NLP Trauma Recovery Manual

Trauma Recovery: A Manual For NLP Practitioners

Richard Bolstad et alia, Use Permitted as Needed

Contents
RESILIENCE, RECOVERY AND CHRONICITY ................. Resilience, Recovery and Chronicity .......................................... Patterns of Resilience and Recovery ........................................... Patterns of Chronicity .................................................................. Key Questions ............................................................................... 3 3 5 6 7

IMMEDIATE RESPONSES ....................................................... 8 Problem Ownership ..................................................................... 8 Roadblocks to Communication / Reflective Listening .............. 9 The Worst Is Over (Verbal First Aid)......................................... 10 Acknowledgements: NLP Responses to Major Disaster ........... 12 MANUAL: ENGLISH VERSION............................................... RESOLVE Model ......................................................................... Purpose of This Information. Getting Practical Help First ...... Helping People in the First Weeks .............................................. Preparing for the Trauma Process ............................................. Factors That Make the Process Work ........................................ The NLP Trauma Process ........................................................... Eye Movement Integration .......................................................... 13 13 14 14 15 18 19 22

MANUAL: JAPANESE VERSION ............................................ 24 MANUAL: SAMOAN VERSION................................................ 35 CIVIL DEFENCE HANDOUTS AND APPENDICES ............ 43 A Guide For Emergency Response Workers ............................. 43 Research Form .............................................................................. 49

Resilience, Recovery and Chronicity

When a traumatic event occurs, a neural network is set up with memories of the event (VAKOGAd), instructions about attempted responses (K), a time/place coding (Hippocampus) and an emergency rating (Amygdala). If the emergency rating is low enough, a pattern of Resilience occurs, where the person is distressed by the event but able to keep functioning normally. If the rating is high enough then at least for some time a PTSD-style response will occur and the person will have severe difficulty performing normal daily functions. The neurotransmitters which connect the new neural network are those present at the time, which is likely to include a lot of transmitters such as noradrenaline and adrenaline. The aim of the Amygdala connection is so that in any future similar events, the neural network will have override priority and be able to stop the Frontal Cortex (Conscious Goalsetting etc) from endangering life by thinking through a planned response. While this mostly saves lives, occasionally it results in a panic response which is triggered accidentally by sensory stimuli that are themselves not dangerous. In that case most people will gradually edit the neural network over the next couple of months so that it no longer interferes with everyday functioning, a pattern called Recovery. Some people have a pre-existing thinking style which makes recovery difficult (eg a pattern of constantly checking in case something bad is about to happen again) and they will then continue to have problems long term, a pattern called Chronicity. Which of the 3 patterns will occur is determined by the pre-existing thinking style and model of the world, previous experience of similar trauma, the severity of the current traumatic events, and the social support available at the time of the current trauma.

Trauma and Human Resilience

Epidemiological studies estimate that the majority of the U.S. population has been exposed to at least one traumatic event, defined using the DSMIII criteria of an event outside the range of normal human experience, during the course of their lives. Although grief and trauma symptoms are qualitatively different, the basic outcome trajectories following trauma tend to form patterns similar to those observed following bereavement. Summarizing this research, Ozer et al. (2003) recently noted that roughly 50%60% of the U.S. population is exposed to traumatic stress but only 5%10% develop PTSD (p. 54). However, because there is greater variability in the types and levels of exposure to stressor events, there also tends to be greater variability in PTSD rates over time. Estimates of chronic PTSD have ranged, for example, from 6.6% and 9.9% for individuals experiencing personally threatening and violent events, respectively, during the 1992 Los Angeles riots (Hanson, Kilpatrick, Freedy, & Saunders, 1995), to 12.5% for Gulf War veterans (Sutker, Davis, Uddo, & Ditta, 1995), to 16.5% for hospitalized survivors of motor vehicle accidents (Ehlers, Mayou, & Bryant, 1998), to 17.8% for victims of physical assault (Resnick, Kilpatrick, Dansky, Saunders, & Best, 1993). Although chronic PTSD certainly warrants great concern, the fact that the vast majority of individuals exposed to violent or life-threatening events do not go on to develop the disorder has not received adequate attention. It is well established that many exposed individuals will evidence short-lived PTSD or subclinical stress reactions that abate over the course of several months or longer (i.e., the recovery pattern). For example, a populationbased survey conducted one month after the September 11th terrorist attacks in New York City estimated that 7.5% of Manhattan residents would meet criteria for PTSD and that another 17.4% would meet the criteria for subsyndromal PTSD (high symptom levels that do not meet full diagnostic criteria; Galea, Ahern, et al., 2002). As in other studies, a subset eventually developed chronic PTSD, and this was more likely if exposure was high. However, most respondents evidenced a rapid decline in symptoms over time: PTSD prevalence related to 9/11 dropped to only 1.7% at four months and 0.6% at six months, whereas subsyndromal PTSD dropped to 4.0% and 4.7%, respectively, at these times (Galea et al., 2003). Bonanno, 2004 Bonanno, G.E. Loss. Trauma and Human Resilience American Psychologist, January 2004, Vol. 59, No. 1, pages 2028 (Quote from page 24)

Patterns of Resilience and Recovery

The American Psychological Association says research suggests "10 Ways to Build Resilience", which are: (1) maintaining good relationships with close family members, friends and others; (2) to avoid seeing crises or stressful events as unbearable problems; (3) to accept circumstances that cannot be changed; (4) to develop realistic goals and move towards them; (5) to take decisive actions in adverse situations; (6) to look for opportunities of self-discovery after a struggle with loss; (7) developing self-confidence; (8) to keep a long-term perspective and consider the stressful event in a broader context; (9) to maintain a hopeful outlook, expecting good things and visualizing what is wished; (10) to take care of one's mind and body, exercising regularly, paying attention to one's own needs and feelings and engaging in relaxing activities that one enjoys. (11) Learning from the past and (12) Maintaining flexibility and balance in life are also cited. In the research below, Japanese ancestry Americans had only 14% of the incidence of PTSD that European ancestry Americans had. That beats any PTSD treatment success rate I've read about! Polynesian (in the research, specifically Hawaiian; in many ways the same culture as New Zealand Maori or Samoan) ancestry also reduced PTSD rates to 35%. Resilience is pretty much the core successful human response to disaster that NLP seeks to remedially create (in fact NLP goal-setting, reframing and dissociation are all listed in the 10 points above). Note that research show that resilience is not a set personality trait so much as a set of actions you can choose to take. Also note that in the same research, a past history of being a survivor of violence almost doubles the risk of PTSD (177%). Good relationships buffer us from harm, bad ones signal a need for extra support. Schnurr, P.P., Lunney, C.A., and Sengupta, A. Risk Factors for the Development Versus Maintenance of Posttraumatic Stress Disorder, Journal of Traumatic Stress, Vol. 17, No. 2, April 2004, pp. 8595

Patterns of Chronicity
Adapted From Andy Austin These strategies or patterns of thinking may seem innocuous during easy times, and then create Chronicity during traumatic times. To the person, they seem normal ways of approaching challenges, and it can help to show them how these patterns ensure that positive change is impossible. Having done that it becomes possible to install more resilient patterns, for example installing new key questions. The Big What If Question Yes, but, what if which means(an impossible to manage scenario)? The positive intention of negative What if? questions is to attempt to anticipate and find solutions to future challenges, but by running it on impossible scenarios, the person is locked in panic. 5

The Big Why? Question Why did this happen to me? The positive intention of past-related Why? questions is to find new meanings, but the person rejects each possible future-oriented meaning and keeps searching as if trying to find a meaning which can change the traumatic event or recreate the past.

The Big Maybe Response When asked to scale their current experience of an emotion, or give any report on their internal experience, the person says they are not sure, or prefaces their answer with Maybe. The positive intention of Maybe responses is to avoid mistakes such as false hope, but by refusing to commit to any specific data, the person can never measure change and can never experience success.

Testing for Existence of The Problem Rather Than Testing for Change Even though 99% improvement might be made, if the person with chronicity is able to locate just 1% of the problem existing, this will generally be seen as representative of 100% of the problem existing. The positive intention of Can I still do it? responses is to detect and respond to danger effectively, but by failing to notice improvement the person continuously reinstalls the entire problem.

Negative Nominalisations The person talks about their traumatic responses as if they were things rather than actions. I have Trauma, I have PTSD, I have a Wounded Inner Child, I have a Clinical Depression.. The positive intention of Negative Nominalisations is to explain what is happening by labelling it, but the result is that the processes being discussed seem permanent, damaged and even become personified as malevolent, and so are unable to be simply changed.

Being At Effect rather than Being At Cause By being at effect the person experiences emotional problems happening to them, rather than being something that happens by them. A person at effect will seek treatment rather than seek change. Questions such as Will this work for me? or statements such as It didnt work for me. And It worked for a day and then the problem came back. Presuppose that the problem and the NLP process are 100% responsible and the person themselves is 0% responsible for their own results. The positive intention of At Effect responses is to explain what is happening without being at fault, but by not allowing for the possibility of their responses affecting their internal experience, the person makes it impossible to change their experience.

Three Stage Abreaction Process The person has a nocebo (I will not please; the opposite of placebo) response to NLP processes where they have an uncontrollable negative response to all interventions designed to actually help them change, although they permit interventions which maintain their problem. The positive intention of Abreaction responses is to protect the person from feared results of the change process, but it blocks all change. Stage 1. Signal (Implied Threat of Emotion) eg This is making me feel ill. Stage 2. Increased Amplitude of Signal (direct Threat of Emotion) eg Now I really feel sick. Your process is harming me. Stop or I will start screaming! Stage 3. Abreaction (Punishment of the Practitioner) eg vomiting, convulsing, running out of the room screaming, uncontrollable crying.

Key Questions
Deciding what youll ask of life! Adapted from Steve Andreas (Core Questions) 1. Resourceful state; Rapport 2. Ask them what situation, or what context they want to find the core question for. (eg. at work my relationship with my kids dealing with a client/student) 3. As you think of that situation, imagine stepping back into your body there. Notice what you see through your eyes there, what you hear, and what you feel in your body. Be aware of how you are deciding what actions to take. 4. If there were a question that quietly guided all your behaviour in this context, what would it be? 5. Now think of that question. Check that when you say that question to yourself, it reminds you of the situation. (Youre checking it has the same submodalities; ie feels like thinking of that situation itself). 6. If you knew, what is your unconscious minds positive intention in asking this question in this situation? If the person tells you a negative intention (like to get me worried) ask And if it gets you that fully and completely, what even more important thing will you get through that? 7. Is there a question that would be even more effective in getting you the positive benefits you want in that situation? 8. If there is, say Id like you to step back into your body in that situation, and say the new question to yourself -actually say it aloud now, as you imagine being in that situation. Notice that when youre in that situation now, the new question is quietly at the back of your mind, guiding your behaviour, and check that that feels much more enjoyable! Imagine a future time, when youll be in that situation again, and check how asking that new question changes the way it feels.

Immediate Responses
Who Owns The Problem?
Different communication skills work in different situations. Learning communication skills is no help unless you also learn when to use which skills. One interesting question to ask any time you are talking, or spending time with another human being is, 'Who needs to have their problem solved so that everyone will feel happy?' If the answer is 'no-one', that's great! In that situation no-one owns a problem, to use a new piece of jargon. If the answer is 'me', then I own a problem, in this sense. And if the answer is anyone else, then the other person owns the problem. This way of understanding situations was developed by Doctor Thomas Gordon, author of P.E. T Parent Effectiveness Training and many other books. Notice that this way of using the words 'own a problem' is different from the way many people use the phrase. For now, I'd like you to get used to this new way of thinking about it. When I talk about someone 'owning a problem', I don't mean that it's their fault, and that they should fix things up or anything like that. I mean that they are the ones who are not feeling happy about things, or who need something to change so they can feel happy. They are the ones who feel angry, hurt, sad, frightened, resentful, embarrassed, or otherwise unaccepting of the situation. The following diagrams explain this model as it is used in this training.
No Problem Area I Own A Problem Other Person Owns A Problem Both Of Us Own A Problem (Conflict)

The Problem Ownership Model

Rapport Problem Solving & Assertive Skills

Helping Skills Conflict Resolution Skills The skills which achieve these aims

Instructions: Read each situation below. Identify, in these terms, who owns the problem 1. The person who shares your workspace plays a radio at a high volume, making it difficult for you to concentrate. 2. A colleague tells you she is worried about failing an important staff evaluation. 3. Your family often have political debates, such as discussing whether Ronald Reagan was a good or bad economist. 4. Your partner expresses disapproval of your taking a training course. 5. A repair shop has failed to meet three consecutive promises to have your car ready. 6. A worker in your department complains that her responsibility level isn't challenging enough. 7. Your partner looks increasingly worried and tense and tells you they cant cope with it all. 8. One of your family members is increasingly late getting the dishes washed, and you end up waiting to be able to use the bench space. 9. Your child fails to turn up on time for a dental appointment that you must pay for anyway. 10. A lot of your work time is spent willingly giving advice to less experienced staff. 8

Roadblocks
Roadblocks are responses intended to be helpful, but which are high risk responses when someone else owns a problem. Thomas Gordon lists twelve such responses. Imagine how it would feel for you if you asked the instructor to explain something in the course and got a response like this...

Solution Giving
Commanding: "Just shut up and calm down will you!" Warning: "If you carry on interrupting I'm not having you in this course." Moralising: "You should have more consideration for those who did understand." Lecturing: "Research shows that a state of uncertainty is a valuable learning aid; it helps you pay attention to the next part." Advising: "Why don't you go out of the room and look it up in the book."

Judgments
Blaming: "There's no-one to blame but you for that is there?" Name-calling: "We really do get some idle-brained people on the course don't we." Analysing: "I'm sure I was quite clear. Are you looking for a bit of attention?"

Denying
Praising: "Good on you for making an attempt to get it. That's the main thing." Reassuring: "You poor old thing. Hang in there; it's bound to make sense later." Distracting: "Maybe we should play a game at this point."

Interrogating
Questioning: "Do you always have trouble with learning? Is there something outside the course that's distracting you tonight?

Reflective Listening
This skill involves reflecting feelings and information from what you heard the other person saying. Colleague: "I'm in a real stew over this class presentation we've got on Monday." You: "You're worrying about how your presentation will go?" Colleague: "Well I told my friend I'd meet him for an early lunch at that time. I thought I'd just skip the project session. I didnt realise it would be important." You: "It's changing your plans at this time thats hard?" Reflective listening is an extremely useful helping skill, and to use it well, you need to be feeling free enough of your own problems to focus on the other person. You also need to trust the person to find good solutions rather than wanting to convince them of your own. This is not a skill for when you want to influence the person. Reflective listening also requires the person to be willing to talk: you can't force them to open up. Also, of course, when simple information is required, you need to give it, not just listen empathically. Reflective listening tells the other that you are interested in their concerns, that you can accept them having problems and trust that they will solve them. It deepens your relationship, as you will really start to hear what clients and colleagues say. That is its risk, and its beauty. As a spin-off benefit, colleagues may benefit from your modelling and start to reflectively listen to your concerns about them. Reflective listening is even more effective when you match the sensory system (visual, auditory, kinesthetic, unspecified) of the person you are listening to. For example, if the person said My week has been so gloomy., you might say Its hard to see the light at the end of the tunnel. If the person said My week has been out of tune. you might say Youve had difficulty finding the theme. 9

The Worst Is Over (Verbal First Aid)

From Judith Acosta and Judith Simon Prager, Jodere Publishing Group, San Diego 2002

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The Worst Is Over (Verbal First Aid) continued

From Judith Acosta and Judith Simon Prager, Jodere Publishing Group, San Diego 2002

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Acknowledgements: NLP Responses to Major Disaster Earthquake 2011

Dr Richard Bolstad richard@transformations.net.nz These instructions are in English, Samoan and Japanese Thank you to: Dr John Grinder, Richard Bandler, Steve Andreas and NLP trainers across the world who created the core method. Asenati Toilolo-Meijn (who translated the manual into Samoan) and The New Zealand Trauma Recovery Team at http://www.traumarecoveryteam.org.nz/nlp-traumarecovery/ who taught the method in Samoa Richard Bolstad, Lynn Timpany, Barbara Belger and other NLP Practitioners in New Zealand who developed the methodology in the Christchurch Earthquake Yuile, Yoko-san; Sakai, Toshihiro-san; Ito, Mayumi-san; and Yanai, Reiko-san who translated these notes to Japanese All the NLP Practitioners in Japan, Samoa, Chile, New Zealand and elsewhere, whose courageous spirit will put this into practice.

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An N.L.P. Model of Therapy (RESOLVE)

1. Resourceful state for practitioner
-self anchoring -clear problem ownership

2.

Establish rapport (pacing)

-rapport skills -match sensory system use -Milton model language eg Verbal First Aid -match clients values/Metaprogram use

3.

SPECIFY outcome.
-How would you know if the problem disappeared? -challenge presuppositions -set wellformed outcome

4.

Open up clients model of the world

-elicit current strategy -pattern interrupt (interrupt the strategy) -pretest. Can you do it now? -content/context reframes

5.

Leading to desired outcome (change techniques)

-anchoring techniques eg Resource Anchor -submodalities techniques -strategy installation -parts work eg Key Questions -Time Line techniques -trance and healing -physiological techniques eg Eye Movement Integration

6. 7.

Verify change Exit process

-test. Can you do it now? Thats right, it has gone." -use clients convincer strategy. -check ecology -futurepace

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English Manual

Contents
1. Purpose of This Information. Getting Practical Help First 2. Helping People in the First Weeks 3. Preparing for the Trauma Process 4. Factors That Make the Process Work 5. A Sample Script for the Trauma Cure Process

1. Purpose of This Information. Getting Practical Help First

This is information for people with expertise in NLP and is not intended for public use. These notes are designed to support certified NLP Practitioners to help people after an earthquake. An excellent Japanese/English manual on preparing for and handling earthquakes is put out in downloadable form at http://www.seikatubunka.metro.tokyo.jp/index3files/survivalmanual.pdf In an event such as an earthquake, the first priority is to save lives and very basic NLP pacing and reframing is useful in the moments of disaster events happening. At this time, what is useful to say includes encouraging people by telling them that they are doing well, that now that the event has happened the worst is over and they can continue to work out what to do. However, physical actions to provide safety, water, food, community support and eventually electricity and sewage become priorities rather than NLP sessions in the immediate aftermath of disaster. In an earthquake, aftershocks continue to happen for some weeks and alertness about danger is a realistic response. Once people feel safer physically, most people will be remarkably resilient and even helpful to others around them, and their unique way of being resilient (which may seem obsessional, selfish, overly rescuing of others etc) does not need to be fixed wih NLP. After some months, 5-10% of people, depending on the cultural situation, will continue to be sleepless, panicking etc and will benefit from the NLP trauma process described in detail below. Some people who have traumatic responses to older events will have them re-stimulated by the current crisis and may benefit from this process earlier, mostly in relation to the earlier events.

2. Helping People in the First Weeks

In the first weeks after the event, there is still real physical danger. So, in sessions it's really important to accept that some anxiety is normal, and that people also need to be able to relax and rest. Realistic Goals Set goals about responding to the current situation in a way that is satisfying. "Ideally, how would you like to be able to respond to this uncertainty?" "How would you need to respond to feel really pleased about how you had coped with this challenging situation?" "Whats important to you about how you deal with this?" 14

Collapsing Anchors Especially any kinaesthetic triggers for anxiety. Useful Internal Questions Most people having problems, and also most people getting prepared, are asking themselves unhelpful "What if..." questions (What will happen if my house falls and crushes me? etc). Encourage the person to ask more useful "how" or "what" questions (How can I best respond now to be safe?). Peripheral Vision Teach clients how to relax using peripheral vision, relaxing their jaw and spreading their vision out to the side, which causes relaxation. Tell them to teach everyone else they know, especially children. This is by far the easiest way to relax without having to think. It's very fast and very effective. Strategies for Dealing with 'Overwhelm' Another common response is overwhelm, or generalised stress. These people need a really good strategy for prioritising and chunking down to a manageable step. The strategy will usually work much better if it also includes a great core question (eg How can I best respond now to be safe?) as one of the steps. (It could also include peripheral vision as one of the steps.) For example: Trigger such as aftershock - How can I best respond now to be safe? - Imagine the first small step and check that it feels ok - do it! They are checking Whats the first step of the most important thing now? Strategies for Dealing with Aftershocks There may be lots of people panicking with aftershocks. Having a strategy for a resourceful response helps. For example count to 3, taking breaths, if it's still moving, go to the safest place such as under a table. Know which place to go in every room you are in. However you do it, support people to have some kind of plan about how they prefer to respond to the ongoing aftershocks and future pace it. Practical Contacts http://www.traumarecoveryteam.org.nz/ info@traumarecoveryteam.org.nz

If you need help with Free Fast treatment for Earthquake Psychological Trauma please call 0800 NLP Recovery 0800-657-732 and they will take your details and get someone to contact you, or to book a free session email : info@nlprecovery.co.nz

3. Preparing for the Trauma Process

1. Be in a Resourceful State Yourself, and Establish Rapport You may be about to hear some disturbing stories that you want to stay dissociated from. You may be about to see people in profound distress. It may be useful to stack a few more resources on to your own resource anchor, and create a 'thought' access for it (not only pressing fingers together or similar) like a 'word' or a colour or phrase, so you can quickly regain resourceful state each time. Be aware of your response to others: especially if you are working in larger centres where there will be an sense of connectedness. This could mean that emotional events (eg more bad news, somebody 15

turning up with anger...) can shift the whole room full of people (they may have all been in rapport for a few days). Become aware of the 'rapport leader' and get in rapport with them,if ecological and ethical, so you can reframe carefully. Match the person's breathing, posture and voice, and reflective listen. 2. Check Their Resourcefulness Is the person able to stay calm enough to talk to you about something pleasant or neutral? If not (i.e. you calibrate the person is distressed or they tell you they are distressed) check with them whether they want to learn how to relax now, so that the experience is easier (this is useful as they may have some misconceptions about an NLP session being the same as a counselling session - i.e. that you need to talk about painful experiences, this would be an opportunity to teach them it will be different to that). If, after helping/teaching them how to relax, this is still difficult you may need to arrange to conduct the session at a later time. There may be some obvious acute physical responses to anxiety that you need to be prepared for; vomiting, hyperventilation, fainting or screaming. We would suggest you have a "first aid kit" handy for such times, which could include a discretely placed bucket, tissues, and a soft cushion / place to lie down. 3. Check What Problems the Person Has Been Experiencing What symptoms of trauma does the person experience? Briefly ask them to tell you, and reflective listen (restate what they say). Reassure them this can change. From their description you may be able to check off many symptoms from the list on the form. Post Traumatic Stress Disorder (DSMIV 309.81) symptoms include: repeated, distressing memories / dreams of event acting or feeling as if the event were still happening intense distress when exposed to images or sounds resembling the event efforts to avoid anything that could remind the person of the event inability to experience a normal range of emotions and interest in life not planning as if life had a future difficulty concentrating, or relaxing, or difficulty sleeping sudden anger / Startle responses nightmares or sleep disturbances Are there any other problems you need to know about (for example, medical problems)? The scaling question could be asked before beginning the script. It says: "On a scale of 1 (neutral or calm) to 10 (the worst they can think of) how bad does it feel now?" You can use this same question in follow-up to check the success of the process. 4. Set the Goal How would the person be acting, thinking and feeling if these problems were solved? If this person's problems were solved, what else would change? Is that okay for them? If not, ask what they need to do to make it okay for them. You are checking for ecology issues eg that the person is afraid that if they don't have their panic, they might not keep themselves/others safe. Use Reframing e.g.: Client "I know that I should try and stop panicking, but I'm afraid that if I get too relaxed I won't be able to respond fast enough if another one happens." Practitioner "You wonder if your anxiety is sort of protecting you by helping you stay alert so you can respond quicker." 16

Client "Yeah" Practitioner "Well I think of it as being like electricity power points in the wall. I know they're dangerous and I need to be alert when I'm round them, but being frightened when I am trying to plug in something doesn't make me safe; it would make me more likely to do something unhelpful. Actually it's being able to be calmly aware that helps me to be most safe." Client "I can't stop thinking that this could happen again at any time. How can I ever feel safe again?" Practitioner "I agree with you that one of the things we learn from events like this is that the world is not always safe. But what happens out in the world is not what causes us to feel safe or feel unsafe. There are many people who are completely physically safe and have never experienced a physical injury, but who have terrible panic attacks. There are many people who live calmly even though their job, for example cleaning windows on high buildings, involves placing themselves in real physical danger. Feeling safe is something that we do inside. What happens in the world is not predictable and not always in our control. What happens inside us can be changed once we learn how to take charge of our brain. Once we do that we can change the things in the world that can be changed, live comfortably in the uncertainty about those things that we cannot predict or change, and learn to choose wisely which situations are which." 5. Give an Overview of the Process Eg "This whole process usually takes less than half an hour. The aim is for you to feel relatively comfortable throughout. Most people find that their symptoms disappear immediately. Your brain learns new responses very quickly." You may give The Person An Experience Of How The Way They Imagine Things Causes Their Body To Respond eg Have the person turn around with their arm stretched out pointing. Tell them "Just go round carefully to where your arm feels tight, and see where you're pointing.... Now come back to the front.... Now imagine turning round again, but this time imagine that your body flows easily way round further, perhaps twenty or thirty centimetres further than before. You'd be pointing at a totally different place. What would you be saying to yourself if you went around that far?... and now turn around with that same hand and see how far you go NOW!" 6. Explain Dissociation in NLP Terms Eg "We are going to teach your brain to react differently to the memories of the event. People can remember events in two different ways. If you think of a simple, enjoyable event you've experienced recently, like eating breakfast today [choose another event if breakfast reminds the person of the trauma], you can remember what you saw through your own eyes [wait for the person to remember] and enjoy all the feelings of eating that breakfast. It may even make your mouth water. That's one way to remember it. Another way to remember it is to imagine seeing yourself sitting in the room eating. Watch yourself over there eating, as if you were watching from a distance. Even make a still picture of yourself, like a photograph, perhaps a black and white photograph. When you see that picture, it's not so easy to get the feeling of enjoying eating breakfast. You need to step back into your body to taste it again. It's quite okay to remember the feeling in your body eating breakfast. But there are some things it's better to step back from, so you can see what happens, but you feel separate from it. People who are enjoying their life can choose which way to remember each thing. We are going to teach your brain to automatically remember those old unpleasant events in a way that keeps you separate from the feelings you had then. That means the other problems you've had will disappear, and you'll get the enjoyment you want in life. Does that sound useful?"

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4. Factors That Make the Trauma Process Work

1. Rapport Breathe in time with the person Sit in a similar position to them Use similar voice tone, speed and volume Restate their comments to confirm you've understood 2. Use Language That Creates Positive Internal Representations of Success Rather than "This may be scary", say "I'm not saying this will be totally comfortable". Once you've started, refer to "the way you used to feel when you thought of this" and "the problem you had", placing the difficulty in the past. 3. Get a Clear Pretest and a Clear, Convincing Post-Test Before, at step 3. of the process, ask the person to notice their anxiety just enough so you and they can confirm that it has been a problem, and they would know if it changed. After, at step 8 of the process, ask the person to try to get back the anxiety and have them confirm that it has changed. If it hasn't, don't try to pretend its working. Actually re-run the process till it works and the person is convinced, or has a plan to test it as soon as possible. Many people do not fully notice the change until you point it out to them. Some people need to try three or even five times to be convinced. 4. Keep the "Roles" or Perspectives in Each Chair Distinct Always speak to the person as if they are actually in the theatre when they sit on the theatre seat. Always speak as if they are actually in the projection booth when they sit in the projection booth seat. If, while in the projection booth seat, the person begins to talk about what it was like inside the traumatic experience, have them stand up and move "out of the projection booth". You want both seats safely separated from the memory. 5. Know Your Choices for Times When the Person Isn't Dissociating a) Have the person stand up and fire their resource anchor. b) Walk around the room with them. c) Have the person get out of the projection booth and imagine they are further away from the movie screen. d) Use the Reframe below 6. Be Clear in Your Mind What a Phobia/Traumatic Response Is in NLP Terms If it could be caused in 30 seconds it can be cured in 30 seconds. Emotionally healthy individuals recall positive experiences associated and negative experiences dissociated. A phobia or an anxiety disorder caused by trauma is just an accidental mis-storage of a memory. 7. Reframe: for When a Part of the Person Doesn't Want to Let the Fear Go "Now I know that there's a part of you that thought it was important for you to hold on to those old feelings. A part of you may have been trying to keep you safe, or to make sure that you really learned the lesson of this event. But holding on to the feeling hasn't actually kept you safe. It has made your life more dangerous by having you live in fear. If that part of you really wants you to have learned from that event, then it will really keep you safe by letting go of the feeling now, and keeping the things you needed to learn." 18

5. The NLP Trauma Process

A Sample Script For The Trauma Process 1. Establish Rapport, Set Up Resource Anchor

"Before we start, what I'd like you to do is to remember a time when you felt in charge of what you were doing, perhaps when you were doing something you know how to do [like baking a cake, or driving a car], and get back the memory of a specific time, so you can step into your body at that time, and see what you saw, hear the sounds, and fell the feeling of being in charge. Now, as you feel that feeling, I want you to press together the thumb and little finger of your left hand and enjoy the sense of being in charge ... Great; now release the fingers and come back to being in the room here, and stretch." Repeat for two other positive feelings instead of "being in charge" e.g. "confidence", relaxation", "humour". Your being able to create that positive feeling in yourself as they think of it will also help. If they can't think of a time when they felt positive, have them remember a time when someone they like had that feeling, and feel what that person must have felt like. 2. Test Resource Anchor

"OK, now stretch and have a look out the window. Just see something you didn't notice before ... Good; now press that thumb and little finger together and feel the difference." Check that the anchor (thumb-finger touch) causes the person to shift their breathing/body position/facial expression back to a positive state similar to the one they used remembering the times. If not, repeat step one, emphasising their re-experiencing each positive state. 3. Pretest

"Right, now before we start, I just want to check this thing that has been a problem. I'd like you to just briefly think about the things that have been upsetting you. What does it feel like to remember that? On a scale of 1 to 10 where 1 is calm and neutral and 10 is the worst imaginable, how does it feel now? Check for a clear shift in breathing, body posture and facial expression. If you need to, to draw them back out, have them stand up and press the thumb and little finger together until they are out of the memory. "OK. Come back to here now. You'll know when that changes now won't you?" 4. Set Up The Movie Theatre

"Now panic attacks [or "flashbacks/nightmares/Post Traumatic Stress/phobias like you've been having"] is just a result of the brain having a scary experience and storing it in a less than useful way. The brain did that the first time you had that experience, and it took it less than 30 seconds to do. So its just that easy to change once we know how the brain did that." "To change it, what we need to do first is set up a kind of movie theatre here. You've been to a movie sometime, so you know there are seats here [point to movie theatre seat] and a screen up here [point to front -ideally a blank wall]. And sitting in the movie theatre here, I want you to see a picture up on the screen, of yourself, a black and white photo. It could be of the way you look now, or of you doing something you do at home, or just a photo like a recent one you've seen in a photo album ... Have you done that?" 19

Good. Now, before you had that experience that was scary, there was a time when it hadnt happened yet, and you were safe. Take all the time you need to remember that time, and make a picture of yourself at that safe time before the event. Put that picture of you looking safe before the event up on the screen now, and turn it to black and white too. Have you done that? Great. And after that experience that was scary, there was a time when it was over, and although you still had memories of the event, you were physically safe. Take time to remember that safe time after it happened, and put a picture of yourself at that time on the screen. Have you done that too? nb if there has not yet been a time that is physically safe, you may need to create an imaginary time in the future. "OK. Now I'd like you to stand up out of that chair and come back here. This is a chair in the projection room from where they show the movie [seat the person now in the second chair, behind the movie theatre chair]. There's a glass screen through which you can see the movie theatre and you can see that other you sitting in the movie theatre, watching a black and white photo on the screen. Can you see that person in the theatre seat?" 5. Run The Movie Forward "Dissociated"

"So now, as you stay in the projection room, safe behind the glass, you can run the movies, and watch as that other person in the theatre watches them. And because there are holes on the side of the glass, you can hear the movie, because we're going to show a movie soon. And youll be safe and comfortable here, maybe with something nice to eat and drink while you watch the person watching the movie." "What I want you to do is to run a movie of yourself in that time when the unpleasant event happened. The movie will start before the event, at the time when you were safe before, and will run through the time after the event, once you were physically safe again. Like any movie, it will show the important parts of the story, form beginning to end, but this movie will be in black and white, like an old film. OK? Now, while you run the movie, Id like you to watch that person the movie theatre. They may have some response to the movie, but you're in the projection room, so just run it through and watch their watching. OK, go ahead, and tell me when you're done." 6. Fast Rewind the Movie "Associated"

"Now, in a moment, I'm going to get you to pretend that you float out of the projection room and into the movie at that safe end scene. It may help you to close your eyes to imagine that. Once you're in the movie, in the body of that earlier you, turn the movie to colour. Then we're going to run the movie backwards, from the end to that safe beginning, but fast, like fast rewind on a video. You've seen a video rewind, but this will go so fast the whole thing will only take a second and a half, so it goes zziiiiiiipp! Got that? Okay, now; float into the movie, at the end, turn it colour and zziiiiipp! ... Once you're done, turn the movie back to black and white, and float back to where you actually are, here in the projection room ... Hi." 7. Repeat until Change Occurs

"OK. Now I want you to be here in the projection booth and watch again as that person in the movie theatre sees the movie through from safe beginning to safe end ... OK? Great; and again, imagine you float into the end and turn the movie to colour, then run it backwards zziiiiipp, and come back to the projection booth once its done ..."

20

"Great. Have a stretch ... Now try and get back that picture at the start of the movie [If they can't, go to step 8]. Now again, watch from the movie projection booth as that person watches the black and white movie, float into the safe end and run it backwards fast in colour, and come back here. Tell me when you're done...". "Good. Now I want you to try to do this process, a bit faster, and do it through as many times as it takes till you can't get back the movie, or you realise that the feeling has suddenly gone. Some people say the movie gets blank spots and fades out; some say it's as if the tape snaps. It's probably started already. Just go ahead and try to run the movie each way till you know you can't. Then tell me ...". 8. Verify Change (Post-test)

"Great. ,And notice that the feeling went with the picture. Okay; now stretch and look out the window. Notice something there you haven't seen before ...". "Okay, now what I want you to do is have a go at remembering that time, and try and get back the feelings you used to have about it." [Smile]. "How's that now? Different!" Check from the person's body posture, breathing and facial expression that this is a different, more relaxed response than the pretest. "Now I'm not suggesting you'll enjoy that thing now. Just that the uncomfortable feeling is gone. There's often a little uncertainty, as you try to go to remember, because this was a reliable response you had. You had that problem for a while, and its strange for it to be different, now. Pretty amazing isnt it?" [Try again until the person realises its different]. 9. Ecology Check and Future Pace

"Now one thing that has happened occasionally, is that when someone had an anxiety, it gave them something to do. So now its important to find out what you can do instead. I'd like you to think of a future time, the kind of time when, in the past, you would have responded in that old way; and notice what you're doing instead, and how you're feeling. How is that? ...". "And think of another situation when, in the past, you'd have had that problem. How is it different now? ... Is that okay for all of you?" On a scale of 1 (neutral or calm) to 10 (the worst you can think of) how does it feel now? "Excellent. Welcome to your new life. That was big change wasn't it!"

21

NLP Eye Movement Integration

Some General Notes Eye Movement Integration (EMI) was developed by Connirae and Steve Andreas in 1989. Similar processes are noted in previous Reichian Therapy, and of course previously NLP trained psychologist Francine Shapiro has a similar method called Eye Movement Desensitization and Reprocessing (EMDR). Compared to EMDR, EMI has less interest in creating a long therapeutic protocol, less interest in conscious memory restructuring, and more flexibility with the movements used. EMI also uses NLP insights about anchoring and eye movement accessing cues. Gestalt Therapist Danie Beaulieu has built a more elaborate model around the method in her book Integral Eye Movement Therapy. Andrew Austin has a quicker protocol which he calls Integral Eye Movement Therapy (IEMT) on which the following notes are based.

Recommended Readings
Austin, Andrew, Integral Eye Movement Therapy Practitioner DVD Set, IEMT, London, 2010 Beaulieu, Danie, Eye Movement Integration Therapy, Crown Publishing, Bancyfelin, Wales, 2004 Shapiro, Francine, Eye Movement Desensitization and Reprocessing, Guilford Press, New York, 1995

22

Integral Eye Movement Therapy (IEMT)

Adapted from Andrew Austin: a) Resourceful state for the Practitioner. b) Establish rapport c) Elicit the undesired state Ask: What is the feeling you want to change? And out of ten, how strong is this feeling, with ten being as strong as it can be? Ask: And how familiar is this feeling? I thought so; thats why its a problem. Ask: And when was the first time that you can remember feeling this feeling now it may not be the first time it ever happened, but rather the first time that you can remember now. Allow the client 20-40 seconds to access an event. Do not offer guidance or advice and allow the client to perform his or her own search. When client has accessed their earliest recollection ask: And how vivid is this memory now? d) Do the Eye Movement Process Tell the client: OK, look at my hand and keep your head still. As I move my fingers hold that memory vividly in your mind for as long as possible and if this memory fades, try very hard to bring it back try as hard as you can to retain that experience. Face the person with your hand a metre from their face. Tell them to stop moving their head, until they actually do stop. Use smooth even movements and a wide range. Move back and forward starting with horizontal movement (A) and then with corner to corner across the centre (C). Do three movements each way. If one movement is very easy, use others. Continue until client protests that they cannot retain or recall visual memory. e) Perform The Three tests Test 1. Ask: And how does that memory feel now? Test 2. Ask: And what happens when you try access that feeling now? Test 3. Ask: And when you think about the possibility of that kind of event in the future now, what comes up for you now? If a negative kinesthetic emerges then repeat the process and locate next memory. f) Variation for multiple issues: As you start to do this, instruct the client: And you can talk to me as we do this. Allow your mind to move around through time to different events, experiences and memories, the logic of which need not make any sense and talk to me as this happens, tell me what images come to mind as we do this Observe closely for state shifting and changes in representation. These are often represented by muscular twitches around the eye etc. At each shift, prompt the clients awareness: Ask: and what was that one 23

Japanese Manual

http://www.seikatubunka.metro.tokyo.jp/index3files/survivalmanual.pdf NLP 510 24

etc. 25

 3 http://h.hatena.com/herbe/243597512623822452 http://blog.twitter.jp/2011/03/blog-post_12.html http://savejapan.simone-inc.com/ http://japan.person-finder.appspot.com/?lang=ja http://www.google.co.jp/intl/en/crisisresponse/japanquake2011.html

) 26

 ) NLP PTSD(DSM-IV 309.81) 10 110 27

 C P C: P: C: P: 30 20 30 28

 NLP

29

 NLP 30 30

5.

1. 30


2.

3.

4.

31


5. 6. 32

 7. 8.

9. 33

34

Samoan Manual Tapenaina ole faasologa o le polokalama.

1. Faavae I le tuufaafeagai Faatutusa le manava, nofo, ma le leo Siaki: pe e logo ma sefe lea tagata i lau fesoasoani atu? A leai, ona faaalu lea o le taimi e faamasani ai i lea, pe tuu atu i se isi tagata. 2. Siaki le faaoaina o le tagata E toa le talanoa atu a lea tagata ia te oe e uiga i se mea manaia, poo se mataupu e le patino ia te oe poo ia? A leai, faaalu lea o le taimi e faamalosi ai ma faamafanafana, faatoa ai, pe filifili se isi taimi. 3. Siaki poo a aafiaga sa ootia ai lea tagata O a auga o le pagatia o loo maua e lea tagata? Afaina talu ona tupu se mea matautia, ma faamamafaina e le tino (DSM-1V) e iai ona auga: -moe miti agai i se mea na tupu -gaioi, ma faalagona mea sa tutupu -le saoloto pe a faalogo i ni leo poo ni ata e tai tutusa ma le mea sa tupu -taumafai e alo ese mai soo se mea e toe manatua ai se mea sa tupu -faigata na toe maua faalagona masani, le fiafia i mea e tupu i aso fai soo -le mau tonu mo le lumanai -faigata ona sologa lelei le mafaufau ina ia maua se toafilemu (ae maise pe a moe) -vave oso le ita, ma le tei i mea A fuaina i le 0 (toa) ma le 10 (tu leaga) o mea e lagona i le taimi nei? (e mafai ona faaaogaina lenei fesili pe a toe iloilo le manuia poo se suiga i lenei polokalama) E iai nisi faafitauli e tatau ona e iloa (pei o ni faamai)? 4. Seti le faamoemoega Pe faapefea gaioiga, mafaufauga, ma faalogona a lea tagata pea fofo le faafitauli? Afai e fofoina faafitauli a lea tagata, o a nisi mea o lea suia? E manao iai o ia i ia mea? A leai, tuufesili pe o le a le mea e tatau ona faia e lelei mo i latou ia? 5. Faamanino pe faamalamalama le faiga o le polokalama atoa Faataitaiga O lenei faasologa e lalo o le afa itula. O le naunautaiga mo oe ina ia malolo, ma sololelei i taimi uma. O le tele o tagata latou te le toe mauaina auga ia sa iai pe a maea le polokalama. O le tele o auga e tutupu pe a iai se aafiaga e tasi. E tasi foi la le faasologa o le polokalama e soloia ai le faafitauli lea. E vave le aogaina o le tali mai a lou mafaufau. 6. Ave se faataitaiga i le tagata o le mea e manatu iai e mafua mai ai le tali poo le faatinoina e le tino. Faataitaiga, fai i le tagata e tu ma tusi le lima tusi i fafo, fai ia e liliu i ou autafa ma tusi pea lou lima i mea e tau atu iai pe a liliu lou tino seia e faalogo atu ua gata. Autilo i le mea lena e tusi iai lou limatoe faasaga mai lea i lumao le taimi lenei, mafaufau o loo e toe faataamilo, ae o le taimi lenei, manatu e faigofie lou liliu i lou itu taumatau, e faigofie lou tino ona liliu i tua, pei e luasefulu, pe tolusetulu senitimita le mamao atu i le mea na e gata mai ai muamua. E ese le mea o le a e tusi iai. O le a ni ou manatu o le a iai pe a e liliu tele faapena?...i le taimi lenei, liliu ma lou lima tusi lena sa faaaoga muamua ma siaki pe fia le mamao o lau taamiloga NEI!

35

Faamalamalama le le fesootai i le faa NGP

Faataitaiga, o le a aoaoina lou mafaufau e sui ana taga e faatatau i mea na tutupu. E lua ni ala e manatua ai e tagata mea e tutupu. A e manatu i se mea lelei ma le faigofie sa tupu ia te oe i se taimi lata mai nei, pei o le taumafaina o lau meaai o le taeao (sui seisi mea e te manatua pea toe maua mai manatu o aafiaga ogaoga), manatua mea ma e iloa atu i lau vaai (faatali sei manatua e le tagata), manatua uma faalogona lelei sa e maua i lea mea taumafa. E susua ou laugutu pe a e mafaufau iai. O le tasi lena o ata e te toe manatua ai. O le isi ala e manatua ai mea e tutupu, o le mafaufau o loo e iloa atu oe, e te nofo i se potu ma ai lau mea taumafa. Autilo atu ia te oe o loo tausami mai, pei e te maimoa ia lou ata mai i se mea mamao. Tago e fau sou ata, pei o se ata sa pue, se ata lanu paepae/uliuli. A e vaai i lea ata, e faigata ona maua faalagona fiafia i lau mea meataumafa. Toe foi i tua i lou tino e toe taumafa lau mea ai. E lelei le manatua o le taumafataga o le taeao. E iai le leleiga pe a e tepa i tua - e iloa atu le mea o loo tutupu, ae le fesootai iai. O tagata e manuia o latou olaga, latou te filifili ituaiga mafaufauga e manatua ai aafiaga. O le a tatou aoaoina le mafaufau e faafaigofie ona manatua aafiaga sa tutupu ma faaeseese faalagona. Lona uiga o faafitauli sa iai o le a tea atu, ona maua lea o le fiafia e manaomia mo le olaga. E aoga lena lagona?

O faiga e galue lelei ai le faasologa

1. Tuufaafeagai Manava i le taimi tutusa ma le isi tagata. Nofo faatasi ma ia. Ia tutusa le leo, taimi, ma le leotele/leolaititi ma le isi tagata. Toe faauiga ia upu a le isi tagata e mautinoa ai ua e malamalama. 2. Faaoga gagana e fausia ai faalagona fiafia, (manuia) Ina nei faipea atu E faafefe tagata, ae tautala ou te le faiatu atu e tu lelei nei. A amata le polokalama, ia faapea au upu o faalagona sa ia te oe pe a e mafaufau i nei mea ma faafitauli sa iai, o le tuuina lea o faigata i le taimi ua tuanai. 3. Ia manino le suega ao lei amata, ma ia mautinoa le suega pe a maea Ao lei oo i le sitepu lona tolu (3) o lenei faasologa polokalama, fesiligia le tagata na te toe manatua le aafiaga mo sina tamai taimi ina ia iloa e ia le faafitauli, ma le suiga e maua. A maea le sitepu lona valu (8) o le polokalama, fesiligia lea o le tagata e taumafai ona toe maua mai faalagona sa iai, ia mautinoa ua sui. Afai e leai se eseesega, aua nei faataga fai iai ua sui. Ae toe faasolo le polokalama seia maua le suiga i le tagata, pe siaki e lea tagata i se taimi lata mai na te faamaonia ai le suiga. O le toatele o tagata e le amanaia se suiga sei vagana ua e tau atu iai. O isi tagata e fai faatolu, pe faalima le faasologa o le polokalama e talitonu ai. 4. Ia ese le nofoa o le fale tifaga, ma le potu vili ata. Ia talanoa i le tagata pei o la e saofai i totonu o le potu tifaga - pe a nofo i le nofoa o lea potu. Talanoa i le tagata pei o la e saofai i le potu vili ata pe a nofo i le nofoa o le potu lena. Afai e talanoa mai le tagata i aafiaga ao iai i totonu o le potu vili ata, fai iai e tu i luga ma sau i fafo o le potu vili ata. E manaomia ia tuu faaeseese le nofoa lea ma manatu faapea. 5. Ia mautinoa ala eseese mo taimi e le tuuvalavala ai manatu aafia a) fai iai e tu i luga ma oomi le taula faaola b) savalivali faataamilo ma ia i le potu c) fai i le tagata e sau i fafo o le potu vili ata ma mafaufau ua alu mamao ma le fale tifaga d) faaaoga le Toe Faata mo le isi itu o le tagata e leo manao e faamamulu le fefe (itulau 25) 36

6. Ia mautinoa i lou mafaufau o lea le fefe vale/aafiaga matuia i malamalama faa NGP Afai e tolusefulu sekone le taimi e faatupu ai, e mafai foi ona toe fofo i le tolusefulu sekone. O tagata e maloloina lelei o latou olaga, latou te manatua mea lelei ma tuufaatasi pe faalatalata mai, ae o aafiaga e tuueseese pe tuumamao atu. O le fefe vale poo le popole e tupuga mai i le aafiaga ua faila sese e le manatu. 7. Toe faavaa le ata: Mo le isi itu o le tagata e leo malie e tuu le fefe Ou te iloa e iai lou itu e manatu ae e taua le taofi o faalagona tuai. O lou itu lea o loo taumafai e te saogalemu, ma mautinoa le lesona i mea sa tutupu . Ae o le taofia o nei faalagona e leo maua ai sou mapusaga. Ua atili faigata ai lou soifua i lou ola fefe vale. A fai e manao lou itu lea e te aoaoina mai ai i mea ua tutupu, e pito sili ona e saogalemu pe a faamamulu loa ia faalogona nei lava, ae teuina nao aoaoga e te manaomia.

37

Fasifaitau tofo o polokalama mo aafiaga

1. Ia fesootai, ma seti le taula faaoa

A Sample Script for Trauma Process

1. Establish Rapport, Set Resource Anchor "Before we start, what I'd like you to do is to remember a time when you felt in charge of what you were doing, perhaps when you were doing something you know how to do [like baking a cake, or driving a car], and get back the memory of a specific time, so you can step into your body at that time, and see what you saw, hear the sounds, and fell the feeling of being in charge. Now, as you feel that feeling, I want you to press together the thumb and little finger of your left hand and enjoy the sense of being in charge ... Great; now release the fingers and come back to being in the room here, and stretch." Repeat for two other positive feelings instead of "being in charge" e.g. "confidence", relaxation", "humour". Your being able to create that positive feeling in yourself as they think of it will also help. If they can't think of a time when they felt positive, have them remember a time when someone they like had that feeling, and feel what that person must have felt like. 2. Test Resource Anchor

Ao lei amata, ou te manao e te toe manatua se taimi sa e pule ai i au mea sa fai, pei o le taimi sa e faatinoina ai se mea e te agavaa iai, (pei o le kuka o se keke, ave o le taavale, taalo o se taaloga, pese, siva) ia toe manatua lena taimi, ia e toe foi i lou tino i lena taimi, toe vaai i mea sa e iloa atu, faalogo i leo na iai i lea taimi, ma le lagona o oe e pule. Ao iai pa lena lagona, ou te manao e tago lou lima tauagavale e oomi faatasi lou lima matua ma le tamai lima ao e fiafia i lena faalagona e te pule ai Lelei, ia toe faavaivai ou tamailima ma toe foi mai i le potu, falo lou tino. Toe fai mo isi faalogona lelei se lua, pei o le faalogona o le toa, saogalemu mea malie. E manaia foi pe a toe manatua ou lagona lelei ao manatua e le isi tagata. A le mafaufauina e leisi ni taimi lelei, ona fai lea e manatua se taimi sa iai lea lagona i se tagata e fiafia iai, ma lagona faalagona i lea tagata. 2. Siaki le Taula faaoa

Ua lelei, ia falo ma autilotilo i fafo o le faamalama. Vaai i se mea e te lei amanaia muamua Lelei. Ia tago e oomi faatasi lou lima matua ma le tamai lima ma lagona le eseesega. Siaki le taula (tago le lima matua/laititi) ia sui le manava/tino/foliga i uiga faalia manuia. A leai, ona toe fai lea, ma ia faamamafaina le taua o le toe iai i taimi e manatua ai mea lelei. 3. Suega ao lei Amata

"OK, now stretch and have a look out the window. Just see something you didn't notice before ... Good; now press that thumb and little finger together and feel the difference." Check that the anchor (thumb-finger touch) causes the person to shift their breathing/body position/facial expression back to a positive state similar to the one they used remembering the times. If not, repeat step one, emphasising their re-experiencing each positive state. 3. Pretest "Right, now before we start, I just want to check this thing that has been a problem. I'd like you to just briefly remember one of the times it's been a problem now. What does it feel like to remember that?" Check for a clear shift in breathing, body posture and facial expression. If you need to, to draw them back out, have them stand up and press the thumb and little finger together until they are out of the memory. "OK. Come back to here now. You'll know when that changes now won't you?" 38

I lenei taimi ao lei amata, o loo manaomia e siaki le aafiaga ua avea ma faalavelave. Ia e toe manatua vave se taimi sa iai lea faalavelave nei. O a ni lagona o e toe manatua? Siaki le suia o le manava, tino, ma foliga. A e manaomia e toe aumaia le tagata i fafo mai i aafiaga, ona faatu lea i luga ma oomi faatasi le lima matua/laititi seia mou lea manatu. Ua lelei, toe foi mai i le taimi nei. E te mautinoa lelei se suiga, a ea?

4.

Seti le Ata Tifaga

4.

Set Up The Movie Theatre

O le fefevale, (poo manatu faaemo/maluia/mea faamamafa i le mafaufau talu mai se aafiaga matuia/matafefe gofie pei ona tupu ia te oe) o manatu ia i le faiai ua fefe vale ma faamauina i se mea e le aoga tele. Sa faatupu e lou faiai i le taimi muamua sa e aafia ai, e lalo ma le tolusefulu (30) sekone na fai ai. E faigofie foi ona toe suia pe a iloa le ala na fau ai e le faiai. A suia , e muamua ona seti se ata tifaga iinei. Ua e alu e matamata i se ata, e te iloa e iai nofoa (tusi i nofoa o le tifaga) ma le mea e faaali ai le ata (tusi i se itu o le fale e leai se ata o iai). E saofai i le faletifaga iinei, ou te manao ia e iloa atu sou ata i luma, o lou ata i le lanu uliuli/paepae. E mafai ona pei o se ata o oe i taimi nei, poo oe ao fai sau feau i lou fale, poo sou ata sa e vaai iai i se tusi ataua uma ona faia lea mea? Lelei, o le taimi nei, ao lei tupu le manatu lena sa e fefe ai, sa iai le taimi e lei tupu ai, sa e saogalemu ai. Ia faaaoga le taimi umi e te manaomia e manatua ai, ma fau sou ata o lea taimi saogalemu ao lei oo i le mea sa tupu. Tuu lou ata saogalemu i le taimi muamua i luma e vaai ai le ata, ma liliu i le lanu uliuli/paepae. Ua maea ona e faia? Lelei, e iai le taimi ua maea le aafiaga sa e fefeai, sa iai le taimi ua muta ai, e ui lava, e ui lava o loo e manatua mea sa tutupu, o loo e saogalemu Ia faaaoga le taimi umi e te manaomia e manatua ai ina ua maea, tuu lea o lou ata i lea taimi e luma e te vaai atu iai. Ua uma ona e faia? Lelei. Ou te manao e te tulai i luma o lou nofoa ma savali mai i tua. O le nofoa lenei i le potu e vili ai le ata (faanofo le tagata i le nofoa lona lua, i tua o le nofoa o le potu tifaga). E iai le faamalama lea e te autilo atu ai i le potu tifaga ma iloa ai le isi oe o loo saofai i le potu tifaga, o loo matamata lou ata lanu uliuli/paepae i luma. O e iloa atu le tagata i le potu tifaga?

"Now panic attacks [or "flashbacks/nightmares/Post Traumatic Stress/phobias like you've been having"] is just a result of the brain having a scary experience and storing it in a less than useful way. The brain did that the first time you had that experience, and it took it less than 30 seconds to do. So its just that easy to change once we know how the brain did that." "To change it, what we need to do first is set up a kind of movie theatre here. You've been to a movie sometime, so you know there are seats here [point to movie theatre seat] and a screen up here [point to front -ideally a blank wall]. And sitting in the movie theatre here, I want you to see a picture up on the screen, of yourself, a black and white photo. It could be of the way you look now, or of you doing something you do at home, or just a photo like a recent one you've seen in a photo album ... Have you done that?" Good. Now, before you had that experience that was scary, there was a time when it hadnt happened yet, and you were safe. Take all the time you need to remember that time, and make a picture of yourself at that safe time before the event. Put that picture of you looking safe before the event up on the screen now, and turn it to black and white too. Have you done that? Great. And after that experience that was scary, there was a time when it was over, and although you still had memories of the event, you were physically safe. Take time to remember that safe time after it happened, and put a picture of yourself at that time on the screen. Have you done that too? "OK. Now I'd like you to stand up out of that chair and come back here. This is a chair in the projection room from where they show the movie [seat the person now in the second chair, behind the movie theatre chair]. There's a glass screen through which you can see the movie theatre and you can see that other you sitting in the movie theatre, watching a black and white photo on the screen. Can you see that person in the theatre seat?"

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5.

Vili le ata agai i luma faataape

5. Run The Movie Forward "Dissociated" "So now, as you stay in the projection room, safe behind the glass, you can run the movies, and watch as that other person in the theatre watches them. And because there are holes on the side of the glass, you can hear the movie, because we're going to show a movie soon. And youll be safe and comfortable here, maybe with something nice to eat and drink while you watch the person watching the movie." "What I want you to do is to run a movie of yourself in that time when the unpleasant event happened. The movie will start before the event, at the time when you were safe before, and will run through the time after the event, once you were physically safe again. Like any movie, it will show the important parts of the story, form beginning to end, but this movie will be in black and white, like an old film. OK? Now, while you run the movie, Id like you to watch that person the movie theatre. They may have some response to the movie, but you're in the projection room, so just run it through and watch their watching. OK, go ahead, and tell me when you're done." 6. Fast Rewind The Movie "Associated"

O lenei, a o e iai i le potu vili ata ma le saogalemu i tua o lenei tioata, e vili le ata, ma e matamata i le tagata i le potu tifaga o loo matamata i luma. E iai pupu i itu o le tioata, e faalogo atu ai, aua toeititi ona vili lea o le ata tifaga. Ae e sefe ma e malu iinei, atonu e iai ma ni au mea taumafa manaia, ma se vai e inu ao e matamata i le tagata lea e matamata i le ata. Ou te manao ia vili sou ata o le taimi lea sa e aafia ai. Ia amata le ata ao e saogalemu e lei tupu le mea sa e afaina ai. Vili le ata e oo i le taimi ua sopoia le mea sa tupu, ua e toe mapu ai. Pei o isi ata, e faaalia mea taua o le tala, o le amataga se ia oo i le faaiuga, o lenei ata e vaaia i le lanu uliuli/paepae pei o lanu o ata tuai. Ua lelei? O le taimi nei, ia vili le ata, ma e matamata i le tagata lea e nofo i totonu o le potu tifaga. E iai ona uiga faaalia i le ata o loo maimoa atu iai, ae o oe e te iai i totonu o le potu vili ata, amata le viliga o le ata ma matamata i le o loo vaai iai. Ua iai, vili loa, tau mai pe uma. 6. Vili i tua le ata tuufaatasi

Toeitiiti lava, ou te manao ete manatu ua e lelea mai i fafo o le potu vili ata, lelea i totonu o le ata mulimuli e te saogalemu i le ata faaiu lea i luma. A fesoasoani, ona moeiini lea o ou mata ma e faatinoina i lou mafaufau. A e iai loa i totonu o lou ata, i le tino o lena ata, ona faaliliu lea o le lanu o le ata e faalanu. Toe vili i tua le ata, mai i le faaiuga seia oo i le amataga, ae vave lava pei o le viliga i tua o le vitio. Ua e vaai i le vitio ae vili i tua, ae vave atu le viliga o le ata, nao ni nai sekone e faapea siiiiiip! Ua iai? Ua lelei. Ia lelea ane loa i totonu o le ata, i le faaiuga, faaliu lanu le ata, vili i le amataga siiiiip. A uma loa, ona toe liu lanu uliuli/paepae lou ata, ma lelea mai i le potu vili ata. Talofa

"Now, in a moment, I'm going to get you to pretend that you float out of the projection room and into the movie at that safe end scene. It may help you to close your eyes to imagine that. Once you're in the movie, in the body of that earlier you, turn the movie to colour. Then we're going to run the movie backwards, from the end to that safe beginning, but fast, like fast rewind on a video. You've seen a video rewind, but this will go so fast the whole thing will only take a second and a half, so it goes zziiiiiiipp! Got that? Okay, now; float into the movie, at the end, turn it colour and zziiiiipp! ... Once you're done, turn the movie back to black and white, and float back to where you actually are, here in the projection room ... Hi."

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7.

Toe fai seia iai se suiga

7.

Repeat until Change Occurs

Ua lelei. Ou te manao ia e toe iai i le potu vili ata e matamata i le tagata ile potu tifaga ao ia vaaia le ata mai i le saogalemu ile amataga se ia oo i le sefeaga i le faaiugaua iai? Lelei, manatu ua e lelea atu i totonu o le ata ma liliu faalanu le ata, toe vili i tua i le amataga siiiiip, sui uliuli/paepae le ata, ma toe lelea mai i le potu vili ata pea uma Malo. Ia faloloIa e toe manatu lou ata i le amataga o le ata (afai e le mafai alu i le vaega 8). Ia toe fai, matamata mai i le potu vili ata le tagata ao vaai i le ata lanu uliuli/paepae, lelea atu i totonu o lou ata saogalemu i le faaiuga, toe vili vave i tua i le amataga le ata, faalanu, ma e toe lelea mai iinei. Tau mai pe a uma Lelei, Ou te manao e te faatamoe le faasologa, toe fai ma toe fai faatele seia le toe maua le ata, pe mou atu se lagona sa iai. Fai mai isi tagata ua le toe iloa atu se ata, o isi fai mai ua motu le ata. Ai ua amata. Toe faaalu le ata i luma ma tua seia e iloa ua le toe mafaia. Ona tau mai lea 8. Faamaonia le suiga (suega pe a maea) Lelei, ua e iloaina ua mou atu faalagona sa iai faatasi ma le ata. Ua lelei; ia falolo ma autilotilo i le faamalama, vaai ane i se mea e te lei amanaia muamua Ua lelei, ou te manao e te taumafai e toe manatua lena taimi, ia e toe maua mai faalagona sa ia te oe e uiga i le mea na tupu. (mata ataata), ea mai nei? Ua ese! Siaki le tu a lea tagata, manata, foliga ua suia ma tuu faitalia e ese mai i le suega ao lei amataina le faasologa o le polokalama lenei. Nei la, ou te le faapea atu e te talia lenei tulaga ua iai. Nao le faalagona le saoloto ua mou atu. E iai le le mailoa, pe a e toe manatua, aua o lagona mautinoa lena sa iai. Sa ia oe lena faafitauli mo se taimi umi, ma e uiga ese le suiga ua iai nei. O se mea e maofa ai, a ea? (toe siaki se ia mautinoa e le tagata le suiga)

"OK. Now I want you to be here in the projection booth and watch again as that person in the movie theatre sees the movie through from safe beginning to safe end ... OK? Great; and again, imagine you float into the end and turn the movie to colour, then run it backwards zziiiiipp, and come back to the projection booth once its done ..." "Great. Have a stretch ... Now try and get back that picture at the start of the movie [If they can't, go to step 8]. Now again, watch from the movie projection booth as that person watches the black and white movie, float into the safe end and run it backwards fast in colour, and come back here. Tell me when you're done...". "Good. Now I want you to try to do this process, a bit faster, and do it through as many times as it takes till you can't get back the movie, or you realise that the feeling has suddenly gone. Some people say the movie gets blank spots and fades out; some say it's as if the tape snaps. It's probably started already. Just go ahead and try to run the movie each way till you know you can't. Then tell me ...". 8. Verify Change (Post-test)

"Great. ,And notice that the feeling went with the picture. Okay; now stretch and look out the window. Notice something there you haven't seen before ...". "Okay, now what I want you to do is have a go at remembering that time, and try and get back the feelings you used to have about it." [Smile]. "How's that now? Different!" Check from the person's body posture, breathing and facial expression that this is a different, more relaxed response than the pretest. "Now I'm not suggesting you'll enjoy that thing now. Just that the uncomfortable feeling is gone. There's often a little uncertainty, as you try to go to remember, because this was a reliable response you had. You had that problem for a while, and its strange for it to be different, now. Pretty amazing isnt it?" [Try again until the person realises its different]. 41

9.

Siaki siosiomaga ma laa i luma

9.

Ecology Check and Future Pace

O se tasi mea e tupu i si taimi, afai sa iai se mea sa faapoppoleina ai se tagata, sa iai ana galuega sa fai. E tatau la ona sailiili poo iai ni galuega ese e faaalu iai lona taimi. Ou te manao e te mafaufau i se taimi i le lumanai, le tuaiga taimi, e pei o taimi ua tuanae tulai mai ai se faafitauli, ma tupu ai manatu pei o mafaufauga tuai e faafetauia ai; o e iloa atu au mea na ua fai, ma faalagona ia te oe. Ea mai lea? Toe mafaufau i se isi taimi e te iloa lelei a tulai mai pei o taimi ua tea, e avea ma faafitauli mo oe. O le a le eseesega ua iai nai?...E talafeagai mo outou uma? Malo lava. Maliu mai i lou olaga fou. O se suiga matuai tele, a ea!

"Now one thing that has happened occasionally, is that when someone had an anxiety, it gave them something to do. So now its important to find out what you can do instead. I'd like you to think of a future time, the kind of time when, in the past, you would have responded in that old way; and notice what you're doing instead, and how you're feeling. How is that? ...". "And think of another situation when, in the past, you'd have had that problem. How is it different now? ... Is that okay for all of you?" "Excellent. Welcome to your new life. That was big change wasn't it!"

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Civil Defence Handouts

A guide for emergency response workers and their managers
Engaging in response efforts in the wake of a traumatic event is inevitably stressful for those involved in the emergency response. While the work is personally rewarding and challenging, it also has the potential for affecting responders in harmful ways. The long hours, breadth of needs and demands, ambiguous roles, and exposure to human suffering can adversely affect even the most experienced professional. Too often, the stress experienced by responders is addressed as an afterthought. With a little effort, however, steps can be taken to minimise the effects of stress. Stress prevention and management should be addressed in two critical contexts: the organisation and the individual. Adopting a preventive perspective allows both workers and organisations to anticipate stressors and shape responses, rather than simply reacting to a crisis when it occurs. Organisational approaches for stress prevention and management 1. Provide effective management structure and leadership. Elements include: Clear chain of command and reporting relationships. Available and accessible supervisors. Disaster orientation for all workers. Shifts of no longer than 12 hours, followed by 12 hours off. Briefings at the beginning of shifts as workers enter the operation. Shifts should overlap so that outgoing workers brief incoming workers. Necessary supplies (e.g., paper, forms, pens, educational materials). Communication tools (e.g., mobile phones, radios). 2. Define a clear purpose and goals. 3. Define clear intervention goals and strategies appropriate to the assignment setting. 4. Define roles by function. 5. Orient and train staff with written role descriptions for each assignment setting. When a setting is under the jurisdiction of another agency, inform workers of each agencys role, contact people, and expectations. 6. Nurture team support. 7. Consider creating a buddy system to support and monitor stress reactions. Promote a positive atmosphere of support and tolerance with frequent praise. 8. Develop a plan for stress management. For example: Assess workers functioning regularly. Rotate workers among low-, mid-, and high-stress tasks. Encourage breaks and time away from assignment.

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Common Reactions to Disasters

Most people involved in a traumatic incident experience some kind of emotional reaction. Although each persons experience is different, there are a number of common responses that are experienced by the majority of those involved. It is reassuring to know that, even though these feelings can be very unpleasant, they are NORMAL reactions in a normal person to an ABNORMAL event. You are not losing your mind or going crazy if you have these feelings. It is often difficult for those who were not involved to understand what the survivor is going through; you may wish to show this pamphlet to friends and relatives, and perhaps discuss your reactions with them. Outlined below are some of the normal reactions to trauma: Emotional Shock disbelief at what happened feeling numb, as if things are unreal Fear of a recurrence for the safety of oneself or ones family apparently unrelated fears Anger at who caused it or allowed it to happen at the injustice and senselessness of it all generalised anger and irritability Sadness about the losses, both human and material about the loss of feelings of safety and security feeling depressed for no reason Shame for having appeared helpless or emotional for not behaving as you would have liked Physical Sleep difficulty getting off because of intrusive thoughts restless and disturbed sleep feeling tired and fatigued Physical Problems easily startled by noises general agitation and muscle tension palpitations, trembling or sweating breathing difficulties nausea, diarrhoea or constipation many other physical signs and symptoms Thinking Memories frequent thoughts or images of the incident thoughts or images of other frightening events flashbacks or a feeling of reliving the experience attempts to shut out the painful memories pictures of what happened jumping into your head dreams and nightmares about what happened unpleasant dreams of other frightening things difficulty making simple decisions inability to concentrate and memory problems Behaviour Social withdrawal from others and a need to be alone easily irritated by other people feelings of detachment from others loss of interest in normal activities and hobbies Work not wanting to go to work, poor motivation poor concentration and attention Habits increased use of alcohol, cigarettes or other drugs loss of appetite or increased eating loss of interest in enjoyable activities loss of sexual interest.

Remember that all responses are NORMAL to an ABNORMAL situation.

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Coping Personally a) General Information for Communities

Distress is an understandable and normal response to major disasters. Common causes of distress may be related to having been directly at risk from an emergency event, being concerned about family and friends who may be affected, witnessing injuries and distress to others, or being caught up in the panic and confusion that often follows. In addition, feelings and memories related to previous experiences of disasters or other grief and loss may also resurface. Most people experience acute stress during emergency events and most manage with courage and strength. However, sometimes it is only later when the distressing images are recalled that some of the stressful effects start to show. While most people will manage with the support of family and friends, there are times when extra help and support may be needed. Those who have lost loved ones, have been seriously injured, or are highly distressed by an emergency, will often need particular support and care. Our communities have a history of coping with uncertain and troubled times with courage and strength. There are three important things you need to know: 1 normal reactions to this type of emergency positive ways of coping when to get extra help. Normal reactions to a disaster like this include: 1 shock and numbness, often fear at first horror and grief when the extent of loss is realised frustration, anger, helplessness and even sometimes despair when it all seems too much sometimes fears or old worries may resurface. These feelings usually settle over the early weeks. Positive ways of coping may be: 1 supporting one another, especially in the family and in your community providing emotional support comforting each other carrying out practical tasks tackling the jobs that need to be done a bit at a time and counting each success sharing your experience and feelings with others - a bit at a time when it is right for you looking after your own and your familys general health rest, exercise, food and company all help (being careful not to drink too much alcohol). When to Ask for help Sometimes post disaster stress can be ongoing and affect your physical and mental health and wellbeing. Its time to ask for help if: 1 your sleep is badly affected you feel very distressed, irritable, on edge or agitated much of the time you feel hopeless, despairing, miserable or that you cant go on you have trouble concentrating, are distracted and cannot do your usual tasks you feel your health is not so good you have recurrent nightmares or intrusive thoughts about the emergency you have new symptoms or old problems may seem to have returned, e.g. breathing, heart and stomach problems. 45

For children, withdrawal, aggressive behaviours, difficulties at school, problems separating from parents or going to sleep may indicate the need for help. Adapted from information issued by Queensland Health: Fact Sheets for Psychosocial Disaster Management

Coping Personally b) Information for Volunteers

Health, other staff and volunteers are frequently called upon to deal with emergencies, and for some this is the major component of their day-to-day work. When a disaster occurs, there is inevitably an escalation of response. This brings new challenges, intense involvement and often both satisfaction and stress during the response and sometimes in the aftermath. It is important for staff and volunteers to recognise these needs, responses and coping strategies. They are normal reactions for the most part but may, at times, mean that there is a need for extra support or expert assistance. Health and other emergency staff often have very high expectations of themselves. They, and others, often believe that they should be able to deal with any emergency. So those who find they are having difficulties are often reluctant to seek help. Seeking help early is one of many positive coping strategies. We also know that there are some situations that are more stressful than others. Deliberate attacks, for instance, have particular implications because they can confront us with the malevolent intent to harm others, ongoing threat, uncertainty and concerns for the future. In general they create a background of anger and fear, while at the same time, there is usually a determination not to give in to such threats. Common reactions Staff and volunteers are usually aroused and focused to their tasks in the immediate response period, while at the same time confronting what may be quite horrific injuries, pain and suffering in those they are assisting. At the same time, there is recognition of the loss, grief and trauma that many of their patients confront, and some degree of identification with this. If identification is strong, for instance the patients remind one of ones children, partner or other loved ones, this may be particularly stressful. The injuries of children and innocent victims are difficult to deal with at all times. Thoughts and images of their distress and ones own feelings may come back over the weeks that follow. We know that people usually respond well in the emergency, but sometimes have difficult reactions in the aftermath. People have many different ways of dealing with their experiences Sharing feelings with others, including those who have been through it with you, your family and your friends may be important coping strategies involving mutual support. Each person also uses their own particular coping styles, some action-oriented, some more focused on emotional response. Personal strengths, which have been effective in coping with past difficulties, may be useful again. Types of assistance available The types of assistance that are available include provision of information to you personally or through websites. These sources can provide information on some common reactions and what you can do to deal with problems that arise. Assistance may also involve an opportunity to talk things over and have your concerns understood general supportive counseling. Specialist clinical counseling and treatment can be provided by people with specific expertise in this field. Issues that may arise 46

Some of these are listed below. If they are prolonged, persistent, disruptive and distressing it is useful to seek further advice or assistance. Difficulties in returning to normal roles and life. These may seem to be of lesser significance when compared to the intensity and meaningfulness of work during the emergency. You may feel disengaged, irritable or a sense of feeling let down afterwards. Persistence of these feelings of disengagement after the early weeks may indicate a problem. Distressing images, memories and nightmares, disrupted sleep, feelings of irritability, being on edge, difficulty concentrating, fearfulness and anxiety or depression may occur. These reactions usually settle, but if persistent after the early weeks, they may indicate the need for advice or assistance. Feelings of numbness, a loss of feelings generally or feelings for others, may occur as part of a psychological defence to help you with the experience initially. If this persists, it may interfere with your relationships and it could be useful to seek further advice. Old traumas may come to the surface again. These may be reawakened by the stress of the new experience and may need to be dealt with. Other reactions in the aftermath may relate to the intense bonds that are formed with those you have helped, a need to know what has happened to them after they have left your care. These special attachments usually settle over time and are a common response. However, if they become an intense and ongoing focus this may interfere with other relationships and may indicate that you could benefit from the chance to talk through your feelings with a counsellor or others. Coping strategies We know that each person has their own style of coping and these should be respected, especially if they have helped you in the past. Some important points that can assist staff are outlined below: Sharing your experience with others when you feel ready, including family, friends, and colleagues, and those who have gone through the experience with you. Supporting one another is usually helpful. Talking through any concerns with your supervisor is also likely to be help. Operational reviews and debriefs in later weeks which give you a chance to get your experience in perspective and to recognise both its value and what you have learned. Time out for R&R (rest and recreation). It is vitally important to make time to relax, exercise, eat well and engage in positive life-affirming activities. Time with friends and family and a positive commitment to something you enjoy that is separate from your work, for example physical activities, sport, music, theatre and reading, can be helpful. Writing about your experience. This helps in terms of putting it down, and in a way, outside yourself. Studies now show that this can have positive health benefits. Family Trauma may have a range of impacts on families, some related to separation from you and concern for you. It is important to stay close and share thoughts and feelings with family members at your own pace. Children may be affected indirectly by watching shocking media images, or listening to other childrens stories which may have distressed them. Parents and carers can help by answering childrens questions honestly; acknowledging concerns and fears and helping children understand how they are protected. When to ask for extra help Sometimes post-incident stress effects can be ongoing and affect your physical and mental health and wellbeing. Its time to ask for help if: 47

your sleep is badly affected you feel very distressed, irritable, on edge or agitated much of the time or are having angry outbursts you feel hopeless, despairing, miserable or that you cant go on you have trouble concentrating, are distracted and cannot do your usual tasks you have recurrent nightmares or intrusive thoughts about the emergency you feel your health is not so good you have new symptoms or old problems have come back you are having trouble with your work you are having difficulties with your relationships you find that you are drinking excessively or doing other things that may have adverse effects.

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OFFICE USE ONLY

Unique No: Name Address (or former address) Date of Birth Phone Home Mobile Date

I consent to the information gathered on this form being seen by other authorised personnel involved with the NLP First Response team, and the NLP Trauma Recovery Trust. This information will be used for follow-up calls, checking on my progress, and for statistical purposes including research to support future funding). Signed:
(by guardian if under the age of 16 years)

BEFORE PROCESS Brief Description of symptoms (clients words)

Note in particular: Sleeping difficulties, general anxiety, panic attacks, sudden anger/emotional highs and lows.

Which of these symptoms did they have (DSM IV)? repeated, distressing memories / dreams of event
acting or feeling as if the event were still happening intense distress when exposed to images or sounds resembling the event efforts to avoid anything that could remind the person of the event inability to experience a normal range of emotions and interest in life not planning as if life had a future difficulty concentrating, or relaxing, or difficulty sleeping sudden anger / Startle responses nightmares or sleep disturbances

On a scale of 10 to 1 how does it feel now? Neutral/Calm

BEFORE PROCESS AFTER PROCESS ONE WEEK LATER

Worst they can think of 3 3 3 4 4 4 5 5 5 6 6 6 7 7 7 8 8 8 9 9 9 10 10 10

1 1 1

2 2 2

Please return forms (once a week) to: info@traumarecoveryteam.org.nz

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