Let’s Talk

Mental Trauma and Help

Growing up, we had it easy or tough, who knows, but our emotions were much unrefined back then and we could express ourselves openly. If we were angry, we screamed, when sad, we cried our hearts out, and laughed like crazy when things delighted us. This was way before we were taught to abide by the norms of society, and were warned about expressing what we were really feeling or wanted to say. An odd thought to put forward, but let us just take a moment to think about it. On how many occasions did you muster up your inner strength to point out to an in-law that her behaviour or comment has been causing you stress? Or how many times were you able to openly communicate your true desires to your spouse? What about that pesky aunt or annoying uncle who would say things to make you doubt your abilities and yet you had to stay quiet because it would have been considered inappropriate if you had spoken up against them. We suppress ourselves everyday for the sake of peace and harmony, and as a result, we are burdened by our own thoughts and negative emotions that we are unable to vent. And thus, fomenting all the emotional disorders, stress-related depression or depression in general.
Then there is emotional or psychological trauma. We are exposed to a hundred and one things on a day-to-day basis, and chances are we might get traumatised by passing events, such as a harrowing accident, a violent crime or a devastating natural disaster.  Immediately afterwards, shock and denial are typical.
The effects of trauma interfere with an individual’s ability to function normally and may affect the way a person leads his or her life. Different people get affected in different ways, and express themselves in their own unique manner. When a person is traumatised, he or she might lose the capacity to identify their our  behavioural changes or irrational expressions. Loved ones and family members should be able to notice the changes and in some cases, help may be necessary to treat the stress and dysfunction brought about by the traumatic event, to reinstate the individual’s emotional security. Trauma can manifest itself days, months or even years after the actual event.
Some key signs of trauma include anger, sadness, withdrawal and emotional outbursts. Since disorientation is common in traumatised people, a victim may transmit the devastating feelings they experience towards other sources, such as peers or family members. In many cases, a traumatised person may be affected physically and a few signs of that include lethargy, paleness, racing heartbeat, poor concentration and fatigue. The physical symptoms are quite as alarming and can be as serious as that of an injury or illness that should be addressed and promptly treated.
The Weekend Independent talked to eminent psychologist Mehtab Khanam, who is also a professor in the Department of Educational & Counselling Psychology at Dhaka University, to discuss trauma and depression and what coping strategies should be adopted, and the importance of seeking help when needed.
“The emotional effect of trauma varies from person to person. It is possible for a person to face a traumatic situation and then move on normally, it depends on one’s coping strategy/mechanism. Some people suffer single but severe trauma, while some come out with a series of early traumas. For those who have been victims of trauma in the early stages of their lives, their capacity to deal with shock or distress is compromised because they keep on losing that capacity with every incident. When you are young, you do not have such refined emotions as an adult to understand cause and effect, therefore, you are getting affected without understanding the cause. Thus, the level of trauma differs from individual to individual.  For example, after the Rana Plaza incident, we got several calls from bystanders, who were the indirect victims of trauma. We kept on receiving calls for quite a few months from people who were part of the rescue effort. They would report instances where they relived the harrowing experiences. Many talked about nightmares where they would jump up in the middle of the night and look for survivors under their beds. Many could hear the desperate shouts asking to be rescued. In many cases, a shopkeeper or bystander who merely witnessed the collapse was traumatised, whereas, a member of the rescue team was not and just moved on with their respective lives. We do not have proper psychological first-aid teams to give initial support to disaster victims. BRAC did take an initiative and trainers from Norway came and conducted sessions, but it was not rolled out,” Mehtab Khanam said.
“A victim may experience acute stress disorder for up to three months, one month is normal. But once it exceeds three months, medical intervention may be needed. Once this condition persists and crosses six months, the person is developing post-traumatic stress disorder (PTSD) and extensive treatment may be necessary. After a distressing experience, what a person needs most is support, love and understanding from loved ones. Friends and family members should remain calm and not stress along with the victim, this is what happens mostly. When a victim is reacting or stressing, family members tend to panic and get stressed, too. That should not be the case. They need empathy and support. If the situation persists  and the distressed person keeps on having extreme anxiety or recurring nightmares, there are medicines that can help to recover sleep and fight anxiety. Supportive counselling might help, but once it turns towards PTSD, we go for psychological intervention. We apply psychological techniques such as stabilisation exercises, and lots of imagery exercises to make a person feel safe once again. We encourage people to revisit happy memories and create a network of positive feelings, which weaken the negative feeling network that has been created by a series of traumas over time,” she added.
“Sometimes, some people go through a single big trauma in life. If they seek help immediately, they might recover quickly and effectively though Eye Movement Desensitisation and Reprocessing (EMDR), a psychotherapy treatment that is designed to alleviate the distress associated with traumatic memories. But if a person has history of early traumas, we do not go for EMDR immediately, and they should seek help as there is a chance that PTSD might set in and then he/she may need years and years of treatment to recover,” the professor explained.
“In case of prolonged depression, eventually your physical health gets affected. Mental health and physical health are very much interconnected. If a person is not addressing or seeking help for depression, he/she might feel very restless, anxious or extremely aggressive. They might feel so aggressive that they may cause bodily harm to others. They do not care properly for themselves and become more and more introverted, and people around them get affected. At times, they are prone to outbursts as anger is connected to depression. As a result, they are spreading negative energy, which in turn cause outbursts in people around them. They feel guilty and are pushed into further depression,” she continued.
“We are still not aware of the importance of seeking help for strong mental health. When I started working in this field, I became aware that people do not seek help for fear of being judged. They try to hide the fact that they have sought psychological assistance. As a result, they do not get to encourage others to do the same. When I was providing counselling at a private university, many students complained about the location of the consultation room. It was in a semi-private cubicle, on the same floor as the vice-chancellor’s office and they felt exposed, many hesitated to seek help. The university authorities did not understand how much privacy was necessary for sessions like that. I think educational institutions should make it mandatory for students, as well as teachers, to talk to counsellors. Every educational institution should have psychologists working for them. A handful of English-medium schools have counsellors and a few universities, too, but the culture is yet to be accepted widely. Awareness is the key. People seeking help are sometimes stuck, it is not necessary to have a persisting disorder to seek help. Even we, therapists, go for counselling sessions. It promotes self-growth and development and equips us to handle and channel negative emotions successfully,”  Khanam concluded.

Photos: Courtesy

Lets Talk

Mental Trauma and Help

Growing up, we had it easy or tough, who knows, but our emotions were much unrefined back then and we could express ourselves openly. If we were angry, we screamed, when sad, we cried our hearts out, and laughed like crazy when things delighted us. This was way before we were taught to abide by the norms of society, and were warned about expressing what we were really feeling or wanted to say. An odd thought to put forward, but let us just take a moment to think about it. On how many occasions did you muster up your inner strength to point out to an in-law that her behaviour or comment has been causing you stress? Or how many times were you able to openly communicate your true desires to your spouse? What about that pesky aunt or annoying uncle who would say things to make you doubt your abilities and yet you had to stay quiet because it would have been considered inappropriate if you had spoken up against them. We suppress ourselves everyday for the sake of peace and harmony, and as a result, we are burdened by our own thoughts and negative emotions that we are unable to vent. And thus, fomenting all the emotional disorders, stress-related depression or depression in general. Then there is emotional or psychological trauma. We are exposed to a hundred and one things on a day-to-day basis, and chances are we might get traumatised by passing events, such as a harrowing accident, a violent crime or a devastating natural disaster. Immediately afterwards, shock and denial are typical. The effects of trauma interfere with an individuals ability to function normally and may affect the way a person leads his or her life. Different people get affected in different ways, and express themselves in their own unique manner. When a person is traumatised, he or she might lose the capacity to identify their our behavioural changes or irrational expressions. Loved ones and family members should be able to notice the changes and in some cases, help may be necessary to treat the stress and dysfunction brought about by the traumatic event, to reinstate the individuals emotional security. Trauma can manifest itself days, months or even years after the actual event. Some key signs of trauma include anger, sadness, withdrawal and emotional outbursts. Since disorientation is common in traumatised people, a victim may transmit the devastating feelings they experience towards other sources, such as peers or family members. In many cases, a traumatised person may be affected physically and a few signs of that include lethargy, paleness, racing heartbeat, poor concentration and fatigue. The physical symptoms are quite as alarming and can be as serious as that of an injury or illness that should be addressed and promptly treated. The Weekend Independent talked to eminent psychologist Mehtab Khanam, who is also a professor in the Department of Educational Counselling Psychology at Dhaka University, to discuss trauma and depression and what coping strategies should be adopted, and the importance of seeking help when needed. The emotional effect of trauma varies from person to person. It is possible for a person to face a traumatic situation and then move on normally, it depends on ones coping strategy/mechanism. Some people suffer single but severe trauma, while some come out with a series of early traumas. For those who have been victims of trauma in the early stages of their lives, their capacity to deal with shock or distress is compromised because they keep on losing that capacity with every incident. When you are young, you do not have such refined emotions as an adult to understand cause and effect, therefore, you are getting affected without understanding the cause. Thus, the level of trauma differs from individual to individual. For example, after the Rana Plaza incident, we got several calls from bystanders, who were the indirect victims of trauma. We kept on receiving calls for quite a few months from people who were part of the rescue effort. They would report instances where they relived the harrowing experiences. Many talked about nightmares where they would jump up in the middle of the night and look for survivors under their beds. Many could hear the desperate shouts asking to be rescued. In many cases, a shopkeeper or bystander who merely witnessed the collapse was traumatised, whereas, a member of the rescue team was not and just moved on with their respective lives. We do not have proper psychological first-aid teams to give initial support to disaster victims. BRAC did take an initiative and trainers from Norway came and conducted sessions, but it was not rolled out, Mehtab Khanam said. A victim may experience acute stress disorder for up to three months, one month is normal. But once it exceeds three months, medical intervention may be needed. Once this condition persists and crosses six months, the person is developing post-traumatic stress disorder (PTSD) and extensive treatment may be necessary. After a distressing experience, what a person needs most is support, love and understanding from loved ones. Friends and family members should remain calm and not stress along with the victim, this is what happens mostly. When a victim is reacting or stressing, family members tend to panic and get stressed, too. That should not be the case. They need empathy and support. If the situation persists and the distressed person keeps on having extreme anxiety or recurring nightmares, there are medicines that can help to recover sleep and fight anxiety. Supportive counselling might help, but once it turns towards PTSD, we go for psychological intervention. We apply psychological techniques such as stabilisation exercises, and lots of imagery exercises to make a person feel safe once again. We encourage people to revisit happy memories and create a network of positive feelings, which weaken the negative feeling network that has been created by a series of traumas over time, she added. Sometimes, some people go through a single big trauma in life. If they seek help immediately, they might recover quickly and effectively though Eye Movement Desensitisation and Reprocessing (EMDR), a psychotherapy treatment that is designed to alleviate the distress associated with traumatic memories. But if a person has history of early traumas, we do not go for EMDR immediately, and they should seek help as there is a chance that PTSD might set in and then he/she may need years and years of treatment to recover, the professor explained. In case of prolonged depression, eventually your physical health gets affected. Mental health and physical health are very much interconnected. If a person is not addressing or seeking help for depression, he/she might feel very restless, anxious or extremely aggressive. They might feel so aggressive that they may cause bodily harm to others. They do not care properly for themselves and become more and more introverted, and people around them get affected. At times, they are prone to outbursts as anger is connected to depression. As a result, they are spreading negative energy, which in turn cause outbursts in people around them. They feel guilty and are pushed into further depression, she continued. We are still not aware of the importance of seeking help for strong mental health. When I started working in this field, I became aware that people do not seek help for fear of being judged. They try to hide the fact that they have sought psychological assistance. As a result, they do not get to encourage others to do the same. When I was providing counselling at a private university, many students complained about the location of the consultation room. It was in a semi-private cubicle, on the same floor as the vice-chancellors office and they felt exposed, many hesitated to seek help. The university authorities did not understand how much privacy was necessary for sessions like that. I think educational institutions should make it mandatory for students, as well as teachers, to talk to counsellors. Every educational institution should have psychologists working for them. A handful of English-medium schools have counsellors and a few universities, too, but the culture is yet to be accepted widely. Awareness is the key. People seeking help are sometimes stuck, it is not necessary to have a persisting disorder to seek help. Even we, therapists, go for counselling sessions. It promotes self-growth and development and equips us to handle and channel negative emotions successfully, Khanam concluded. Photos: Courtesy