I am a veteran Gennevarian about to retire from clinical practice; I shall discuss and inform our brothers and sisters the effects and consequences of trauma sustained after the raid and how to minimize the pain. The trauma experienced by the Gennevarians especially those whose gold or money were confiscated by the bandits consisting the BMM and other agencies is the main subject of today discussion. When that trauma leads to post-traumatic stress disorder, damage may involve physical changes inside the brain and to brain chemistry, which changes the person’s response to future stress.
A traumatic event like the GM raid can completely overwhelm the individual’s ability to cope or integrate the ideas and emotions involved with that experience. The sense of being overwhelmed can be delayed by weeks, years or even decades, as the person struggles to cope with the immediate circumstances.
Such psychological impact an lead to serious long-term negative consequences that are often overlooked even by mental health professionals. There is frequently a violation of the person’s familiar ideas about the world and of their human rights, putting the person in a state of extreme confusion and insecurity. This is also seen when people or institutions, depended on for survival such as government, violate or betray or disillusion the person in some unforeseen way. However, different people will react differently to similar events. One person may experience an event as traumatic while another person would not suffer trauma as a result of the same event. In other words, not all people who experience a potentially traumatic event will actually become psychologically traumatized.
Symptoms of trauma
People who go through these types of extremely traumatic experiences often have certain symptoms and problems afterward. How severe these symptoms are depends on the person, and the emotional support they receive from others. Reactions to and symptoms of trauma can be wide and varied, and differ in severity from person to person. A traumatized individual may experience one or several of them. After a traumatic experience which remains unresolved over a period of time, a person may re-experience the trauma mentally and physically, hence avoiding trauma reminders, also called triggers, as this can be uncomfortable and even painful.
They may turn to psychoactive substances including alcohol to try to escape the feelings. Re-experiencing symptoms are a sign that the body and mind are actively struggling to cope with the traumatic experience.Triggers and cues act as reminders of the trauma, and can cause anxiety and other associated emotions. Often the person can be completely unaware of what these triggers are. In many cases this may lead a person suffering from traumatic disorders to engage in disruptive or self-destructive coping mechanisms, often without being fully aware of the nature or causes of their own actions. Panic attacks are an example of a psychosomatic response to such emotional triggers.
Consequently, intense feelings of anger may surface frequently, sometimes in very inappropriate or unexpected situations, as danger may always seem to be present, as much as it is actually present and experienced from past events. Upsetting memories such as images, thoughts, or flashbacks may haunt the person, and nightmares may be frequent. Insomnia may occur as lurking fears and insecurity keep the person vigilant and on the lookout for danger, both day and night.The person may not remember what actually happened while emotions experienced during the trauma may be reexperienced without the person understanding why.
This can lead to the traumatic events being constantly experienced as if they were happening in the present, preventing the subject from gaining perspective on the experience. This can produce a pattern of prolonged periods of acute arousal punctuated by periods of physical and mental exhaustion. In time, emotional exhaustion may set in, leading to distraction, and clear thinking may be difficult or impossible. Emotional detachment, as well as dissociation or “numbing out”, can frequently occur. Dissociating from the painful emotion includes numbing all emotion, and the person may seem emotionally flat, preoccupied, distant, or cold. The person can become confused in ordinary situations and have memory problems.
Some emotional traumatized people may feel permanently damaged when symptoms do not go away and they do not believe their situation will improve. This can lead to feelings of despair, loss of self-esteem, and frequently depression. If important aspects of the person’s self and world understanding have been violated, the person may call their own identity into question. Often despite their best efforts, traumatized parents may have difficulty assisting their child with emotion regulation, attribution of meaning, and containment of post-traumatic fear in the wake of the child’s traumatization, leading to adverse consequences for the child In such instances, it is in the interest of the parent(s) and child for the parent(s) to seek consultation as well as to have their child receive appropriate mental health services.
Self-medication is the use of drugs, alcohol, or other self-soothing forms of behavior to treat mental distress, stress, anxiety, mental illnesses and/or other effects of psychological trauma.
Before assessing an individual’s psychological symptoms, it is necessary to determine whether the individual has returned to a state of psychological stability. If an individual remains in a state of crisis (i.e., overwhelmed with emotion, experiencing cognitive disorganization), it may not be appropriate or possible to conduct a psychological assessment until intervention has been provided. If deemed appropriate, the assessing clinician may proceed by inquiring about both the traumatic event and the outcomes experienced (e.g., post-traumatic symptoms, dissociation, substance abuse, somatic symptoms, psychotic reactions).
During assessment, individuals may exhibit activation responses in which reminders of the traumatic event trigger sudden feelings (e.g., distress, anxiety, anger), memories, or thoughts relating to the event. Because individuals may not yet be capable of managing this distress, it is necessary to determine how the event can be discussed in such a way that will not “retraumatize” the individual. It is also important to take note of such responses, as these responses may aid the clinician in determining the intensity and severity of possible post-traumatic stress as well as the ease with which responses are triggered.
Further, it is important to note the presence of possible avoidance responses. Avoidance responses may involve the absence of expected activation or emotional reactivity as well as the use of avoidance mechanisms (e.g., substance use, effortful avoidance of cues associated with the event, dissociation). In addition to monitoring activation and avoidance responses, clinicians carefully observe the individual’s strengths or difficulties with affect regulation (i.e., affect tolerance and affect modulation). Such difficulties may be evidenced by mood swings, brief yet intense depressive episodes, or self-mutilation. The information gathered through observation of affect regulation will guide the clinician’s decisions regarding the individual’s readiness to partake in various therapeutic activities.
There is a large body of empirical support for the use of cognitive behavioral therapy for the treatment of trauma-related symptoms, including Post-traumatic Stress Disorder. Cognitive behavioral therapies as the most effective treatments for PTSD. Two of these cognitive behavioral therapies, Prolonged Exposure and Cognitive Processing Therapy are recognized in the treatment for veteran GI in the USA.
Following traumatic events, persons involved are often asked to talk about the events soon after, sometimes even immediately after the event occurred in order to start a healing process.
While debriefing people immediately after an event has not been shown to reduce incidence of post-traumatic stress, coming alongside people experiencing trauma in a supportive way has become standard practice. Suggestions:
- Form a support group like our GMS FB so that the affected can vent out their anger. You can even vent out at those whom you think are outsiders trying to make you even more stupid than you already are. Vent out at instigators as well. Vent out at BNM and BN.
- See local GP for relieving anxiety, insomnia and irritability.
- See a psychiatrist.
- Forgive the offenders; this is hard to do but is very effective.
Can the Government hospital take on the role of healers after BNM had acted out as offenders? The longer the issue remains unresolved; the worst will be the situation. I leave it to you to comment on the political impact on the ruling BN.
By KE Goh, Genneva Malaysia Supporters