Most people experience events in their life which they consider stressful. When an event is exceptionally stressful it may be called a trauma. What usually makes an experience traumatic is a sense of horror, helplessness, serious injury, or the threat of physical injury or death. In some cases, the survivor of trauma may witness an event rather than being directly injured or threatened.
The best predictors of problems after trauma are the severity of the incident, the individual’s psychological health prior to the event, other stressors in the survivor’s life, the age of the survivor, and the support the individual has from friends, loved ones, and the community.
Two types of problems can result from the experience of being traumatized. Acute stress disorder (ASD), typically occurs in the first month following a catastrophic stressor. The second, called Posttraumatic stress disorder (PTSD) is virtually identical to ASD except that the problems persist beyond 3 months, for many months, or even years in some people. The difficulties associated with ASD or PTSD are usually categorized into three main categories:
- Re-experiencing: Images, sounds, or other sensations reminiscent of the trauma can interrupt or dominate the person’s thoughts. At times, he/she actually feels as if the event were happening again (flashbacks). Nightmares are also common.
- Avoidance: Many trauma survivors try to avoid situations, thoughts, or feelings that remind them of the trauma. When reminded of the trauma, the person may feel extremely tense or anxious. Grief, sadness or guilt after trauma can be so overwhelming and difficult to talk about that a person may only report feeling numb. Another way of avoiding is called “dissociation.” People disengage from their surroundings. In effect, the survivor’s body is present, but their mind has gone elsewhere.
- Hyper-arousal: People who have been traumatized are usually quite anxious and may often feel “jumpy” or “on edge”. A sharp noise may cause them to jump, or a horn may result in a pounding heart or an involuntary “safety response,” such as ducking down.
Counseling for survivors of trauma with ASD or PTSD can help a person gain relief from many of the symptoms. Telling one’s story is central to feeling more in control. The more quickly the survivor obtains help, the more likely serious problems can be averted or prevented. Treatment often focuses on two goals: decreasing anxiety and increasing the connection the survivor has with support (i.e., family, friends, or the job setting).