During and after a traumatic event, we need other people. Relationships are key to helping individuals and communities heal after something bad happens.
Social connections can reduce the impacts of trauma. They let us lean on others during our times of greatest need.
Strong relationships can bring people together, even those who feel alone or excluded.
Social connections take time and energy to build and maintain.
It’s worth investing in trusted relationships. When they are formed, those who have experienced trauma can feel supported and find hope for their future.
How can I build social connections after trauma?
Look at your current relationships:
Think about the people who are already in your life.
This might include family, friends, co-workers, or neighbours.
Ask yourself: Can I turn to them for support?
Find community social supports:
Are there nearby groups and organizations you can join?
Look for clubs, groups, teams, committees, online forums, and more.
Connect with cultural and identity-based orgs:
Are any groups related to your culture, identity, or religion?
This might include family, friends, and others who share your values or beliefs.
Map out your social connections:
Write down or draw a diagram of the connections you have just identified.
Include people and groups from across your personal, community, and cultural areas.
Plan to connect:
Select one connection to reach out to first.
Make a plan to do that using the S.M.A.R.T. method: Specific, Measurable, Achievable, Relevant, and Timely.
Citation: Heber A, Testa V, Groll D, Ritchie K, Tam-Seto L, Mulligan A, Sullo E, Schick A, Bose E, Jabbari Y, Lopes J, Carleton RN. Glossary of terms: A shared understanding of the common terms used to describe psychological trauma, version 3.0. Health Promot Chronic Dis Prev Can. 2023;43(10/11). doi.org/10.24095/hpcdp.43.10/11.09
A collection of feelings, behaviours, and experiences that can occur in the first month after a person is exposed to a potentially psychologically traumatic event (e.g. actual or threatened death, serious injury, or sexual violence). The exposure can occur in many ways. For more information about exposures that may lead to ASD, see potentially psychologically traumatic event (PPTE).
Clinical anxiety
Describes anxiety symptoms severe enough to require formal medical or mental health treatment.
Symptoms can include intense worry, nervousness, restlessness, rapid heart rate, muscle tension, irritability, trouble concentrating, and feelings of worry or dread, or physical changes such as increased blood pressure.
Clinical depression
Describes symptoms of a major depressive episode that requires formal medical treatment.
A major depressive episode typically lasts for a period of several weeks. Symptoms include feeling sad or numb, low mood, lack of interest in usual activities or relationships, difficulty concentrating, poor sleep, feelings of hopelessness, and sometimes, suicidal thoughts.
Complex posttraumatic stress disorder (C-PTSD)
A type of posttraumatic stress disorder that results from experiencing repeated, severe psychologically traumatic events.
People with C-PTSD have a profound loss or absence of a sense of identity and difficulty controlling their emotions. They are often involved in unstable relationships as adults, and often have patterns of impulsive choices, feelings of emotional instability, and behavioural problems. Sometimes they experience chronic unhappiness, suicidal thoughts, and suicide attempts.
Complex trauma
A psychological injury that results from severe types of potentially psychologically traumatic events (PPTEs).
A form of talk therapy where a counsellor sits down with a client to help them work through their issues in a safe, confidential environment. Counselling can take many forms, ranging from in-person to online to telephone sessions.
Refers to any type of harmful behaviour against a person or group of people because of their sex, gender, sexual orientation, or gender identity.
Intersectionality
Recognizes the multiple aspects of an individual’s identity that influence their experiences. Identity factors include ethnicity, religion, age, physical and cognitive ability, sex, gender identity, sexual orientation, and socioeconomic status.
Interpersonal violence
The harmful physical and psychological behaviour by a person or group of people toward another person. It is a type of potentially psychologically traumatic event (PPTE) and can contribute to mental health conditions in either the person causing the harm or the person who is harmed.
Mental health
Mental refers to thoughts, feelings, emotions, and related brain functioning.
Mental health exists on a continuum from poor to good. In good mental health, a person:
understands themselves and their abilities
copes well with normal stress
experiences good feelings from their interactions and relationships with others
is able to work or function well in their usual activities, and
contributes to their family and/or community.
Mental health injury/psychological injury
May be used as different names for a mental health condition, including a mental disorder, especially when the condition is caused by exposure to one or more potentially psychologically traumatic events.
The word “injury” is used when describing mental disorders or conditions to try to reduce the stigma associated with mental illness.
Mental illness
Refers to emotions, behaviours, and difficulties in thinking that affect a person’s ability to clearly understand the real world and what is happening to them and around them. These emotions, behaviours, and difficulties are generally the signs and symptoms of the mental illness. The signs and symptoms of a mental illness can range from mild to severe.
Mental illness is often accompanied by distress and decreased functioning in social, occupational, or other activities of daily life.
Moral injury/moral distress
During potentially psychologically traumatic events (PPTEs) or other unusually stressful situations, people may carry out, witness, or fail to prevent events that go against their moral beliefs and expectations.
A moral injury can occur in response to doing something or witnessing behaviours or acts that go against a person’s values and moral beliefs. Events that cause moral injury can be:
acts of commission (what someone has done)acts of omission (what someone has failed to do), or
acts of betrayal.
Navigation tool
A website with general mental health advice and information on local mental health services, supports and programs.
Peer support
A supportive, recovery-oriented relationship between individuals who have had or have the same experience, that is, they have a shared lived or living experience. It can offer social, emotional, spiritual, and instrumental support to promote a person’s well-being and path to recovery from mental health problems.
Peer support can be delivered one-to-one or by a group, and some peer support is a combination of both.
Posttraumatic growth (PTG)
The positive personal changes that may result from a person’s struggle to manage the consequences of being exposed to one or more potentially psychologically traumatic events. PTG can include a new appreciation for life and future possibilities, a newfound sense of personal strength, improved relationships with others (e.g. a new focus on helping others), and spiritual or existential change.
Posttraumatic stress (PTS)
Refers to stress resulting from exposure to one or more potentially psychologically traumatic events (PPTEs).
Posttraumatic stress disorder (PTSD)
The collection of feelings, behaviours, and experiences that can occur after a person is exposed to a potentially psychologically traumatic event (PPTE). The exposure can occur in many ways. For details of exposures that may be associated with a PTSD diagnosis, see potentially psychologically traumatic event (PPTE).
PTSD reactions can include:
immediate feelings of terror, panic, anxiety, rage, or sickness when exposed to a sound, sight, or smell that is a reminder of the event
vivid and intrusive memories of the event, which can sometimes feel as if the event is happening again (“flashbacks”)
nightmares and disturbed sleep
not remembering the event (amnesia), or feeling emotionally numb
avoiding places, people, or circumstances that are reminders of the event
being hyperalert to threat or danger, and
feeling that things are unreal or that you are living in a dream (depersonalization or derealization).
A stressful event that has caused psychological trauma and has the potential to cause PTSD and other trauma-related mental health conditions. This term is more precise than terms like critical incident or crisis.
Typical examples of potentially psychologically traumatic events (PPTE) include:
adverse childhood experiences
motor vehicle accidents
sexual assault and other types of violence
unexpected violent or accidental death of a loved one or threatened death of a loved one, and
threat of or actual severe physical injury, experiencing military combat, natural disasters, or exposure to human remains.
Psychological first aid (PFA)
An immediate way to help people after a disaster or traumatic event. PFA aims to provide support to reduce initial distress and promote resilience. By addressing basic needs such as safety, comfort, and emotional connection, PFA helps reduce the risk of long-term mental/emotional harm.
Recovery
The personalized journey to a way of living that allows a person with a physical or mental health condition to have positive mental health and good well-being.
Resilience
The long-term physical and mental determination that people draw on to deal with ongoing adversity. It is a quality that an individual may naturally possess or develop through work and life experiences.
The extent to which you feel yourself supported by others. People have social support networks of different sizes. Social support also includes various groups or networks, including people from work, family, and friends from different parts of a person’s life.
Stigma
A set of highly negative ideas and beliefs that society has about something. To be stigmatized means to be symbolically marked as a disgrace. Mental illnesses are among the most highly stigmatized conditions in society. When a health condition is stigmatized, the person experiences not only the symptoms of the condition itself, but also the social rejection, disapproval, and the shame that the stigmatization creates.
There are four types of mental health stigma:
Structural stigma is when organizational policies and practices are unfair to people with mental disorders.
Public or interpersonal stigma is when the public think or act negatively toward people with a mental disorder.
Self-stigma occurs when people with a mental disorder believe the negative public views and apply these views to themselves.
Stigma-by-association is when those close to or related to the stigmatized group (such as family, friends, or mental health providers) are also stigmatized.
Trauma
Something that causes physical, emotional, spiritual, or psychological harm.
A person’s experience during an event that is so distressing to them that it overwhelms them emotionally; psychological trauma can be the cause of mental disorders such as posttraumatic stress disorder.
Can be defined using a broad framework that includes seven interacting domains:
employment or meaningful purpose
financial security
health
life skills and preparedness
social integration
housing and physical environment, and
cultural and social environment.
Wellness
There is no consensus on a definition, but some definitions of wellness overlap with definitions of well-being.
Defined by the First Nations Mental Wellness Continuum Framework (FNMWCF) as a balance of the mental, physical, spiritual, and emotional. In this framework, mental wellness is enriched when a person has purpose, hope for their future, a sense of belonging, and a sense of meaning.
Wellness support
Health services, programs, or activities that focus on the promotion or maintenance of good health. These supports are designed to improve well-being while reducing pain, stress, and anxiety.
Sometimes you are exposed to situations that challenge your sense of right and wrong. These experiences can vary in how long they last and how intense they feel. They can stir up feelings that range from mild moral frustration to more serious moral injury.
Understanding moral challenges
A moral challenge might cause moral frustration, such as worrying about the state of the world. Usually, this feeling does not affect you too deeply or last for very long.
Moral distress can bring up emotions like anger, sadness, and guilt, although it rarely has a lasting negative effect. Being lied to or having something stolen might cause moral distress.
A potentially psychologically traumatic experience can be a singular event or an ongoing situation. It is a rare but intense violation of your deeply held moral beliefs. Many PPTEs are high-stakes scenarios that can create long-standing challenges in how you see yourself or other people.
Types of potentially psychologically traumatic experiences
PPTEs can happen in different ways, such as:
Transgressions of the self involve doing (or not doing) something you think is right.
Transgressions of others happen when someone else’s actions or inactions go against your morals.
Betrayals occur when people or institutions you trust let you down.
Examples of potentially psychologically traumatic experiences
Things that might be considered PPTEs include:
Seeing something harmful or immoral happen and being unable to stop it.
Experiencing misconduct from a trusted person or institution.
Feeling unsupported by leadership after a major event that went against your beliefs.
Carrying out orders you believe are immoral.
Feeling like you should have done something to prevent someone’s death or injury.
Witnessing suffering in others caused by actions that were committed by you or someone else.
Signs of moral injury
After a PPTE, you might notice changes in your emotions, behaviours, and social life — perhaps even your beliefs. These could include:
Feeling exhausted or disconnected from your work and the people around you.
Feelings of shame, guilt, anger, or hopelessness.
A sense of betrayal or injustice.
Loss of purpose or sense of identity.
Having difficulty concentrating.
Losing trust in yourself or others.
Isolating or feeling cut off.
Blaming yourself.
Struggling with your spiritual or existential beliefs.
Self-sabotaging, self-harming behaviours, like using alcohol or drugs to cope.
What can help?
If this sounds familiar and you think you are experiencing a moral injury, here are some steps you can take:
Write down your thoughts and reflect on the values that matter to you.
Talk to people you trust, like colleagues, family members, spiritual advisors, peer supporters or your friends.
Seek help from a mental health professional.
Learn more about moral injury within your community (e.g., first response, health care, military).
Resources
If you are interested in learning more about moral injury — particularly among essential service workers — you can read:
Moral injury is the potential outcome of witnessing an event that goes against ones moral beliefs, or participating in the act oneself. Moral injury can also be caused by feeling betrayed by someone you trusted, like a coworker, supervisor, or workplace.
It often results in intense feelings of guilt, shame, disgust, and anger.
What is posttraumatic stress?
Posttraumatic stress (PTS) is a response to traumatic events that one has personally experienced, has learned about happening to a loved one, or has been exposed to. This could include actual or threatened death, serious injury, or sexual violence.
PTS symptoms can include:
Reliving the event repeatedly in your mind
Having nightmares
Avoiding family and friends
Having trouble sleeping
Losing interest in enjoyable activities
Avoiding places and people that remind you of the event
Some people with PTS also experience dissociation. This means that they feel disconnected from themselves, or feel like things happening around them are unreal or unfamiliar.
Though most people who experience a traumatic event will have a strong reaction, many will recover over time. Experiencing trauma doesn’t mean you will develop PTS.
Psychological trauma refers to lasting emotional impacts of living through or learning about a distressing event. These events, known as traumatic events, can be singular (e.g., assault), or repetitive (e.g., abuse), and while some people are more likely to experience a traumatic event, these may happen to anyone, regardless of profession or background.
Importantly, if you are having trouble managing your emotions, reactions, or day-to-day life following traumatic events, please seek support.
Common impacts following a traumatic event include:
Muscle tension
Low mood
Feeling “out of control” of your actions or emotions
Increased irritability or anger
Memory difficulties (e.g., gaps, loss)
Disinterest in activities you used to enjoy
Short term memory challenges (e.g., forgetting where you parked your car)
New difficulties controlling negative patterns of thinking (e.g., feeling hopeless)
Difficulty with concentration and decision making
Increased intensity or frequency of fear responses (e.g., more easily startled)
Changes in how you think about yourself, other people or the world around you
Recurring thoughts, memories, or dreams about the traumatic event
Difficulties with sleep (e.g., falling asleep, staying asleep, waking up in the middle of the night)
Withdrawing or disconnection from your surroundings
Other impacts of psychological trauma that aren’t talked about as often include:
Dissociation, which is a way to “numb out” when things get overwhelming, through disconnection from our surroundings, and can occur either through depersonalization or derealization.
Depersonalization: feeling as though your body does not belong to you, or as though you are “outside” of your body
Derealization: feeling as though things around you are unreal or strange (e.g., as though you’re in a movie)
Guilt, which are feelings of having done something “bad” or “wrong” following the traumatic event. Often, these feelings may show up as thinking about past events and thinking that you or someone else “could have” or “should have” done something differently. Sometimes people may even feel guilty that they survived an event that another person did not. This is known as survivor guilt, and can lead to feelings of negativity about ourselves, or even thoughts about whether we “deserved” to survive compared to those who lost their lives.
Shame is the feeling that part of me is “wrong” or “broken”, and can be a very challenging emotion to navigate following traumatic events. These events may make us feel like the way we reacted means something bigger about who we are as people, or even as though the traumatic event that happened was someone their fault. Shame is a negative feedback loop that can stop us from wanting to seek help because we may feel like we do not “deserve” to live a stable, healthy life.
Moral injury is a type of stress response that occurs after a morally distressing experience, where we feel that our own deeply held morals have been violated in some way. Symptoms can include psychological, social, behavioural, and spiritual changes that might impact how we see ourselves or other people.
Moral stressors and our associated moral reactions exist on a spectrum. Moral challenges may prompt feelings of moral frustration but do not lead to any lasting impairment, such as worries about “the state of the world.” Moral distress brings up moral emotions and cause short term increases in distress levels. Experiences such as being lied to or stolen from might induce moral distress, but they are unlikely to leave lasting impacts. On the far end of this spectrum are morally injurious events, which cause moral injury.
Vicarious traumatization, also called secondary traumatization, is something that can be especially challenging for individuals who work or volunteer in public safety, military, and healthcare settings, due to their more frequent exposure to victims of traumatic events and violent acts. This can occur when we hear about or witness events that have occurred but do not have direct impacts on us as individuals. The symptoms that occur following vicarious trauma are similar to that of experiencing a traumatic event personally.
Having trouble coping with my behaviours, emotions, or social changes following a traumatic event? This may be a normal reaction to witnessing, experiencing or hearing about traumatic situations that people go through. However, if this is causing you a lot of distress or getting in the way of how you would like to live your life, it may be important to seek support.
Supports can include:
Peer support
Talking with family or friends
Religious or spiritual leaders
Mental health professionals
Self-driven activities that may help reduce distress include:
Identifying people, places or situations that trigger your stress responses in order to increase your awareness and cope ahead
Labeling your emotions as you notice them rather than avoiding them
Boxed breathing
Progressive muscle relaxation
Setting boundaries with other people and with yourself
Coping strategies can help you manage stress and assist with healing. It can be hard to find the energy to engage in them, so having a few go-to tools can be very helpful. Here are some you can begin to use right away:
Set and keep routines that help with work-life balance. Focus on a healthy diet, enough sleep, exercise, and time with friends and family.
Set small goals for yourself. These will give you a sense of accomplishment, and signal that you are taking care of yourself.
Practice deep breathing. Inhale for four counts, exhale for four counts, practice for four minutes. Deep breathing sends oxygen to the brain and helps relax the body.
Positive self-talk. Redirect negative thoughts by reframing them.
Visualization. Pay attention to all senses and visualize positive images. For example, imagine the sounds, smells, and sights of a calming scene.
Self-care. Go for a walk, engage with your religion/spirituality, journal, read a book, take a nap or bath, listen to music. Do something that feels good!
Self-compassion. Show yourself the same kindness you would to a friend who is struggling. Find guided self-compassion exercises here.
Mental Health Continuum Model. The mental health self-assessment tool helps identify your current mental health status and provides relevant resources.
Social support