and ICUs; and fearful times when their loved ones suffer calamitous falls, severe confusion or unremitting pain. More recently, some Americans have also had to deal with the devastating effects of natural disasters, such as hurricanes and fires, which disrupted and even threatened the lives of affected caregivers and care recipients.
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According to the American Psychological Association’s just-released “Clinical Practice Guideline for PTSD,” overwhelming events such as these can be defined as “trauma” and may cause a host of negative psychological aftereffects that usually show up months or years after the danger has passed. Foremost among them are so-called flashbacks of the event that suddenly crash into our conscious thoughts unbidden and unwanted. These memories can make us jumpy or numb us to our own emotions. We may begin avoiding people and places that remind us of the trauma in the hopes of squelching our memories. We may never regain a sense of complete safety and then always be keyed-up and on guard against new dangers around the next bend.
This was Evelyn’s main concern. Her husband had, in fact, mostly recovered and resumed many of his previous activities. But she still doted on him anxiously during the day and, at night, stared at him while he slept to reassure herself he was not having another stroke. He thought her increased attention to him and her overall fearfulness were excessive and annoying at times.
How can caregivers like Evelyn decrease the psychological impact of trauma? Here are some ideas.