Trauma: The Aftermath of Disaster

The recent devastating earthquakes in Nepal and the staggering death toll wrought by nature’s fury are a stark reminder of the fragility, tenuousness, and preciousness of life.

Disasters of various kinds can happen at any time and to anyone. While wide scale natural disasters are fortunately relatively rare events, life is full of circumstances that can potentially inflict the phenomenon we know as trauma.

Just what is trauma? It’s the injury we sustain from a life-endangering event. Our bodies have a characteristic way of responding to various types of assault. While the injuries we sustain can be primarily physical in nature, they can also be emotional or a combination of both. Catastrophic events inevitably leave a mark. Physical wounds are perhaps the most easy to see (although it’s not uncommon for automobile accident victims, for example, to suffer internal injuries that aren’t necessarily immediately apparent), whereas the emotional scars of trauma are often more difficult to recognize.

In the aftermath of a horrendously upsetting event (e.g., a rape, tornado, fire, bombing or explosion, etc.) people can experience a variety of acute stress reactions. For example, they can experience shock, which is a physiological state in which for various reasons they’re not getting enough blood supply to their vital organs. They can also go into a state of denial, a psychological state that’s nature’s way of protecting us from realizing the full impact of the catastrophe or experiencing the full degree of pain that might be associated with it.

It’s perfectly natural and normal to be “shaken up” after a terrifying event. Sometimes the acute stress responses we experience in the aftermath of a disaster can be quite severe in their own right. But because our bodies have many remarkable self healing properties, many of us are able to eventually bounce back from a disaster in truly amazing ways. Still, it’s not uncommon for trauma survivors to experience distressing, sometimes debilitating, longer term effects in the aftermath of trauma. Sometimes these lingering effects are primarily of an emotional and psychological nature and are manifested in a syndrome we have come to call Post Traumatic Stress Disorder (PTSD).

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Having PTSD is more than having a greater than normal degree of difficulty “re-adjusting” to life. It’s a distinct syndrome with certain common features that make it difficult for a survivor of tragedy to simply put things behind them and resume a more “normal” life. Soldiers who have either directly experienced or witnessed horrifying events (e.g., death, torture, physical maiming, etc.) are among the more common sufferers of PTSD. (See “A Combat Vet’s Take on PTSD”.) While the signs and symptoms of PTSD vary somewhat from person to person, there are common distinctive features of this mental disorder (see NIMH and MH Reference):

Re-Experiencing or Re-Living the Catastrophic Event

PTSD suffers can experience sudden, unwanted, and intrusive “flashbacks” or recollections of the terrifying event. They can also experience dreams or nightmares, the content of which depicts the event or evokes emotions associated with the event. Perhaps most insidiously, trauma survivors can be “triggered” into remembering terrifying events or re-experiencing the the terrifying emotions connected with those events merely by seeing something, hearing something, or finding themselves a situation that in some way bears a similarity to the traumatic event or reminds them of it in some other way.

Anxiety and Avoidance Behaviors

Folks suffering from PTSD are likely not only to experience chronic anxiety but also to try and avoid doing or exposing themselves to things that make them more anxious or in some way causes them to re-experience any of the other troublesome emotions they experienced in response to their past trauma (e.g., avoiding crowds, places where there might be loud noises, outdoor events that expose them to the elements, etc). Sometimes, they might appear to develop new fears. A person traumatized in a car accident might avoid either riding in or getting behind the wheel of a car, for example. Initially, the avoidance behavior might be related purely to the fear of the possibly of another accident, and as such should become less frequent over time. But avoidance behaviors can also persist as the person seeks to avoid the anxiety they’ve come to associate with being in a vehicle. This pattern of avoidance can become quite debilitating.

Heightened Arousal

Survivors of a terrifying event often become hyper-alert, hypersensitive, hyper-vigilant, and have great difficulty relaxing. Others typically describe them as “on edge” a lot of the time and easily startled or upset. Sometimes, this fairly natural biological response of hyper-arousal diminishes in time. Sometimes it persists long after any genuine threat has passed, becoming just another component of the PTSD syndrome.

Regressive Behavior

Traumatized individuals can sometimes lose skills and coping abilities they acquired long ago and revert to more primitive or inadequate ways of functioning. This is especially common in child trauma survivors. Young children might begin wetting the bed again or experiencing heightened anxiety when faced with possible separation from caretakers. They sometimes have to re-learn skills they have forgotten or become reinforced in skills they were either weak in or lost as the result of their trauma.

Recovering from the effects of trauma can sometimes be a daunting task, but fortunately there are many effective treatments available. PTSD sufferers who join support groups, learn anxiety management skills, and avail themselves of the various psychological and pharmacological treatments are often able to recover a sense of security and self efficacy and lead normal lives. While some trauma survivors never stop having “flashbacks” altogether, over time, and with regular practice of their coping techniques, flashbacks usually decrease in both intensity and frequency, helping put an end to the nightmare that began on that fateful, traumatic day.

• abuse and trauma
• anxiety and stress
• violence