Search and Rescue

NATURAL disasters or man-made terror, the aftermath for the survivors is eerily similar. Apart from coping with the death of loved ones, the...

NATURAL disasters or man-made terror, the aftermath for the survivors is eerily similar. Apart from coping with the death of loved ones, they need to come to terms with changed realities, serious injuries and sudden instability. All of these can add up to severe trauma, often calling for professional counselling and domestic support.

What causes trauma?
‘‘Any situation that makes for partial or complete disruption of life in the personal, social, familial or work spheres can cause trauma,’’ says Dr Jitendra Nagpal, psychiatrist at VIMHANS, New Delhi. ‘‘The consequences that follow have a deep impact on individuals and communities.’’ In other words, any event or series of events that causes moderate to severe stress reactions can be described as traumatic.

Who are the first victims of trauma?
The most vulnerable are the survivors of the event, followed by rescue workers and friends and relatives of those directly involved. Those who may potentially suffer injuries or losses come at the end, along with real-time or television witnesses.

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How does trauma usually affect victims?
According to doctors, trauma is characterised by a sense of horror, helplessness, serious injury—or the threat of it—and death. Those below 18 and the elderly find it most difficult to adapt to changed circumstances, with the common complaints being nightmares, depression and sleeplessness.

‘‘The effects can be divided into cognitive, emotional, physical and behavioural,’’ says Dr Nagpal. ‘‘Poor concentration, confusion, uncertainty, disorientation, indecisiveness, loss of memory, fear of harm, nausea, light-headedness, gastrointestinal problems, rapid heart rate, tremors and headaches are manifestations of trauma.’’


on Call These professionals have worked extensively with victims of trauma • Dr Nagpal, VIMHANS, New Delhi. 98100 54860 • Dr Thirunavu Kkarasy, Professor of Medicine and Head of Psychiatry, Stanley Medical College, Chennai. 94440 34647 • Dr PC Shastri, Head of Psychiatry, Nanavati Hospital, Mumbai. 98213 49317

How does trauma progress?
When something unforeseen and uncontrollable befalls a normal, healthy individual, the immediate psychological reaction is shock, followed by denial. Then a state of bargaining sets in (‘I’ll be good if this is not true’), followed by acceptance of the new reality. Some might then spin into a state of depression, while others surmount the problem.

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Any tips on dealing with trauma victims?
Professional crisis intervention is essential within 48 hours of the event. ‘‘Next to first aid, crisis intervention is most important, otherwise victims might slip into a lifelong state of helplessness,’’ says Dr Nagpal.

• Listen or encourage patients to talk about their reactions when they feel ready. Help them understand the reality of the event
• Validate their emotional reactions. Communicate person-to-person, rather than expert-to-victim
• Help them get back to a normal routine
• Help them find ways to relax
• Encourage them to face situations, people and places associated with the traumatic event, rather than shy away
• Resolve day-to-day conflicts so that they don’t build up and add to their stress
• Identify sources of support, including family and friends, who will encourage them to talk about their experiences and feelings without getting into the gory details

Who is at risk for long lasting reactions to trauma?
Most people are able to come to terms with their traumatic experiences within 10 days. Those with closer exposure to the event, however, may slip into post-traumatic stress disorder (PTSD), depression and generalised anxiety. ‘‘Especially in the case of children, teachers and family members have to look for long-term symptoms. Around 12 per cent of children who have witnessed trauma end up with PTSD and need clinical help,’’ says Dr Nagpal.