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Trauma: Recovering from Natural Disasters
Trauma: Recovering from Natural Disasters

Section 7
Self-Criticism in Trauma

Question 7 | Test | Table of Contents |
Psychologist CEs, Counselor CEUs, Social Worker CEUs, MFT CEUs

In the last section we discussed struggling regarding sharing the trauma story with a loved one and stopping flashbacks.

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

For clients, like Tom and Julie, who have been through a natural disaster such as an earthquake for Tom or hurricane for Julie and are coping with trauma, do you find, like I that they are often blaming themselves for what happened during the traumatic experience? I offer the following 3 exercises to help clients begin to forgive their limitations and stop the self-blame.

Exercise 1: Learn the Theory and the Freeze Response
While this may not seem like the typical way for a client to cope with their trauma, I have found that helping clients understand and encouraging them to research the neurobiological components of trauma can be helpful for clients who are inclined to research. Perhaps in some cases like Julie, clients find it beneficial to understand how the freeze response, in which they become immobilized during the trauma and unable to move or even think, affected them. This freeze response is an involuntary physiological response to threat. Understanding the freeze response can go a long way to helping your client understand their reaction at the time of the trauma, and accepting this freeze response was involuntary and not their fault thus decreasing self-blame. Do you have a client like Julie has been through a trauma that can benefit from a discussion of their freeze response?

Exercise 2: In Someone Else’s Shoes
Another exercise I often use with my clients facing trauma from a natural disaster is to have them put themselves in someone else’s shoes or rather put someone else in their shoes. I used this exercise with Julie when she was having a hard time forgiving herself because she believed, "I could have done more to better prepare me, my husband, and my baby for this hurricane to happen." I begin by telling Julie, "consider how you would feel if your best friend or someone else you love were in the same traumatic situation. Would you hold him or her responsible for what happened? If you would not hold your friend responsible, how does your situation make things any different for you? Is there a way you can direct this compassion for your friend toward yourself? If you would hold them responsible, what would you consider a fair amends? Would this be acceptable for you? " In other words, by switching roles and having your client think about their situation having happened to a friend, and asking them, "Would you not show compassion for that friend? And could you show this same compassion for yourself now?"

Exercise 3: Talk with Others

I also fully encourage my clients to discuss with their trusted family and friends regarding their experiences concerning their own self-forgiveness. I found this technique very helpful with my client, Tom. I stated to Tom, "why don’t you talk to your friends and family about how they would feel if they were in your shoes. Would they find it difficult or easy to forgive themselves? Ask them why or why not."

If you have a client who is finding it hard to forgive themselves, could they benefit from one or more of these techniques?

We will now transition and begin to discuss self-blame clients may feel following a trauma and how to control that self-blame.

One issue that clients facing trauma deal with is self-blame. Would you agree? When Julie, whose family had survived a hurricane but whose home was destroyed, came in for a session, she blamed herself and told me "What did I do to cause this? I HATE myself!! I just have been feeling felt so shitty for so long about myself."

6 Upsides or Benefits of Self Blame:
My first step was to help Julie see why she uses self-blame. I explained to her, "here are a few reasons why self-blame may seem like an upside. By upside I mean of benefit, or a positive that results from self-blame". We then discussed the following list of ways in which self-blame can be an upside or have certain benefits:
1. Events have meaning and are not random: If you feel blameless, self-blame may be disconcerting because it means that the world is random and chaotic in which anything can happen.
2. The world is okay: Self-blame can be easier and more reassuring to believe that you are wrong instead of the whole world being wrong. In other words its easier to think that you are wrong rather than the whole world is wrong.
3. Illusion of control: Thus, Self-blame creates an illusion of control. If only I would have done something differently, the outcome would have been different.
4. Avoid the trauma: Self-blame you link your behavior to the cause of the trauma, thus by controlling your behavior you can avoid the trauma.
5. Future Precautions: By linking your behavior to the cause of the trauma, it also gives you the power to protect yourself from the trauma and take precautions in the future.
6. Feel safe: When you fell that you could have done something to prevent the trauma, it makes you feel safer and helps you control your fears and feelings of helplessness surrounding frightening events.
After going through this list, I gave an example to Julie. I told her "For instance, you mentioned that your home was not hurricane proof and that was something you could do now. Self-blame of this sort can lead to responsible action."

7 Downsides or Negative Outcomes of Self Blame:
After going through the above list of six upsides or benefits of self-blame, I also discussed with Julie how self- blame can have a negative effect. I went through the following list of seven downsides of self-blame:
1. Seeing danger realistically: If you see your behavior as the only cause of the trauma, you cannot see clearly the real danger. For example, Julie was angry at herself for insisting that they buy the house that ended up being destroyed, rather than following her husband’s preferences to buy a house in a nearby suburb which was practically untouched by the hurricane. Clearly, future hurricanes or other natural disasters can happen anywhere. For example, no matter where you live, fires caused by lightning hitting trees, broken gas or water mains, can happen anywhere.
2. Stopping Anger: Self-blame can often stop you from feeling anger. The benefits of this type of anger is, anger can help you feel in charge and in effect can be healing. Julie, like many females have problems expressing anger. She would rather feel self-blame regarding purchasing that particular house several years ago, rather than feeling anger at the randomness of life.
3. Difficulty Receiving Help: I stated to Julie, "It can be difficult for others to offer their help to you when you are blaming yourself. Not receiving the necessary help you need from others can be harmful."
4. Seeking Help: I then stated to Julie, "Furthermore, if you are blaming yourself you may often find it troubling to seek out help."
5. Survivors Guilt: "One form of self-blame is survivor’s guilt, when you perceive others as having suffered less than you and thus feel responsible. This creates an unnecessary burden on yourself." The family that lived across the street from Julie had a child whos leg had to be amputated due to injuries caused during the hurricane. Julie felt guilty at herself and her family who were physically unharmed from the hurricane.
6. Unpredictability of the World: I stated to Julie "When you blame yourself, others may conclude that your trauma came from your poor judgment or behavior, rather than because of the unpredictability of the world."
7. Isolation: "Guilt from self-blame isolates you which in turn leaves you feeling bad, confused, and ashamed."

Are you currently treating a Julie who has experienced a natural disaster such as a hurricane? Could he or she benefit from a discussion of any of these seven downsides or negative outcomes concerning self-blame?

As a review, the seven downsides or negatives to self-blame are…The self-blame prevents your client from realistically seeing circumstances which could have changed the outcome of the natural disaster; self blame stops your client from experessing anger which may be necessary for their healing; self-blame can make it difficult for your client as they feel unworthy to receive any form of assistance; self-blame also may make it impossible or difficult for your client to seek help; self-blame may generate survivors guilt when they compare the outcome of their situation to others whom they feel have experienced greater loss; self-blame may prevent your client from acceptance regarding the unpredictability of life; and finally, self-blame may generate feelings of shame, leading to isolation.

Exercise: Making Words
After going over the above lists of 6 Upsides or Benefits of Self Blame and 7 Downsides or Negative Outcomes of Self Blame, Julie realized that her self-blame was actually stopping her from getting the help she needed. To help Julie stop self-blaming, I encouraged her to find words to describe the experience of trauma. I explained "Trauma is both an emotional and physical experience. It is also not a thinking or thought recall experience, but rather an experience of fragmented images and emotions. Would you agree that a trauma for your client not only involved their thoughts or memories, but fragmented images or emotions as well? I have found, using words to describe these images and emotions can help your client exercise control over their trauma. An essential part of resolving trauma is to express the meaning of the trauma. For example, Julie stated, "I felt terror, panic, and literally got sick to my stomach when I saw our flattened house."

Do you have clients facing trauma due to a natural disaster could benefit from 6.Upsides or Benefits of Self Blame and 7 Downsides or Negative Outcomes of Self Blame?

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

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

Source: Rothschild

Peer-Reviewed Journal Article References:
Benight, C. C., Shoji, K., James, L. E., Waldrep, E. E., Delahanty, D. L., & Cieslak, R. (2015). Trauma Coping Self-Efficacy: A context-specific self-efficacy measure for traumatic stress. Psychological Trauma: Theory, Research, Practice, and Policy, 7(6), 591–599.

Kaurin, A., Schönfelder, S., & Wessa, M. (2018). Self-compassion buffers the link between self-criticism and depression in trauma-exposed firefighters. Journal of Counseling Psychology, 65(4), 453–462. 

Toussaint, L. L., Kalayjian, A., Herman, K., Hein, A., Maseko, N., & Diakonova-Curtis, D. (2017). Traumatic stress symptoms, forgiveness, and meaning in life in four traumatized regions of the world. International Perspectives in Psychology: Research, Practice, Consultation, 6(1), 5–16. 

When a client experiences a natural disaster, what are six upsides or positives that can result from their self-blame? To select and enter your answer go to Test.

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