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3.1 Basic knowledge of trauma , trauma reactions and triggers
Aim . To understand common survival and trauma reactions .
KEY TO KNOW
‘ 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 ”. 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 fright reaction generates “ fight , flight or freeze ” responses : the person at risk tries to resist or to escape or submits – the body closes down and the person becomes passive (“ plays dead ”).
A severe traumatic event often changes the way in which the children understand the world around them . They may lose their sense of safety and feel vulnerable and helpless . If the event involved acts of violence and the intention to hurt , trust in other people may be lost and the child ’ s inter-relational 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 lead to depression ( deep sadness , loss of the will to live , etc .) or anxiety . A personal encounter with violence and death may also haunt the child , who may painfully re-experience the event in dreams or daily life ( intrusion ). Intrusion is often set off by reminders , which may cause the child to try to hide from anything that might bring to mind the event ( avoidance ). In this manual , we call the reminders that cause intrusion ‘ triggers ’.
A trigger can be anything which is associated with the trauma . Triggers can be any stimuli coming from outside as a sound , a smell , a sight , a touch and from interaction with others . Or it may come from inside like heartbeats , nausea or thoughts and feelings . These reminders lead to uncommonly strong reactions . Sometimes the connection between a special feeling or reaction and the traumatic event is obvious , but at other times this link is less clear . In many children we may see sudden reactions such as panic attack or temper tantrum where neither the helper nor the child are aware of the connection , and the sudden reaction appear difficult to understand . Being a “ detective ” together with the child to find the connection- what happened just before the strong reaction / what triggered you now- is a good help .
Children may also feel disconnected from their bodily sensations and feel numb or be unable to recall traumatic memories . A state of heightened arousal is also common . The child may be on its guard all the time , startle easily , sleep poorly , be irritable , or find it difficult to remember and concentrate ( hyper-arousal ). If the child lacks support and help , these reactions may last for months or years . Psychiatrists call this state of mind ‘ post-traumatic stress disorder ’ ( PTSD ).