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5 . A brief introduction to ‘ trauma ’
5 . A brief introduction to ‘ trauma ’
Aim . To clarify ‘ trauma ’ and ‘ traumatic events ’ and their effects on people .
‘ 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 ”.
PART I : POINTS OF DEPARTURE
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 is expressed by ‘ fight , flight or freeze ’ responses , submission or ‘ playing dead ’.
A severe traumatic event often changes the way in which survivors understand the world around them . They may lose their sense of safety , and feel vulnerable and helpless . If the event involves acts of violence and the intention to hurt , trust in other people may be lost and the survivor ’ s interrelational 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 leads to depression ( deep sadness , loss of the will to live , etc .) or anxiety . A personal encounter with violence and death may also haunt the survivor , who may painfully re-experience the event in dreams or daily life ( also called intrusion ). Intrusion is often set off by reminders , which may cause survivors to try to shun everything that might bring to mind the event ( called avoidance ). In this manual , we call the reminders that cause intrusion ‘ triggers ’. Survivors may feel disconnected from their bodily sensations and feel numb , or may be unable to recall traumatic memories . A state of heightened arousal is also quite usual . Survivors may be on their guard all the time , startle easily , sleep poorly , be irritable , or find it difficult to remember and concentrate ( called hyper-arousal ).
If survivors lack support and help , these reactions may last for months or even years . Psychiatrists call this state of mind ‘ post-traumatic stress-disorder ’ ( PTSD ).
Three types of symptoms are therefore 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 . Our work aims to restore their sense of control , and empower them by giving them coping skills and helping them to rebuild social relationships and trust .