Coping after a traumatic injury

What is a traumatic event?

A traumatic event is an unexpected and often frightening situation, associated with immediate danger. Examples of traumatic events that have happened to major trauma patients include:

• road traffic accidents
• being attacked
• falling from height
• industrial or workplace accidents

A traumatic event can result in physical injuries, such as broken or fractured bones, chest injuries or head injuries.

A traumatic event affects everyone differently, and we usually have some kind of an emotional response to threatening or distressing situations. It is normal to experience increased feelings of distress and shock after an unexpected event, but usually, in time, difficult thoughts and feelings begin to settle without the need for professional help.

How does our brain process a traumatic event?

The brain's threat (alarm) system can become overactive, causing us to feel heightened fear and be on the lookout for danger, even when we may be safe.

Our brains can struggle to process traumatic events, with memories feeling vivid and current as the brain struggles to tell the difference between the past and the present.

We can experience 'flashbacks', where it feels like the event is still happening, and notice intense emotions and distress. Shock, denial and difficulty making sense of what happened are all normal, common responses.

Common responses to trauma

There are many other thoughts and feelings you may experience at this time and in the weeks after the trauma.

• You might feel relieved that you have survived and hopeful that you will soon return to normal life, but it is perfectly normal to also feel teary, sad, be more fearful, and hypervigilant to danger.
• There may be increased feelings of helplessness, feeling vulnerable, angry or frustrated.
• You might notice that you are re-experiencing the event, that you aren’t sleeping as well, feel more tired than usual or are experiencing nightmares of vivid dreams. This may impact on your attention and concentration.
• You may notice fear of becoming overwhelmed by your emotions, which leads to numbing or blocking them out.
• Sometimes people start blaming themselves or others, or feel guilty about what has happened and how they have survived when others might not have.
• Following a traumatic event you may want to avoid people and places and withdraw from your usual activities. You may find that you do not want to talk to people about what has happened.
• Sometimes people report that they become more focused on physical sensations of pain and discomfort even in the absence of physical injury as the brain tries to make sense of the events. You might notice this too.

The impact on daily life

You may notice that your usual daily functioning is understandably impacted as you come to terms with what you have experienced. You may struggle with work or studies, noticing difficulties with your concentration. You might notice that your emotions are more intense and unpredictable, feeling stressed and anxious.

You may experience difficulties in your relationships as a result. Leisure activities can become less enjoyable or be avoided entirely. Basic home tasks may feel overwhelming. You may want to interact less socially, due to feelings of fear or anxiety. Physical injuries from the event can require significant adjustments, adding further challenges.

What can I do now to help my recovery?

All these reactions are normal and understandable, given what you have experienced. But there are strategies you can start to use yourself to help your recovery.

Self-care and compassion

• Try not compare yourself to others: recovery takes time, and there will be good days and bad days.
• Prioritise sleep, rest, and nutrition to support physical and emotional health.
• Set small, realistic and achievable goals and celebrate small successes.
• Find creative outlets: work through your emotions through art, writing, or music.

Time

• Give yourself time to process and accept what has happened.

Ask for help and talk to others

• Spend time with supportive friends and family and talk about your experience, when you feel able to.
• Ask for and accept practical and emotional support from others.

Remind yourself

• The traumatic event is in the past and is not happening to you now.
• Reassure yourself that you are safe by focusing on the differences between the traumatic event and your current surroundings. Take a moment to observe what’s different around you - your location, the people nearby, and what you can see, hear, or touch.

Routine

• Try to keep to your usual daily routine as much as possible to bring structure and normality back to your life.
• Be active and get time outdoors, taking into account any physical limitations in your recovery.

Coping strategies to try

When we are feeling overwhelmed it can be easy to get caught up in our thoughts and feelings and lose sight of the present moment. Being able to ground ourselves can help us to develop present moment awareness and be more in our bodies and less in our heads. Try using these techniques if you are experiencing panic or anxiety; they may not work immediately and require some practice.

5-4-3-2-1

Look around, what are 5 things you can see? 4 things you can hear? What 3 things you can touch or feel? What 2 things can you smell? Take 1 deep breath, and focus on the feeling of stress and anxiety leaving your body.

4-4-6 breathing

Breathe in to the count of 4, hold for a count of 4, breathe out for the count of 6 (repeat x 4).

Diaphragmatic breathing

Take a deep breath in and imagine you are inflating a balloon, expanding your stomach as you breathe in, and as you breathe out imagine that balloon deflating (repeat x 4).

Focused attention

Focus your attention on an object you can see. Describe that object to yourself in detail. Don’t just notice the green chair; consider the texture, the shade of green, the shape, the weight. Explore with curiosity.

Mindfulness

We have a constant stream of thoughts and feelings we experience, and can quickly become caught up in these. Mindfulness involves paying attention to what is going on inside and outside ourselves, moment by moment, without judgement, and helps us learn to take a step back from our thoughts and notice their patterns. Reminding yourself to take notice of your thoughts, feelings, body sensations and the world around you in your daily life is the first step to mindfulness.

What if I find that I am still struggling?

For many people, difficult thoughts and feelings start to reduce in the months following a traumatic event. You might notice however that you continue to have difficulties, such as feeling overwhelmed by thoughts and emotions, difficulty sleeping, avoiding your usual activities, or notice a difference in your relationships.

It’s okay and normal to seek support after a traumatic event. Major Trauma Psychology can offer further assessment and intervention if required, offering a safe space to understand your emotions, and develop coping strategies to help your deal with the impact these difficulties are having on your daily life.

Further information

View or download information on this page as a document: NHS Highland Major Trauma Psychology - Coping after a traumatic injury (pdf, April 2025)