I’m so tired and I cannot sleep,
As my fears all surface and drag me in deep.
The darkness and anguish hit me between the eyes.
All those memories I desperately try to deny.
The dark shadows follow me around every day.
Those thoughts of despair I can’t shake away.
(One verse from a poem the author wrote after suffering PTSD)
What is trauma?
Trauma is a deeply distressing experience and can impact an individual at their core, in mind, body and spirit. Often individuals associate trauma to major events such as: war, road traffic accidents, kidnapping & hostage taking, sexual violent crime, serious accidents, childhood physical and sexual abuse and natural disasters. Individuals can also experience trauma symptoms from domestic violence, a difficult relationship breakup, adoption, bullying at school or in the workplace, displacement, harassment, being a target of stalking and losing a job.
Furthermore, individuals can experience trauma symptoms vicariously. This is also called ‘secondary trauma’, which can be triggered by living with someone who is traumatised or carrying out a role where you are indirectly listening to or witnessing traumatic material. Mission and aid workers, journalists, therapists, medical staff, social workers, care workers can all be exposed to vicarious trauma. Likewise, office staff can be exposed vicariously to trauma. This was highlighted in the Ebola response. Aid workers that were exposed to stories remotely started to experience trauma symptoms and requested psychological support.
Common trauma symptoms
Below I list many of the common trauma symptoms.
- Flashbacks – Flashbacks and intrusive thoughts can appear when we are least expecting them to, it may seem they come ‘out of the blue’, although something will have triggered them whether it be a sound, smell or place reminding us of the traumatic or distressing memory.
- Palpitations and panic attacks - Our heart and lungs have to work really hard to pump the blood and oxygen around the body at speed. This increases our heart rate, which can lead to palpitations and/or raised blood pressure.
- Concentration and memory impairment – The logical thinking part of the brain can go off-line which can cause difficulty with concentration and memory.
- Difficulty sleeping – Sleep is often the first thing to deteriorate after a distressing or traumatic incident. This can also lead to dreams or nightmares that disturb our sleep, often with the theme of ‘not feeling safe’.
- Changes to appetite – Some individuals start to binge eat, eating unhealthy foods. The liver produces glucose to inject us with an energy boost. Therefore we can be drawn to eat sugary foods. Others may lose their appetite altogether and feel nauseas.
- Stomach problems – Our bladder, bowels and digestive system start to shut down when we are traumatised or acutely stressed. Initially we may feel the need to go to the toilet more often than normal or feel ‘butterflies’ in our stomach. Over a period of time individuals can start to experience stomach issues such as, Irritable Bowel Syndrome (IBS) or stomach ulcers.
- Emotional outbursts – Some individuals will experience unexpected moments of bursting into tears, or becoming irritable and angry towards those closest to them.
- Numbness – Some individuals will feel a sense of ‘not being there’, as if watching the world go on inside a TV set or feeling slightly removed and disconnected from what is going on.
- Anxiety and depression – It is common to feel a great deal of anxiety when distressed. This makes it hard for individuals to relax. This also consumes a great deal of energy, which can then lead to feelings of depression.
- Shaking – Some individuals may experience shaking directly after a traumatic event. Adrenalin pumps through the muscles to prepare us for action.
- Avoidance – Individuals may be inclined to avoid certain places or events that will remind them of the distressing incident.
- Immune system – Our immune system is not needed in an emergency situation and, similar to the stomach, shuts down. In the longer-term this will make it much harder for our body to fight off infection and illness. Fibromyalgia and chronic fatigue can also be related to the trauma or acute stress response.
- Increase in alcohol or drug usage – Some individuals will start to self-medicate whether through alcohol or drugs, as a way to supress emotions and induce sleep. This will need to be monitored, as the risk is that it could become a crux and develop into an unhealthy coping strategy.
- Negative thinking – Often self-berating thoughts of ‘I’m not good enough, ‘I failed’, ‘I am to blame’, ‘I am weak’ start to remunerate in our minds. There is a great deal of shame or guilt associated with traumatic events.
- Exhaustion – All the above symptoms take their toil on the body, therefore it is not surprising that individuals can feel exhausted.
Some individuals do not evidence any trauma symptoms after a traumatic event, and those that do will experience their own personal combination of the above symptoms. Most people recover from trauma naturally, within four to six weeks. It is also important to keep in mind that some individuals will experience a ‘delayed trauma’ response. This can happen months or even years after an event.
If you are concerned about a colleague or have suffered a traumatic event do reach out for support. FD consultants (www.FDconsultants.net) offer specialist trauma and critical incident care. If you visit my website you can read my RESPECT resilience model (Dunkley, 2018) to increase resources in managing the symptoms of trauma.
There is a great deal written about post traumatic growth, by working through a trauma we can become stronger and some individuals go on to use their experiences to help others. I find working with trauma inspiring, not only because of witnessing the human spirit to survive, but also because of the privilege to travel such difficult terrain with an individual who is suffering to a path of greater resilience, self-compassion, and traumatic growth.
(Extract taken from: Dunkley [2018] Psychosocial Support for Humanitarian Aid Workers: A Roadmap of Trauma and Critical Incident Care. Routledge, Taylor & Francis Group. Oxon and N.Y.). To order a copy of Fiona’s new book, Psychosocial Support for Humanitarian Aid Workers, click here https://tinyurl.com/y74qhjsu
Find out more
If you want to read more about trauma and critical incident care please feel free to visit the resources on my website here: https://tinyurl.com/yavd934t
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