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After he moved to a safer part of his country , he went to see a doctor about the physical injuries he had suffered during torture . The doctor conducted a so-called IP ( Istanbul Protocol ) examination , which formally documented the injuries . Finally , someone had taken him seriously and acknowledged the effects of his torture . He believed this evidence could be valuable if one day he was able to bring a case to court .
One of his neighbours invited Kumar to join a community dinner to distract his thoughts . The dinner was convened by a local organisation to support survivors of war . Sometimes they ate dishes that evoked memories of his hometown , and he felt saddened . During this event , a local helper talked about the long-term effects on people of imprisonment , violence , and trauma . The helper said it can be difficult even to imagine having a normal life again . Kumar recognised himself in what the helper was describing , and they agreed to work together with what Kumar described as his most difficult trouble in daily life - a constant feeling of anxiety and restlessness .
The helper said that his symptoms were common among people who have lived in danger for a long time . Making use of the minefield metaphor , she encouraged Kumar to focus on the fact that he was now out of danger . The metaphor helped Kumar to get some perspective on his situation and understand why he reacted as he did .
To deal with his constant feelings of anxiety and restlessness , the helper gave him some instructions and taught him some simple grounding exercises . He was told to tell himself , for example , “ I am here now , I am safe , I am out of danger and there are people around me who take care of me ”. ( See the Safe Place exercise in Appendix 1 .) The helper also used the window of tolerance metaphor to explain his trauma reactions . She suggested he should review his window of tolerance before and after performing a grounding exercise , to see if the exercise changed his activation level . She also suggested he could sit , then calmly and slowly turn his head to the left , to the right , and to the front , saying aloud what he saw . ( See the Reorientation to the Present exercise in Appendix 1 .) Kumar started to use this exercise when he felt his inner turmoil and anxiety were becoming too strong .
HELP AND ACTION
Kumar also confided that he struggled with intrusive thoughts and feelings . At night he would wake from nightmares and hear himself shouting . When this happened , he lost contact with the here and now and experienced strong feelings of anxiety and restlessness . The helper added a new technique to the Reorientation exercise . To keep painful thoughts in check , she suggested he should squeeze a small rock or ball to help him return to the present . At first Kumar found this idea strange , but it worked when he tried it .
After they had talked together several times , Kumar indicated very indirectly , for the first time , that he could not overcome the feeling of guilt that he had done nothing to help others who had been abused . Mixing confirmation and psychoeducation , the helper answered that she could understand how painful Kumar ’ s feelings must be , and why he might feel guilty ; then she added that those who commit abuse “ know what they are doing ” and are responsible for all the pain their acts cause .
She taught Kumar different grounding exercises , ways to “ ground the body ”, for example by sitting and feeling your feet on the ground . ( See the Grounding the Body exercise in Appendix 1 .)
Kumar went on to talk about sounds and smells and other stimuli that made him frightened . He explained that he realised these were triggers , but said he also felt lifted above the ground , and never felt completely present or at rest .
The helper explained that the injuries that caused his reactions were inflicted on purpose to break his resistance , make him talk , silence others , confess , or maybe even just scare him . Even though he had not gone into detail about his treatment , she understood he had been tortured , and she