Managing the After-Effects of Trauma

The psychological effects we may experience following our involvement in an unexpected event can vary for all of us. Our uniqueness extends to our ability to cope and manage with our own experiences as the individual injured – or who has suffered a significant medical emergency – or as a known loved one or witness.

And if we are that witness, our recollections of an event and the emotions associated can be even more powerful – if we believe we were powerless to make a difference. We might then assign all manner of judgements and ‘should haves’ to compound our pain further!


We don’t even have to physically witness an incident to be adversely affected!


Just being told of something devastating, especially if we can make even the most tenuous connection or association can be enough! Many in my local community are currently (naturally) feeling emotions ranging from devastation – to shock and dismay, following a recent tragic road crash which resulted in the deaths of four souls.

When people think of ICE!

In 2005, I was a serving paramedic and a concept I created became world renowned for helping to address a need to quickly identify individuals who had succumbed to trauma or become so medically unwell they couldn’t communicate for themselves. I designed ICE – In Case of Emergency to satisfy a number of needs, each inter-dependent on the other. It’s the final point in the list below that is most relevant to this article:

  • Contact the identified next-of-kin rapidly via the individual’s mobile phone by looking at the uniformly accepted letter ‘I’ – for an ICE Contact. The person who has agreed to be the point of contact who will…
  • Confirm the identity of the injured/ill person
  • Identify any significant medical history so as to avoid further harm and facilitate rapid interventions if needed.
  • Repatriate the loved ones and the hospitalised person at the earliest opportunity.

Dancing at the Party

 …while my loved one dances in and out of consciousness – alone! Imagine finding out, many hours – and even days later, that a loved one has been lying critically ill (or worse!) in hospital – as a patient unknown. (P/U). What is likely to be the psychological outcome for both the injured/sick – and the loved ones?

Guilt – Anger – Should-Haves – Injustice – Sadness?

In mitigating the information flow, at the earliest opportunity, both casualty and loved ones can begin the process of coming to terms with the ‘unexpected’ event, and have less emotions to contend with! There really can be significant differences in psychological outcomes when exposure is provided to what need to be addressed at the earliest opportunity.

That said, casual observers of traumatic incidents can in some specific circumstances benefit from a delay before intervention.

Knocked off his Bicycle

I recall a time in the mid-80’s when I was ‘touched’ by a number of events which I now led to my response to another unexpected event.

Following the death of a family member and during a period of fairly low-level depression, a work colleague’s father (whom I had met only briefly) was tragically killed in a traffic incident. Out of the blue; I felt devastated! I can recall vividly – even today, sitting in my kitchen after finding myself unable to sleep as thoughts and judgements swept me away. The level of grief emotions I felt was so disproportionate to my knowledge of the victim, yet, it felt as if he had been my own father.

Two Soldiers

We cannot accurately predict how two people witnessing the same incident will respond after an event. Two soldiers in a ‘theatre of war’ may witness untold horror – and humanity at its worst. Let’s imagine they are side-by-side and observe a mother and child killed by a bomb. We might imagine that would be enough to deeply traumatize anyone, yet, they may well have very different recollections of the event – and as a direct result, very different emotions.

PTSD – Post-traumatic Stress Disorder

Most commonly associated with the military, PTSD is diagnosed in so many more outside of ‘active’ duty. It may be from a domestic incident, such as emotional abuse, physical or sexual abuse. It may be due to sustained exposure to traumatic events, such as with the daily work undertaken by paramedics, police, and fire officers; when emotional resilience runs low – the symptoms of ‘safety-seeking’ – among others, may begin to manifest and become observably apparent.

The Heart Attack     

Serious medical illness can also be just as devastating for some more than others. I’ve witnessed first-hand, the loss of confidence and enhanced sense of one’s own mortality that can be met with elation and a healthy fresh perspective, and those who fall into deep depression!


To engage with help, we have to drop the expectations of others.


So many sufferers, of what can be short-lived mental health illness, delay seeking guidance and therapy (such as that found via talking therapies, including cognitive behaviour therapy (CBT) and counselling), where to intervene and engage sooner can bring sustainable and measurable improvements to the trauma encountered.

Why do individuals delay seeking help?

Because to consider seeking help, may lead to an incorrect and inappropriate sense of ‘failure’ or ‘weakness’, not meeting the perceived expectations of others.

You can take accountability for your wellbeing.

Whether as a witness or directly injured/ill, only at that time of that event were you a ‘victim’. Choose to be empowered to remove yourself from ‘that’ moment, and gain fresh perspectives once again. Speak to a counsellor, who can be recommended, to build enough evidence to trust in the process of ‘letting go’ of the emotions associated with the memory emblazoned in your mind.

About the author

Bob Brotchie is a counsellor, mindset consultant and creator of "Conscious Living by Design"™. He writes for Anglia Counselling, is featured on various other websites and introduces us to many guest writers all covering topics related to mental health and wellbeing.

Bob provides bespoke counselling services to individuals and couples in the privacy and comfort of a truly welcoming environment at his Anglia Counselling company office, located near Newmarket in Suffolk, England. Bob also provides professional online counselling, for local, national, and international clients. The therapeutic models offered are bespoke to the client’s needs, especially those in receipt of 'childhood emotional neglect' (CEN), whilst integrating a mindful approach to psychotherapy and cognitive behaviour therapy (CBT) principles. For clients experiencing trauma and/or phobia, Bob offers EMDR (Eye Movement Desensitisation and Reprocessing).


  1. Very good post, Bob. This had made me think of a recent ‘road rage’ incident where a 79 year old man was repeatedly stabbed and died. I read that this was not only devastating to the family (especially as he had just been given the all clear of cancer) but that the witnesses were traumatised.

    • Thanks Sonya, I appreciate the feedback. Yes, that kind of tragic event is traumatising for many reasons. Visualisation can occur, the sense of obvious injustice, and the sheer ‘unexpectedness’ of the act!
      It is often not the known that traumatises us, rather the unknown and unexpected. One reason why paramedics and others do what they do because we used to go to work ‘expecting’ anything!
      In fact, after a while in service, the more bizarre the better, such is the conditioning!

Comments are closed.