The resilient Pakistani’s are trying to get in term with the heinous act of terrorism that hit too close to our hearts and souls. A lot has been lost but much is left to save. Trauma always hits us out of the blue and numbs as to the soul; the real pain starts after the trauma passes and the numbness wears off. but here the important consideration is that do the survivors and affectees need help now or do we have to hold on to our impulse to help them?
Since yesterday i have been getting these invites to join groups to go on with the psychological rehabilitation of the victims and their families; and the treatment of those who have developed PTSD. It made me think that isn’t it too early to jump in at this time? And how do we know who got PTSD, because its too soon to diagnose. And what are we going to help them with, like what is the plan? I discussed with my colleagues and supervisor; here is my understanding on this issue now and i want all the professionals to consider this before jumping in to help.
Whenever we are struck by trauma, an immediate normal human experience would include Post-traumatic stress (not disorder) as the people are terrorized, they are afraid for the loss of life or property, they are under the adrenaline fight and flight response where they are unable to process the experience in a rational manner. After the stress wears off, people start feeling grief; grief is a normal response to loss and it is multifaceted, it has emotional, physical, behavioral, cognitive, and spiritual affects. People go through this natural process to come to terms with the loss that they have experienced, it is a process through which people try to normalize the trauma and to move on with their life. Grief has five stages, and everyone passes through these stages on their own pace and this DOES NOT determine if they have developed a pathology. The stages are:
- Denial —— here the person is unable to accept what has happened and they would deny by saying something like “No this can’t happen to me”.
- Anger —– here the person experiences extreme anger on why they had to suffer, why did they loose. “Why me?” “What have i done wrong?”
- Bargaining ——- in this stage the person starts absorbing that he/she has suffered a loss and he/she would like to get the loved one back by giving up anything; statements like “Why didn’t i die in his place?” “Please God take all that i have but give me my kid back”
- Depression —– in this stage the sadness actually sinks in and the person realizes that they have lost it and they can not get it back by any way now. This is the stage of silent mourning.
- Acceptance —— finally the person reaches the stage of acceptance, where they learn that the trauma has happened and they have to live without the loved one now.
These stages like i said take their own time and any individual might remain in one or the other for varying amount of time and it is TOTALLY NORMAL reaction to trauma.
Here onward some people might linger on with some reminiscent of the depressive stage and have a deeply engraved effect on their cognition which might change their world view in a way that they develop certain behaviors to avoid the trauma, and slightest cues give them extreme distress (re-experiencing) bringing back all the memories. This leads to dysfunction and maladjustment in everyday life and finally the person can be diagnosed with a Post Traumatic Stress DISORDER (PTSD). And researches prove that in general, in any event there are only 15-20% of people who have a tendency to develop PTSD.
So i would strongly suggest that we need to let people experience grief as they want to before jumping in with our treatments. And during this time we need to plan, train, and prepare; before we go out in the field. We all want to help i know, i feel the same but this would be serving myself and not those suffering people because they might not be in need of it yet.