How to deal with trauma?

What is trauma?

Trauma can be described in a number of ways. In short we can say: Trauma is the result of (a chain of) events or circumstances that are perceived by a person as a physically or emotionally dangerous threat and that have a lasting, negative effect on the physical, social, emotional and mental condition of the person.

The word “trauma” is derived from the Greek word that means “wound”. In the same way that people can be wounded physically, they can be wounded emotionally and mentally. Even communities can be wounded mentally. Just think of how the staff and learners of a school or the citizens of a town can be traumatised after a disaster. When a wounded person walks with a bandage or plaster cast on his or her arm, he or she gets a lot of sympathy. Mental wounds are not so noticeable and therefore many people are burdened with their trauma, without receiving much sympathy.

What causes trauma?

A traumatic incident can come to you in several ways. It can come from the outside – something that someone does to you or something that happens to you. You can also be traumatised by something that you see or that you hear happened to others, for example, observing someone being assaulted, or seeing or hearing an accident happen. You can be traumatised when you are informed that someone close to you has brutally been murdered or assaulted, even though you may not have been present. Traumatisation can also be through your own fault. It can be through something you do unto someone else, even if by accident, and also by what you have inflicted upon yourself.

How does the trauma process elapse? 

Impact phase

Trauma usually happens unexpectedly. A person can peacefully be busy doing something one moment and the next a traumatic incident takes place. It is then that a strange series of things happen to you. You literally go cold with fright. Your blood withdraws from you skin and rushes to your brain and to the other organs that you will need. Your brainwaves become slower and everything feels far away and as if it is happening in slow motion. Your brain, among other things, secretes endogenic opiates that are natural painkillers. This phase lasts from a fraction of a second to a few minutes.

Reaction phase

Now the adrenal glands secrete adrenaline. This causes you to want to fight, flee of freeze in the situation. People react differently, but irrespective of how you react, you can know that your reaction is a natural reaction in an unnatural situation. There is no need for you to feel guilty later because you might have fled, or to blame yourself because you, perhaps, fought or froze. With the high level of adrenaline and opiates in the blood people do exceptional things that they cannot normally do. They jump extraordinarily high, hit very hard and run, even if they are injured. This phase can last for hours or even days.

Withdrawal phase

When the immediate danger has passed, the withdrawal phase starts. Although the adrenaline decreases, the body secretes another stress hormone, namely cortisol. This phase is characterised by strange behaviour like avoidance. People avoid the place where the traumatic incident happened or people or things that are related to the incident. Some people’s sleep is severely disturbed by dreams or triggers that enter their thoughts and constantly upsets them. Others are nervous, afraid and anxious. If this phase passes normally (depending on the intensity of the trauma, as well as how the individual handles the traumatic incident) it can last a few days to six weeks. As time goes by the symptoms subside and the person sleeps better again. The victim does not have nightmares anymore, the anxiety disappears and normal behaviour returns.

Integration phase

After six weeks the last phase should start. This is where the trauma is processed and the person accepts that the trauma is over. The person is no longer plagued by the memory of the traumatic incident, makes sense thereof, experiences growth as a result of the incident and can live fully again. If the traumatic incident is the death of a loved one, the mourning process, which lasts much longer, will continue.

Complications

Sometimes it happens that a person does not experience the integration phase and, instead of a completed withdrawal phase, experiences a continuation of the symptoms of intrusion (triggers, flashbacks and nightmares), avoidance of people, places and things, as well as anxiety and inapt fear. These continued symptoms exhaust the person and can lead to unproductiveness, listlessness and depression. Occasionally, after a long, pleasant holiday away from everything, such a person may return to normal by integrating the events.

Should the withdrawal phase and integration phase stay away permanently, Post-Traumatic Stress Disorder (PTSD) develops. Typical symptoms are phobias (fears), a change in normal behaviour, recurring nightmares, flashbacks, triggers, avoidance of places, people, conversations and thoughts on the trauma, struggling to fall asleep, distrust, outbursts, over cautiousness, excessive nervousness and disturbed relationships.

When should I seek help?

It is advisable to get help after any traumatic event. Families who were traumatised together, groups that went through trauma together, for example a disaster, armed robbery, accident, et cetera, can benefit from group defusing.

Even if you do not suffer from the symptoms as mentioned above, it is beneficial to go for defusing in the first two weeks after a traumatic incident. The best time for help is three to seven days after the traumatic events (then the adrenaline levels are not so high anymore). In cases where someone has died, it is wise to wait until after the funeral before trauma counselling takes place. If you get help in time you can prevent the development of later symptoms.

Where can I get help?

Psychologists or counsellors can be very helpful. Make sure that the counsellor who defuses you is equipped to handle trauma. Not all counsellors are trained in effective trauma-defusing methods. Ask the counsellor beforehand whether he or she has been trained for the task. Persons, who are not specifically trained to deal with trauma, will probably not be able to improve your situation and may even make it worse.

Of course, it is also necessary to get spiritual support. The assistance of a minister, care group or trustworthy co-believer can be very helpful. One must, however, guard against too easy answers, or rousing guilt feelings because the healing process might not be happening fast enough, or a denial of the reality of the trauma. But it is good to know that God is close to us, that he carries us, that he knows about us, that he is our safe hiding place and that he makes all things work out for good in the end, even though we do not understand how he does it.

We may cast all our anxiety on him because he cares for us! (1 Peter 5:7) It is also good to read the appropriate Scriptures prayerfully, for example Romans 8:28-29, or the many Psalms that were written from a traumatic situation, for example Psalm 23, 42, 46 of 131.

A few places where you can seek help:

LifeLine telephonic help: 0861 322 322

www.lifestresscounseling.com (a considerable number of trauma counsellors are listed here)

http://www.itn.org.za/ Inter Trauma Nexus

http://janviljoen.weebly.com/

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