Veterinary Defence Association Australia

03/04/2024

Your local vets for vets organization needs your support!

By joining the VDA Australia you will be helping to support the veterinary profession as a whole.

The VDA is wholly owned by its members (Australian vets) and is governed by an elected board of directors. Surpluses are injected back into the association to expand and improve services, and into reserves to keep the membership fees as low as possible. The VDA refers members to its dedicated broker who arranges insurance cover for each member with an insurance provider.

Benefits of joining the VDA:

-Alternate Dispute Resolution (ADR) of client grievances with 98% success rate in resolving grievances.

-Responses to veterinary board complaints.

-Assistance with Civil Administrative Tribunal and consumer tribunal.

-Professional Indemnity, Public Liability and Practice business cover through the VDA's insurance partner.

-Advice and guidance on adverse situations that arise during a veterinarian's life in practice.

-Use of our proprietary Informed Consent to Treatment forms.

-Use of our proprietary Members' Handbooks.

-Access to our social media platforms, Newsletters, Articles

02/12/2022

Obituary

David John Carser 1956 – 2022

Dr David Carser, BVSc, LLB, Cert. Medicine and Law President and Founder of the Veterinary Defence Associations in South Africa, Australia, Asia and America (USA and Canada).

Dear Members,

It is with great sadness that we inform you of the passing of Dr David Carser.

Before finding his true passion – Veterinary Defence – David established, ran and practiced in four veterinary clinics and hospitals, the last of which was turned into a 24-hour emergency center for the combined use of surrounding veterinary practices in the South of Johannesburg.

David founded the first defence association for veterinarians in South Africa, in 1992. His approach was considered revolutionary at the time because veterinarians had not ever had representation to assist them with Board complaints or an advice system to safeguard them when dealing with unhappy or antagonistic clients.

David literally wrote the book for veterinarians - and laid down the rules and the tools for a more defensive approach for vets to follow. He empowered vets to take control of their own destiny and his style of “prevention is better than cure” as the first course of action, followed by ADR (Alternate Dispute Resolution) has assisted countless vets in their workplace, bringing so many veterinarians peace of mind.

To bring his vision to life David spent a few years taking a certificate course in Medicine and Law, followed by an LLB, after which he was admitted to the Independent Advocates Bar in South Africa.

Once David had fine-tuned his ideas he brought this message to veterinarians in other countries, establishing Veterinary Defence Associations in Canada, the USA, Australia and Asia (Hong Kong) over the next 18 years.

His opinions were strong and fierce and true to himself. He made a name for himself as he stood his ground and strode his determined path. Many veterinarians around the world now label David as “unique”, “passionate”, a “visionary” and a “leader in the veterinary and legal professions” stating that “our profession is better for his impact”. He was known for his incisive mind, his sharp wit, his generous spirit, and a demeanor that made him seem larger than life itself, giving one the sense that nothing in life was impossible. He was also known by many as a fiercely loyal friend; a complicated - but an extraordinary - individual.

Although he was devoted to his businesses, he also spent many energetic hours in his other favorite pastimes. He was an accomplished builder, electrician and plumber, and took on the most difficult project of all, the VDA headquarters in Gosford, NSW, which was built over a period of 10 years with the constant help and physical assistance of his wife, Margaret.

He also found time to indulge in flying light aircraft, and in collecting a large number of classic cars with an eye to restoring these in future years. And for lighter recreation he was an enthusiastic member of Alberton Toastmasters Club, where he has been a member since 1992, and the Welsh Male Voice Choir of South Africa (Côr Meibion Cymru de Affrig) of which he was a member for 12 years.

David leaves behind his wife Margaret, daughter Amber, and granddaughter, Madalaine, upon whom he doted. His wife and daughter have loved and supported him through all his various endeavors, and both remain very active in his Veterinary Defence Associations.

David will be sorely missed.
The Veterinary Defence Associations continue to be here for you!

Under the able guidance of Dr Craig Greenwood, the VDAs that were established by Dr David Carser and Mrs Margaret Carser are going strong and supplying advice and guidance every day of the week to our members.

Our team of consultants, the most senior of whom is Richard Carter (who is known and loved by many vets in South Africa), backed by an administrative team headed by Margaret Carser, are here to continue the good fight.

We will never give up looking after our members and plan only to evolve and develop in the most positive way to the benefit of every veterinary population that we serve!

01/06/2022

VDA Australia now has a new phone number! Leave us a message on 0280064966

01/06/2022

23/11/2021

Resilience

“As a profession, is it possible to strive for perfection, but to accept and embrace failure transparently when it occurs?”

Resilience is the ability to adjust to or recover from adversity, such as illness, major life changes or challenges. Resilience is the psychological strength or mental reservoir that an individual has in order to cope with stress or hardships without falling apart.

Dealing with stress, change or loss, is part of life. Even more so for vets! How we deal with these problems plays an important role in the outcome (such as overcoming obstacles) and our long term psychological health (learning from life lessons and building strength of character in this process).

Individuals that are resilient are better able to handle this adversity and rebuild their lives after facing catastrophe. They use their skills and strengths to cope and recover from challenges and problems. Facing difficulties head on and using solution-based coping methods is characteristic of resilient people.

It may appear that resilient people do not experience distress, grief and anxiety, or suffer as much during trying times. But they do! They just handle these situations in a productive way, a way that fosters growth and strength. They also do not have as many previous problems sitting on their shoulders when facing a new stress, since they deal with each situation in a timely fashion.

Individuals who lack resilience become easily overwhelmed in challenging situations; they tend to dwell on problems and focus all their energy on these problems. This is unproductive and can lead to destructive coping mechanisms such as using mind-altering substances to ease the pain.

Resilience is not a magic power that removes the difficulties of everyday life. Rather, it gives an individual the tools to be able to prepare for, and cope in an efficient manner with challenges. Luckily, resilience is not just a trait that you are born with - it can be learned.

How to build resilience:

1. Reframe Your Thoughts
When facing a negative situation, take a step back and assess the situation realistically. Often we give too much energy to a situation, depleting our reserves to effectively deal with it. Break the problem down into smaller tasks that can be solved. There is always a positive in every situation; try to focus on that and then reassess. For example, when challenged by the behavior of a difficult client, you might try giving yourself a moment to think about your family at home, which would create positive energy to counter the negativity. With refreshed empathy, you are now able to find out why the client is being so difficult. Upon further investigation you discover that the client is struggling financially and cannot afford the surgery required on his pet but was too embarrassed to explain this. You offer him a payment plan and the client relaxes.

2. Seek Support
A reliable social support structure is an invaluable asset. Being able to confide in others regarding difficulties may bring light to situations that you hadn’t considered. For example, upon discussing with your wife that you have difficult clients, she suggests finding out if they can afford the treatments you offered them because many people are struggling through the Covid pandemic and their income stream may have been compromised. This is not something you had considered.

3. Focus on What You Can Control
Every day, a vet faces multiple challenges and it is easy to get overwhelmed. By the end of the day you are exhausted from carrying this anxiety with you and you have not provided full attention where necessary to other tasks. Practice the method of leaving the problem at work while you walk out the door. Close your eyes, take a breath and think of your family. Welcome the change of pace as you arrive home and live in the moment. Persuade yourself that sleep will heal your thinking processes and allow you to face your challenges with renewed vigor in the morning.

4. Create achievable goals
Having goals to work towards creates a sense of achievement when accomplished. Short term goals (such as completing a 5km walk once a week or getting a haircut) are as important as long term goals (such as saving for an engagement ring or completing a triathlon).

5. Learn from failure
Each time you fail or are faced with a challenge, try to view this as a learning opportunity. Just changing your viewpoint to one of positivity and openness goes a long way. Walking into your morning consultations with an optimistic view will create a warmer environment for your client, possibly helping them to open up and admit to whatever concerns they may be facing. When a challenge presents itself, learn from your immediate reactions and improve where necessary. These challenges are a reminder that life is not a streak of perfect wins, and that there will be ups and downs. The trick is to cope with the downs productively to reduce their impact.

6. Health habits
Getting enough sleep, eating well, exercising and focusing on general wellbeing reduce stress which boosts resilience. Putting energy into relationships while life is on an up has benefits when you need support during a down. Vets are a helping profession and generally put others ahead of themselves as a consequence. Your care of others will be better when you are healthy and strong. To help others, you need to help yourself first.

7. Mindfulness
Being mindful, or having presence of mind, cultivates resilience. Mindfulness is the practice of paying attention in a non-judgemental fashion to the present moment you are in. If you are mindful, you will automatically be practicing towards being resilient.

When things get tough, reflect on what you have already accomplished. You have the tools within you to be more resilient. It is just about application and practice

Reference:
Luu, S., Patel, P., St-Martin, L., Leung, A. S. O., Regehr, G., Murnaghan, M. L., Gallinger, S., & Moulton, C.-a. (2012). Waking up the next morning: Surgeons’ emotional reactions to adverse events. Medical Education,46, 1,179–1,188. doi: 10.1111/medu.12058

23/09/2021

Compassion Fatigue
While helping animals is a job that many consider a dream, when one considers the high su***de rates in the veterinary profession, it’s clearly not all rainbows and unicorns. One factor that is unique to the Helping Professions category (which includes veterinarians) is compassion fatigue.

Traumatologist Dr. Charles Figley defines compassion fatigue as “a state experienced by those helping people or animals in distress; it is an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it can create a secondary traumatic stress for the helper.” Compassion fatigue encompasses all of the negative emotions; emotional, physical, psychological, and spiritual exhaustion and the depletion from being repeatedly exposed to another’s pain and suffering- that are associated with veterinary practice.

Compassion fatigue is exacerbated in the veterinary profession in that the vet has a relationship with their patient and with the client. This triangular relationship engenders complex communications and often places the vet in an ethical or moral dilemma which is emotionally exhausting. Further, vets are particularly prone to compassion fatigue given their close proximity to death and illness. They are the primary bearers of bad news, while still fulfilling high stress situations (such as complicated surgery) and handling emotional clients who are embroiled in their own conflicts between attachment for their pets and control of their pocketbooks. “Over time, your ability to feel and care for others becomes eroded through overuse of your skills of compassion” - Dr. Frank M. Ochberg

When compassion fatigue is left unaddressed it becomes much harder to treat and often ends in burnout. The signs of compassion fatigue can often be confused with depression and/or burnout. However the difference is that compassion fatigue has a more rapid onset.

Compassion fatigue presents in different areas with the following signs:

Personal
*Personality changes
*Anger and irritability
*Tearfulness and easily feeling overwhelmed
*Lethargy (with both physical and emotional exhaustion)
*Physical deterioration and negative self-image
*Being accident prone and careless
*Memory loss or forgetfulness
*Interpersonal problems and increasing isolation
*Cynicism and resentfulness
*Reduced sympathy and empathy for others
*Mood swings, anxiety, depression and expression of suicidal thoughts
*Recurring illness (such as stomach flu) due to a stressed immune system

Professional
*Client and staff complaints about changing attitudes or behaviours
*Loss of efficiency and reliability
*Indecision and inappropriate clinical judgement
*Compromised patient and client care
*Unpredictable work habits and patterns
*Excessive time at work or increased sick time away from work
*Avoiding certain patients, clients, and situations (such as euthanasia)
*Inappropriate venting about work/life

Practice
*High staff turnover rate
*Decreased customer satisfaction with respect to customer service
*Staff attendance issues
*Declining employee morale
*Lack of teamwork

If you are concerned for your or a colleague’s mental health, please seek professional help, or contact the VDA for assistance.

In Conclusion
Think of your emotional coping mechanism in the same way as you think of how you refuel your car: You start off with a full tank, but if you travel a distance you use up fuel. If you encounter a steep hill or heavy traffic, you will use even more fuel. However, when the road is clear and straight, the fuel usage is normal and you require less fill-ups.

We all tend to start the day on a full “emotional tank”, but any negative situations will drain them. How often does your tank drain but you carry on going? If this pattern continues, you will eventually start your day on an empty tank.

The question is, how long can your tank keep going when it’s on empty, before the engine blows?

The VDA recommends:
*Consider posting a ‘HELP AVAILABLE’ notice in your staff room, listing local and online resources, along with a National Su***de Prevention Hotline.
*Balance the negatives and the positives - focus on the puppies or kittens and successful surgeries as much as, or more so, than the difficult clients and long working hours. This takes practice since we naturally gravitate towards the negative. A few minutes of mindful thinking daily will help us to find more positives to be thankful about.
*Make time to seriously consider the positive aspects of why you went into veterinary medicine and then remind yourself of this as often as you can.
*Debriefing after a difficult or traumatic event or case should be mandatory
*Ask your colleagues how they are doing and make sure to actually listen when they talk. Weekly one on one meetings are a great place to start.
*Doing activities outside of work assists in relationship-building and decompression. The planning of these activities and post-experience glow gives the team something to talk about besides work.
*Create a culture of compassion - not just for the animals but for human colleagues too!

Sources
**Compassion fatigue in the veterinary industry – Understanding the symptoms and signs | VetSuccess
**The Antidote to Compassion Fatigue | Today's Veterinary Nurse (todaysveterinarynurse.com)
**Veterinary Compassion Fatigue: How To Prevent It In Your Practice (vetxinternational.com)

02/09/2021

Refunding Clients

The VDA is seeing a rising trend where aggrieved pet owners demand that the cost of prior veterinary treatment be refunded so that they can afford to have further treatment carried out. Pet owners allege that if previous treatment did not cure a condition, then the fees charged are not legitimate. This skewed logic can be fueled by vets experiencing feelings of defensiveness and guilt for the wrong reasons. Veterinarians need to remember that when you do not draw a line between what is your responsibility versus reasonable expectations and the owner's responsibility, it impinges enormously on your liability.

One Friday, an 8 year-old Collie-cross dog with a thick, dark bloody discharge of 2 weeks duration was presented to Dr A. The dog had been on heat two weeks prior.

Dr A examined the dog and concluded that the dog had endometriosis and recommended an ovariohysterectomy. During the procedure Dr A found that the left uterine horn was enlarged and the endothelium smear showed bacteria, confirming an endometritis.

The dog recovered uneventfully and was discharged on the Saturday.

On Monday Mrs X telephoned to inform Dr A that the dog had been eating well but had bled over the whole weekend. Dr A recommended re-hospitalization which was agreed to by Mrs X.

Dr A again examined the dog, using a speculum to visualize internally, but could not see any mass. He then performed an exploratory laparotomy and saw that there was no bleeding in the abdomen, but he placed an additional ligature as a precaution.

On Wednesday there was blood in the cage and, upon examination, a mass (hypertrophy) was now palpable. At this point Dr A offered a third surgical procedure or the alternative of referral to a specialist.

Mrs X decided on a referral to a specialist. Dr A transported the dog to Dr B, a specialist veterinarian. Dr A then made the mistake of telling Mrs X that he would pay for a procedure to determine the source of the fresh bleeding, but that further treatment was for Mrs X’s account. Dr A unfortunately also made the error of sending his clinical notes to Dr B. (We will discuss why this aspect can be problematic later in the article).

Dr B palpated the mass and visualized it using a speculum with a light source. He informed Dr A that his cytobrush examination provided no additional information.

Dr B offered Mrs X an endoscopy and biopsy and explained the findings and costs. Mrs X declined all tests and treatment due to financial constraints, instead choosing to care for the dog at home.

Unfortunately, Mrs X failed to understand (or it was not clearly explained) that the ovariohysterectomy had been the correct initial treatment and that the endometritis had been cured; and she did not appreciate that the mass was hormonally driven and had arisen between the two consultations, which of course meant that it was not there at the first consultation with Dr A.

Due to her misconceptions, (or perhaps opportunistically) Mrs X became argumentative with Dr A and claimed the original discharge was due to the mass and that the spay was unnecessary. She has threatened to take the matter to the veterinary board and, further, has threatened to advertise her displeasure at services rendered on social media platforms.

Discussion:
Even though Dr A knew he had been right with his initial diagnosis and treatment, he still, out of some or other misplaced feeling of guilt, offered to pay for part of the next treatment. This started a spiral of doubt on the part of the pet owner.

Guilt is an emotion based on the irrational fear that we have caused harm to an owner or a patient. There are a number of forms of guilt:

1. Guilt for something that you did - when you actually do something wrong including causing harm to others (such as being a drunk driver that caused a motor vehicle accident) or when you do something to harm your own moral code (such as cheating on your partner). In this instance there is no doubt that you have done something “wrong”. It is normal to feel guilty as this pushes us to “fix” the situation by taking steps to mitigate the harm and seeking ways to ensure it doesn’t happen again.
2. Guilt for something you didn’t do, but want to do - wanting to commit acts that go against your moral code, such as doing something illegal like taking drugs or being unfaithful to your partner.
3. Guilt for something that you think you did - thinking you have or may have done wrong (based on irrational thought processes) can result in greater feelings of guilt than if you had done something wrong. You may experience moments of knowing that you did not do anything wrong while simultaneously feeling guilty - this is understandably a very confusing place for an individual to be. This is the place where vets often find themselves. Considering the stressful vet work environment and threats of social media backlash and vet board complaints, one can understand why many vets are driven to attempt to make “reparations” even though they are not to blame for situations that develop.
4. Guilt that you didn’t do enough – This often accompanies compassion fatigue. Working in a helping profession, such as veterinary practice, compassion fatigue is a daily struggle. Wanting to help others but not having the physical or emotional resources available creates a feeling of obligation even though it is not necessarily your responsibility.
5. Guilt that you are doing better than someone else - also known as survivor guilt. This is often found in military situations or after traumatic death/ disaster scenarios, where the person who survives feels guilty for outliving another individual. This may also refer to individuals with more means than others, such as a pet owner without the financial means to help their animal and a vet practice manager who is financially secure.

Feelings of guilt make us do strange things, and while some of these reactions are positive, there is also an array of negative guilt-related outcomes. To help reduce the negative guilt emotions, consider the following points:
• After a stressful situation, spend a quiet moment recalling the events. Write them down if necessary. Being able to gain clarity will assist with possible later feelings of self-doubt.
• We have to learn our limits - it is ok to say NO!
• Remember that, while we may not be able to help every pet or owner, we are doing so much good and helping so many already.

The VDA recommends:
Never offer to pay for a procedure, whether performed by yourself or someone else. An offer to pay is often interpreted as an admission of wrongdoing!

Be patient. Wait for all the information to be collected and collated, and for some time to pass (for resolution or complications or signs to repeat themselves). This period may be many days, weeks or even months. All too often veterinarians are too impatient to see the end of a bad situation and want to make some form of payment or reparation too soon- thereby hanging themselves.

For example, in another case of post-spay internal bleeding, the pet owner alleged that the veterinarian was negligent for not tying a ligature properly. It turned out, months later, that the dog had a bleeding tendency which had nothing to do with the ligatures or the spay surgery. It was eventually discovered that the dog had a clotting disorder.

Don’t send your clinical notes to anyone- including to the second veterinarian. Your clinical notes are your private aid to memory and are often confusing and misleading to another vet. Rather speak to the second veterinarian on the telephone and provide verbal information, answer questions and brainstorm with the second veterinarian.

Providing your raw clinical notes to a third party creates liability for you, since you will not have written the notes in order to ‘educate’ someone else. The third party may well misinterpret your cryptic, personal notes, or look for actions that may or may not have been taken, claiming that the “proof” of what you have or have not done is in the notes – when, due to your need to be concise, this may well not be the case. Incompetent Veterinary Boards are notorious for looking for fault within written notes, and for convicting and penalizing vets on this basis.

Sources:
*https://www.psychologytoday.com/us/blog/fulfillment-any-age/201208/the-definitive-guide-guilt
*VDA Cases.

-Please note: certain “offensive” words were removed. Please see the VDA website for the original article.

03/08/2021

We now accept credit card and debit card payments through square! Do you need square for your business? We each get $1000 free processing fees when you use this link to sign up. https://squareup.com/i/F84B753AD3

Signing up for Square is fast and free with no commitments or long-term contracts.

20/07/2021

A Lesson in Trauma, PTSD and Coping Skills
Trauma is an emotional response to a terrible event such as an accident, death or natural disaster. Such an event is perceived to have threatened your sense of security that causes physical, emotional, spiritual, and/or psychological harm - rendering you feeling helpless. Trauma includes those situations that leave us feeling overwhelmed and isolated. It is important to note that trauma is a subjective emotional experience and will be different for each individual, based on past experiences and current mental health.

A trauma includes events that are both one-off (such as an accident) and stressful events that are ongoing (such as regularly being required to perform euthanasia, dealing with animals that have been abused, or encountering abusive clients). Being continually exposed to stressful events can overwhelm your nervous system and create traumatic stress.

Symptoms of psychological trauma
Your responses to traumatic events are NORMAL reactions to ABNORMAL events. Immediately after a traumatic event, shock and denial are typical behaviours. Longer term reactions include unpredictable emotions, flashbacks to the event, problems in relationships, anxiety, depression and even physical symptoms like headaches, body aches or nausea. While these feelings are normal and generally fade away to infrequent memories, there are still some people who have difficulty moving on with their lives.

Emotional & psychological symptoms include:
• Shock, denial, or disbelief
• Confusion, difficulty concentrating or focusing
• Anger, irritability, or uncontrollable mood swings
• Anxiety or fear
• Guilt, shame, or self-blame
• Withdrawing from others or a lack of trust
• Feeling sad or hopeless
• Feeling disconnected from others or numbness
• Feeling overwhelmed

Physical symptoms include:
• Insomnia or nightmares
• Fatigue
• Being startled easily
• Racing heartbeat
• Edginess and agitation
• Aches and pains or muscle tension

Dealing with a traumatic event may take a few days to a few months. However, if psychological symptoms don’t ease up, or if they become worse and you are not able to move on from the event, you may be experiencing Post Traumatic Stress Disorder (PTSD).

PTSD
Your mind and body are in a state of distress after a traumatic experience. Normal trauma becomes PTSD when your nervous system gets stuck and you remain in a state of psychological shock - where you are unable to process your emotions or the event that occurred. This may become apparent shortly after the event or much later; randomly; or when triggered by something that reminds you of the original trauma.
While PTSD is an individual experience, there are four main types of symptoms:
• Re-experiencing the traumatic event through overwhelming memories, flashbacks, nightmares, or intense mental or physical reactions when reminded of the trauma.
• Avoiding anything that reminds you of the trauma; being unable to remember aspects of the event; a loss of interest in activities; feeling emotionally numb and detached from others.
• Hyperarousal (including sleep problems such as insomnia, and irritability) hypervigilance (on constant “red alert”; feeling jumpy or easily startled; and angry outbursts), and aggressive, self-destructive, or reckless behavior.
• Pessimistic outlook (feeling alienated and alone); difficulty concentrating or remembering; mood changes (depression and hopelessness, mistrustful and betrayed); as well as feeling guilty.
Coping Skills

The difficulty to move on from trauma should not make an individual start accusing themselves of being weak. Rather, their brain has not been able to effectively process the trauma. Fortunately there are easy methods one can use to help the brain move past this. These methods are also helpful in building the resilience to cope with future traumatic incidents.
• Talking through an event, sooner rather than later is most beneficial. Sometimes talking is not a possibility. If you do find an opportunity, remember that, while it is beneficial, you should only push yourself as far as you are comfortable.
• Making a connection with someone after an event assists with a feeling of being engaged and accepted by others, diminishing feelings of wanting to isolate.
• Taking time to recover and process the behaviours after a traumatic event.
• Writing about the traumatic event to promote reflective thinking
• Helping others who are or have gone through similar events such as yourself can assist with feelings of helplessness and loneliness
• Movement and exercise burns off the adrenaline and releases endorphins which can assist with the feelings of fear caused by the state of hyperarousal.
• Practicing mindfulness by just being present in the moment and being fully aware of all your feelings in that space. This could be while meditating or practicing yoga, or while going for a walk or drinking a cup of tea. All the while focusing on your breathing and feeling grounded. This will help to calm your nervous system, relieve anxiety and promote your sense of control.

A piece of interest: Veterinarians’ Emotional Reactions and Coping Strategies for Adverse Events in Spay-Neuter Surgical Practice, by Sara C. White, DVM, MSc (2018), describes veterinarians as they cope with adverse patient events. Dr White describes four factors that are related to coping: technical learning, perspective, support and emotional learning. (See figure on VDA Webpage)

As seen in the figure, the response to an adverse event results in either resilience or trauma depending on a vet’s ability to apply technical learning, have perspective and support, and achieve emotional learning. Immediately after an event, the response is flight or fight, while the long term result is based on the above-mentioned four factors.
1. Technical Learning - learning about the technical aspects of patient care, where possible, and where the failure occurred or might occur, assists in moving past the event.
2. Perspective - using frames of reference to put the event into a larger frame, such as using religious beliefs or an affirmation of how you may have helped countless animals through spay/ neutering in a lifetime of performing veterinary medicine.
3. Support - talking with others, experiencing support from family or friends or colleagues.
4. Emotional learning - learning how to handle and what to expect from oneself through the event and being aware of emotional tools available for assistance in times of need.

You require help from a professional if you are having trouble functioning in your everyday life, due to severe anxiety or depression, terrifying nightmares or flashback memories, avoiding situations that remind you of the event, emotional numbness, or using alcohol or drugs to cope. Recovering from trauma and PTSD is a gradual and ongoing process, but it is most certainly possible and should be identified in a positive manner so that you can begin the journey that will begin your emotional healing.

References
https://www.apa.org/topics/trauma/
https://www.helpguide.org/articles/ptsd-trauma/coping-with-emotional-and-psychological-trauma.htm
http://dx.doi.org/10.1080/08927936.2018.1406205