Getting over trauma

hope & cope

The month of April always brought her fond memories. The summer vacation had begun and she was looking forward to going to the annual fair held in her locality.

She had just turned 12 and had convinced her parents to let her go with her friend. The two girls rushed into the amusement site, unable to contain their excitement. But soon, they started getting swayed by the crowd and their grip on each other’s hand loosened.

Suddenly, the young girl realised she was alone, when she felt a grip around her waist. It was uncomfortable. She did not like it. Someone was pressing down her chest. She wanted to shout, but could not. She wanted to pull away from the hands that were manhandling her, but she wasn’t strong enough. Eventually, the unwanted touch left her. She made her way out of the crowd. She could finally breathe. Anguished and relieved at the same time, she wondered, “What just happened?”

This is an example of a traumatic incident. Many of you reading this may have experienced something similar at some point in your lives. This article will help you understand the meaning and consequences of trauma along with the avenues of recovery from its after-effects.

What is trauma?

Trauma is defined as either a “physical injury caused by a direct external force or psychological injury caused by extreme emotional assault” (Reber, 2001). It represents a sudden and rapid loss of resources that are of highest value to the individual, such as safety, trust, self-esteem, etc. Sudden death of a loved one, vehicular accidents, life-threatening illnesses or situations, domestic violence, child abuse, natural disasters, war, witnessing a fatal assault and sexual harassment are a few examples.

Trauma leaves behind mental images that are powerful in impact and can be evoked easily. Many a times, people experiencing trauma cope well when the experience is occurring. However, they may precipitate symptoms of various clinical conditions later on.

One of the commonest clinical conditions is Post Traumatic Stress Disorder (PTSD). The worldwide prevalence of PTSD ranges from as low as 0.3% in China to 6.1% in New Zealand (WHO, 2008). As an after-effect of the tsunami that struck south-eastern coastal regions of India in December 2004, the prevalence of PTSD in South India was reported to be as high as 12.7 %.

What happens?

A person experiencing PTSD usually goes through a painful re-experiencing of the event. This may occur in the form of repeated recollection, thoughts, images and dreams about the stressful experience. They may suddenly act or feel as if the event is happening again. There may be associated physical reactions like heart pounding, difficulty in breathing, sweating, etc. They may feel very upset if anything reminded them of the event.

A pattern of avoidance and emotional numbing is also experienced. Individuals may avoid talking about or thinking about the stressful event. They may also avoid activities, places, situations, and /or interacting with people who may remind them of the event.

Trouble related to remembering important facts about the incident is also commonly experienced. A lack or loss of interest in activities that they had previously found enjoyable may occur. They feel emotionally distant from their loved ones and experience thoughts about life coming to an end abruptly.

A fairly constant hyper-arousal is another common feature of PTSD. Patients may feel irritable, angry and jumpy, and are unable to focus on the task at hand. They are easily startled and have difficulty falling and staying asleep.

Along with these, feelings of guilt, rejection and humiliation are also reported. Depressive features, aggression and difficulty in impulse control are common symptoms of PTSD.

How it is treated

Treatment methods are decided by mental health professionals based on the intensity and severity of the condition. This is ascertained with the help of detailed evaluation of the patient’s history and current mental state, along with psychological assessment.

For severe cases, a combination of pharmacotherapy along with psychotherapy is most efficacious. The pharmacotherapeutic approach is best handled by trained psychiatrists, while the psychotherapeutic approach can be administered by clinical psychologists. In cases of mild to moderate PTSD, patients may choose to get treated through psychotherapy alone. Practitioners may adopt relaxation exercises, exposure therapy and stress management techniques to treat the patient, and sometimes, also their family members.

A good social support system is essential to help an individual recover from this condition and make their peace with the demons of the past. The condition is treatable. Timely and regular treatment can help a person recover and strengthen their ability to better handle the vicissitudes of life.

(The author is senior psychologist, Konsult)