ysabetwordsmith: Text -- three weeks for dreamwidth, in pink (three weeks for dreamwidth)
[personal profile] ysabetwordsmith
Shock can take physical or emotional form. Both can pose significant dangers. Although physical shock tends to be more serious in the short term, emotional shock can easily turn into chronic conditions such as PTSD or depression which can kill later. Also, either version can feed into the other. Responses to trauma vary along a spectrum of severity. Acute stress reaction is a normal response to abnormal situations which exceed the victim's coping capacity. Symptoms typically subside within a few hours or days. This is best treated by Emotional First Aid unless symptoms pose a threat to self or others, or interfere with everyday life, in which case professional care may help. Acute stress disorder spans a period approximately two days to one month after trauma, with symptoms serious enough to upset ordinary functions that aren't healing or seem to be healing slower than expected. Treatment at this stage may reduce the chance of developing post-traumatic stress disorder, a chronic form of trauma reaction. It is important to distinguish between normal response (which heals on its own), disordered response (which may need a little extra support), and a disorder (which typically requires professional care). Just like physical injuries, mental injuries can be mild, moderate, or severe and need different levels of attention.

Local-American advice is not to seek hospital treatment for emotional shock; the facility is not equipped to provide the soothing atmosphere needed for trauma survivors or people with a loved one in the hospital. In many situations, little or no treatment is available for mental issues at mild or moderate levels. People can only get help for severe problems. Unfortunately this has much the same effect on mental injuries as on physical ones: ignoring them increases the chance they will not heal cleanly and that serious complications could develop.

Terramagne does have a Shock Room alongside the Emergency Room at most hospitals. The SR provides a clinical setting for Emotional Trauma Care, just as the ER treats physical trauma. They have an assortment of private and ward therapy rooms for techniques that help traumatized people feel safe or let them burn off excess energy after a trauma. Some are like industrial-strength quiet rooms; others are padded rumpus rooms. Therapeutic video games such as Tetris help process experiences into new memories in a healthy way. A small hospital might have only a few treatment options, while a large one has many, just as they expand support for more types of physical complaints. Specially trained therapists provide immediate comfort care, followed by assessment and then arrangements for long-term care if needed. (Doing the assessment first, while the person is still overwrought, can make matters worse.) They can also teach people about self-care following a trauma. This helps tremendously in preventing the initial upset from crystallizing into long-term damage. Sometimes it works amazingly fast, although most of the time it takes longer.


Trauma-informed care accounts for the fact that many survivors of trauma don't tell about it, and that they are prone to self-destructive behavior, rages, and other negative coping strategies. It also recognizes communal trauma and offers interventions. Terramagne pays more attention to evidence-based care with higher standards for establishing best practices. In regard to the Shock Room, that means either restoring as much agency as possible if the person can handle making their own decisions, or taking care of them until they're ready to resume that responsibility. Ideally, if a trauma survivor is too shocky to think for themselves, a relative or close friend is asked to take over for a while. In particular, if someone has impaired consent due to current trauma and/or negative experience with health care, they may need support in getting to where they can accept help, or may be unable to accept it and pressuring them just makes matters worse. There are tips for trauma survivors, therapists dealing with traumatized clients, and parents of traumatized children. Here's a whole batch of tipsheets on different types of trauma-informed care.

The SR is usually kept warmer than average room temperature, because emotional shock tends to cause chills. They are also generously stocked with comfort objects such as warm fuzzy blankets and soft cuddly toys which recipients can take home if they wish. Many of these are supplied by charities.

People who feel cold and isolated may feel better in a very cozy and warm-toned "womb room." Individual ones are quite small to create a feeling of being cradled. Such comfort cubicles typically have a sliding sign to indicate availability. They may use lots of soft fuzzy pillows for contact comfort.

Ward rooms facilitate caring for multiple patients together, especially useful when a single event -- such as a school fire -- has upset numerous people. Warm colors and curving lines are used to create a similar sense of security. Beds may be partially separated for privacy, without making anyone feel isolated.

Small rooms may be used for counseling or quiet space. Yellow is gently warming and uplifting but not overstimulating. Blue is a soothing color that helps people calm down.

This is a waiting room for children. It has couches for cuddling, chairs for sitting alone, a playfulmural, and a few toys for distraction. Here is a cuddle room for infants and toddlers. The soft, cheerful colors are uplifting. The floor is covered in mats so adults can sit comfortably with children, and there are nap mattresses for children who don't want to be touched.

A therapy room for children may contain various features. This one has a bookcase full of books and games, a tent for hiding, and art therapy supplies.

This is a family therapy room. It has a loveseat for cuddling and toys for expressive play.

A play therapy room may contain such things as a puppet theater, sand tray, dollhouses, play kitchen, books and toys. While most child-friendly parts of the Shock Room have toys, the whole point of this room is for children to relieve stress and express emotions through play.

Individual or group aquarium rooms provide soothing sound as well as something pleasant to watch. This can help people who were subjected to loud noises regain their composure or deal with ringing ears. Here a bed contains an arch-shaped aquarium as a headboard. This ward comes with one lounge chair per aquarium, giving patients a choice of different aquascapes -- one person may feel cheered by fish swimming through aquatic plants while another prefers a coral reef with white sand.

For people who really need to abdicate adulthood for a while, there are hanging nests whose rocking motion may evoke happy memories of childhood.

People who feel vulnerable and threatened may benefit from a private "pod" room, available in a variety of colors and styles for resting, bathing, eating, and so forth. Computerized pods like these typically have an automatic red/green occupancy panel that lights up to indicate usage.

This one consists of a chair and video console for processing traumatic memories. Stacking-sorting games such as Tetris can help prevent PTSD or relieve flareups by helping the brain to file upsetting memories properly instead of repeating them over and over.

Ambivalent people appreciate adjustable furniture such as this closeable chair. Many features for treating emotional trauma are designed to create a sense of privacy and safety, while allowing a therapist to remain within immediate reach.

This cuddle chair provides a more open place to curl up. Cuddle noodles are long fuzzy pillows big enough to wrap up in or to lie upon.

A hugging couch provides pressure therapy to people who need to be held but don't feel comfortable with human touch right now. Friendship pillows serve a similar purpose in a different shape. These help with people, such as survivors of rape or abuse, who need contact comfort but may not feel ready for human company yet.

Assisted peer counseling enables friends or family to support each other during difficult times, with the aid of a professional therapist. Suitable furniture cradles shaky bodies to facilitate cuddling in various positions. These items are often scattered throughout a hospital's waiting rooms and other areas for generalized emotional support. The lighter, portable models may be moved wherever they are needed. Some private consultation roomlets also have this type of furniture. Those usually have a sliding sign to show availability.

Here is a side-by side cuddle chair for couples. Round cuddle couches may accommodate more people and positions.

In addition to regular rocking chairs, family rockers offer seating for multiple people. This one is a chair-and-cradle rocker for an adult with a toddler or infant who needs to be lying flat.

This looped cuddle chair places people face-to-face, useful both for peer and professional counseling. Conversely, a traumatized person may not feel like facing a counselor or friend. Courting chairs point people in opposite directions, providing both proximity and a firm barrier between individuals. This courting couch can hold several people, all back-to-back.

A tent canopy is portable and convenient for creating cozy, private space within a larger room. Some fabric enclosures have a vrip patch with a green Go/Vacant sign which can be pulled loose to reveal a red Stop/Occupied sign, to show availability when the curtains are closed.

Hydrotherapy helps people to feel clean again after experiences have made them feel dirty, especially a concern with sexual trauma or self-blame. Studies show that washing the body creates a sense of psychological cleansing. For this purpose running water is best. These almost always come as private stalls with a sliding sign to show their availability.

People melting down from sensory overload can take refuge in a sensory deprivation tank. While typically kept at body temperature, these can also be lowered a bit to cool those who feel overheated as well as overstimulated. Because they require an electronic control panel, occupancy is usually indicated with automatic red/green lights.

Massage provides extensive physical and emotional benefits. In Emotional Trauma Care, the emphasis is on healthy touch and contact comfort, along with using endorphins to soothe emotional pain. These massage therapists are specially trained in how to avoid exacerbating any physical problems, and how to address the emotional venting often released by massage in these situations. Massage is customarily offered in small, private rooms which can be used for a wide variety of hands-on care. Privacy is maintained with sliding signs. Tapping is another way to ease distress.

Aromatherapy combines perfectly with massage. Scented oils may also be used in hydrotherapy or with a diffuser. In clinical settings, heat-activated methods such as candles or simmering pots are not preferred.

Live plants and birds in a Jungle Room can help remind people that life goes on after they have witnessed horrors. It also provides a soothing environment for those who find the warmer tones too overstimulating. This private room has a whole wall of plants. Light filtering through plant leaves has a buffering effect -- warming up people who feel cold and lifeless, yet soothing those who feel overstimulated.

Animal therapists as well as human ones provide comfort to traumatized patients. People may feel comfortable telling a dog or a cat things they would not tell another human.

A soft playroom allows children a safe space to scream, run, bounce off the walls, or whatever else they need to physically express what they feel, without being told to stop. A larger, simpler rumpus room for older patients may also be available.

Adult patients, especially men, may prefer a therapeutic gym where they can run hard, lift weights, use resistance machines, or hit things that are meant to be hit. Walls and other surfaces are customarily padded, both for safety and for noise reduction. A thrash coach is a personal trainer knowledgeable about physical and emotional matters, who can coach patients in finding the right exercises for their body and current feelings.

An art therapy room with diverse supplies will give people a chance to express emotions, thus reducing the chance of negative experiences sticking somewhere that could cause trouble later. This can also reveal things that a traumatized person is not able to articulate yet. Individual art therapy may be available for those uncomfortable in a group setting.

Music therapy offers another way for upset people to process and release their emotions. Recorded music may be played in almost any therapy environment. A music therapy room contains many musical instruments, some of them suitable for complete novices. A trained therapist may also be able to provide live music and/or assist a patient in playing a musical instrument. This is especially helpful for traumatized musicians, most of whom are already familiar with using music for emotional regulation, and just need a little extra support right now.

Comfort food both soothes and grounds people after a traumatic experience. Fresh, homemade, nourishing food is more restorative than institutional food. Many people use cooking as a coping skill. A comfort kitchen and a therapeutic cook can also teach this method to people who do not yet have sufficient coping skills of their own, using easy recipes for comfort food. Extra food may be distributed through other parts of the Emotional Trauma Care facility.

A multisensory room can help withdrawn people emerge and interact with the world again.

A contemplation garden provides a serene place to recover from stress.

Someone asked what a psychiatric ward would look like if the patients designed it -- that is, what they would find helpful.

I noticed several clusters of requests. One dealt with quiet, private, homey things:
* the hospital I need to be in is my flat, but made safe
* a shed
* Northumberland -- sheep farm up in the hills, sunsets, views
* feral cats (don't need feeding)
* dogs and cats allowed
* garden with a stream running through it
* a horizon
* stargazing


In Terramagne there are some care facilities in rural areas, such as the Dumont Veterans Retreat outside of Easy City. The Starfish Life Support Centers are converted from large private houses to shared households of suicidal people and their support staff. They also have some two-bedroom apartment buildings where one client is paired with one life companion. These contexts help people heal by providing a quiet, soothing, low-stress environment with peer support or maybe a little professional support.

Another cluster dealt with clinical settings and ways to make those more appealing to people who need them. These parallel many of the features offered in quiet rooms and/or Emotional Trauma Care.
* no spectactors but not claustrophobic
* perfect cafe -- an interested nonintrusive person behind the counter, like "Friends"
* fruit buns and ice cream
* flotation chamber
* records
* books
* a very well organized charity shop
* room full of bubble wrap
* a weather room
* a dance floor, space to dance with one other person
* a playroom for adults
* hotel rooms -- order everywhere


T-American hospitals focus on creating space which is safe, soothing, and conducive to the healing process. Therapists customarily start by trying to identify what is wrong and how to fix it. "What is bothering you? What are your goals? What would help?" Therefore many of the resources are simply aimed at assisting people's own coping techniques, or teaching new ones to clients who may not have enough yet. Many different environments and services are offered to suit different needs. Except in the most severe cases, the therapists are available but don't pressure people to accept care.

A third cluster concerns agency. People who have been violated in the past, or who have special needs, find choices an essential part of recovery. They need opportunities and resources.
* able to access anything I need to
* opportunity to walk (not forced)
* a network of places rather than one, go on journeys
* lose yourself in a good way
* no walls


Terramagne generally functions on a fail-out rather than qualify-in basis, and respects people's agency unless they prove that they can't make good decisions on their own. There is a network of homeless shelters where people can travel from one to another, and be assured of somewhere to go and someone to greet them if they wish.

Conversely, other studies have shown that sometimes people go numb and withdraw after trauma. They may not feel able to think clearly or make their own decisions for a while. In these cases, they need a safe person to do that for them, or to assist them in making choices. Pressuring people to deal with paperwork and important decisions while in this state is both harmful and ineffective.

Some things mentioned in the original article are unfeasible in our world, but doable in Terramagne.
* switch-on children
* teleport system where I can bring people to me, to remind me of who I am when I'm not there
* holographic room that knows what you needed


Gizmotronic animals are available already, so androids might be. Teleporters do provide transportation for some hospitals lucky enough to hire them, and not all teleporters have the finesse to serve as a human ambulance but are fine as taxi drivers. Virtual reality rooms of various complexity have been built, although the telepathic interface would require super-gizmology. Somebody probably has one, but I doubt that it's in a hospital. Kraken is more likely because they have the concentration of soups, the money, the talent, and the need for such a thing given their custom of grooming vulnerable recruits.

(no subject)

Date: 2017-05-02 02:40 am (UTC)
kyleri: (Default)
From: [personal profile] kyleri
This is ridiculously useful -- I've been slowly putting together a small 'safe spot' as part of my merchant booth, & this will help a LOT. (Currently it's got whatever chairs aren't in use out front, various blankets, & a cat or two.)

Re: Yay!

Date: 2017-05-02 03:04 am (UTC)
kyleri: (Default)
From: [personal profile] kyleri
It sort of invented itself at the last event we did, because there were cats & chairs & friends who needed quiet; it wasn't til halfway through that I realized that it was a Thing as opposed to just a thing. (Though I have a number of friends who have an open invite to come by my booth & hide under the table as necessary.) There will be a sign next time, though!

Re: Yay!

Date: 2017-05-02 03:27 am (UTC)
kyleri: (Default)
From: [personal profile] kyleri
The booth these days is a conglomeration of ez-ups, so hanging curtains more-or-less as needed is happily easy. Plus we'll get to show off some of our pretty pretty fabric. :) I will take pictures, assuming I remember, which is ... intermittently.

Re: Yay!

Date: 2017-05-02 06:34 am (UTC)
thnidu: my familiar. "Beanie Baby" -type dragon, red with white wings (Default)
From: [personal profile] thnidu
"Ez-ups?"
(Google)
E-ZUPs!
Edited Date: 2017-05-02 06:34 am (UTC)

Re: Yay!

Date: 2017-05-02 07:28 pm (UTC)
kyleri: (Default)
From: [personal profile] kyleri
They're terribly useful! It's also become a generic term in much the same way as 'kleenex' for 'tissue', in that there are lots of options that _don't_ cost a zillionty bucks.

Profile

ysabetwordsmith: Cartoon of me in Wordsmith persona (Default)
ysabetwordsmith

July 2017

S M T W T F S
       1
2 3 4 5 6 7 8
9 10 1112131415
16 17 18 19 20 21 22
23 24 25 26272829
3031     

Most Popular Tags

Page Summary

Style Credit

Expand Cut Tags

No cut tags