Acute Traumatic Stress Management

Whatever happens to us during peak emotional experiences in our lives, the gifts of life and the losses of life, will stay with us forever.

In the same way that negative experiences are etched in our minds, so too may the positive force of Acute Traumatic Stress Management. Having someone say and do the right thing, at the right time, can dramatically affect an individual's recovery.

It's important to realize that addressing emergent psychological needs in the aftermath of a tragedy doesn't require an advanced degree in mental health. In fact, the best help is often rendered by people on the front lines - people who take the time to listen and say the right things at the right time.

However, it's important for caregivers to know what to say and do before they reach out to help others. Traumatic experiences, by their very nature, compromise our ability to think clearly and often leave us feeling out-of-control. By having a plan, a traumatic stress response protocol, caregivers will be in control. They'll know what to say and do. They'll be prepared.

Beyond having an understanding of traumatic events and traumatic stress, caregivers must be equipped with practical tools that they can use to help others in the face traumatic exposure. This is the primary goal of Acute Traumatic Stress Management (ATSM).

ATSM was developed as a 10 stage model in order to provide structure during an unstructured period of time - and to enable caregivers to "read off the same page."

i.e., if I was helping an individual to remain in a functional state, by focusing on the facts of a given situation, it would be unfortunate and potentially problematic for another caregiver to walk over and ask, "How ya feeling?"

In fact, this situation was described to me by a New York City police officer in the wake of September 11th. He reported that he was talking with a colleague about extricating bodies when, "...some nut in a red jacket came over and asked me how I was feeling.... I told him to get the ____ out of here. I wanted to kill the bastard!" There's a right thing to say and a right time to say it.

Following, is a brief overview of the 10 Stages of ATSM. For additional information, caregivers are encouraged to read Comprehensive Acute Traumatic Stress Management (www.ATSM.org).

Noteworthy, is that ATSM was built on a strong, empirically-based foundation. The first 4 stages of this model are of primary importance to emergency medical personnel and have to do with considerations surrounding situation management and emergency medical care. The latter 6 stages may be implemented by all caregivers.

It's important to recognize that time constraints and the intensity of individuals' reactions, will vary. Consequently, appropriate intervention may not fall neatly into a linear progression of stages. Caregivers will need to be flexible given the presenting circumstances.

1. Assess for Danger/Safety for Self & Others

Upon arriving at the scene, assess the situation in order to determine whether there are factors that can compromise your safety or the safety of others. You'll be of little help to someone else if you're injured; i.e., don't enter a building that has obviously sustained structural damage. If possible, remove people from the location in order to risk further traumatic exposure.

2. Consider the Mechanism of Injury

Form an initial impression of those impacted by the event. In order to understand the nature of an individual's exposure, it's important to assess how the event may have physically impacted the person - that is, how environmental factors transferred to him.

i.e., if people are unconscious, it's important to know what factor, or factors led to their loss of consciousness. It's also important to consider the perceptual experiences of victims.

i.e., directly observing the bodies of children who have drowned will have a powerful impact on observers. Similarly, the sounds of people moaning will etch a lasting impression in the minds of all who arrive at the scene to help.

Ask yourself whether it's necessary for you to expose yourself to the inner perimeter. Direct exposure to a gruesome scene can compromise your ability to address emergent psychological needs.

3. Evaluate the Level of Responsiveness

It's important to determine if an individual is alert and responsive to verbal stimuli. Does he feel pain? Is he aware of what's occurred, or what's presently occurring? Is he being influenced by a substance?

In the aftermath of Rita and Katrina, it's quite possible that people are experiencing "emotional" shock. Therefore, symptomatology may mimic acute medical conditions (i.e., rapid changes in respiration, pulse, blood pressure, etc.). Recognize that a psychological state of shock may be adaptive in preventing the individual from experiencing the full impact of the event too quickly. Keep in mind that during traumatic events, people can experience a wide range of emotional reactivity.

4. Address Medical Needs

5. Observe & Identify

Observe and identify those who've been exposed to the event. Very often, these individuals will not be the direct victims. They may be secondary or hidden victims.

As I stated previously, witnessing, or even being exposed to another individual who has faced traumatic exposure, can cause traumatic stress.

As you observe and identify who has been exposed to the event (i.e., directly &/or indirectly), begin to observe and identify who is evidencing signs of traumatic stress.

An awareness of the emotional, cognitive, behavioral and physiological reactions suggestive of traumatic stress is important. Carefully look around you.

Anyone, including yourself, may be a direct or hidden victim. This observation and identification stage of ATSM may be viewed as the first traumatic stress - specific stage.

6. Connect with the Individual

Introduce yourself and let people know your role (e.g., "My name is Ron, I'm a social worker"). If the individual isn't physically injured and he has been cleared by emergency medical personnel, move him away to prevent further traumatic exposure.

Begin to develop rapport by making an effort to understand and appreciate his situation. A simple question such as, "How are you doing?" may be used to engage the individual. Use appropriate non-verbal communication (e.g., eye contact, body turned toward him, a gentle touch, etc.).

Recognize that during a traumatic experience, individual reactions may present on a continuum from a totally detached, withdrawn reaction to the most intense displays of emotion (e.g., uncontrollable crying, screaming, panic, anger, fear, etc.).

In view of the magnitude of these hurricanes, you may likely find yourself working to connect with small groups of individuals.

7. Ground the Individual

When you have established a connection with an individual or small group of individuals (e.g., eye contact, body turned toward you, dialogue directed at you, etc.), you can initiate this grounding stage. Begin by acknowledging the hurricane at a factual level.

Here, you attempt to orient the person by discussing the facts surrounding the event. Address the circumstances at a cognitive, or thinking level. While we don't discourage the expression of emotion, attempt to focus on the facts in the here-and-now and help the individual to know the reality of the situation.

His "reality" may be seriously clouded due to the nature of the event. Remember, traumatic events overwhelm an individual's coping and problem-solving abilities. Assure him that he's now safe, if he is. He may still be "playing the tape" of the event over and over in his mind.

By reviewing facts, you may disrupt "negative cognitive rehearsal" (i.e., repetitive, potentially destructive thinking), help the individual to function and enable him to deal with the circumstances at hand.

It's important to "place the individual in the situation." Encourage him to "tell his story" and describe where he was, what he saw, what it sounded like, what it smelled like, what he did and how his body responded. Encourage him to discuss his behavioral and physiological response - rather than "how it felt."

8. Provide Support

Factual discussion and the realization of a severe hurricane, may likely stimulate thoughts and feelings. This is often the time when individuals who are exposed to trauma need the most support.

However, in reality, it's also the time when many people look the other way. Many individuals feel terribly unprepared to handle others' painful thoughts and feelings. Oftentimes, they fear that they'll "open a can of worms" or "say the wrong thing."

Generally, a reasonable attempt to help others is preferable to avoidance.

It's important to establish and maintain a facilitative or helping attitudinal climate. Here, you attempt to understand and respect the uniqueness of the individual - the thoughts and feelings that he's experiencing.

You strive to "give back" a sense of control that has been "taken from" him by virtue of his exposure to the event. You support him and you allow him to think and feel.

Due to the magnitude of these storms, many people will experience an overwhelming sense of aloneness and withdraw into their own world. You should make a respectful effort to "enter that world" and to help the individual to know that he isn't alone and that his unique perception of his experience is important.

Don't attempt to talk a person out of a feeling (e.g., "Don't be scared, you're fine."). Communicate an appreciation of the other person's experience. Attempt to understand the feelings that lie behind his words (or perhaps actions) and convey that understanding to him.

While providing support with young children, you may need to hold and cuddle the child. Reassure him that he's safe, if he is. Know that children will take cues from adults around them, particularly those with whom they're close. It's therefore important to separate children, as quickly as possible, from all stressors - including emotionally overwhelmed adults.

Engaging children must be made consistent with their developmental level; i.e., offering more information than a child is cognitively able to manage may do more harm than good.

Recognize too that children, particularly young children, are generally unable to express their feelings verbally. They may likely convey their feelings through their behaviors/actions. If you have the time, providing children the opportunity to draw with crayons may be helpful.

i.e., you may encourage them to draw something that they remember about the event. The drawing may then be used as a vehicle to understand the thoughts and feelings the child's experiencing.

9. Normalize the Response

While you're attempting to support an individual by giving him the opportunity to express his thoughts and feelings, begin to normalize his reaction to the tragedy. This is an important component when intervening with people who've been exposed to trauma and who may be feeling very alone.

Experiencing a cascade of emotions, or perhaps a lack of emotional reactivity, may cause him to feel as if he is "losing it" and perhaps, "going crazy."

Normalizing and validating an individual's experience will help him to know that he is a normal person trying to deal with an abnormal event.

It's important that you don't become sympathetic and over identify with the situation with statements such as, "I know what it feels like.... When I was...." Rather, you should attempt to normalize and validate the individual's experience with statements like,

"I see this is overwhelming for you right now...seeing so much devastation would be hard for anyone to handle."

An important component of the normalization process is to begin to educate the individual by helping him to know how people typically respond to traumatic events. Discuss the emotional, cognitive, behavioral and physiological reactions that people frequently experience.

Remember, these reactions don't necessarily represent an unhealthy or maladaptive response. Rather, they may be viewed as normal responses to an abnormal event.

10. Prepare for the Future

The final phase of the ATSM process is aimed at preparing the individual for what lies on the road ahead.

It's helpful to

1) review what we know about the hurricane

2) bring the person to the present

3) describe likely events in the future

The educational process initiated during the previous Normalization Stage should continue during this final stage of ATSM.

Be careful not to tell someone as you near the end of your intervention that "everything is going to be okay," or that "everything is going to work out." These kinds of "band-aid" statements may only serve to minimize an individual's feelings and cause him to feel misunderstood.

Instead, focus on the facilitative attitudinal climate that you have established - "I'm glad that I had the opportunity to be here with you during such a difficult time."

ATSM shouldn't be viewed as counseling or psychotherapy. Rather, ATSM provides a road map that can guide individuals through this horrific event, keep people functioning and lessen the likelihood of ongoing emotional suffering.

Conclusion

In the aftermath of hurricanes Rita & Katrina, our nation is rushing to address the devastating loss of life and destruction. Beyond the physical & safety needs of survivors, we must recognize and address the hidden trauma - traumatic stress. In this column, I've provided practical information about traumatic events and traumatic stress that should be reviewed by caregivers and shared with survivors.

Consider the potential of radio, television and the printed news media in helping survivors to understand that their reactions are normal given such an abnormal circumstance? By educating people about traumatic stress, we can give survivors back a sense of control that these hurricanes seem to have taken away. Knowledge is power!

I have additionally presented an overview of a traumatic stress response protocol, Acute Traumatic Stress Management (see www.ATSM.org). ATSM aims to keep people functioning and mitigate long-term emotional suffering. By reaching survivors early, we can potentially prevent the acute traumatic stress reactions of today from becoming chronic posttraumatic stress disorders of tomorrow.

www.DrMarkLerner.com

avoidance learning

Avoidance learning is the process by which an individual learns a behavior or response to "avoid" a stressful or unpleasant situation.

The behavior is to avoid, or to remove oneself from, the situation.

Researchers have found avoidance behavior challenging to explain, since the reinforcement for the behavior is to not experience the negative reinforcer or punishment.

In other words, the reinforcement is the absence of punishment. To explain this, psychologists have proposed 2 stages of learning:

• stage 1: the learner experiences classical conditioning; a warning, stimulus, paired with punishment. The learner develops a fear response when he experiences the stimulus

• stage 2: the learner experiences operant conditioning; whereby he realizes that an action response to the stimulus eliminates the stressful outcome.

The problems of avoidance

• Actively avoiding trauma related thoughts and memories

Avoidance

Avoidance symptoms affect relationships with others: The person often avoids close emotional ties with family, colleagues & friends.

At first, the person feels numb, has diminished emotions & can complete only routine, mechanical activities.

Later, when reexperiencing the event, the individual may alternate between the flood of emotions caused by reexperiencing & the inability to feel or express emotions at all.

The person with PTSD avoids situations or activities that are reminders of the original traumatic event because such exposure may cause symptoms to worsen.

The inability of people with PTSD to work out grief & anger over injury or loss during the traumatic event means the trauma can continue to affect their behavior without their being aware of it.

Depression is a common product of this inability to resolve painful feelings. Some people also feel guilty because they survived a disaster while others, particularly friends or family, didn't.

How does trauma affect relationships?

Trauma survivors with PTSD often experience problems in their intimate & family relationships or close friendships.

PTSD involves symptoms that interfere with trust, emotional closeness, communication, responsible assertiveness & effective problem solving.

• Survivors may experience a loss of interest in social or sexual activities, they may feel distant from others & they may be emotionally numb.

Survivors of childhood sexual & physical abuse & survivors of rape, domestic violence, combat, terrorism, genocide, torture, kidnapping, & being a prisoner of war often report feeling a lasting sense of terror, horror, vulnerability & betrayal that interferes with relationships.

• Survivors who feel close to someone else, who begin to trust & who become emotionally or sexually intimate may feel like they're letting down their guard.

Although the survivor often actually feels a strong bond of love or friendship in current healthy relationships, this experience can be perceived as dangerous.

• Having been victimized & exposed to rage & violence, survivors often struggle with intense anger & impulses. In order to suppress their anger & impulsive actions, survivors may avoid closeness by expressing criticism toward or dissatisfaction with loved ones & friends.

In the first weeks & months following a traumatic event, survivors of disasters, terrible accidents or illnesses or community violence often feel an unexpected sense of anger, detachment or anxiety in their intimate, family & friendship relationships.

Most are able to resume their prior level of intimacy & involvement in relationships, but the 5-10% who develop PTSD often experience lasting problems w/relatedness & intimacy.

Yet, many trauma survivors don't experience PTSD & many people in intimate relationships, families & friendships with individuals who have PTSD don't experience severe relational problems.

People with PTSD can create & maintain successful intimate relationships by:

• Establishing a personal support network that will help the survivor cope with PTSD while he or she maintains or rebuilds family & friend relationships with dedication, perseverance, hard work & commitment

The Avoidant Lovers

An estimated 25% of the people in romantic relationships don't feel comfortable being close to their partners. They don't allow themselves to rely on their partners & feel nervous when other people get too close to them.

Characteristics of this attachment style include:

• Less invested in relationships

• Show less grief following loss

• During sex with a partner, fantasizes about someone else

• More casual sex

• Prefers to work alone

• Workaholics as a way to avoid close relations

• Tend to recall parents as rejecting & rebuffing

• Tend to have experienced childhood trauma (e.g., abused, alcoholic parents)

• Withdraws from partner when partner or self is stressed

• Find social interactions boring & irrelevant

• Don't like self-disclosure by self & others

• Positive mood induction fails to increase their creativity

• Unable to remember relationships well

• Hostile/hateful when provoked

• More likely to be atheist / agnostic; "born again" religious experience during adolescence if mother wasn't religious

• Have death anxiety but tend not to reveal it directly

New Twist in the Avoidant Attachment Style

When observing people with the avoidant attachment style, psychologists have noticed a certain inconsistency across the group.

i.e., some avoidants have higher self-esteem than others & they're less dependent. Researchers call this type of avoidants the "dismissing avoidants."

The other group, the "fearful avoidants", fail to bond with others often due to lack of self-confidence & fear of rejection, but not lack of conscious attachment desire.

Recently, new hypotheses have been formed to explain the differences between the "dismissing avoidants" & the "fearful avoidants".

Some researchers suggest that these 2 sub-styles of avoidant attachment style share common early childhood roots, but sex-role socialization may have contributed to their later divergence.

Studies show that there are more male dismissing avoidants & more female fearful avoidants.

Other psychologists suggest the possibility that dismissing avoidants & fearful avoidants are two somewhat independent attachment styles, with different causes.

Ignoring or Avoiding Feelings

Using praise, sympathy, humor, sarcasm or false reassurance are common ways people attempt to avoid feelings.

Feelings

It's the essential ingredient in effective communication. But we often avoid them in an effort to avoid the discomfort &/or pain that sometimes accompanies them. It can be humiliating to admit that you feel hurt by another person's actions.

It can be painful to hear your child express feelings of sadness or emotional pain. It's important, however, to allow these feelings to be expressed. It's critical that we become aware of how we avoid feelings so that we can eliminate that defeating habit from our communication style.

Avoiding pain &/or avoiding feelings can lead to serious emotional problems that can last a lifetime. We do our children a disservice when we resist expressing & experiencing our own feelings. It's also important to realize that feelings come in layers; like an onion, the feelings on the surface only a cover for the more tender feelings below.

Anger is often the safe feeling that we fall back on when we're feeling intensely. Generally, the anger is only a cover for feelings that feel vulnerable. If we look underneath the anger, (either ours or our child's) we will find that the root of the anger is hurt, guilt, sadness or fear.

Fear is the deepest layer of feeling that is masked by anger.

click the underlined title below to travel over to the 2nd avoidance page! scroll down towards the bottom of the page to read this article!

Avoiding Unleashing Anger

Managing Anger & Fear: In an Angry  & Frightened World

by Gary Egeberg

Emotions That Challenge

Anger & fear are two of the most challenging emotions that teens, as well as adults, must face in a positive, healthy & constructive manner during peaceful times. In times of heightened national insecurity, the challenge is still greater.

Together with feelings such as guilt, hatred, jealousy & sadness, anger & fear are considered by many to be “negative” or “bad” emotions or feelings.

If you believe that anger & fear are indeed “bad” or “negative,” you might feel that you're bad or that something is wrong with you each time you experience them. This may tempt you to stuff them or get rid of them as soon as they surface in your life rather than accept & befriend them.

You'll also be prone to feeling guilty when anger & fear get the best of you. When you “go off” in anger, especially, you may try even harder to stuff or get rid of these troublesome feelings.

Around & around you go: Stuffed or rejected anger or fear leads to mistakes in handling. Perhaps you blow up at someone (anger) or refuse to take a healthy risk (fear). Then you feel lousy about yourself.

This causes you to deny your feelings once again & the circle repeats itself.

Though anger & fear challenge you, trouble you & often involve pain, they're neither negative nor bad in & of themselves. They're simply part of your complex humanity with a bad reputation, because of the circle I just described - one of destructive handling.

If you can begin to view these two powerful emotions as natural, normal & potentially good rather than as negative, abnormal & always bad, you have a much better chance of managing them, rather than allowing them to manage or dominate you.

The challenge for all of us - teens & adults - is to discover & practice healthy coping skills, so that unchecked anger & unchallenged fear don't lead us astray from the courageous & compassionate way of life modeled for us by Jesus Christ.

Anger Is Scary

Anger, your own or someone else’s, is uncomfortable. Other people usually don’t want to be around you when your anger is excessive or constant. It figures, since you usually don’t want to be around other people whose anger is extra-large or extra-long, do you?

Anger scares us all. Your own or someone else’s anger can come on suddenly &/or with unsettling intensity. You may be having a perfectly fine day. Then someone - many times it’s a family member - can say or do something & you end up “losing it.”

Or you might say or do something that results in someone else “going ballistic.” You (or they) might yell or scream or swear or slam a door & stomp off in a huff. Or you (or they) might use the silent treatment, sarcasm or put-downs as a way of unleashing angry feelings. Afterward, when the storm has passed, you are left with guilt, shame, remorse or embarrassment.

Anger, by its nature, is always going to be wild & powerful. Anger serves a very good purpose in your life, for it's often a response to injustice or hurt, whether real or imagined.

So when another person treats you unfairly or with a lack of respect or if you believe someone has, anger is a normal, self-protective response. Not to feel angry in the face of mistreatment is to invite more of the same.

Oddly enough, many people have trouble with anger that isn’t expressed often enough. For instance, you might frequently feel angry, but you may fail to deal with & release your anger energy in a direct manner. You let irritations & other little things that cause you to feel angry build up to the breaking point rather than addressing them as they occur.

You’re setting yourself up for an explosion or rage attack. Often, it’s some little thing that causes you to “go off” on someone else, like the straw that broke the camel’s back.

When you have reached the “rage stage” or boiling point, your words & actions can become violent & out of control. You might say things you don’t mean or break things or even try to hurt someone physically, maybe even yourself.

If, however, you can deal with your anger as you feel it or shortly thereafter, then it doesn't have to reach the rage stage. My wife & I have a loose “48-hour rule” in which we try to address conflicts, problems, unkind comments to each other within a couple of days.

Keep in mind that anger is often a mask for fear.  Anger leaves you feeling much less vulnerable than fear. In order to avoid the discomfort of vulnerability, you may sometimes appear angry when, underneath the anger, you're really afraid.

Kevin, a high-school senior, quite unknowingly uses anger as a self-protective mask for his underlying fear. He nearly always presents an angry image to others, which results in people keeping their distance from him.

Underneath his anger is a fear of being abandoned by anyone he really cares about. This fear may very well be linked to the fact that his mother died of cancer when he was 7.

Fear Hides

Fear, in contrast to anger, is more of a hidden emotion. When people are angry, you can usually tell just by looking at them. It's more difficult to detect visible signs of fear.

Anger is usually about something that happened in the past, whether the event occurred just a moment ago or months or years back. Fear, on the other hand, is nearly always about the future.

Sarah, who is 17, experimented with alcohol for the first time at a party last weekend. Her fears aren't about the drinking, which is in the past, but about her parents’ reaction, should they find out about it. This is in the uncertain future.

Fear can be healthy, as in the example of Sarah. Her fears are telling her that there are negative consequences, such as a loss of driving privileges, should she continue to drink in the future. In this case, fear is like a wise advisor or coach.

Fears can also be unhealthy. You probably know people who never take a healthy risk in order to have a happier, fuller life.

Steve has always wanted to try out for a part in a play, but his excessive fears have prevented him from taking such a risk. In this case, fear can be like an overprotective parent who wants to, but can’t spare Steve the pain of possible rejection.

Fear often walks a fine line between being helpful & crippling. Perhaps we can view fears as being in a parade or progression from unhealthy to healthy. Initially, a fear might be unhealthy & extreme, only to become more healthy & moderate as you face it & deal with it creatively over the course of time.

Collective fears

Our nation’s responses to September 11 are good examples of how we as a people experienced the full range of healthy & unhealthy fears. Right after the attacks, our country, quite understandably, was gripped with overwhelming fear.

Citizens of Middle Eastern descent, who had lived relaxed & normal lives prior to the attacks, became, overnight, among the people who were feared the most.

Fear led to anger. Mixed together in large amounts, these emotions can be a destructive mix.

On the news, you saw some Americans dealing with their anger & fear by shooting at pictures of Osama bin Laden at local rifle ranges. At the other end of the spectrum, we saw reports of some of our fellow Americans, who were just as angry & just as afraid, urging our government not to retaliate with violence.

The media reported small numbers of Americans who reacted in unhealthy & destructive ways by attacking innocent Arab Americans. Other reports featured stories of compassionate & brave Americans who stood up for & befriended their grieving or fearful neighbors. All of us deal with anger & fear in a variety of ways, some of which are much more healthy & constructive than others.

Management Skills

Let’s look at the skills professional people use to deal with emotion. If the manager of a particular business wants her employees to be productive & happy, she needs to develop a number of skills & traits, including these 4:

1) she needs to accept & value her employees as a team & as individuals

2) she needs to be firm yet gentle

3) she needs to be a good listener so that employees’ concerns & ideas are respected & honored

4) she needs to be the decision-maker

You & I need these same 4 qualities in order to manage our emotions, particularly the challenging, painful & upsetting emotions of anger & fear.

1. Accept & value your feelings. Most of us have probably rejected our feelings of anger & fear as powerfully as people in Jesus’ time despised tax collectors & lepers. Jesus himself always accepted people as they were.

By valuing each person, Jesus empowered those persons to make positive changes, to become whole, healthy people. You can do this with your powerful emotions.

2. Be firm yet gentle with your feelings. Because anger & fear can be a bit wild & extreme, we need to be like the best of parents, coaches & teachers: firm yet gentle. You're firm when you choose not to act in destructive ways & choose not to allow fear to prevent you from taking risks that'll help you grow.

You also should be gentle rather than “beat up on yourself.” Tell yourself: O.K., I just lost my temper. I can’t undo what I just said or did, but I can forgive myself, apologize, make amends & try to do better next time. Or I’ve let my fears run wild this past week & have suffered because of it. I'll be kind & gentle to myself as I step out again in faith.

3. Listen to your feelings & allow them to teach you.

Your anger & fear simply want the basic courtesy of being listened to, acknowledged & taken seriously, just as you want others to listen to, acknowledge & take you seriously when you're sharing something important.

When you feel angry (or afraid), you might simply sit down & ask, “What's my anger (or fear) trying to tell me?” If you do this, you may learn what you need to do.

i.e., “Hey, you were mistreated by X & that’s not O.K. Go talk to him about his behavior. Tell him how you'd like to be treated in the future so that I, anger, can move on & out of you.”

4. Take charge of your feelings so that anger & fear don't inspire decisions they're unqualified to make alone. You don’t want your emotions to run the show of your life, to dominate you, especially when you’re upset. In my opinion, 7 key aspects (including feelings) make up a whole person. Each part has a role to play in your healing & wholeness.

These aspects of your humanity can help you deal with all your painful emotions. You can call upon your faith & turn to God as a source of forgiveness & support. You can use your intelligence to help you think through situations, so that anger & fear don't have the final “mis-managerial” say.

You can exercise as a way of decreasing your anger & coping with fear. You can take action, even just a small step such as sharing your concerns with another person. This is particularly helpful in overcoming the paralysis of fear.

You can call upon your heart & take courage, for it does take great heart & profound courage to live as people of faith in such uncertain times.

“Be stouthearted, and wait for the Lord,” we pray in Psalm 27. This prayer can affect your attitude toward life, turning negativity & hopelessness into a positive & hopeful view.

Anger & fear are alive in our world. As followers of Jesus, your goal isn't to rid yourself of these 2 feelings, but to learn to live with & integrate them. As you act in ways that help this happen, you're participating in your own healing & wholeness as well as that of our society, our nation & indeed, the whole world.

Gary Egeberg is a former religion teacher & the author of several books, incl. My Feelings Are Like Wild Animals! How Do I Tame Them? He currently works as a Catholic chaplain in a California prison, where his duties include helping inmates work thru their feelings of anger & fear. Bruce A. Hengstler (15), April J. Ruppert (18), Kimberly Yahl (15) & Ryan M. Yahl (18), from St. John Parish in Fryburg, Ohio, took time to review this issue on a Sunday morning after Mass. Ann Limbert, parish director of religious education, gathered the group.