The families and friends of person who have been victims or even witnesses to major traumatic events such as motor accidents, fires and armed holdups are usually sympathetic and understanding initially, but often do not understand that the traumatised persons might require a very long period to regain their normal psychological equilibrium. In extreme cases it might never be fully regained. Reactions to trauma of course can vary according to the personalities of the victims.
Normally we expect the world to be a safe place in which to go about daily living. We adopt a “nothing dramatic ever happens to me” belief and attitude. And so when we find ourselves in mortal danger, suffering life threatening trauma or even just witnessing someone else who is physically or emotionally close to us suffering the trauma, our whole view of our universe, and of ourselves is turned upside down. The victim’s values, political and religious viewpoints and ideas on crime and punishment can be altered. In situations of extreme trauma, violence or fear we can be surprised at our own emotional and physical responses, and possibly feel guilty or ashamed as a consequence. This can lead to a loss of self esteem. Most importantly we stop seeing the world as a safe place in which we are competent to deal with all exigencies. We may become phobic, for example about driving a car, or walking the dog in a park where we have enjoyed walking for decades. Some traumatic stress victims even suffer a foreshortened sense of their own future, i.e. they don’t expect to live long.
Trauma Therapy Toronto victims often report irritability, and a dislike of being touched by others, even by friends and spouses. Essentially the victim becomes chronically anxious. This frequently manifests itself in such behaviours as:
a. scanning, always looking around;
b. hypervigilence – being quick to notice any minor anomalies in someone else’s behaviour or appearance.
c. exaggerated startle response – i.e. an exaggerated jumpiness or alarm in response to an unexpected stimulus.
d. chronic anger, especially directed at, not only the persons held to be responsible for the trauma, but also others who appear in some way similar to those persons.
Trauma victims can experience difficulty in decision making and problem solving, poor attention span, memory problems, difficulty in performing calculations, disorientation in time and space, mentally re-seeing the event and disturbing dreams.
The person affected by the trauma might benefit from a day or two off work but in general should be back at work as soon as possible especially if the work does not involve public or customer contact because, remember, the victim is likely to be irritable and dealing with the public usually requires patience, calmness and good humour. Also if the victim’s work is potentially dangerous and requires concentration then that person’s initial return to work should be on modified duties because the victim’s mind is likely to be distracted by its own ruminations. But too long off work could even be detrimental if the victim does not have a support network of available family and friends.
It is good practice for counseling to be available to victims as soon as possible after the traumatic event. The counseling should be available on demand for several weeks. Psychologist-counselors can measure the extent of the anxiety being suffered, and thoroughly debrief the victims.