Trauma is defined as a unique individual experience triggered by a sudden, external overwhelming event or of persistent overwhelming conditions in which one’s ability to cope is compromised, as one experiences a real or perceived threat to his/her life, bodily integrity, or that of a significant other (Saakvitne, K. et al, 2000).
Trauma impacts internal and external psychological functioning, and therefore requires treatment which addresses internal processes, as well as structured and problem-oriented intervention.
What is PTSD?
PTSD is a debilitating Anxiety Disorder triggered by exposure to a traumatic event or experience which is regarded as unnatural, overwhelming, and beyond one’s control. A traumatic event could be an interpersonal event such as physical, emotional or sexual assault, rape, exposure to disaster or accidents, natural catastrophes, serious injury, terrorism, combat or witnessing a traumatic event.
The diagnosis of Post-Traumatic Stress Disorder (PTSD) is made by a trained Clinical Psychologist or a Psychiatrist in the mental health field. Our psychologists are more concerned at addressing and focusing on significant impairment and how distressed you or a significant other feels after the traumatic event experienced.
Symptoms
Symptoms listed below may be experienced after some delay as symptoms do not usually develop directly after the traumatic event. Symptoms of PTSD fall into three main categories:
1. “Reliving” the traumatic event which disrupts day-to-day activity:
- Flashback episodes, where the event is relived
- Repeated disturbing memories or images of the traumatic event
- Repeated nightmares of the event
- Strong, distressing reactions to situations that remind you of the traumatic event
2. Avoidance
- Avoiding places, people, or thoughts that remind you of the event
- A lack of interest in normal activities
- Emotional “numbing,” or feeling as though you do not care about anything
- Feeling detached
- Being unable to remember important aspects of the trauma
- Feeling like you have no future
3. Hyper-Arousal
- Difficulty concentrating
- Easily and exaggerated startled response
- Hyper-vigilance (feeling more aware)
- Irritable or outbursts of anger, tearfulness
- Difficulty falling or staying asleep
- Guilt about the event (including “survivor guilt”)
Psycho-somatic complaints:
- Agitation or excitability
- Dizziness
- Fainting
- Feeling your heart beat in your chest
- Headaches
- Sweatiness
Treatment:
One can increase the chances of a good psychological outcome with an
- Early diagnosis
- Early intervention
- Strong social support system
Early treatment and a good support system can help prevent PTSD from developing after a trauma. Should PTSD occur, confronting the original trauma through various forms of treatment “” may be used. E.g.
Trauma debriefing, Trauma Counselling, Talk Therapy or Psychotherapy, EMDR (Eye movement Desensitisation and Reprocessing), Cognitive Behavioural Therapy are a few techniques used.
Therapeutic Treatment assists in:
- Reducing symptoms by encouraging one to remember and relive the traumatic event in a safe therapeutic space and express feelings about it
- Over time, memories of the event should become less frightening and reprocessed
- Assist in finding effective coping skills to deal with the trauma
- Assist in confronting the trauma therapeutically instead of traumatically
- Support groups, where people who have had similar experiences share their feelings, may also be helpful
People with PTSD may also have problems with Alcohol or other substance abuse, Depression or Related medical conditions. Medicines that act on the nervous system can help reduce anxiety and other symptoms of PTSD.
Trauma Counselling for children and adolescents:
Trauma is an extraordinary experience in which dangerous and potent stimuli overwhelm the child’s capacity to regulate emotions. – Early Trauma Treatment Network
The subjective experience of trauma or danger depends on the child’s developmental age and stage.
Traumatic events can be in the form of physical or sexual assaults, natural disasters, traumatic death of a loved one, or emotional abuse or neglect. The child could be a witness to the traumatic event or have been told about it. Severe emotional trauma has widespread effects on children’s development. These include affecting children’s sense of security in a reasonable and safe world in which they can grow and explore, as well as causing a child to not believe that their parents can protect them from harm. Traumatized children and teenagers become preoccupied with danger and vulnerability, sometimes leading to misperceptions of danger, even in situations that are not threatening. Many researchers note that, once posttraumatic stress symptoms emerge, PTSD leads to neurophysiological correlates that impact brain function in developing children and adolescents.
What to look out for – Symptoms in children:
The initial response to the trauma, which involves the experience of horror, helplessness, fear or disorganised behavior in children. Symptoms of re-experiencing the trauma, avoidance, and persistent arousal last more than one month and the disturbance causes clinically significant distress in social, school, or family settings.
- Intrusive recollections
- Repetitive play of themes or aspects of the traumatic event
- Play reenactment
- Recurrent distressing dreams (the dreams are frightening but may not have recognizable content)
- Acting or feeling as if the traumatic event is recurring
- Flashback episodes
- Intense psychological distress upon exposure to cues that symbolise an aspect of the traumatic event
- Physiological reactiion upon exposure to cues that symbolise an aspect of the traumatic event
- Numbing and withdrawal
- Efforts to avoid thoughts, feelings, or conversations associated with the trauma
- Efforts to avoid activities, places, or people that arouse recollections of the trauma
- Inability to recall an important aspect of the trauma
- Markedly lowered interest or participation in significant activities
- Feeling of detachment or estrangement from others
- Restricted range of affect (e.g., unable to have loving feelings)
- Sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or normal lifespan)
- Constriction of play
- Relative social withdrawal
- Loss of acquired developmental skills (including regression and loss of skills such as toilet training)
- Persistent symptoms of increased arousal
- Sleep difficulties (getting and staying asleep, not related to fears of the dark, night terrors, night waking)
- Irritability or outbursts of anger
- Difficulty concentrating
- Hyper-vigilance
- Exaggerated startle response
- New separation anxiety
New fears (e.g. Fear of using the bathroom alone; Fear of the dark; New fears of things or situations not directly related to the trauma)
.
In teenagers, symptoms may include:
- Invasive images
- Restlessness, aggression, hostility
- Sleep difficulties
- Concentration difficulties
- Loss of interest in previously pleasurable activities
- Social and family withdrawal
- Changes in life attitudes
- Numbing
- Sadness
- Detachment
- Self-injury
- Substance Abuse
- Eating Disorders
- Sexual Acting Out
- Personality Change
Treatment for children:
The Play Therapy Room provides a safe space for children to express distressing feelings and thoughts through symbolic play and drawing. Short-term treatment (approximately 6 sessions) is used to assist children in understanding the traumatic incident(s), making meaning, identifying distressing feelings and thoughts triggered by the trauma. Once a symptom-evaluation and a Parental Guidance session has been completed, the child may need to continue with the Play Therapy process to address possible underlying distress.
Various techniques are used to work therapeutically with a child:
Eye Movement Desensitisation and Reprocessing
Play Therapy
For more information please contact one of our Clinical Psychologist at PsychMatters Family Therapy Centre in Bedfordview, on 011 4503576 or info@psychmatters.co.za
