Losing a job, the departure of a loved one, the news of a serious illness are extreme, even traumatic events. Everyone experiences such a trauma differently. Some give up, others fight. We talk to Mariola Kosowicz, a psychotherapist and psycho-oncologist about a man in his life.

When we find ourselves in a difficult situation, a hormonal storm occurs in the body. The production of about 30 neurotransmitters that transmit signals between nerve cells is increasing. The reactions of the body and psyche are sometimes very violent …

- Sometimes patients with broken heart syndrome come to hospitals - its symptoms resemble a heart attack. Even the EKG trace looks the same. But there is no heart attack, there is a human tragedy after surviving the trauma …

Mariola Kosowicz: We have a medical explanation for this. A critical situation increases the level ofadrenalinein the blood up to 30 times. This blocks the flow of calcium to the heart cells, which stop contracting due to a lack of this mineral. And this is like having a heart attack.

But not everyone reacts so strongly to difficult events …

M.K .: The reaction tostressis always individual. The same incident causes enormous stress on one person, while on another it does not feel so much. This is because it is not the objective situation itself that causes the stress. It is caused by the importance we place on this situation, how we think about it - positively or negatively. We were fired … We can say: "that's good, I was underestimated, I will find something better." Or we take a different attitude: "I won't find another job because I'm good for nothing."

What does our attitude towards a traumatic situation depend on?

M.K .: From our beliefs, values, upbringing, temperament, worldview, that is, in short, from personality. More susceptible to stress are people who are impatient, shy, live in a hurry, take on too many responsibilities, pursue their goals at all costs, and those who avoid the truth about their lives and build an unreal image of themselves and their world. Stress arises from life conflicts, states of uncertainty, and suppressed feelings. A person with a complex becomes irritable, sensitive to criticism, he is powerless in the face of the environment and the world, and therefore more stressed. Thatpeople with a cheerful disposition, friendly to the world, and going towards their goals without a pointless struggle do better with stress. Those that do not worry in advance, but realistically react to difficult situations and are aware of their resources and psychophysical deficits.

According to an expertMariola Kosowicz, psychologist and psycho-oncologist

Mobilization or destruction

Putting the body into combat readiness, if it lasts a short time, does not wreak havoc, as long as mobilization is followed by rest, which allows you to regenerate and balance the levels of individual hormones. This kind of stress is creative - it motivates us to act, inspires us, helps us overcome difficulties. But it can also cause unpleasant reactions on the part of the body, such as trembling of the arms and legs, palpitations, sweating, abdominal pain, diarrhea. When the stress is gone, the discomforts also disappear. When the effect of the stressor is prolonged, we enter the immunity phase. The fight hormones are still produced with redoubled energy, the tension remains, but the body gets used to it. If we do not release the tension in time, stress goes into a phase of disarming and then a phase of destruction. This one is the most dangerous for us, because it makes it difficult or impossible to achieve our goals, makes us feel helpless in the face of life situations, and - or perhaps most of all - destroys our he alth. This is because the balance between burning resources and the possibility of their renewal is disturbed.

What else determines the strength of our reaction to stress?

M.K .: The most difficult situations to overcome and survive are situations that deprive us of not only one valued value, e.g. work or a loved one, but those that knock us out of our current roles. When we learn about a serious illness, a personal tragedy is not only the awareness of the loss of he alth. We are depressed and terrified by the lack of body control. We cannot go to work, even though it was an important part of our daily life. We cease to be an attractive sexual partner because the disease takes away our strength. We don't give our kids or friends as much attention as we used to. We fall out of important roles that allowed us to build our own value. Telling the person that the most important thing now is to get better doesn't help at all. Recovering he alth is important, but these other small elements were an integral part of life, often its meaning. Now they are gone. There is a void that can be called mourning.

What does loss of he alth have to do with mourning?

M.K .: Each suffering caused by a great loss is mourning, although we only use this term on a daily basis in the case of the death of our relatives. In other situations, we usually say, “it isI'm sorry, I'm disappointed, I'm sorry. " But emotionally and mentally, we experience the same things as we experience after losing someone important to us, at least to a different intensity.

How does the past affect our attitude in difficult times?

M.K. There are many such reasons, but one of the most important is the home, the atmosphere in which our psyche was shaped, the attitude of our relatives towards difficult events, and the way we were treated in childhood. If our parents constantly discouraged us and criticized us, we did not develop the correct coping mechanisms in difficult times. If my mother kept saying, "I can't handle it, I can't hold on anymore, I'm going to die over all this," then it may happen that we unconsciously adopt the same attitude and carry it into our lives. Like her, we will be helpless, fearful, helpless. We will become the people for whom the glass will always be half empty.

It's hard to break free from this emotional stigma?

M.K .: Sometimes it is even impossible. But a person should cultivate a sense of certainty that what happens to him - despite its weight - makes sense. You have to accept a given situation as a fact, then consciously activate your remedial resources, face the challenge and see sense in your actions. Such an attitude allows us to overcome difficulties, dividing them into stages over which we can realistically control at a given moment. Small victories allow you to act - a person gains the awareness of control over his life, and this significantly reduces stress.

Is there a pattern of our reaction to loss?

M.K .: Everyone reacts individually, but certain emotional responses are given to us in a similar way. When something that I did not expect and that violates the order, the sense of security, regardless of how we understand it, the first reaction is shock and disbelief: "this cannot be true, it will pass in a moment." After all, in a sense, we have a fixed picture of the world, and an unexpected situation threatens the basic assumptions by which we build our sense of security and we magically believe in the continuity and predictability of our lives. That is why, in a situation that violates our sense of security, a defense mechanism, called denial, is often triggered. We do not allow ourselves to be aware of what has happened, and in that first moment it helps to reduce the tension. The problem begins when the mechanism of denial goes on for a long time and we are out of touch with what is going on in our lives. In such a situation, we no longer reduce stress, on the contrary - we deepen it even more.

And it's not that hard timesopen our eyes to the world?

M.K .: It happens so. In a dramatic situation, everything becomes clearer. Sometimes it is only then that we see the true picture of our life, family relationships, relationships with our husband, children and friends. Our eyes are opening. One of my patients was dying of cancer and the most difficult problem for her was the attitude of her husband, who said that he already had another, attractive partner and that he did not care about his wife anymore. The drama was that she saw how she had lived so far, that her husband was always disloyal, a stranger. It happens that after the death of one of the spouses, the other person also leaves soon. Why? Because their relationship was symbiotic, deeply connected, that now we cannot function without a husband or wife. Being together was like air. It is a kind of addiction to another person. These people stay where they broke up with their loved ones. They do not have the strength and courage to take a step forward. It loses them, they often die. Fortunately, most people will mourn over time. Women who, after losing their husband, say to me: "I will never fall in love again" return with a new twinkle in their eyes and confess: "I have met someone". But in the moment of their despair, one must not say: "you will know someone, the pain will decrease, you will forget". Not. You have to listen, give time. "Good advice" at a time like this would be disrespectful to their suffering and sorrow. A mechanism of denial often appears in our reactions. It concerns not only people directly affected by the tragedy, but also their relatives. I'm not talking about the trouble, so it's not here. Sometimes it helps. If someone seriously ill says: "I will live a long time," let's not deny it. Let's not prove that he will die soon. Let us assume his attitude, because that is what he needs now. And when he seriously says: "I'm dying", let's not forcefully deny, let's not change the subject, but let the sick person express themselves with humility in the face of the difficulties of such a situation. We have the right to be helpless and we do not have to find a solution by force. For this, together with the dying person, we can use the time we have left.

Each of us has our own threshold for accepting traumatic events?

M.K .: Yes and no. I often look after people who die in my own home. Their families emphasize that accompanying the passing of a loved one allows them to get used to death. But that doesn't mean it's easier later. Each of us has a strong instinct to adapt to unusual situations. The late doctor Marek Edelman told a lot about love born in the ghetto. It was a feeling that made me feel needed, maybe even more secure. It's the same in everyday life. Thanks to sometimes strange actions, we find strength in ourselves,to endure to find a way out of a difficult situation. But there is a fine line between what helps us survive and what starts destroying us.

Is it worth asking someone for help in extreme situations?

M.K .: I will not find a good answer here, because every situation is different, each of us is different. A cordial conversation, shopping, and an invitation to a joint trip can be of help. Whatever we mean by help, we may not get it. A seriously ill patient I look after recently told me: “I would like to talk so much about my situation, about my fear, about the future. But when I start such a conversation with my children, they say one thing - mother, not a word about the disease ”. A person in a difficult situation does not want to hear: "Somehow it will be fine, you can do it". These are empty words. When he complains of unbearable pain, someone replies, "Oh, I'm in constant pain too." Such answers prove that the interlocutor does not want to know our problem.

Then people's masks fall off …

M.K .: In a difficult situation, the truth about our life, relationships with people and relationships always comes out. When we face any misfortune, we expect everyone to be empathetic, good, service-minded, honest, and ideally they should guess our needs. We forget about the professions that our loved ones used to do to us before the misfortune happened to us. But we didn't always pay attention to it or pretended that everything was fine, because it was more convenient.

How to deal then?

M.K .: Nobody will survive the difficult times for us, but we need other people. However, we often say, "no, thank you for your help" because we do not believe that we will get it. It is also worth remembering that even if we honestly say what kind of support we expect, we will not always get it. The reasons may be different: someone cannot, cannot, is afraid or does not want to sacrifice for us. And it doesn't matter that we were helpful to these people in the past. It also happens that we do not ask for help, because we are afraid of other people's opinions. The woman hides that her husband left her, because she does not want to hear that she is guilty, that she did not care for the marriage enough … In my practice, I encounter situations when the "friendly" not only pass judgments about us, but also try to take control over our life. They do not think about the needs of the unhappy person, but about their own: “I'm helping this poor man, I'm good. I bring him soup every day - I sacrifice myself ".

So how should we behave towards people in extreme situations?

M.K .: It is not a good solution to pretend that nothing has happened or to avoid a sick, abandoned, unemployed or despairing person after losing a husband or a child. I believe that, for example, we shouldmake a phone call and at least say we feel sorry for you. However, I would warn against rashly declaring help. If we say: "you can always count on me, I am at your disposal," let's do it responsibly. It may happen that we receive a request. If you are not strong enough to help, or if you are not really ready to help, don't throw your words to the wind. If you know you can't get someone else's work, don't promise to talk to your boss. Don't build false hopes. If you feel that you will not be able to take care of a sick person for several hours, so that the caregiver will catch his breath, do not offer your services.

But how can you refuse to help someone in a difficult situation?

M.K .: It's difficult, but I don't condemn such people. They refuse because they usually want to protect themselves, but that's fairer. Their proposal can be taken very seriously, as a last resort. So if we can't afford all of the help, let's be clear about what we can do. For example: “On Friday I am going shopping, I will gladly bring you water and juices. What else do you need? This is the specificity that allows a person at the bend to rebuild the world and he althy relations with the environment. It allows you to believe that despite all the misfortune, he is not alone, that someone is thinking about him and really wants to help.

Mariola KosowiczFor many years she has specialized in the treatment of depression and couples therapy. She works with patients and their families at the Rehabilitation Department of the Oncology Center in Warsaw (Maria Skłodowska-Curie Institute). She is a therapist and trainer of Rational Behavior Therapy - she teaches how to deal with serious personal and family problems.

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Psychology