18
Asma from Sudan
Reactions and symptoms
Her father ’ s violence and her parents ’ divorce made Asma sad . When her father then sexually abused her , Asma became insecure . She was afraid of men , afraid of closed places , and intensely anxious . She became hyperactive and lacked concentration . She was unable to pick games to play , could not concentrate and was easily distracted . She had nightmares , and sometimes woke up in panic . She wet her bed . She avoided talking about her father or what had happened to her , refused to go to kindergarten , lost her appetite and felt sad . At night she felt anxious : darkness triggered bad memories .
What helped ?
When Asma first visited the therapist at the trauma centre , she was worried and anxious . During the early sessions , she was hyperactive and could not play with one toy at a time or stay in one place . She walked around the room , unable to focus , and was easily distracted . The therapist explained to her that her feelings were a normal reaction to what she had experienced . She told Asma that eventually all her fears would go away .
In the beginning Asma and the therapist played and talked randomly . The therapist listened carefully to Asma ’ s story without judging her . This helped gain Asma ’ s trust . After a while , Asma started to open up and speak about what had happened to her . She said : “ I will not forget when he slapped me ”. She said she hated going to kindergarten and joining the other children . The therapist listened carefully because she knew Asma had loved kindergarten . They talked about what she liked and disliked ; and eventually Asma decided to return to kindergarten and began to play with her friends again . The therapist invited Asma to draw and crayon to help her express her feelings . She asked Asma to draw what happened , and to draw pictures of her house and family .
In parallel the therapist continued to counsel Asma ’ s mother , and to strengthen her ability to support her daughter . They used psychoeducation to talk about symptoms of trauma , and what Asma ’ s mother could do to help Asma . The therapist explained that Asma ’ s hyperactivity and lack of concentration were not forms of misbehaviour but a response to what she had been through ; and that avoidance was a way to not re-experience pain .