Trauma: The Shattered View
By Dr. Ingrid Artus June 2012
As South Africans, it is not so uncommon to know or even to be a person who understands the practical reality of a traumatic experience. In my experience of counselling traumatised clients, I have encountered many cases relating to armed robberies, hijacking, rape, car accidents, sudden death of a loved one and other forms of witnessing violence to self or others. The key shift that a traumatic experience often brings is a shattered assumption about life and how it should unfold. These typically include the following assumptions:
Invulnerability: We may replace the idea of the world as a safe place with the notion that the world is not secure. This may lead to hypervigilence and a fear to move around between places – especially places that remind of the event.
Rationality: The senselessness and meaninglessness of traumatic events makes the world appear as an unpredictable and unstructured environment. This sense of meaninglessness can lead to great despair and in some cases unhealthy activities to relieve the pain. This may include addictive or compulsive behaviours which provide some sense of anxiety reduction and being in control.
Morality: Trauma can break the notion of a moral worldview where good is rewarded and evil is punished. The sense of a belief in justice is deeply wounded and can result in a painful faith crisis and intense anger at the injustice.
Personal identity: Traumatic experiences may include a direct or indirect attack on our sense of self, such as being capable, confident, strong, wise, valuable, and so forth. Our identities may be bruised, crushed or robbed to the degree that we view ourselves as victims without hope of being restored to our former whole and integrated selves. Many people report feeling as if they have lost something of who they are.
This perceptual change is normal within the abnormality of a traumatic experience.
We often move through various phases during trauma. The initial response is called the impact phase and involves a type of emotional and cognitive paralysis. At this point we are anxious, fearful and numbed by the unfolding events. Biologically, our extremities may become very cold as the blood rushes to the muscles. Brain activity changes from the normal awakened beta-state to the pre-conscious theta-state. At this point, the unfolding scenes may feel as if it is playing in slow motion. The brain may also not categorise the events in logical order which makes it difficult to recall the exact sequence of events directly after a traumatic incident. This is why deep trauma counselling is more meaningful about 72 hours after the initial trauma when we had time to process and recollect the events in a more structured manner.
The recoil phase involves the flight-fight-freeze response as the adrenal glands release adrenalin. This hormone-rush allows us the physical ability to accomplish things that we will normally not be able to do, such as lifting a heavy object or outrunning a thief. The most meaningful intervention directly after a trauma is to provide physical assistance in the form of practical help and emotional support by listening, encouraging and providing a calm, safe environment.
Somewhat after the incident, we may enter the avoidance phase during which various trigger situations, places, people and so forth are avoided. The stress hormone cortisol is released and as a result we find ourselves in a state of intense awareness and alertness. The event may play itself out in nightmares and intrusive thoughts are not uncommon. If we remain in this intensely stressful state it may develop into burnout or even post-traumatic stress disorder. Our bodies use vitamin B to cope under stressful situations, and as such it is imperative to assist the body by replenishing the resources with a good vitamin B complex supplement. At this point we will benefit greatly from deep-level counselling as we are guided thought the stages of grief.
As we progress through the healing process, we reach the final stage of integration. Our body and brain functioning gradually return to normal and we reframe and integrate the experience as part of our life stories. Optimal healing is found in our abilities to find meaning through our experiences of trauma. When we are able to face and truly work through our pain, we often emerge as wiser and deeper people – able to view the world through lenses of hope and gratitude. . .