Marianna Drinoczi, a psychologist specializing in the treatment of post-traumatic stress disorder, answers our questions on the subject of trauma and the importance of putting words to pain.
Could you explain what a traumatic event is?
A traumatic event occurs and is perceived as a real or potential threat to the physical and/or moral integrity of a person or group of people.
The level of stress experienced varies depending on the individual and the traumatic events they have been through. These events may include sexual assault, transport accidents, war, hostage-taking, natural disasters, or terrorist attacks. They may also include physical or psychological violence in everyday life (at work, in social, family, or romantic relationships).
The person who suffers and finds themselves in a state of stress may be the direct victim of the threat. However, they may also simply be a witness to the traumatic scene.
When faced with events, always more or less violent, that burst into reality, it is normal to feel shocked. But sometimes, more than the actual severity of the events, it is the perceived severity that seems to determine the subsequent appearance of psychological and/or physical symptoms that change people's lives. This is referred to as post-traumatic stress disorder (PTSD).
What are the health impacts of a traumatic event?
Post-traumatic stress disorder is an anxiety disorder, often severe. It appears following the event and leads to a state of distress.
First, there is the so-called acute stress reaction, which generally lasts less than a month. In some people, this period of stress can persist. In fact, it can become part of everyday life in the form of a set of symptoms (psychological and/or physical) that then constitute a syndrome.
The duration of post-traumatic stress disorder varies greatly. It can range from a few weeks (spontaneous recovery) after the initial reaction to several years.
Being exposed to a traumatic event can cause significant and sudden distress. Such an event can cause intense, overwhelming fear, feelings of helplessness, horror, shame, or guilt. These elements challenge the core values of normal existence: safety, kindness, solidarity, affection, etc.
It should be added that a person who has experienced a traumatic event may develop disorders several months or even years later. These disorders arise following a triggering event, such as the anniversary of the event. This is known as a latency period.
Traumatic event – Signs to look out for
Anxiety attacks or panic attacks are generalized anxiety disorders characteristic of PTSD. If the person has, or believes they have, some responsibility for the traumatic event (e.g., a car accident), the anxiety is often accompanied by a loss of self-esteem. After a few months, these symptoms have a strongly negative impact on daily life. Complications can then arise. These include eating disorders or substance abuse (alcohol, drugs, medication). In 25 to 30% of cases, depressive symptoms appear.
Three main categories of symptoms – reactive disorders:
- Symptoms of continual re-experiencing of the traumatic event in thoughts through flashbacks or nightmares. This is accompanied by a certain feeling of emotional numbness and detachment.
- Symptoms of avoidance of anything that might remotely remind the person of the trauma. The physical sensations experienced at the time of the trauma resurface and are accompanied by a tendency to flee from anything that might remind the person of the trauma. This avoidance behavior can lead to partial or total amnesia of the events.
- Symptoms of hypervigilance despite the absence of imminent danger. These may include sleep disturbances, irritability, distress, difficulty concentrating, and anxiety attacks, for example.
Risk factors
Some people are more predisposed to developing post-traumatic stress disorder. Firstly, people who are highly sensitive to grief or have an anxious temperament. Secondly, those who are naturally naive and believed the world to be a benevolent place. Finally, people who suffer from emotional isolation and cannot rely on a network of friends or family. The elderly and children are also particularly vulnerable.
Various therapeutic treatments:
- In-person or remote psychotherapy;
- Therapeutic hypnosis can be beneficial for symptoms such as anxiety, anxiety and panic attacks, nightmares, and associated physical pain.
- EMDR (Eye Movement Desensitization and Reprocessing – developed in the 1980s in the United States);
- In some cases, the prescription of anxiolytics (tranquilizers) or hypnotics (sleeping pills), on authorized medical advice, may have a beneficial effect in the short term.
The helpline: support during a traumatic event
Some companies set up helplines and psychological support services for their employees. Can you explain how this support tool can be useful in the event of a traumatic event?
The psychological support hotline provides an opportunity to verbalize emotions after trauma; if possible, to defuse them and identify individual vulnerability factors.
Psychologists are trained to identify existing disorders and inappropriate automatic behaviors (hyper-reaction: agitation, excessive anxiety, panic escape, or hypo-reaction: shock, confusion, inability to act).
They play a role in referring people to a therapist or doctor and providing advice, such as not resorting to the false solution of alcohol or drug use.
This involves listening without judgment, asking open-ended questions to help the person express how they feel without making them relive the trauma; advising them to learn more about PTSD, for example from a patient association or victim support group (legal assistance), because understanding the symptoms they are experiencing is the first step toward recovery; They are helped to relax and take their mind off things through breathing techniques, meditation, and positive self-hypnosis to make them feel safer.
