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Three types of symptoms are 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 .
The techniques proposed in this manual aims to restore their sense of control and empower them by giving them coping skills and helping them to rebuild social relationships and trust .
The table below summarises common trauma criteria , reactions and challenges .
What is a trauma
A threatening external event
Attacks the person ’ s sense of reality .
What trauma reactions follow
The experience feels unreal , dissociated
What the helper needs to try to do
Be a witness ; confirm what happened , make it real
KEY TO KNOW
The event is sudden , the person cannot control it . Attacks the person ’ s selfagency .
The person has a deep feeling of helplessness .
Strengthen the person ’ s sense of autonomy , influence and self-agency .
The event is emotionally overwhelming .
Attacks the person ’ s emotions .
The person feels overwhelmed and has unregulated emotions .
Co-regulate the person ’ s emotions .
Expand the window of tolerance .
The event is hard to understand .
Attacks the person ’ s cognition .
The person is confused , blames him or herself , feels guilt and shame .
Memory is fragmented .
Correct misunderstandings .
Give a correct picture of responsibility .
Create a coherent narrative .
Loss of relational protection
Attacks the person ’ s trust in personal relations and their attachment system .
The person becomes mistrustful .
Insecure attachment shows clinging or avoidant behaviour .
Build a trustful relationship .
Help understand and set appropriate boundaries for himself / herself and others .