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KEY TO KNOW uniforms , weapons , sounds reminiscent of explosions . Male survivors of sexual violence may feel a strong fear reaction if they encounter someone who resembles the perpetrator or has a similar voice or smell . Triggers are often sensory . But thoughts or emotions , or bodily sensations , can have the same effect . Thus , survivors may be triggered by physical pain during a surgery ; survivors forced to perform oral sex may be triggered by a visit to the dentist , etc . People who are triggered feel “ it is happening again ”, and if they are triggered often , without understanding what is happening , such reactions can become very real and even stronger each time .
REFLECTION QUESTION
Questions to reflect on
• What are triggers ? How can helpers assist survivors to identify and deal with them ?
• Give some examples of situations where persons have been triggered ?
2.4.4 Overactivation and “ hyperarousal ”
Over-arousal and hyper-arousal symptoms are an expression of the “ fight-flight ” response to stress . A traumatic event triggers a high stress response in the body , including its hormonal system : survivors physiologically prepare to flee or fight . This same response can be triggered by memories , inducing the survivor to believe that a traumatic event is happening again , here and now . Some symptoms are similar to panic or anxiety disorders .
A person may enter a state of overactivation quickly – as a result of a slamming door , for example , or the sound of a police car . Most often , survivors are activated all the time ; they ceaselessly scan their surroundings for signs of danger . When this state of mind is very pronounced , it can appear that the survivor is having delusions or is paranoiac . Survivors who are very tense all the time often suffer muscular problems , continuous pain and headaches .
Survivors in this state are often extremely irritable . They exhaust themselves and , because their anger lacks any cause that other people can understand , their behaviour creates serious problems in their relationships with family , partners and friends . Survivors may therefore experience significant relational problems on top of their “ inner ” mental distress and may find it difficult to function in society and in the workplace .
2.4.5 Sleeping difficulties
Sleeping difficulties are common . Survivors may wake up several times at night , often disturbed by nightmares . They may not know where they are when they wake up after a nightmare . Afraid that traumatic memories will return if they sleep , many survivors avoid going to bed at all . This results in a reversed circadian rhythm . Over- or under-activation very often leads to a mixture of fatigue , imbalance , and an irregular circadian rhythm .
2.4.6 Emotion flattening , numbness
People exposed to traumatic events may become emotionally flat or numb to protect themselves . It is as if they are detached from their own feelings . This emotional state affects the quality of life and is socially insupportable . People feel different . It is a form of not being able to care , a disconnection , that shuts down feelings and severely restricts the ability to express emotion . In many ways this can be a form of underactivation and “ hypoaroused ”.