Positive coping actions are those that help to reduce anxiety, lessen other distressing reactions, and improve the situation in a way that does not harm the survivor further. These types of coping actions improve things not only for today but for the future as well. Positive coping methods include:

• Using natural supports and talking with friends, family, and coworkers at your own pace. It is helpful to follow one's own natural inclination with regard to how much and to whom you talk.

• Learning about PTSD. It is useful for disaster survivors to learn more about PTSD and how it may affect them. Learning how common PTSD is and finding that these problems are shared by hundreds of thousands of survivors of disasters can help people with PTSD recognize that they're not alone, weak, or "crazy."

• Talking to other survivors for support. When survivors are able to talk about their problems with others, something helpful often results. Through the process of seeking support from other disaster survivors, the survivor may come to feel less alone, feel supported or understood, or he or she may receive concrete help with a problem situation. One of the best places to find support is in a specially designed support group. Being in a group with others who have PTSD may help a survivor reduce his or her sense of isolation, rebuild trust in others, and it may provide an important opportunity to contribute to the recovery of other survivors of disasters.

• Talking to a doctor or therapist about the disaster and PTSD. Part of taking care of oneself means mobilizing the helping resources that are available. A doctor can take better care of a patient's physical health if he or she knows about the patient's PTSD symptoms, and doctors can often refer disaster survivors for more specialized and expert care. Finding a therapist who knows how to help someone after a disaster can also be very helpful.

• Practicing relaxation methods. These can include muscular relaxation exercises, breathing exercises, meditation, swimming, stretching, yoga, prayer, listening to quiet music, spending time in nature, and so on. While relaxation techniques can be helpful, they can sometimes increase distress by focusing attention on disturbing physical sensations or by reducing contact with the external environment. Be aware that while negative or painful physical sensations may become more apparent when a person is relaxed, continuing with relaxation in a way that is tolerable (i.e., interspersed with music, walking, or other activities) is, in the long run, helpful in reducing negative reactions to thoughts, feelings, or perceptions.

• Increasing positive distracting activities. Positive recreational or work activities help distract a person from his or her memories and reactions. Artistic endeavors have also been a way for many survivors to express feelings in a positive, creative way. These endeavors can help improve a person's mood, limit the harm caused by PTSD, and can help a person rebuild his or her life. It is important to emphasize that distraction alone is unlikely to facilitate recovery; active, direct coping with traumatic events such as a disaster and their impact is also important.

• Calling a counselor for help. Sometimes PTSD symptoms worsen and ordinary efforts at coping don't seem to work very well. If the survivor feels fearful or depressed, it is important that he or she reach out and telephone a counselor, who can help the survivor turn things around.

• Taking prescribed medications to tackle PTSD. Many people with PTSD have found that by taking medications they are able to improve their sleep, anxiety, irritability and anger, or urges to drink or abuse drugs.

• Starting an exercise program. It's important to see a doctor before starting to exercise, but after getting the OK, exercise in moderation will potentially benefit those experiencing post-disaster stress in a number of ways. Walking, jogging, swimming, weight lifting, and other forms of exercise may reduce physical tension. These activities may also help distract the person from painful memories or worries and thus give them a break from difficult emotions. Perhaps most important, exercise can improve self-esteem and help people feel that they have some control in their lives.

• Volunteering in the community. It's important to feel like you have something to offer to others and that you are making a contribution. When you're not working, you may not feel that you are contributing anything worthwhile. One way that many survivors of a disaster have reconnected with their communities and regained a feeling of connection and importance is to volunteer: to help with youth programs, medical services, literacy programs, community sporting activities, and so on.
  
  

Coping with Traumatic Stress

Many trauma experts (Staab, Foa, Friedman) agree that the psychological outcome of our community as a whole will be resilience, not psychopathology. For most survivors, symptoms of fear, anxiety, re-experiencing, urges to avoid, and hyper-arousal, if present, will gradually decrease over time.

There are a number of common strategies that individuals utilize when coping with extraordinary stress in their lives. These strategies, while effective at manageable levels of stress, can become unproductive or detrimental when stress reaches overwhelming or traumatic levels. It is important to remember that individuals have their own way of and pace for processing traumatic events such as a disaster, and each individual must listen to and honor his or her own pace and way. It is suggested that survivors monitor their reactions and increase the coping strategies that have worked in other stressful situations. It has also been found believing in yourself and your ability to get through this is very important for recovery.

Research on individuals with positive responses after a traumatic event such as a disaster indicates that their preferred coping mechanisms are to:

• When problem-solving, focus on brief time intervals (e.g., think only about what the next step is), or focus on a larger time interval to obtain a less devastating picture of the disaster (i.e., as one tragic event in a full and meaningful life)
• Maintain a view of oneself as competent and a view of others as willing and able to provide support
• Focus on the current implications of the trauma and avoid regretting past decisions and actions
• Set reasonable goals for each day that are achievable to increase your sense of accomplishment and coping capability.

The process of converting a highly stressful event into a growth experience has the following characteristics:

• It is usually done by the individual alone, but confidants can also suggest new ways of viewing the situation.
• It usually occurs between 2 weeks and 4 months following the stressor.
• It can enhance one's ability to cope with subsequent stressors.
• It usually depends more on an individual's psychological resources than on the characteristics of the stressor event.
• It is intuitive, rapid, and sudden rather than being an extended logical thinking process (i.e., it is characterized by sudden insight and revelation). (Finkel and Jacobsen, 1977)