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From the author: This article was published on the Doctor at Work website. The Doctor at Work portal is a registered mass media – reg. EL number No. FS77-45439 dated June 16, 2011. All posted materials are equivalent to publications in the media and are subject to the legislation of the Russian Federation on the media. The article uses materials from Ofra Ayalon, MD, director of the Israeli Nord Cope Center, world-famous trauma psychologist, author and trainer in the field of working through traumatic experiences, published in Therapy Today, September 2009. People who have experienced a disaster can find themselves in a whirlwind of helpless despair or climb a healing spiral with the help of associative metaphorical cards. Crises and disasters are part of our lives. We are exposed to dangers during military operations, terrorist attacks, natural disasters, as well as such manifestations of human life as betrayal, death, loss of property, orphanhood, etc. Survivors of such disasters often find themselves caught in a vortex of trauma, what Peter Lewin called a chaos vortex in reference to psychic trauma. Another name is the black hole of trauma, which develops in a downward spiral consisting of trauma traps that are difficult to detect and control, because it occurs at the level of images, sensations, feelings, thoughts and behavior. The essential needs of existence in safety are shaken and destroyed, as well as the needs for a sense of personal competence and control over the situation. Grief and anger, coupled with a deep sense of powerlessness, can end up being turned inward or on others. Trauma can create a vortex that pulls a person back, throwing away all past achievements and plans for the future. The “traumatic narrative” becomes the center of a person’s life, occupying thoughts, feelings and influencing relationships. The price for this is accepting the position of a victim and giving up control over your own life. There are many examples of this, for example, one of my cancer patients still, after 5 years, reacts very emotionally, with tears, to the slightest mention of the traumatic situation of a breakup with a friend with whom she had been friends for more than 20 years, while she herself often returns to the topic of the breakup with a friend in any normal conversation. The results of the injury are shaped like a spiral. And a person can find an internal hidden resource in this spiral in order to transform priorities, attitude towards family, social and spiritual values ​​for his own benefit. How to move from the role of a victim to the role of a winner? Someone can resolve a crisis by taking responsibility for the situation and self-healing. Others choose the path of compassion and forgiveness. A striking example is farewell rituals, for example, church rituals of farewell to the deceased. There are methods of healing from psychological trauma that can retraumatize those who have difficulty controlling their own emotions and feelings. In this whirlwind of emotions, a person fluctuates between optimism, hope, altruism and fatigue, disappointment, polarity of thinking. If the trauma does not find verbal expression, then we look for nonverbal and psychologically safe ways of expression. People easily use the ability to gradually approach traumatic memories through metaphors. One of the most effective tools in this case can be the cards of the COPE deck from the OH-card family. These cards were drawn by Russian artist Marina Lukyanova and published by Moritz Egetmeier specifically for working with traumatic experiences. 88 cards allow you to open access to deep feelings and talk about your experiences in a playful or therapeutic form. While working with the cards, you can determine your own characteristics of your usual ways of coping with stress. Random selection of cards and emerging associations allow you to generate new ideas and solutions, rather than continuing to useineffective ways at the level of thoughts and actions. COPE cards allow you to reach deep inner pain and discover inner strength. A kind of virtual learning is useful in dealing with difficult situations, in experimenting with possible options for resolving conflict in a safe metaphorical space. In the process of research on the path to developing resilience and a healthy way of coping using COPE cards, a new model of “coping resources” was developed. It is a holistic multimodal framework containing 6 resource coping modes: belief system, affective expression, social support, imagination/creativity, cognitive processing, behavioral/physical aspects. These 6 modalities merge into a single powerful coping system for overcoming the consequences of psychological trauma and are represented by 6 main cards in the COPE deck. The main cards are six cards with certain specific images that metaphorically convey the meanings below.1. A belief system includes belief in God or something supernatural, trust in other people and in oneself. Faith and hope are excellent examples of resources for overcoming trauma.2. Affect is a sensory manifestation of consciousness. The heart symbolizes love and hate, fear and courage, sadness and joy, jealousy and compassion, etc. This coping modality includes the ability to recognize and name feelings and then express them verbally (talking, writing letters, or performing drama) or nonverbally through dance, creativity, free play, painting, music.3. Coping through social skills focuses on interacting with other people. These interactions include receiving support from family, friends, and professional helpers. In the immediate post-trauma period, there is a greater need for recognition of the traumatic experience in the form of listening, participation, containing emotions, tolerance and caring.4. Creative expression of coping is key to experiencing traumatic experiences “beyond the word.” There are many creative ways to manifest painful memories. Images of the COPE deck or a combination of them evoke personal hidden memories or fantasies related to trauma. Any image of a COPE deck can be an opportunity to transcend difficult reality and find solace in the image.5. Cognitive processing means using cognitive skills to understand a situation narratively, showing how it develops through response to a series of images from cards. This is another way to have control over post-traumatic issues and painful memories. The purpose of retelling a traumatic situation is to get out of the grip of horror and terror of memories in a safe way, analyze and understand the situation, determine a plan and strategy for rescue and overcoming.6. Physical reactions (mind and body). Trauma always remains in the body. Levine suggests using the body as a tool for processing trauma by unfreezing the bodily sensations associated with the trauma and regaining mind-body control. These techniques are used to build a flexible balance of tension and relaxation, create bodily and personal boundaries, and redefine the relationship of personal space and trust. Other projective metaphorical cards in the deck, which support verbal and nonverbal methods, allow you to reach deep-lying repressed feelings. Professionals who use these metaphorical maps find them to be an effective approach to helping people overcome the effects of trauma, negotiate ways to resolve conflicts, and prevent suicide and domestic violence. In actual traumatic situations, people usually use a combination of coping mechanisms in order to survive a difficult situation. The first step to healing and recovery from mental trauma is achieving physical and psychological safety. In a safe place you can express feelings verbally and non-verbally, share dreams,nightmares and other manifestations of traumatic experiences. When appropriate, mourning and funeral rituals can promote positive resilience. Any COPE card or combination of cards can become a trigger for a narrative about an event and the response to it. Using COPE cards provides an opportunity to experience difficult memories in a safe environment because... metaphorical stories are triggered by the visual images of the cards and are a step towards exiting the painful reaction. This “creative distance” is to remember and work through the traumatic experience. Using imagination and imagery serves as a protective shield against being overwhelmed by strong emotions. When the memories become too much, you can always return to the story in the picture or look for other cards that can anchor feelings of prosperity, survival and healing. This work aims to discover and unblock our usual ways of coping with a difficult situation that become blocked during a crisis. What resources may be required?1. Place the 6 main COPE cards face up on the table. Give aloud a definition for each card (faith, affect, social, creative, cognitive, physical coping).2. Take another 6 cards from the deck at random. Place them face down on each of the main cards, covering them with one another.3. Turn over the cards one at a time, while telling how exactly this or that component of the coping strategy manifests itself for you. For example, my creative coping model is that I can separate myself from my worries through creativity (positive aspect), and my social habits manifest themselves in the fact that I am needy and dependent on other people's opinions and attitudes (negative aspect).4. Now think about how you usually react in a crisis situation. Select from the remaining face-up deck 3 cards that will help you describe the experience.5. Try to determine for yourself which of the already discussed forms of overcoming stress was used by you in these specific crisis situations. Use the cards to talk about your experiences.6. Now try to remember which coping methods you did not use in these situations. Turn face down the core cards that represent them. These are the resources that were blocked during the crisis.7. Find cards in your deck that will help you reactivate blocked resources. To do this, you can use cards from the COPE deck or from the resource decks Myhts, Morena, Saga, Habitat. 8. Combine identified existing and reactivated (previously blocked) resources in a common process to overcome the crisis. Expand your experience through a new story, transforming it with the six ways you know to overcome traumatic situations. There are many coping strategies, each of which is suitable for a specific situation, for a specific person. Each person, family, society has its own set of coping strategies in accordance with the basic language of meaning that they understand. An effective path for the therapist is to align with the victim language and point toward additional resources for coping with the trauma. Literature:1. Ayalon O. Healing trauma with metaphoric cards. Therapy Today, September 2009. 2. Levine P. Waking the tiger: healing trauma. Los Angeles: North Atlantic Books; 1997. 3. Desivilya S, Gal R, Ayalon O. Long-term effects of trauma in adolescence. Anxiety, Stress and Coping. 1996; 9(3):13-150. 4. Ross G. Beyond the trauma vortex: the media's role in healing fear, terror and violence. Los Angeles: North Atlantic Books; 2003. 5. Ayalon O. The HANDS project: helpers assisting natural disaster survivors. Community Stress Prevention. 2003; 5:127-135. 6. Ayalon O. Rescue! Community oriented preventive education. Ellicott City: Chevron Publishing Corporation; 1992. 7. Lahad M. Darkness over the abyss: supervising crisis intervention teams; 2006.

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