Saturday, February 2, 2008


What is trauma?

There are two types of trauma — physical and mental. Physical trauma includes the body’s response to serious injury and threat. Mental trauma includes frightening thoughts and painful feelings. They are the mind’s response to serious injury. Mental trauma can produce strong feelings. It can also produce extreme behavior; such as intense fear or helplessness, withdrawal or detachment, lack of Concentration, irritability, sleep disturbance, aggression, hyper vigilance (intensely watching for more distressing events), or flashbacks (sense that event is reoccurring).

A response could be fear. It could be fear that a loved one will be hurt or killed. It is believed that more direct exposures to traumatic events causes greater harm...
However, second-hand exposure to violence can also be traumatic. This includes witnessing violence such as seeing or hearing about death and destruction after a building is bombed or a plane crashes.

Traumatic response in different people

There is no clear answer to this question, but it is likely that one or more of these factors are involved:

the severity of the event
the individual's personal history (which may not even be recalled)
the larger meaning the event represents for the individual (which may not be immediately evident)
coping skills, values and beliefs held by the individual (some of which may have never been identified)
the reactions and support from family, friends, and/or professionals

Anyone can become traumatized. Even professionals who work with trauma, or other people close to a traumatized person, can develop symptoms of "vicarious" or "secondary" traUmatization. Developing symptoms is never a sign of weakness. Symptoms should be taken seriously and steps should be taken to heal, just as one would take action to heal from a physical ailment. And just as with a physical
condition, the amount of time or assistance needed to recover from emotional trauma will vary from one person to another.

Symptoms of emotional trauma

There are common effects or conditions that may occur following a traumatic event. Sometimes these responses can be delayed, for months or even years after the event. Often people do not initially associate their symptoms with the precipitating trauma. The following are symptoms that may result from a more commonplace, unresolved trauma, especially if there were earlier, overwhelming life experiences:

Possible effects of emotional trauma

Even when unrecognized, emotional trauma can create lasting difficulties in an individual's life. One way to determine whether an emotional or psychological trauma has occurred, perhaps even early in life before language or conscious awareness were in place, is to look at the kinds of recurring problems one

might be experiencing. These can serve as clues to an earlier situation that caused a dysregulation in the structure or function of the brain.

Common personal and behavioral effects of emotional trauma:

substance abuse
compulsive behavior patterns
self-destructive and impulsive behavior
uncontrollable reactive thoughts
inability to make healthy professional or lifestyle choices
dissociative symptoms ("splitting off" parts of the self)
feelings of ineffectiveness, shame, despair, hopelessness
feeling permanently damaged
a loss of previously sustained beliefs
Common effects of emotional trauma on interpersonal relationships:
inability to maintain close relationships or choose appropriate friends and mates
sexual problems
arguments with family members, employers or co-workers
social withdrawal
feeling constantly threatened

What if symptoms don't go away, or appear at a later time?

Over time, even without professional treatment, symptoms of an emotional trauma generally subside, and normal daily functioning gradually returns. However, even after time has passed, sometimes the symptoms don't go away. Or they may appear to be gone, but surface again in another stressful situation. When a person's daily life functioning or life choices continue to be affected, a post-traumatic stress disorder may be the problem, requiring professional assistance.

Torture in modern society

Torture is widely practiced worldwide: Amnesty International received reports of torture or cruel, inhuman or degrading treatment or punishment in more than 150 countries during the four year period from 1997 to 2000. These accusations concerned acts against political prisoners in 70 countries and other prisoners and detainees in more than 130 countries. State torture has been extensivEly documented and studied, often as part of efforts at collective memory and reconciliation in societies that have experienced a change in government.

Surveys of torture survivors reveal that torture "is not aimed primarily at the extraction of information ... Its real aim is to break down the victim's personality and identity." When applied indiscriminately, torture is used as a tool of repression and deterrence against dissent and community empowerment.

The effects of torture are complex. While wounds, bruises and broken bones heal over time, the deeper psychological trauma often last for a lifetime. Anxiety, depression, insomnia, nightmares, memory difficulties, social withdrawal, irritability, feelings of helplessness, affective numbing, flashbacks, shame, mistrust, ruminations, unexplained pain, the feeling of being permanently injured and changed, many medical complaints, and digestive and sexual difficulties, are some of the most common symptoms. All these, especially the feeling of being permanently changed, are part of the contemporary torturer's objective: to destroy the victim's humanity through a systematic infliction of severe pain and extreme
psychological humiliation.

Survivors of torture frequently have difficulties in trusting themselves and others and in building relationships. A number of therapists hold that disempowerment and disconnection from others are the core experiences of the psychological trauma of torture, which are expressed through depression, fear, feelings of isolation and powerlessness. Thus torture affects not only the individual, but the family and the entire community.

Amnesty International's medical groups discovered three things after collecting and analyzing the findings of twenty-five years of work with survivors of torture:
1. Torture continued to persecute the survivors many years later with its physical and mental sequelae.
2. In modern times it is not aimed primarily at the extraction of information, as commonly portrayed in films. Its real aim is to break down the victim's personality and identity.
3. Torture is aimed at strong personalities, people who have stood up against repressive regimes.

Breaking down these persons effectively cows the rest of the community into silence.

The process of torture is designed to invade and destroy the belief of the subjects in their independence as a human being, to destroy presumptions of privacy, intimacy, and inviolability assumed by the subjects, and to destroy their unspoken trust that these things (or indeed society as a whole) cares, or can save them. Beyond merely invading the subjects' mental, physical independence on a one-to-one
level, such acts can be made more damaging via public humiliation, incessant repetition, depersonalization, and sadistic glee, and, on occasion, their opposites, false public praise, insidious pandering, false personalization, and masochistic manipulation.

Beatrice M. Patsalides, Ph.D describes this process in "Ethics of the unspeakable: Torture survivors in psychoanalytic treatment":[1]

"As the gap between the 'I' and the 'me' deepens, dissociation and alienation increase. The subject that, under torture, was forced into the position of pure object has lost his or her sense of interiority, intimacy, and privacy. Time is experienced now, in the present only, and perspective - that which allows for a
sense of relativity - is foreclosed. Thoughts and dreams attack the mind and invade the body as if the protective skin that normally contains our thoughts, gives us space to breathe in between the thought and the thing being thought about, and separates between inside and outside, past and present, me and you, was lost."

Post-torture psychological effects of torture

Torture subjects often suffer from a post-traumatic stress disorder (PTSD). Their strong feelings of hate, rage, terror, guilt, shame, and sorrow are also typical of subjects of mobbing, childhood abuse, domestic violence, domestic vice, rape and incest. They feel anxious because the perpetrator's behavior is seemingly arbitrary and unpredictable—or mechanically and inhumanly regular.

Inevitably, in the aftermath of torture, its subjects feel helpless and powerless. This loss of control over one's life and body is manifested physically in impotence, attention deficits, and insomnia. This is often exacerbated by the disbelief many torture subjects encounter, especially if they are unable to produce scars, or other "objective" proof of their ordeal. Language cannot communicate such an intensely private experience as pain.

Interpersonal effects

Subjects typically oscillate between emotional numbing and highly sensitive arousal: insomnia, irritability, restlessness, and attention deficits. Recollections of the traumatic events intrude in the form of dreams, night terrors, flashbacks, and distressing associations.

Long-term coping mechanisms include the development of compulsive rituals to fend off obsessive thoughts. Other psychological consequences include cognitive impairment, reduced capacity to learn, memory disorders, sexual dysfunction, social withdrawal, inability to maintain long-term relationships, or even mere intimacy, phobias, ideas of reference and superstitions, delusions, hallucinations, psychotic
microepisodes, and flat affect.

Depression and anxiety are very common. These are forms and manifestations of self-directed aggression. The sufferer rages at their own suffering and resulting multiple dysfunction. They feel shamed by their new disabilities and responsible, or even guilty, somehow, for their predicament and the dire consequences borne by their nearest and dearest. Their sense of self-worth and self-esteem are crippled.

Women: The Forgotten Majority

Of the 23 million refugees around the world today, the majority are women and girls ... a forgotten majority who constitute more than three-quarters of the world's refugee population. Of these a large number will have experienced torture, or will have family and friends who have been tortured or killed.

Women who are tortured because of their political activities often suffer special degradations at the hands of their male torturers. They may also be persecuted by authorities in order to gain information about relatives' activities. Often women suffer inhumane treatment by authorities in order to 'get at' their family, since violence against women can humiliate men who have been brought up to see their role as that of protecting women in the family.

Many children have witnessed the torture, rape, or even killing of family members. The burden of their emotional support falls on women. Men also need their wives for support in dealing with their memories of torture and trauma. Many women who have suffered rape also have to carry the burden of shame felt by their husbands since their ordeals.

Adolescents and Torture

Adolescents are targeted in oppressive regimes throughout the world. Adolescents are often coerced into combat roles by such regimes and forced to engage in warfare. In the best-case scenario, adolescence is a time of excitement, learning, and taking on new challenges. In the worst-case scenario, adolescence is a time of learning also, but learning abot violence, oppression, and murder.

Not all adolescents are impacted directly by torture or other oppressive measures. Some are affected through such traumas as the loss of family members, generalized social violence, and warfare. Direct and indirect exposure to torture can have lasting and devastating effects and without recognition, the future can be extremely bleak.

For many adolescents who have been exposed to torture there is a gap between their age and level of maturity and their academic knowledge and skills. Consequently, many youth who have lived through violent and oppressive regimes are older than their years.

After-Effects of Torture

Psychological symptoms of torture frequently include anxiety, depression, irritability, paranoia, guilt, suspiciousness, sexual dysfunction, loss of concentration, confusion, insomnia, nightmares, impaired memory, and memory loss.

Survivors of torture are often unwilling to disclose information about their experiences. They may be suspicious, frightened, or anxious to forget about what has happened. These feelings may discourage them from seeking the help they need.

Treatment for both physical and psychological after-effects requires a great deal of sensitivity on the part of healthcare professionals. For example, it is important to remember that those seeking psychiatric help are healthy people who have been systematically subjected to treatment intended to destroy their personalities, their sense of identity, their confidence, and their ability to function socially.

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