Trauma, abuse and bereavement

Trauma, abuse and bereavement / Category / Emile Du Toit / April 10th 2014

Trauma, abuse and bereavement are separate areas that all overlap strongly with each other. They are all really forms of trauma and in my opinion there are a lot of similarities in what the survivor has to deal with afterwards. This section will cover all articles that touch on identifying, processing and recovering from trauma, abuse and bereavement. We will also take a look at the perpetrators of some of these acts.

Trauma

Trauma can be defined as psychological shock or severe distress from experiencing a disastrous event outside the range of usual experience, as rape or military combat.

Three categories of trauma

Trauma can be broken down into three basic types, and this is often a helpful functional distinction in terms of treatment:

Simple trauma

Simple trauma occurs where the individual is subjected one particular trauma, or a few discreet traumatic events over time.

Continuous trauma (continuous traumatic stress)

Continuous traumatic stress is a term that acknowledges that some people – particularly in 3rd world countries, the military and certain poorer neighbourhoods of 1st world countries are subjected to ongoing traumatic events, and often live under constant threat of them occurring. So an example would be someone in Lavender Hill, South Africa who has been mugged or raped many times, and has the fear of being robbed or shot every time they have to go get on a minibus taxi.

Complex trauma

Complex trauma refers to trauma that occurs repeatedly and cumulatively. It is more than the threat of encountering a traumatic event, but rather serious trauma(s) that repeat quite frequently. Examples of this might be sexual abuse or physical abuse being perpetuated frequently in a home, or indeed can occur as the result of war, captivity, uprooting and/or human trafficking.

Abuse

Abuse could briefly be defined as ‘to treat with cruelty or violence, especially regularly or repeatedly’.

It is generally regarded that there are 3 types of abuse, although the DSM-5 places some emphasis on a fourth as well.

Physical abuse

Physical abuse includes physically violent acts such as hitting, choking or pushing, as well as physical intimidation where there is a threat of violence.

Sexual abuse

Sexual abuse is forcing undesired sexual behavior onto someone else that has not consented to it or does not desire it. Sexual abuse also covers all purposeful behaviours by an adult towards a child where the child and/or the adult are sexually stimulated, irrespective of whether or not the child gives consent. So as an example of this, exposing your naked body to a child would count as child sexual abuse. Emerging from the shower into your bedroom without the knowledge that a child had wandered in there is not.

The consent of a child is disregarded as the child is too young to be able to form their own opinions on something like this and so it is not considered informed consent.

Emotional abuse

Emotional abuse includes any sort of verbal or other abuse that is not directly, physically or sexually abusive or threatening, but that has a negative emotional impact on the other person. Examples would include blaming, swearing, criticizing and other attacks on self-esteem.

Neglect

Neglect will often overlap with one or more of the above 3 categories and is generally applied when the victim is a child. It is an omission where the child suffers significant harm or impairment of any area of development by deprivation of food, clothing, warmth, medical care, hygiene, intellectual stimulation, safety, or affection by an adult.

Bereavement

Bereavement is the conception or fact of being bereaved or deprived of something or someone. This is normally followed by a period of loss and mourning.

Stages of mourning / bereavement

Bereavement is generally broken down as occurring in 5 stages, although in practice what happens is that the grieving person moves in and out of phases but with an overall temporal progression towards spending more time in the later phases. As can be seen the 1st three phases all have elements where the reality of the loss is still being denied.

Elizabeth Kubler-Ross’s 5 stages of bereavement are the following:

  1. Denial/shock: ‘This cannot really be happening to me…’
  2. Bargaining: ‘Please make this not be happening and I will commit to doing…’
  3. Anger: ‘This is all the fault of …. that this is happening.’
  4. Depression: ‘I am too sad to be able to deal with anything’
  5. Acceptance: ‘I have found a level of peace / purpose in what happened’

People generally think about the death of a loved one when the term bereavement is used. However, it can be any loss or conceived loss that is subjectively important to the person.

So relationship break-ups and divorces would be a different kind of ‘loss’ of a person. Equally, and addict who gives up his drug of choice also has to go through a mourning process. As can be imagined many traumas or types of abuse (e.g. rape or childhood sexual abuse) also are a serious loss and this process of bereavement has to be worked through.

Emotional symptoms of trauma

As you can see, many of these symptoms occur not only with trauma, but also with bereavement and abuse (which come with their own traumatization)

Emotional symptoms might include the following:

  • anxiety and fear
  • shock, denial or disbelief
  • withdrawing socially or emotionally from others
  • emotional numbing or restricted range of feelings
  • feelings of detachment
  • concern over burdening others with problems
  • feeling disconnected or numb
  • grief or disorientation
  • increased need to control everyday experiences
  • feelings of self-blame and/or survivor guilt
  • minimizing the experience
  • attempts to avoid anything associated with trauma
  • expectation of doom and fear of the future
  • difficulty trusting and/or feelings of betrayal
  • confusion and difficulty concentrating
  • hyper-alertness or hypervigilance
  • irritability, restlessness or outbursts of anger
  • emotional swings – like crying and then laughing
  • feeling sad or hopeless
  • worrying or ruminating – intrusive thoughts of the trauma
  • nightmares
  • loss of a sense of order or fairness in the world
  • flashbacks – feeling like the trauma is happening now
  • feelings of helplessness and panic
  • feeling out of control
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  • shame
  • diminished interest in everyday activities or depression
  • unpleasant past memories resurfacing


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Physical symptoms of trauma

As you can see, many of these symptoms occur not only with trauma, but also with bereavement and abuse (which come with their own traumatization)

Physical symptoms might include the following:

  • sudden sweating and/or heart palpitations (fluttering)
  • difficulty concentrating
  • decreased or increased appetite
  • easily startled by noises or unexpected touch
  • more susceptible to colds and illnesses
  • constipation or diarrhea
  • increased use of alcohol or drugs and/or overeating
  • edginess and agitation
  • Increased muscle tension
  • aches and pains like headaches, backaches, stomach aches
  • insomnia, hypersomnia or nightmares
  • fatigue
  • decreased interest in sex


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If you have suffered a trauma and are experiencing several different physical and / or psychological symptoms then you might be suffering traumatization. In this case you might want to take a look at the diagnostic criteria for post-traumatic stress disorder (PTSD).

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