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Posts Tagged ‘
Lesa Warren ’
Introducción
Cuando un evento traumático interrumpe repentinamente en la vida de uno, parece como si el mundo se parara de repente. Los asesinatos, asaltos y accidentes trágicos que ocurren sin aviso previo son especialmente perturbadores y difíciles de manejar. La recuperacin que hacen los individuos cuando se presentan estas situaciones depende a menudo del funcionamiento psicolgico previo de la persona, la naturaleza precisa del trauma, y de la capacidad del individuo de recuperar una sensacin de seguridad y de control sobre su entorno.
Cuando sucede una tragedia, hasta cierto punto esperamos encontrar dolor y simpatía; a veces nos sorprende tener una sensacin de impotencia que nos asusta. Los desastres naturales, los accidentes y los eventos traumáticos hacen surgir en nosotros sentimientos de vulnerabilidad significativos y una pérdida de control. Cada día que pasa nos proporciona amenazas incontables y así como cualquier cantidad de posibilidades de peligro. Nuestra evolucin psicolgica hace que nos "aislemos" de estos temores y que vayamos por la vida como si alguien nos garantiz a nosotros, y a todas las personas a nuestro alrededor, que viviremos otro día más. Hacemos a un lado la posibilidad de muerte o de una pérdida, y nos es cmodo lo predecible. Creamos una burbuja alrededor nuestro que nos permite obviar nuestra mortalidad y la posibilidad de que la vida súbitamente cambie de curso de manera irreversible. Cuando estalla esa burbuja, nos deja sintiéndonos vulnerables e impotentes. De repente la vida se vuelve impredecible, nos asusta y esas emociones nos pueden paralizar.
Para recobrar una sensacin de control y encontrarle sentido a la vida después de un evento que aparenta no tenerlo, podemos empezar a buscarle un significado a la situacin, y también un culpable. Una y otra vez repasamos mentalmente los sucesos de la tragedia y los eventos anteriores para intentar reestablecer una sensacin de algo predecible. Nos dedicamos a buscar y consumir toda la informacin disponible para ver si encontramos algo, lo que sea, que pudiéramos haber hecho para prevenir y evitar la situacin traumática: "Si tan slo hubiera tomado la otra calle… Si tan slo los guardias del aeropuerto hubieran revisado a las personas con más cuidado… si hubieran construido el malecn con más cuidado…"
Si llegamos a la conclusin de que alguien pudo haber intervenido y evitado la tragedia; o de que pudimos haber reconocido la secuencia de eventos como un preludio a un desastre; entonces podemos sentir que tenemos la capacidad de prevenir este tipo de perturbaciones en nuestro mundo predecible, y que no volverá a suceder. Si empezamos a creer que en verdad no fue inevitable, entonces creemos que podemos asegurarnos de no volver a cometer los mismos errores, sin que importe alguien o algo culpado. Así borramos lo fortuito de la tragedia y re-establecemos nuestra burbuja impenetrable. La vida regresa a la normalidad y a sus patrones predecibles; y los demonios retornan a las sombras.
Las maniobras antes descritas para re-establecer nuestra sensacin de control sobre nuestro entorno son naturales y, en general, benignas. Pero también pueden ser el catalizador para otra clase de desastre. A veces, e n nuestra búsqueda para encontrarle sentido a lo que no lo tiene, nos culpamos o culpamos a otra persona, creando culpabilidad y responsabilidad donde no toca. Terminamos por restablecer nuestra salud mental a costa de nuestra humanidad.
No podemos evitar del todo estas tendencias trágicas, pero si podemos cuestionar nuestras reacciones y los motivos que encontramos. El enojo, el dolor, la tristeza y la confusin son emociones válidas y comprensibles ante el intento súbito por parte de la vida de imponer su voluntad. Pero estas son emociones que nos toca procesar y resolver a nivel individual. Es importante que reconozcamos que la sensacin de impotencia puede hacer más complicada nuestra recuperacin. Necesitamos encontrar actividades que afirmen la vida para ayudarnos a restablecer una sensacin de paz y de equilibrio.
Si podemos tener claro que nuestras propias respuestas a una tragedia y a la pérdida están basadas en el miedo y en una sensacin de omnipotencia falsa, entonces podemos resistirnos al deseo de hacer un sacrificio humano con nuestro prjimo empujándolo al cráter de un volcán para impedir que haya una nueva erupcin. Cuando podemos aceptar que nuestras vidas son impredecibles de muchas maneras, y que nuestros días son fugaces, podemos empezar a vivir de manera más plena y a valorar cada momento que nos es dado.
A menudo los trabajadores sociales son "los primeros en responder" después de acaecida una tragedia. Prestan sus servicios, tanto en el lugar del evento, como durante los días y meses subsecuentes. Las trabajadoras sociales buscan que las personas afectadas puedan regresar a su vida normal a la brevedad posible, ya sea que se trate de un puñado de individuos –como sería el caso de una balacera—o una regin, como la afectada por el huracán Katrina.
- Los trabajadores sociales ayudan a conectar a las víctimas y a sus familiares con servicios críticos y hacen intervenciones de salud mental para el personal de urgencias.
- Las trabajadoras sociales proporcionan servicios psicolgicos de orientacin continuos para aquellas personas que fueron afectadas de manera directa por la tragedia; y para ayudar a las personas a elaborar su duelo y su miedo relacionado don el trauma.
- Las trabajadoras sociales nos ayudan a normalizar las emociones que crean una mayor sensacin de control.
- Cuando la situacin deja a niños sin hogar, los trabajadores sociales del estado a menudo les ayudan a encontrar una casa temporal o a largo plazo.
- Cuando la tragedia incluye la pérdida del hogar, o de los medios de sustento econmico, las trabajadoras sociales ayudan a encontrar alimentos, ropa y cobijo para los individuos afectados. Los trabajadores sociales también ayudan a que las personas encuentren un empleo y con la solicitud para pedir fondos estatales o federales de asistencia a los que tendría derecho la persona.
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Traduccin español examinada por Maribel Quiala, MSW, LCSW, miembro del Comité NASW Nacional sobre los Asuntos de la Mujer (MCOWI).
Tags: ayudan, la situaci?n, Lesa Warren, los trabajadores sociales, P?rdida, pena
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Grief And Loss, How Social Workers Help |
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Introduction
When life is suddenly interrupted by a tragic or traumatic event, it can seem that the world has come to a screeching halt. Murders, assaults, and tragic accidents that occur without warning are particularly disturbing and difficult to manage emotionally. How individuals recover from such situations often depends on the prior psychological functioning of the individual, the exact nature of the trauma, and the individual's ability to regain some sense of safety and control over his or her world. There are, however, striking similarities in the ways in which we humans attempt to regain our composure and resume our lives after such an event.
While grief or sympathy is an expected reaction, another feeling is also tapped following a tragedy: a frightening sense of helplessness. Disasters, accidents, and traumatic events can invoke significant feelings of vulnerability and a loss of control in all of us. While each day brings countless threats and potential dangers to every human being, we have evolved to psychologically "insulate" ourselves from these fears and to proceed through our lives as if we, and everyone around us, have been somehow guaranteed another day. We dismiss the chance of death or loss, and we find comfort in predictability. We create a bubble around ourselves, enabling us to happily overlook our own mortality and the potential for life to suddenly and irreversibly change course. When that bubble is suddenly burst, it can leave us feeling helpless and vulnerable. Life suddenly becomes scary and unpredictable, and those feelings can be paralyzing.
To regain some feeling of control and to again make sense of life after a seemingly senseless occurrence, we may begin to search for both meaning and often blame. We may replay the specifics of the tragedy and the events leading up to it over and over to try and restore a sense of predictability. We may search all of the available information to find something, anything, that could have been done to prevent it: "If only I had taken another road…If only the airports had screened more carefully…If only the levees had been built better…"
If we decide that someone could have intervened and prevented the tragedy, or that some sequence of events could have been recognized as a prelude to the disaster, then we may feel that it is within our capability to prevent such a disturbance to our predictable world from ever happening again. If we begin to believe that it actually wasn't inevitable or unforeseeable, then no matter whom or what is to blame, we believe we can insure that the same mistakes are never repeated. The awful randomness of tragedy is thereby erased, and our impenetrable bubble is once again restored. Life returns to its normal, predictable patterns, and the demons return to the shadows.
While these maneuvers to restore a sense of mastery over our world are natural and usually benign coping strategies, they can also be the catalyst for a disaster of another kind. If, in our attempt to make sense out of the senseless, we misplace blame on either ourselves or on another, then we create culpability or responsibility where there is none. This results in essentially restoring our own sanity by sacrificing our humanity.
While we cannot be expected to completely avoid these tragic tendencies, we can be expected to constantly question our own motives and reactions. Anger, grief, sadness, confusion are all valid and understandable emotions in response to life's sudden attempt to exert its own will. But they are emotions that we, as individuals, must process and resolve for ourselves. It is important to recognize that a sense of helplessness may be complicating recovery. We must be able to look to life-affirming activities to help restore a sense of peace and balance.
If we are able to keep in mind that our own responses to tragedy and loss are often based in fear and a false sense of omnipotence, then we may be able to resist the desire to throw our neighbor into the volcano to deter the next eruption. Then, once we begin to accept that in many ways our lives are unpredictable and our days fleeting, we can begin to live more fully and cherish each moment that we are given.
In the aftermath of a tragedy, social workers are often "first responders" who provide services both on-site and in the subsequent days and months. Whether the situation involves only a handful of individuals such as in a shooting or an entire region such as with Hurricane Katrina, social workers are involved in the task of getting people's lives back to normal as quickly as possible.
- Social workers help connect victims and their families with critical services and provide mental health interventions for emergency personnel.
- Social workers provide ongoing psychological services for those directly impacted by a tragedy and help individuals move through their grief and fear related to the trauma.
- Social workers normalize feelings which create a greater sense of control.
- In situations where children are displaced, state social workers often assist them in finding temporary or long-term placement.
- When the tragedy involves the loss of a home or income, social workers help locate things like food, clothing, and shelter for the affected individuals. Social workers also help with job placement and the application for state or federal funds for which the individual might qualify.
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Tags: blaming, death, event, grief, help, Lesa Warren, loss, meaning, social workers, tragedy, tragic
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Introduction
Grief. It’s one of the most basic and universal of human emotions. If you are alive, you either have experienced or will experience grief. Grief can occur when someone experiences a loss…any loss. People generally expect grief to follow a death, but it can also occur after a life-altering illness, after the end of a relationship, losing a pet, or because of giving-up of a dream. But even though grief is a common and universal emotion, it can take on very different forms from one individual to the next.
There is no "appropriate" bereavement period for someone who has experienced a loss. Grief is a very individual experience and can vary in length and intensity from person to person, and even from one loss to another. Grief is the natural and healthy task of processing a loss and it can include significant mental, physical, social, and/or emotional reactions. With support from friends and family, however, most individuals are able to grieve their losses and successfully leave the mourning period in their own time. These individuals are generally able to move into the next stage of life with an emotional and spiritual renewal. Time is also a natural healer of intense pain and emotions which are a part of grief.
How does someone know if their grieving becomes unhealthy? Grief can sometimes become what is called complicated grief: grief, which is identified by a significantly extended period of symptoms, an inability to function in daily activities, and/or the presence of very intense symptoms such as violent or prolonged anger or suicidal thoughts and feelings.
Complicated grief can appear as a major depression or even post-traumatic stress disorder, both of which can seriously interfere with functioning. Individuals who are experiencing complicated grief seem unable to move forward and find resolution. At that point, grief stops being a healthy and necessary vehicle for growth and becomes a dark and menacing adversary.
If someone is suffering from complicated grief, the best approach is to seek psychological help, perhaps with medication support. While complicated grief like other mental health needs disorders can’t simply be wished away, individuals can usually be assisted through the grief process by a professional and return to a more stable level of functioning.
There are many highly trained social workers available to help those whose suffering is unnaturally prolonged or considered complicated. Many individuals experiencing grief receive support from loved ones, friends, clergy, support groups, online information. They may also receive support from printed materials and sometimes short-term counseling. Temporary medication assistance may help get some individuals through difficult times like the funeral or related events which trigger memories and emotions about their loss.
Many people who experience grief are resilient but they may need formal or informal support of some kind.
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Tags: death, emotions, end, grief, Lesa Warren, loss, medication, psychological
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Grief And Loss, Your Options |
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NOTE: The author is a licensed, clinical social worker who provides outpatient behavioral medicine services for children, adolescents, and adults.
Some of the most frequent questions I am asked by clients involve the use of antidepressant medications. Clients often either think that antidepressants don’t really work (“They just give those pills to anybody!”), that they should be able to feel better without any medication (“I don’t need a pill to feel OK!”), or that antidepressant medications are somehow dangerous and/or addictive.
While not everyone needs or would benefit from antidepressant medication, some individuals have depressions that will only respond to medication. The benefits of appropriately treating these depressions far outweigh any potential risks. The key lies in being able to identify who needs treatment with medication and who does not.
Recent years have seen remarkable breakthroughs in the science of psychopharmacology – the use of medications in the treatment of mental and emotional disorders. These advances are especially evident in the treatment of depression. However, the effectiveness of antidepressant medication depends on the specific type of depression and symptoms experienced.
Many individuals will experience what's generally thought of as a reactive depression at some point in their lives. This type of depression is a direct response to something that is obviously causing stress in a person's life. The depression can range in intensity from mild to severe, but basic physical functions such as sleep and energy levels remain relatively unaffected.
Others may experience a biological depression. With this type of depression there is obvious stressful or worrisome situation that can be identified as the cause of the person’s depression. This type of depression can result from medical illnesses, female hormonal fluctuations, medication and recreational drug use, or biochemical imbalances in the brain, which cause physiological symptoms.
These conditions can cause actual chemical changes in the brain, which affect specific areas of physiological function such as sleep cycles, appetite, energy levels, concentration/distractibility, and short-term memory. Attempting to “talk” or simply “will” these symptoms away is as incomplete a treatment as is attempting to control diabetes or high blood pressure without medication.
However, most depressed people suffer from a mixed depression. A mixed depression starts as a reactive depression. However, the person may soon develop the kind of physiological symptoms seen in biological depressions.
There have been significant advances made in recent years regarding antidepressant medications, and there are several effective and relatively safe alternatives available. All antidepressants work by altering levels of neurochemicals in the brain, but different "families" of medications act in different ways. (These medications are only available with a doctor's prescription.) Generally, the antidepressants affect one or more of the primary chemicals in the brain believed to be related to the symptoms of depression. These brain chemicals include norepinephrine, serotonin, monoamine oxidase, and dopamine.
One of the newer categories of antidepressants called selective serotonin reuptake inhibitors, or SSRI’s for short, have been widely used due to their relatively mild side effects and few drug interactions. The most common side effects of these drugs are nausea and an upset stomach, sleepiness, and problems with sexual function. However, these effects are generally mild and short-lived. None of the antidepressants are addictive, although there has been evidence of some people who abruptly stop taking their SSRI's rather than tapering off them experiencing some negative side effects for a relative short period of time (a few days).
A physician will prescribe an antidepressant based on a person's physiological symptoms. While antidepressant medication can be very successful in treating the physiological symptoms of a depression, it does not address any underlying sadness or sense of loss. For those symptoms, psychotherapy is the treatment of choice.
So, when my clients ask me about antidepressant medications, I try to provide them with the same accurate and complete information that I would expect to receive. I also tell them that, overall, antidepressant medications are safe and effective in the treatment of the physiological symptoms of depression and, when combined with psychotherapy, can often make all the difference in the world.
###The opinions expressed in this article are those of the writer, and do not necessarily reflect those of the National Association of Social Workers or its members.
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Tags: antidepressant, Biological, Lesa Warren, medications, Mixed Depressions, options, Reactive, social worker
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Depression, Your Options |
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