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1 . Trauma
In this section , we define ‘ trauma ’ and describe psychological and physiological responses to extreme life-threatening events . People react in many ways to such experiences , but some patterns of behaviour are common . We describe below typical and frequently encountered immediate and long term reactions to threats , danger and humiliating forms of violence .
PART III : THEORY
Reactions to severe stress and life-threatening events
Human beings have always been exposed to traumatising events . Our physiological reactions have probably been remarkably persistent over time . It is difficult to predict which events cause traumatic reactions , because our perceptions of a threat greatly influence its psychological and physiological effect on us . Some people survive very dangerous experiences without developing symptoms , while others in the same situation will be markedly affected or become ill . Individuals employ a range of coping strategies and tolerate stress to different degrees , reflecting how they interpret their situation and how sensitive they are , as well as the response of the surrounding community .
The stressor
For a persistent reaction to occur , there must be a stressor . To become mentally traumatised in the course of surviving a traumatic event , individuals must experience something that is perceived to be catastrophic and that threatens their life and integrity ( World Health Organisation definition ). For some people , it can be enough to witness such an event . A stressor may be an earthquake , a tsunami , a war , a bank-robbery ; it may also be a continuing experience of domestic violence or poverty .
Though people react differently to stress and threats , events such as rape , torture , and the violence associated with war are experienced as traumatising by nearly everyone , regardless of culture or other factors such as age or gender . It is therefore normal to have some or many symptoms of trauma after such experiences .
Reactions to trauma
Below , we list the most frequent forms of reaction after traumatic events . Our descriptions are based on those of the international diagnostic systems , primarily DSM-IV ( American Psychiatric Association 1994 ) and the World Health organisation ’ s International Classification of Diseases ( ICD-10 ).
Acute stress reaction
This is defined by WHO as “ a transient disorder that develops in an individual without any other apparent mental disorder in response to exceptional physical and mental stress and that usually subsides within hours or days ” ( ICD-10 ).
People typically display erratic and changeable behaviour . Immediately after the event , they are often ‘ dazed ’ and find it difficult to concentrate or focus . They may feel that what happened is unreal , and behave normally as if nothing has occurred . If the stimuli are too powerful , they may become disoriented .
Subsequently , some people may withdraw , dissociate or become ‘ stupefied ’, while others respond by panicking and wanting to flee . They show signs of anxiety and fear , have a rapid heartbeat , sweat , experience nausea , vomiting , tremors , palpitations , breathing difficulties , or a range of