Trauma Survival Strategies

Rescue/Caretaking

The purpose of this strategy is to help others.

People in disasters always try to find their loved ones first to ensure their safety and frequently apply life-preserving measures to threatened and helpless others even at the expense of their own security. Rescuer bond for others includes intense empathy, compassion, and pity, and rescuers feel a need to pick up, hold, protect, and take care of their charges.

If demands to rescue and care are too great, people feel burdened and depleted. Saving and preserving another's life provides extreme satisfaction and purpose. Inability to satisfy the needs for care can lead, as Charles R. Figley and Paul Valent have noted, to compassion fatigue and secondary PTSD and to intense anguish and guilt because, as people see it, they abandoned or even caused the death of people they should have saved.

Physiologically, the female sex hormones estrogen, progesterone, prolactin, and oxytocin promote maternal behavior, and it is hypothesized that opi-oids and cortisol might facilitate caregiving behavior.

Attachment

The purpose of attachment is to survive by being helped and to be taken care of by others. Attachment was first described by psychologist John Bowlby in 1971 as the complementary strategy to rescue/caretaking. While rescuers find, hold, and care, the attached reach out, cling, and are cared for. The attachment bond reciprocates the bond rescuers feel for their charges.

Secure attachment leads to contentment and a sense of belonging. Separation leads to anxiety, yearning, searching, aloneness, helplessness, and a sense of being abandoned and cast out to die.

Table I Survival Strategy Components

Opioids, oxytocin, and prolactin facilitate attachment. According to Allan N. Schore, its more complex elaboration is found in the orbitofrontal part of the right hemisphere of the brain.

Separation distress is facilitated by corticoreleasing factor and glutamate. In the later “depressed” phase of the separation response, according to Jaak Panksepp and his colleagues, heart rate and temperature are decreased, adrenocorticotropic hormone (ACTH) and adrenal cortical secretions are elevated, and the immune system is depressed.

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