How to Recognize the Symptoms of Traumatic Stress

By Dr Douglas Kong

When your company goes through a very rough patch, such as that of a calamity or disaster, or when there are sudden changes in the organization, manpower or leadership of the company there is a lot of stress experienced by your leaders as well as among your personnel and work units. Your management team, various office holders and supervisors often end up running scared and look to each other for support and direction. Most people do not know what to do, and they may appear helpless and directionless.

Hence a large part of our work is to help companies and organizations to be better prepared when they meet with such circumstances. This is done by educating them about disasters and traumatic stress, and to train them in procedures that can help them to handle such contingencies better.

Among the knowledge which would equip and empower people to face traumatic stress better is to understand how people will respond when they are confronted with traumatic stress. Recent events such as the Boston bombing, the factory explosion in Texas and the earthquake in Sichuan is a reminder that traumatic stress is occurring with disturbing regularity these days, and your leadership and staff must know what to do and how to cope.

Responses to Trauma

The modern view of human responses to traumatic stress is that of a normal reaction to an abnormal event. There will be emotional, cognitive, behavioural, physiological and spiritual reactions associated with a traumatic stress. When reactions to traumatic stress occur months and years after the trauma is over, there may be flashbacks, recurrent repetitive behaviours or recurrent dreams including nightmares. Not unusually, a victim’s psychological, occupational and social functions are adversely affected and a psychiatric disorder may also be present.

Let us consider some of the reactions that can be seen after a traumatic event as these are commonly seen in organizations and companies when they go through the experience of it.

Emotional responses

Emotional reactions in response to trauma may include a sense of shock where affected persons can be observed to be stunned or numbed by the trauma, or they can be highly anxious, agitated and hyperactive. Their minds may be clouded as in a “fog” and they are unable to recognize the impact of what happened as in denial. A degree of dissociation sometimes occur with a feeling of unreality. Other emotional responses include feelings of helplessness, hopelessness, fear, panic, hostility, terror, anger, uncertainty, irritability, depression, grief, feelings of guilt and self-blame.

Cognitive responses

Cognitive reactions is often seen in confusion, disorientation, inability to concentrate, short attention span, suggestibility, vulnerability, forgetfulness, thoughts of losing control, and repeated thoughts about the trauma. The picture is that of someone who is pretty incoherent who may not understand what is happening and cannot make himself to be understood.

Behavioural responses

Behavioural responses to trauma include being self-absorbed, uncommunicative, incoherent speech, regressive behaviours, erratic movements, impulsivity, aimlessness, restlessness, exaggerated startle response and antisocial behaviours. When behavioural responses are too exaggerated, the individual may require the attention of some professionals for a more accurate assessment of their dysfunction.

Physiological responses

Physiological responses include rapid heart rapid, elevated blood pressure, muscle tension, pains, fatigue, pale appearance, flushed appearance, sweating, dizziness, chills, hyperventilation, headaches, twitches, gastrointestinal upsets, difficulty in breathing, shock symptoms, chest pains and heart palpitation. The last four may be medically significant and require medical evaluation.

Spiritual responses

Spiritual responses include anger at God, withdrawal from spiritual things, or sometimes an overinvolvement, faith practices such as prayer may suddenly seem meaningless, a perception that God is powerless and does not care with anger at clergy and a questioning of one’s beliefs. Spiritual counsel, if available, can contribute to a better resolution of such responses.

Practical steps

When the above symptoms are present, the most important thing to do is to ensure that the individual is supported by attention to their physical needs. Thus keeping them warm (if they are cold), and removing them to a place of safety and comfort, a warm drink or hot meal are all important in providing a corrective experience to the fear and panic they just had and is needed as much as verbal reassurances. If there is a need to ventilate by talking, crying or any other form of communication, they should be allowed to do so. Do not prevent them from expressing themselves so, and it is unlikely that they could  come to any harm. To avert the latter, just make sure that they are safe while they are expressing themselves. The person so affected must be treated such that they feel a sense of comfort, relief and consolation. 

In cases where there are physical symptoms, they should be brought to medical attention soonest possible. Individuals who are behaviourally out of control or hysterical should be attended to by mental health professionals.


The good news is that in incidents like this, the outcome is generally good for the majority. For those who are predisposed to it because of a weak disposition or with a background of traumatic maladaptation in early life, there is a risk that they may ended up with a Post-Traumatic Stress Disorder(PTSD), in which case they would require more specialized and long term help.

This article is based on material from the manual Comprehensive Acute Traumatic Stress Management by Mark D Lerner, PhD and Raymond D Shelton, PhD and © 2005 by the American Academy of Experts in Traumatic Stress, Inc