South African Institue For Traumatic Stress
18a Gill street
Johannesburg
Tel: (+27 11) 648 7376 , Mobile: 084-2988-135,
saits@saits.org.za

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The S A Institute for Traumatic Stress is developing a National Trauma Referral Database. Should you require a referral or wish to be on the data-base, please call - (011) 648-7376

What problems can occur as a result of exposure to a traumatic incident?

Repeated exposure to traumatic incidents lead to sustained high levels of adrenaline, which may lead to long term changes in behaviour and even physical strain on the body. People who are working with victims of traumatic incidences or whose jobs expose them to repeated traumas (nurses, paramedics, social workers, psychologists, mortuary workers, police etc.) may become traumatised through their exposure to the trauma of others. This is called vicarious trauma. National Centre for PTSD Fact Sheet Common problems that can occur as a result of exposure to a traumatic incident

Posttraumatic Stress Disorder (PTSD):
PTSD is a condition that can develop after someone has experienced a life-threatening situation. People with PTSD often can't stop thinking about what happened to them. They may try to avoid people and places that remind them of the trauma and may work hard to push thoughts of the event out of their head. Feeling numb is another common reaction. Finally, people find that they have trouble relaxing. They startle easily and are often on guard.

Depression:
Depression involves feeling down or sad more days than not, and losing interest in activities that used to be enjoyable or fun. You may feel low in energy and be overly tired. People may feel hopelessness or despair, or feeling that things will never get better. Depression may be especially likely when a person experiences losses such as the death of close friends. This sometimes leads a depressed person to think about hurting or killing him or herself. Because of this, it is important to get help.

Self-blame, guilt and shame:
Sometimes in trying to make sense of a traumatic event, people take too much responsibility for bad things that happened, for what they did or did not do, or for surviving when others didn't. Remember, we all tend to be our own worst critics and that guilt, shame and self-blame are usually unjustified.

Suicidal thoughts:
Trauma and personal loss, can lead a depressed person to think about hurting or killing themselves. If you think someone you know may be feeling suicidal, you should directly ask them. You will NOT put the idea in their head. If they have a plan to hurt themselves and the means to do it, and cannot make a contract with you to stay safe, try to get them to a counselor or call 911 immediately.

Anger or aggressive behavior:
Trauma can be connected with anger in many ways. After a trauma people often feel that the situation was unfair or unjust. They can't comprehend why the event has happened and why it has happened to them. These thoughts can result in intense anger. Although anger is a natural and healthy emotion, intense feelings of anger and aggressive behavior can cause relationship and job problems, and loss of friendships. If people become violent when angry, this can just make the situation worse as people can become injured and there may be legal consequences.

Alcohol/Drug abuse:
Drinking or "self-medicating" with drugs is a common way many cope with upsetting events to numb themselves and to try to deal with the difficult thoughts, feelings, and memories related to the trauma. While this may offer a quick solution, it can actually lead to more problems. If someone close begins to lose control of drinking or drug use, it is important to assist them in getting appropriate care.

The South African Depression and Anxiety Group (011) 783-1474
LifeLine S A National Helpline - 0861-322-322
S A Institute for Traumatic Stress - (011) 648-7376

Why is it important that frontline personnel have trauma response training?
Frontline personnel is a term used to describe people who are not mental health workers, but whose work nevertheless brings them into contact with people who are traumatized. This category includes police officers, emergency personnel, nurses, and teachers. It is important that these people have skills for trauma response in order that they are better able to fulfil their own job functions. An educator who understands the impact of traumatic events on children will be better able to teach a class which includes one or more traumatized children. Similarly a police officer will be better equipped to get the information needed to pursue an investigation if he or she understands the impact of the events on the victims and witnesses. There should be no expectation that these people will become trauma counsellors. Instead they should be skilled enough to support and contain traumatized people as they go about their duties. Furthermore, they should be able to help traumatized people make contact with mental health workers who are skilled in trauma counselling or therapy, and be in a position to recognise when they need to seek the support of a trauma counsellor. People such as frontline workers, who are exposed to ongoing violence and trauma, have different needs to those exposed to a single event, or for whom a period of repeated traumatic exposure is at an end, which impacts directly on their own mental health and personal happiness, leading in some cases to substance abuse and other associated social problems. The most common survival response for people who are poorly skilled to deal with traumatised people is to be emotionally cut off from the people they are dealing with, which is part of what is called negative resilience. People who are emotionally cut off from others are compromised in their ability to do their jobs.