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5. A brief introduction to‘ trauma’
5. A brief introduction to‘ trauma’
Aim. To clarify‘ trauma’ and‘ traumatic events’ and their effects on people.
‘ Trauma’ means wound. In both medicine and psychology, it refers to major physical or mental injuries, including threats to life or physical integrity. As Judith Herman( 1992, p. 33) phrased it, a trauma is“ a personal encounter with death and violence”.
PART I: POINTS OF DEPARTURE
A‘ traumatic event’ is one that has the capacity to cause mental or physical trauma. Faced by such an event, the immediate response of the body and the mind is to struggle for survival. Behaviourally this is expressed by‘ fight, flight or freeze’ responses, submission or‘ playing dead’.
A severe traumatic event often changes the way in which survivors understand the world around them. They may lose their sense of safety, and feel vulnerable and helpless. If the event involves acts of violence and the intention to hurt, trust in other people may be lost and the survivor’ s interrelational world seriously disturbed. Personal encounters with human or man-made violence are considered the most disturbing forms of trauma, likely to have the most lasting impact.
Loss of safety, control and trust commonly leads to depression( deep sadness, loss of the will to live, etc.) or anxiety. A personal encounter with violence and death may also haunt the survivor, who may painfully re-experience the event in dreams or daily life( also called intrusion). Intrusion is often set off by reminders, which may cause survivors to try to shun everything that might bring to mind the event( called avoidance). In this manual, we call the reminders that cause intrusion‘ triggers’. Survivors may feel disconnected from their bodily sensations and feel numb, or may be unable to recall traumatic memories. A state of heightened arousal is also quite usual. Survivors may be on their guard all the time, startle easily, sleep poorly, be irritable, or find it difficult to remember and concentrate( called hyper-arousal).
If survivors lack support and help, these reactions may last for months or even years. Psychiatrists call this state of mind‘ post-traumatic stress-disorder’( PTSD).
Three types of symptoms are therefore typical of severe trauma-related disorders:
• Intrusions: intrusive memories, flashbacks, nightmares.
• Avoidance: shunning situations that recall the catastrophe.
• Changes in arousal( high or low): a person is easily startled, tense and has angry outbursts, or is numb or depressed.
Individuals who have been exposed to trauma may therefore experience a great deal of anxiety and sadness, and feelings of hopelessness and worthlessness. Our work aims to restore their sense of control, and empower them by giving them coping skills and helping them to rebuild social relationships and trust.