Information about how the brain works and why we as human beings react the way we do in traumatic events can be useful. This may provide the survivor with the knowledge and ability to deal with her/his problems in alternative ways. Knowledge means that the survivor understands what traumatic events may do to a person, what she/he may expect and is aware of the reactions she/he may have. We believe that the more a person is aware and knowledgeable about her/his problem and how it affects her/his life and the lives of others, the more control she/he can have over her/his life and the better the person can deal with and live with the reactions. In this way, information about trauma may empower both the survivor and you as a person who is close to a survivor.
‘Trauma’ means wound. In both medicine and psychology, it refers to major physical or mental injuries, including threats to life or physical integrity.
Some key things to know about trauma:
-The situation is overwhelming, inescapable and very frightening
-Threaten life and integrity
-Loss of control and beyond what we are prepared to deal with
-In a short term perspective most people will struggle with serious reactions such as intrusive memories, re-experiences, flashbacks and sleeping problems afterward
-Suffering can be recognized in thoughts, feelings, breathing, heart and body
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. Behaviorally 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 relationships with others 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. It is important to emphasize that the reactions that survivors experience are “normal” reactions to an abnormal event. The survivor is not crazy!
Some important things to know about acute trauma:
- When a person is traumatized, her/his feelings are intense and chaotic
- Fear and shame may cause a survivor to withdraw and refuse social contact
- Trauma cases a survivor’s confidence to collapse
- It is important to act but, at the same time, you as someone who can support the survivor must allow the survivor to decide at what point she/he is ready to make contact and open a conversation
Flashbacks are sudden, often strong, and uncontrollable re-experiences of a traumatic event or elements of that event. 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. 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). We call the reminders that cause intrusion ‘triggers’.
Triggers, or trauma-reminders, are events, objects or situations that remind survivors of their painful experiences and memories. Such reminders may elicit trauma reactions over and over again. They can be extremely distressing and create such anxiety that people are afraid to go out, see people, hear certain sounds, or do many ordinary usual things.
Some key points to know about triggers:
- Unexpected situations can suddenly trigger trauma reactions
- It is possible to prepare against these, by using the senses to feel more present
Calming a survivor who has been triggered:
In order to help a survivor, it is useful to assist her/him in coming back to the here and now. You may say things like this to the survivor:
- “You are at home/a café/in a park (or where you are at the present moment) now”
- “You are safe here in this room”
- “You are here now and not where the traumatic event happened”
- “You are strong and courageous”
- “Remember to breathe”
- “Look around, try to be present here and now” (for example, you can point at different objects in the room and say things like “Do you see the white table over there? Do you see the green carpet? The yellow chair?”)
You may also practice grounding exercises together and try to use them if/when the survivor is being triggered.
We have now provided you with information about how trauma and traumatic events may affect the body and the mind. We hope that this information will be helpful in understanding your/the survivor’s reactions better. We have also given some information about how to calm a survivor who has been triggered.
The grounding exercises that we have described under the heading Self-care: grounding exercises explain how practicing grounding exercises regularly, either alone or together, may help the survivor to deal with traumatic memories, triggers, flashbacks and nightmares if they occur. We, therefore, recommend that you have a look at the page with grounding exercises and try some of them. Maybe this can be helpful in handling the trauma reactions, making good decisions for oneself and others, and take some control back in life.
Remember that, with time, most survivors will get better. Also, remember that nobody can take your dignity away from you. You are you
All manuals can be downloaded from the MHHRI website
The manuals are translated into several languages. The page numbers in each manual remain the same across languages. This allows survivors and helpers to work from copies in their preferred language and read the same content on the same pages. It also makes it easier to teach participants when participants and trainers work in more than one language. The manuals include a toolbox. Survivors can use it individually to regulate their own emotions through grounding exercises or in collaboration with a helper. Helpers can also use grounding exercises to take care of themselves as helpers.
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