Coping with Facial Trauma

Living with changes to your facial appearance as a result of trauma can be incredibly difficult. In fact, studies have shown that people who acquire facial changes as a result of trauma have more difficulty coping than those with congenital disfigurement, or even that resulting from treatment of a disease, like cancers of the face or head. There have not been enough studies on the effects of these changes, and in this post I’m attempting to summarize some of the risk factors, symptoms to look for and strategies to cope.

 

People with oral and/or facial trauma are up to 70 % more likely report symptoms of depression, anxiety and hostility. Injuries to critical facial structures like eyes, ears and dental structures will increase these odds, and these psychological issues can impede your recovery. Being aware of the symptoms and risk factors is critically important to your health.

Key Facts:

 

• There is no correlation between the degree of disfigurement and type, extent or severity of psychological symptoms
• Your satisfaction with your facial appearance is a more important predictor than the objective severity of facial changes
• Women are more susceptible than men
• Depression puts you at increased risk for suicide, poor compliance with treatment and a poor rehabilitation outcome.
• Your surgeon may not recognize these symptoms - so be aware for yourself or loved ones.
• Attributing blame for your trauma to others puts you at higher risk for both anxiety and depression (vs. self-blame, or accepting of it as an accident).

Facial changes and/or disfigurement can result in depression, anxiety and even Post Traumatic Stress Disorder, or PTSD. The symptoms of PTSD are:

1. Re-experiencing the trauma (via intrusive thoughts and/or distressing images and dreams);
2. Avoidance of thoughts, emotions or situations related to the trauma; and
3. Autonomic nervous system hyperarousal, including difficulties sleeping, having an exaggerated startle response and experiencing increased irritability and tension. 

The symptoms of depression, anxiety and PTSD might be at the subclinical level (meaning that they don’t meet all of the diagnostic criteria) and so might be missed, but are serious nonetheless, and can still have adverse effects on quality of life.

 

The biggest challenge is the social aspect of life after an appearance-altering trauma. The response that people have to your appearance can be painful, even if not intended to be. For many, constant worry about reactions their appearance can cause social withdrawal. Just remember that curiosity is a natural human reaction when faced with something we don't understand.  Most people who may be staring at you, or even asking you inappropriate questions, are not doing so to hurt you.  They are simply curious and interested.  There are ways to deflect this unwanted attention. My favourite is: "You seem to find me very interesting!".

 

Another known effect of facial changes due to trauma is that it can ignite negative body image issues and body dysphoria in social situations that can significantly affect your life. Still others can have no body image issues despite disfigurement. It seems that predictor for this response is your self-image prior to the accident. The more value you place on your looks in general, the more likely you are to suffer from a negative body image after trauma.

 

 

Pre-Trauma Personality Traits that Affect Recovery

 

• Presence or absence of psychiatric illness
• Financial and social status
• Family history of psychiatric problems
• Having a family member involved in the trauma
• Family approach to the trauma and recovery
• General resilience
• Response to major life events in the past
• Survivor guilt (if relevant)
• If the trauma was the result of an accident or a workplace/industrial incident
• Presence of compensation and litigation issues

 

 

It can often be hard to know when it’s time to reach out and seek professional help. This is especially hard for loved ones, as we don’t often admit to all the symptoms we are feeling. I urge you to review the list below and be honest about how many apply to you. I bet if you have one symptom, you have at least a few more. Please reach out if even one of these symptoms applies to you.

 

 

Telltale signs that a referral to mental health professional is needed:

• Anger
• Irritability
• Poor support network present
• Crying spells
• Loss of hope for recovery
• Long in-patient stay
• Multiple surgeries
• Depressed mood
• Poor financial support
• Loss of loved ones in the same traumatic event
• Loss of job
• Flashbacks or recurring dreams
• Sleep problems
• Chronic pain
• Family or personal history of psychological illness
• Preoccupation with facial appearance after recovery

 

 

Ways to Cope

 

 

The human mind is a remarkable thing, and the beauty of it is that we are often capable of so much more than we give ourselves credit for. Remember this, and use it to your advantage when you’re feeling low. Actually...keep it in mind all the time. As Winnie the Pooh once said: “You’re braver than you believe, stronger than you seem and smarter than you think.”

There are many ways to care for yourself and improve your resiliency, and it all starts with self-care. The crux of it is to be kind to yourself.

 

 

1. Set yourself up for success. This means taking care of your basic needs - get enough sleep, nourish your body with good food and make your well-being a priority. Don’t take on more than you can handle, and learn to say no.
2. Be active. Don’t worry about how fit you are, or pushing yourself through a difficult workout if that’s not your thing. Go for a walk, or cycle. Just get up and move.
3. Focus on developing your inner self. True beauty comes from confidence, and the best way to feel confident is to feel good about the person that you are on the inside. Take time to develop that. Things you can try are immersing yourself in a non-stressful hobby, meditation, social events.
4. Talk to someone you trust.
5. Try to view your situation as a positive challenge, rather than a threat.
6. Remember that you are a warrior. You have been through challenges that nobody but you can understand. There is power in that. Gather strength from your successes.

 

 

Changing Faces UK is an excellent resource for all people coping with facial disfigurement for any reason. I stumbled across it in my research and found it to be very informative. They have an excellent online learning program (for free!) that teaches you how to handle social reactions to your appearance. There are 5 techniques that they teach:

 

 

1. Explain in a way you’re comfortable with.
2. Make a big effort to reassure people.
3. Distract people away from your condition.
4. Use your sense of humour.
5. Be assertive.

 

 

These bullet points are not enough - I encourage you to review the course for a detailed explanation on how to employ these techniques. The course is built for teenagers, but that’s just in the way it’s presented and in fact I think that only targeting this age group is a mistake on their part. The information within is completely appropriate for all ages. It can be found here: http://learn.happyelearning.co.uk/clients/changingfaces/home.html

 

 

I hope this provides some help and support to you. Please feel free to comment, or message me personally if you need to talk to someone and don’t know who.

And take care of yourself.