With the entry of the Covid-19 virus into our lives, the floods, fires and devastating earthquakes we have experienced in our country for more than a year have caused us a very difficult time since we are not an earthquake country. As if these natural disaster events were not enough, when we look at the country's agenda (if you watch Müge Anlı, you can definitely see it), we continue to accumulate traumatic experiences on the way to becoming a society that does not value women, with news of violence against animals and abuse of women and children. Based on these, in this article, I will tell you about What is Trauma?, What are the Symptoms of Post-Traumatic Stress Disorder?, and Ways of Treating PTSD. If you are ready, let's get started...
What is Psychological Trauma?
Psychological trauma is the experiences that threaten our cognitive, emotional, behavioral and physical integrity, disrupt our routine in daily life, develop unexpectedly, experience anxiety, fear, panic and disrupt our perception process. Slapping for the first time in a long-term relationship can also cause psychological trauma, as can death, serious injury, natural disaster (earthquake, flood, fire, etc.), sexual assault or harassment, or exposure to threats of such. 'Is every negative event a psychological trauma?'We can think of our mind as a factory. This factory processes the events we experience, aiming to turn them into memories, and they are processed into our memory.
The unprocessed event is prevented from turning into a memory and this causes a constant problem, it cannot be sent to the past. Situations and events that remind us of the traumatic event lead us to relive our traumatic experience and cause us to feel whatever we felt at that moment. In such difficult times, we try to stop the factory from working, and sometimes, with the 'flashbacks' we experience, we force the factory to process inputs that are too large for it to process.
Therefore, similar events may not cause the same effects and reactions in every person. Psychological trauma may vary from person to person depending on how we evaluate and perceive the event. Human is a Bio-Psycho-Social being. Therefore, depending on the severity of the traumatic event experienced, Genetic predisposition, social environment and support sources, ways to cope with stress, and past trauma and stress experiences should also be taken into account.
In order to call a situation a psychological trauma:
The event experienced by the individual is a serious threat or risk to the individual's daily life functions.
Perceiving that he/she will suffer physical harm or witnessing someone else's harm,
• Perceiving that family members and friends from close circle will learn about the event and interpreting it as a risk,
• And if the individual reacts with extreme anxiety, helplessness or even horror in the face of this event, it can be said that this event is a psychological trauma experience for the individual.
Post-Traumatic Reactions
Reactions following a traumatic event are acute-normal reactions to abnormal events. After a shocking experience, it is natural to feel intense emotions and react.
Usually, these reactions begin to ease over time
and the individual begins to continue his life functions (going to work/
school, maintaining his relationships and hobbies
>etc.) may continue.
In some cases, if a lot of time has passed since the traumatic event, there may still be some complaints.
and these may affect our mind and our body's It may be due to efforts to reduce its impact.
Sometimes, intense reactions that negatively affect the person's life function may still continue after time has passed since the event.
Physical Reactions: Reactions to stressors occur in our body from the sympathetic and parasympathetic nervous systems. First of all, when danger is perceived, the sympathetic nervous system comes into play. It prepares the body to fight or escape from a dangerous event. During this time, the heartbeat rhythm and breathing accelerate, muscles tense, sweating, nausea, head, chest and abdominal pain occur, and all kinds of sounds and visions that remind of the event occur. Extreme startle and accompanying physical reactions to sights, sensations and smells are observed. Then, when the dangerous event ends or disappears, the parasympathetic nervous system begins to work. It helps end the 'alarm' state we experienced in the past and allows physical symptoms to return to their normal course. Mental reactions; Shock and freezing, need to talk about the event again and again or not wanting to talk, introversion, distraction, thought of losing one's mind, fear of death, feeling like one is reliving the event (earthquake, etc.), frequent images and sounds related to the event, inability to sleep or the constant need to sleep, nightmares, absent-mindedness, memory problems and confusion
Behavioral reactions; Acting as if the event never happened, excessive energy and alertness or not wanting to do anything, intolerance, quick anger, excessive startle against sounds, images, sensations and smells that remind you of the event and accompanying intense physical reactions, alcohol and substance abuse. , eating problems.
Social Reactions; Deterioration in work-school, friendship and marriage relationships, avoiding places and people that remind you of the event, being overly judgmental, blaming others or yourself, wanting to have everything under control, insecurity, anxiety, introversion, being alone, feeling rejected or rejected. It can be summarized as thinking abandoned, moving away, and being prejudiced. Reactions that occur after traumatic experiences and last less than a month are defined as Acute Stress Disorder (ASD), and when they occur less frequently and mildly, they are defined as Adjustment Disorder. If the symptoms last less than three months, it is called acute PTSD, if it lasts more than three months, it is called chronic PTSD, and if it starts after six months, it is called late-onset PTSD. It differs from ASD and PTSD in that the severity of stress is generally milder and there are no re-experiencing symptoms, which are the main symptoms of PTSD.
What are the symptoms of PTSD?
Even though at least 1 month has passed since the incident, if some of these reactions are seen constantly and these experiences do not spoil your relationships with your environment. If it causes a, we can call it Post Traumatic Stress Disorder. In this case, it would be beneficial to get professional support.
Re-experiencing the trauma that still persists a month after the event, avoiding places or situations related to the event, negative changes in your cognitive and emotional belief system, excessive arousal such as anger outbursts, restlessness, hypersensitivity, startle response If there is a loss of functionality in occupational, social or other important areas, these may be symptoms of Post-Traumatic Stress Disorder (PTSD). A small proportion of people who experience traumatic events develop PTSD.
Epidemiology
Lifetime prevalence is 9.2% and PTSD after a natural disaster is 30-40% and concurrent additional pathology (in men: alcohol and substance addiction , depression and conduct disorder. In women: depression, phobia and alcohol addiction) the incidence rate is between 60-80%.
Those exposed to any trauma;
• 20.4% of women and 8.1% of men develop TSD.
• 17.5-45% in war participants and injured people,
• 23-54% in tortured groups,
• 50-55% in refugees,
• It is seen in 13.7% of industrial accidents (Kessler et al. 1995). Experiencing or having experienced other psychological distress before or during the trauma, lack of social support, and alcohol or substance use before or after the trauma negatively affect the process and support the development of PTSD. In summary:
To be able to call it post-traumatic stress disorder, for more than a month, the individual: • Exposure to trauma,
• Re-experiencing after this event and avoiding situations related to the event • Cognitive and emotional beliefs of the individual Negative changes in the system, • Overstimulation symptoms such as outbursts of anger, restlessness, excessive startle response in the individual, • Loss of functionality in professional, social or other important areas are expected to be observed.
What are the ways to treat PTSD? In trauma treatment;
• Medication,
• Psychosocial Interventions r
Many treatment methods can be used, such as Trauma-Focused Cognitive Behavioral Therapy Techniques,
Eye Movement Desensitization and Reprocessing (EMDR)
.
Psychodynamic Therapy
Stress Inoculation Training
Virtual Reality
Antidepressants may have different side effects on the person and may cause relapse if stopped early. relapse) is observed. Therefore, it is of great importance to start, continue and end it under the supervision of a specialist doctor.
According to the EMDR approach, trauma-related memories are stored inappropriately in our memory and this past experience is called “knot”. The knot is the biologically stored experience located in the memory center that is desired to be resolved therapeutically. These inappropriately stored memories are the main reason for dysfunctional reactions and weakening of self-perception. Experiences in the present are connected to existing unprocessed and dysfunctional memories, and when fed into these memories, inappropriate placement can result. Failure to process traumatic memories causes many people to experience the distressing experience over and over again. Therefore, when we process unprocessable and non-functional data in small pieces, we obtain an adaptive output and this causes less trouble to the person. As this adaptation process increases, the improvement in the healing process increases.
In trauma-focused Cognitive Behavioral Therapy (CBT), we aim to establish therapeutic cooperation with the client during the first meetings, provide psycho-education that informs the client about the trauma and the reactions that may occur afterwards, introduce relaxation methods to cope with anxiety, and train the client to apply them. It is a structured treatment method that includes exposure to trauma and cognitive restructuring techniques. Prolonged ExposureConfront trauma safely, emphasizing learning to confront and control fears about trauma
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