Booker Prize-winning author Salman Rushdie isn’t the only one dealing with extreme trauma after his knife attack, saying he and his therapist are working on his “crazy dreams.” Many other survivors of physical assault suffer from repeated nightmares and life-long fears about similar situations they may encounter later. I remember the case of Salil, a 32-year-old IT professional, who said he was an “emotional wreck” as he could not come to terms with an incident that had happened six years ago. He was assaulted by a thief on a train, who had taken advantage of him being alone in a coach as he was travelling alone after midnight. He had to be hospitalized to treat his injuries. Ever since, he had felt a sense of extreme fear and helplessness, emotions which need to be resolved at the earliest and not be allowed to fester. The unique case of 32-year-old Salil He often had intrusive thoughts and questioned himself about what he could have done differently to prevent the assault. This caused him to relive the traumatic event repeatedly. He reported flashbacks and nightmares, making it difficult for him to sleep at night or concentrate on his work. He said he avoided people and places which reminded him of the event. He was easily startled by loud noises or sudden movements, found it difficult to relax, feeling constantly on-the-edge, and had frequent headaches and palpitations. Salil’s mother, a single parent, had accompanied him, and added that Salil was very irritable and had developed a general sense of negativity. She said that he had reduced interest in activities, which he used to enjoy earlier, often excused himself from social gatherings and refused to get married. Based on interviews and psychological assessment, Salil was diagnosed as having PTSD (Post-Traumatic Stress Disorder). Treatment involved a combination of psychotherapy and antidepressant anxiolytic medication. Weekly sessions of CBT (Cognitive Behavioural Therapy) and trauma-focussed medical hypnotherapy helped Salil process the traumatic event. Therapy changes negative thought patterns, develops coping strategies and reduces sensitivities to traumatic memories. It provides a safe space to express feelings, build a therapeutic alliance and validate emotions, which in turn, fosters resilience. Medication helped to alleviate symptoms like sadness, anxiety and sleep disturbances. Salil was advised to practise relaxation techniques (deep breathing, meditation, mindfulness, etc), maintain a healthy lifestyle and participate in activities which brought him joy. Recovery takes time and the healing process varies for each one. But for Salil, he regained his sense of well-being in just six months. His medicines were tapered and stopped but Salil was advised to continue monthly follow-up therapy sessions for a year. At the end of his regime, Salil said that the emotional damage did not control his life anymore. His mother was happy too as Salil had finally agreed to tie the knot. How trauma manifests itself in different people? Trauma is a deeply disturbing experience which overwhelms a person’s ability to cope. It’s often characterised by the person perceiving a threat to his/her life, safety and well-being. Trauma can be acute (caused by one traumatic event), chronic (prolonged exposure to a traumatic event) or complex (exposure to multiple traumatic events). Common reactions include helplessness, fear, anger, irritability, and sadness. Intrusive memories, nightmares, flashbacks (re-experiencing), difficulty in concentrating, or physical symptoms like insomnia, multiple aches/pains, lethargy and fatigue may also be present. People respond to trauma differently. Some recover well while others may develop psychological disorders like PTSD (post-traumatic stress disorder), anxiety or related disorders, depression, or in severe cases, suicidality or psychoses. Dealing with trauma resulting from any violent event can be a difficult journey. Here are some ways to help you to cope and recover. How to manage trauma at a personal level 1) Educate yourself about trauma from books, articles or online resources. This will help you understand and process your reactions as well as provide coping strategies. 2) Structure your daily life. Establish a routine like healthy sleep habits, daily exercise, eating well-balanced meals and engaging in work or some regular activities. This provides a sense of stability. 3) Engage in activities which promote well-being and self-care. This includes staying away from addictions, engaging in favourite hobbies and spending time with nature. Practise relaxation techniques like deep breathing exercises, progressive muscle relaxation, guided imagery, yoga, meditation, mindfulness and other relaxation methods. These must be practised regularly to help you manage anxiety and promote a sense of calm. 4) Explore artistic outlets such as writing, drawing, painting, or playing a musical instrument. 5) Expressing yourself creatively is an important tool to process emotions, release tension, and achieve a sense of control over your life. 6) Engage with understanding and supportive people. Establish a support network consisting of friends, family, or online support groups (of individuals who have experienced trauma). Sharing your feelings with others is extremely therapeutic. 7) Be aware of your limits. Set boundaries. This might involve saying no to certain activities, limiting exposure to triggers, or seeking a safe and supportive environment. It's essential to recognise and communicate your needs to others and prioritise your well-being Healing from trauma takes some time. Also, everyone's journey is unique. So, be patient with yourself, practise self-compassion and acknowledge that it's okay to have good and bad days. If you are experiencing severe distress or struggling to cope with trauma, it’s vital to seek professional help by reaching out to mental health professionals. They can provide you with guidance, support, medication (if needed) and psychotherapeutic treatments like cognitive behavioural therapy (CBT), eye movement desensitisation and reprocessing (EMDR), trauma-focused therapy, and medical hypnotherapy. Do not feel you are alone. There is a customised solution to every problem.
