Simulated Trauma in the Classroom

General Tips

Every class context and group of students is unique, so no single pattern of post-trauma discussion will be equally acceptable or effective for everyone. Thus, in this tip sheet, I outline possible perimeters and suggestions that can assist instructors in creating a helpful and contained learning environment for students participating in a trauma role-play exercise or trauma-based learning experience.

It is important to presume that students are experienced at coping and competent in implementing strategies that have been effective for them in the past. With this perspective, research conducted by Orner, et al. (2003) on early post-trauma interventions in the workplace shows that it is appropriate to allow people who have experienced a trauma event the time to self-monitor their reactions, build a sense of personal control through returning to routines and normality, and talk with colleagues and close friends about their reactions before formally meeting with a group to discuss the experience.

There is also evidence that people deliberately relax, release feelings (e.g., use of humour), and after an incident, talk about it in more general terms (versus details). These findings are important to consider when proceeding with any formal discussion with the class group; having time to mentally and emotionally digest the event can increase the learning experience related to trauma reporting. This may also lead students to understand and work more effectively with their own responses.

The purposes of post-event classroom discussions are manifold. Primarily, instructors should maximize the learning potential of the event, assess how the training exercise prepared students for future work, note any gaps in learning, and evaluate what students need to further master when engaging in trauma reporting or photography. Secondarily, discussions make students’ thought processes available for them to evaluate; decrease potential feelings of isolation in processing their actions and reactions; give instructors a chance to teach about natural reactions to the trauma, and encourage students to accept and appropriately manage their responses in ways to facilitate learning. Finally, instructors can also identify students who may need further help.

Preparation for Discussion

Structuring the Discussion Class

In a successful discussion, the instructor actively structures the class by orienting students to the discussion, having a lucid, competent personal style, and a consistent and coherent group process.1 In the best possible world, the most open structure for a discussion is a circle in a good-sized room that allows for a closed door. This type of spatial boundary invites students into an intimate, open, and contained space to work well. It will add to the stability if no one leaves the room suddenly or unexpectedly during the discussion process.

It’s important that the instructor be firm, explicit, and decisive. Primarily, the instructor must step in to exercise control over who has the floor. Since class time is generally shorter than is needed for this type of discussion, make sure that the whole class is always working, and conversations are effective and on track with the subject at hand. If discussions only involve one or two people, the instructor can direct the students to have the conversation outside of the classroom. With a good orientation to the perimeters of the discussion, and a core period of conversation, the discussion process can end with a summary review of key learning experiences and plans (including time allotments) for any unfinished discussions that still need to take place. 

Orientation and Perimeters of Discussion

It is important to build cohesion among the student group by making explicit their implicit needs for trust, safety, and inclusion in the discussion process. This is done by building a unique set of agreed-upon guidelines for the discussion process long before the discussion takes place (i.e., at the onset of the course, or in the worst case just before the post-event discussion takes place).2 Soliciting students’ ideas about what makes an open discussion possible provides the basis of the guidelines. For example, students may need honesty and openness from classmates and instructor, respect for their diversity, inclusion in decisions and goals in the class, their boundaries respected by being free not to speak, or freedom to learn through their mistakes. Clear information about grading also helps students understand if and how their participation in a trauma scenario will affect their evaluation. In most cases, students should be assured that they won't be negatively evaluated for emotional reactions and responses. Although this may seem time-consuming (give it about 15 minutes), it will bode well if or when the discussion brings up difficult issues (e.g., strong emotionality, conflict, competitiveness, value-based issues). 

Introducing the discussion

A good introduction about how the class will run can increase the motivation of students to participate. The instructor must take the lead in managing the discussion (e.g., making sure that everyone has equal time to talk, presenting discussion questions, containing emotional reactions), emphasizing the voluntary nature of the discussion (e.g., the right of students to decide what they disclose), outlining and maintaining the agreed upon guidelines for open discussion (i.e., applicable to everyone including the instructor), and maximizing every learning opportunity.

Knowing Normative Responses to a Stressor

It’s important at the onset for students to understand the normative response to a stressful or dangerous situation. A quick overview of these types of responses can provide context for the post-trauma discussion, offer a way for students to understand what happened to them personally, and add information for dealing with similar circumstances in the future.

Recognizing Stress Responses and Effects3

Once a perceived danger or stressor subsides, it takes about seven minutes to resolve the build-up of chemical responses in the body and return to a normal state. Symptoms that resolve include such experiences as an increased heart rate, tightened muscles, increased blood pressure, quickened breath, and sharpened senses. These physical changes are necessary to increase strength and stamina, speed reaction times, and enhance focus as a preparation for a fight or flee response from a danger at hand. In the truest sense, a person is physically on “automatic” for survival, and cognitive decision-making is a much slower process when a person is trying to survive a stressful situation.

For journalists, similar stress responses can be experienced whether witnessing someone in distress from a previous trauma or being present first-hand during a trauma event. In a stressful situation students may have difficulty remembering what they had planned because they are overwhelmed by anxiety, making it difficult to concentrate on the task at hand. They may also have poor judgment about what to ask or where to go. After the event or witnessing experience, they may feel irritable, anxious, upset, or worried about what had happened or how they responded. It is also common to only see the negative in the situation or with their encounters with people.

In extreme situations where students experience trauma first-hand or an especially harrowing witnessing of trauma victims or survivors, they may have more acute responses and aftereffects may last beyond the immediate aftermath. Is also important to note that cumulative experiences of witnessing can have long-term impacts for journalists and photojournalists who are consistently in trauma-related contexts.

Discussion Topics

Although most instructors likely have a multitude of discussion leads, I include a few here that are specific to different aspects of processing before, during, or after the event.4 Additionally, questions related to thinking, actions, and emotions can be used in this sequence to help moderate emotionality.

 

Discussion about Pre-event Thoughts

  • What training was most useful in preparing you? What was missing or needed for better preparation?
  • What thoughts or plans did you have before the event about what would happen?
  • What previous experience did you have with similar events?
 

Discussion about Facts about the Event

Student’s role:

  • What was your role? What did you do from that perspective? Why did you decide to do that?

Details about the event:

  • What happened from your point of view?
  • What did you notice around you (e.g., see, hear, touch, smell, taste)?
  • What was your first thought when you began to calm down from your initial reaction?
  • What did you do that you felt good about?

Relationship Aspects:

  • Were there any conflicts with others? How did you handle them?
  • Were there any positive aspects of working with others? What made it positive?
  • Did any of the individuals being interviewed have a special meaning for you? Why?

Emotional Responses:

  • What kinds of things happened to you personally?
  • What was the worst thing about the situation for you?
  • What aspects of the event caused you the most concern or pain?
  • What happened during the incident that made it less chaotic or painful?
  • What techniques helped you handle those uncomfortable feelings?
  • What gave you hope?
  • What was most fulfilling about your role?
 

Discussion about Issues Subsequent to the Event

  • How did you talk about the event with your colleagues, family, or friends after it was over?
  • What help or understanding did you receive from your colleagues, friends, or family since the event?
  • How have you been since the event?
  • Do you have any symptoms of the distress left over from the event? If so, what is happening and what do you need?

Managing Strong Emotions

Crying

When someone cries during a class discussion, it's important that the student does not experience shame in the group. Crying is one way that people respond emotionally to something tragic or violent or to their own reactions to trauma in the aftermath. Always acknowledge that the person is upset, shaken, distressed, sad, angry, frustrated, or whatever the emotion might be. Part of this acknowledgement is being prepared (and expecting) that someone will cry is having some tissues on hand. Often times, people do not want to have attention brought to their tears, but a casual passing over of a tissue, or the opportunity for a person to take some is helpful. Do not try to stop the crying, but include the response as an expected consequence, even saying, “take your time” as they breathe though the tearfulness.

If students are having significant difficulty containing their reactions, the instructor can ask cognitive-based questions (e.g., “What was the first thing that came to your mind?” “What did you notice around you?” “Who was there with you? What did s/he do?”), which get students thinking rather than feeling. As an instructor it is useful to see emotional reactions as teachable moments, especially when it comes to learning how to talk to each other about emotional reactions, normal responses to stress or traumatic stress, and how to take care of themselves after a difficult assignment.

Anger

In order to maintain an open and comfortable discussion where everyone is free to participate, it is important to address any hostile behavior directly towards classmates, including caustic remarks, sarcastic jokes, and other “hit-and-run” types of tactics. Some students may also act in superior, moralistic, judging, or critical ways toward others who are disclosing struggles with the trauma experience. These types of behaviors are very different than typical “gallows” humor between colleagues during trauma assignments. The gallows humor is more of a stress release and not directed towards individuals as a means of hurting or demeaning.

In the case of comments that come from a more destructive impulse, particularly those that demean reactions or opinions of other students, stop the behavior by interrupting or interjecting and rearticulating the agreed-upon norms or guidelines for discussion, exploring the reason for their comments, and/or the impact they have on the person or persons to whom it was directed. Addressing this behavior creates a teachable moment in how to communicate better around the personal impacts of trauma.

Self Care and Other Assistance on Campus

Conclude a post-trauma discussion with reminders of how to take care of oneself after the small or large shocks that a trauma can bring. For students, the first step is taking care of their basic needs, reducing stress as much as possible, and seeking support from trusted family members or friends. Include reminders that in an acute personal crisis they need to call 911 or go to the nearest hospital. They can also call a crisis center (distress line) for additional assistance. These types of crisis lines often exist on college campuses. If students are not in a crisis, the post-secondary school likely has free counseling services available (contact information is most often on the a school website). Make sure that you offer this information to students in the likelihood that they need extra help.

Footnotes

1 For more information on group processes see: Yalom, I. D. & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York: Basic Books.

2 For further discussion on creating guidelines and group management see: Corey, M.S., Corey, G., & Corey, C. (2010). Groups: Process and practice (8th ed.). Pacific Grove, CA: Brooks/Cole.

3 For a more comprehensive explanation see: Levine, P. (1997). Waking the tiger: Healing trauma. Berkeley, CA: North Atlantic Books.

4 Adapted from: Tehrani, N. & Westlake, R. (1994). Debriefing individuals affected by violence. Counselling Psychology Quarterly, 7(3), 251-259.

References

Ørner, R. J., King, S., Avery, A., Bretherton, R., Stolz, P. & Ormerod, J. (2003). Coping and Adjustment Strategies used by Emergency Services Staff after Traumatic Incidents: Implications for Psychological Debriefing, Reconstructed Early Intervention and Psychological First Aid. The Australasian Journal of Disaster and Trauma Studies, 1. Retrieved Nov 2009 from: http://www.massey.ac.nz/~trauma/issues/previous.shtml