Tuesday, May 10, 2022

Shock, Trauma, PTSD - The Basics Without A Lot Of Technical Waffle


Random image to signify stress
Malaysia is a very safe country to live in. We have no wars, no terrorist attacks, and no riots. This is terrific but as a client pointed out last week, it also means that many of us don't really understand how shock/trauma/PTSD works. So I am writing this piece at their request, in the hope that it helps promote understanding.

Story One: Kim

When Kim was small, his mother would beat him every time she didn't score an A at school. His mum would make him wait while she got the rotan.

Today Kim is a grown man with a job in HR. Her colleagues like him, he has lots of friends, but Kim has a secret.

He jokes that he has shares in Foodpanda because he never cooks. Secretly, he doesn’t cook because when he enters a kitchen, his breath catches in his throat, his palms sweat, and he feels sick. 

Story Two: Nora

Nora is a police officer. Three months ago, she was part of a team that investigated a missing man. The family claimed he'd gone off for an outstation job, but the neighbours reported a lot of fights.

Her team was suspicious, so they looked into it. They found the man's body hidden in a patch of rough ground near his family home.

Nora was physically sick when she first saw the body. Then she was okay again.

During the rest of the investigation, the family confessed that they'd beaten and tortured the victim. Nora wrote up her reports, consulted with the prosecutor, and moved on to the next case.

But somehow, this incident has stuck with her. Three months later, she still has bad dreams. She feels disconnected from her family. Sometimes, she catches herself looking at her cousins and wondering if they are secretly judging her.

Also, she can no longer enjoy her favourite Netflix cop show. Whenever on screen they go into an interrogation room, she remembers how normal that family looked as they told her how they'd killed their son.  

What do Kim and Nora say?

Both Kim and Nora worry that they're going crazy. Kim can't figure out what his beef is with kitchens. He thinks he might have kitchen phobia, or a cooking phobia. Nora thinks that police work is tough and maybe she just isn't cut out to be a cop. Both are embarrassed, and so they don't tell anyone about their secret.

What's really going on?

Kim and Nora suffer from shock or trauma. 

Kim suffered from repeated trauma when he was small. His mum often made him wait in the kitchen, and little Kim learned to associate the stove with being beaten. He forgot exactly how it all hung together because more than ten years have gone by, but the body remembers. When Kim sees a stove, his mind goes straight back to the trauma of being beaten.

Nora witnessed a tragedy, a family who actually killed a loved one. Seeing the body and hearing the story over and over again from the family, and writing the report, and discussing it with her colleagues, has traumatised her.

In her shock, Nora wonders if the whole world is secretly nasty and dangerous. And every time she sees something that triggers her memory, like an interview room on TV, she's reminded of the past and traumatised all over again. 

Shock, Trauma, and Posttraumatic Stress Disorder (PTSD)

Experts argue over distinctions and exact definitions are different in various countries. You can get into that if you like it's not necessary for grasping the basics.

What you should know is this. Shock or trauma is upsetting. If you are frightened, angry or scared when it happens, that's a healthy reaction. If someone beats you, or you see a crime, you should have emotions!

In a lot of cases, time will heal. Many of us cry, have a few bad nights, and then the emotions fade and vanish.

But for others, these thoughts and feelings stick around. Sometimes they last for years. Sometimes they actually get worse over time.

What it is not

It's not because people are weak, silly, or being dramatic.

Saying that is victim blaming which is mean.

Note: for the Kims in this world, they are often told, "Oh well, everyone is beaten and they're okay with it." No, they're not. Violence is never healthy.

Why exactly does it happen?

That depends on the model you follow. Me, I think it's not one-size-fits-all. There are several models that work well, but none are universal. Again, I don't think it's important outside of the profession.

Give me a list of possible trauma events

Childhood physical abuse and violence

Being the target of sexual violence

Being the target of a crime

Witnessing a crime

Being in or witnessing a war or terrorist attack

Physical assault

Being in or witnessing an accident

Being threatened with a weapon


When should we look for help?

If you've had a recent shock, talk it through and be kind to yourself. If you're having flashbacks, trouble sleeping, crying jags, or overwhelming feelings after a month, have a chat with a mental health professional. If it's been more than three months, definitely go.

Note: when you do see one of us, we'll help you figure out if it's anxiety, shock, depression, PTSD or a combination, okay? So don't worry.

How do we fix it?

First, we talk it through and figure out how your experiences affect you today. Then we figure out triggers and we help you learn new thinking and behaviour. Useful approaches include cognitive behavioural therapy and exposure therapy. <- you can google these

We do this very gently and we avoid reliving the experience. In the past, people thought bringing emotions to the surface was healing. Now we know that it can be as traumatising as the original experience. So we are very, very careful.  

Note: as a client, you have total power to say stop, to call for a pause, and to put in boundaries. In fact, it's part of the process.

My friend has trauma/shock/PTSD, what do I do?

On TV it's all about hugging and being there but frankly, everyone has different needs.

So my best advice is that you wait until you two are talking quietly together, and you ask, "What do you want me to do?" Then listen.

I hope this helps. If you need to talk to a mental health pro, PM me.