TRAUMA: CAUSES AND CURE

Dr T Ayodele Ajayi explores how people can overcome trauma, and the professional support available

In psychological terms, how we live in the present and how we perceive the future are affected by past emotional wounds, and psychological reaction to traumatic event(s) occur when a person’s experience of the event(s) has not been well processed. Everyone responds differently to events; some may find an event traumatic where others may not. We each react to trauma in various ways.

Traumatic events include bereavement, personal assault, sexual abuse, violence, bullying, domestic violence, being in a car crash, and other serious personal injuries. On a collective note, they also include terrorist attacks, natural disasters, hostage situations, wars or threats of war. The experience can be single, multiple, repeated or chronic.

Another form of trauma to bear in mind is one that children experience. The term ‘Adverse Childhood Experiences’ is commonly used and refers to a range of negative situations –physical, emotional or sexual – a child may face or witness while growing up.

Problematic Trauma

Around one in three adults in England report having experienced at least one traumatic event. However, research suggests that two out of three people who develop problems after a traumatic experience get better within a few weeks without treatment.

Professional help should only be sought when symptoms are sufficiently severe to interfere with day-to-day functioning, or when family, work or school activities are adversely affected. Further reasons for seeking help include feelings of not returning to normal after four weeks; family or friends noticing a change and encouraging help-seeking; and using unhealthy coping methods, such as harmful alcohol or illicit drug use.

Effect of Trauma

Post Traumatic Stress Disorder (PTSD), depression and/or anxiety are among mental health conditions that can follow pathological trauma exposure.

PTSD affects one out of three people who experience trauma. The key features of PTSD are reliving the trauma; using avoidance as a coping strategy; hypervigilance and hyperarousal. Reliving the traumatic event could entail nightmares, flashbacks, repetitive and distressing images or sensations; and physical sensations, such as pain, sweating, feeling sick or trembling. Flashbacks are involuntary, intense and often distressing memories of the traumatic event that can be triggered by certain stimuli. They are often vivid and feel like they are happening again in the present moment. Flashbacks are commonly accompanied by intense emotional reactions, such as fear, anxiety, or anger. Sufferers of PTSD may also experience feelings of isolation, irritability and guilt.

PTSD can develop immediately after someone experiences a disturbing event, or it can occur weeks, months or even years later. Common triggers to a delayed manifestation could include the perpetrator of an assault being released from prison or acquitted; or contact with the perpetrator.

Getting Help For Trauma

Lifestyle changes, such as healthy eating, adequate sleep and exercise, avoiding alcohol and drugs, and seeking support from friends and family are the recommended first interventions after trauma.

Your GP is the ideal first port of call for seeking help. The treatment you are offered will depend on your particular symptoms, diagnosis (if you have one), and on your own unique needs. Keeping an open mind and exploring different options can be useful. Active monitoring in the form of watchful waiting is common with mild symptoms that have lasted less than four weeks. In severe or persistent forms of PTSD, a combination of medication and psychotherapy (talking therapies) could be offered.

NHS Talking Therapies are the agencies that commonly deliver these therapies. The three mostly used talking therapy approaches are Cognitive Behavioural Therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR), and Trauma-Focused CBT. Both CBT and TF-CBT are aimed at helping you to change your ways of thinking and acting, and to come to terms with the event. Usually, 8-12 weekly 60-minute individual or group sessions are offered initially.

EMDR entails a technique that uses eye movements to help the brain to reprocess traumatic memories. A specialist therapist will ask you to recall the feelings and thoughts associated with the event, whilst encouraging you to simultaneously perform bilateral eye movements or hand tapping. Similarly, 8-12 weekly sessions lasting 60-90 minutes is common practice. EMDR has been shown to lower the intensity of the emotions experienced around a traumatic memory, helping to resolve the trauma.

Talking therapies are the first line of interventions recommended. Antidepressants – usually belonging to the group referred to as Selective Serotonin Reuptake Inhibitors (SSRI) – are sometimes required with severe conditions, in those who have not responded to talking therapies, or when there is co-existing depression.

The UK Psychological Trauma Society (https://ukpts.org/trauma) and the Royal College of Psychiatrists (www.rcpsych.ac.uk) are both credible sources of information on trauma.

The important concluding message is that even after several months or years of trauma, treatment and recovery are possible and should be explored.

Ministry leader and pastor, Yvonne Brooks, provides wise, compassionate and insightful advice to readers experiencing problematic life issues

My son has stopped attending church and has joined a gang

I am a lone parent raising three teenagers – two girls and a boy. My daughters are a delight; they are doing well at school and are active in the church youth group. Not so my 14-year-old son. A year ago he said he no longer wanted to attend church with us, and now I fear he’s joined a gang as he now spends time with young men who are up to no good. How do I know? I met with his headteacher who told me my son is hanging out with the worst kids in the school and is not keeping up with his schoolwork anymore. Prior to that my son was a top student. I can’t get help from his father because he’s unreliable. However, I don’t want my son spiralling into a life of gangs and crime. What can I do to get him back on the right path? I do talk to him, but he takes no notice. Any advice you can give will be gratefully received.

Janice, Manchester

Pastor Yvonne: I am so sorry to hear of your predicament. Unfortunately, this situation is increasingly common. Your son is going through puberty, where he is adjusting physically and mentally whilst trying to find himself. He wants leadership and identity as a man.

He does not appear to have examples around him, hence his attraction to gangs. He is trying to make sense of what little experience he has. He feels rejected and resents his father for not being around regardless of the reasons.

Your son wants to be fathered. This will either be by his biological father or by gang members, who appear adept at turning young men into their followers. It is time for you and his father to put differences aside, to talk, and