Sally* (25) used to get frequent, intense headaches, and had to constantly use strong medication. All her sick leave was used up by the middle of the year, and her job was in jeopardy. She eventually decided to see a psychologist, and made an appointment with Claire Newton.
"Sally's headaches turned out to be caused by severe stress, as a direct result of childhood trauma," says Claire. "She had been sexually abused by her teenaged male cousins from the age of 6 to 10 years old. She didn't tell anyone about the abuse until she was 10, when she told mother. Her mother told her she must have done something to make her cousins abuse her, and that it was her own fault."
Sally believed her mother, and thus grew up with the firm conviction that if anything went wrong it was her own fault.
"At every moment of every day Sally was trying to be perfect - the perfect daughter, the perfect employee, etc. - to try and stop things from going wrong," says Claire. "This is why she was under such severe stress."
Through therapy, Sally was able to develop a new belief system - one where she believed that not everything was her fault, and that she did have worth as a person.
Anton* is another of Claire's clients. He was referred to her by his employers, who were concerned that he had a drinking problem. The problem had come to light during a company weekend conference, where Anton apparently got drunk and became physically aggressive towards wife.
Anton had great difficulty expressing his emotions. His wife complained that he was cold and emotionless, and she wanted a divorce. Anton did not want a divorce, and was anxious about losing his two children.
"During therapy, I discovered that, as a small child, Anton frequently witnessed his parents arguing, and his father beating his mother," says Claire. "His mother would shout at him to run to his room, where he would hide under the bed, listening to the fighting. Sometimes the police would come, but the next morning, his mother would act as if nothing had happened.
"Through his mother's example, Anton learnt that 'people don't talk about it.' He bottled up his intense emotions - helplessness, confusion and even anger towards his father – eventually just blocking them out, and it became his survival mechanism."
As an adult, Anton could still not express emotions. It was only when he was drunk, and his defenses were down, that some of them came to the surface. Thanks to long-term therapy, Anton was able to change his thought processes, so that he could get to know himself better. Eventually, he was able to start expressing his emotions.
What is Trauma?
Jimmy Henderson is a Trauma Counsellor, and says that an incident must comprise certain components in order to be classified as a trauma.
"It includes extreme emotions such as fear, helplessness or horror, which manifest themselves through the observation, confrontation, or experience of an event which involves death or serious injury to yourself, friends or loved ones.
"Trauma can also be experienced after severe abuse, or being the victim of a violent crime. Certain circumstances give rise to a carousel of emotional, psychological and emotional reactions which can take years to resolve, and from which some people never fully recover. It can come to the fore at any age, and the impact it has on a person's life depends on the degree of violence, the severity of the case, and the victim's coping mechanism."
Jimmy says in the case of children, who haven't yet developed complex coping mechanisms, the symptoms of trauma include emotional paralysis and withdrawal, outbursts or crying, the inability to complete tasks, not eating or sleeping properly, and physical symptoms such as diarrhoea and cramping. The older child will also feel frightened and helpless.
Claire says it can also translate into disorganised behaviour.
"Children don't necessarily have to look troubled, but that doesn't mean that they're okay," she says. "Hidden symptoms to watch out for are, for example, that the child can't stay involved in routine games, and always has to have their mother (or caregiver) within sight. Younger children may become seriously distressed if their parents aren't close by. They may also develop sleep problems, and may struggle once again with toilet training and bed-wetting."
Trademarks of trauma in a child can include the following:
- Acting out the trauma in a "subtle" way, such as smashing his little toy car into a toy truck and destroying it. This kind of play lets a child feel in control.
- An older child may replay parts of the traumatic event. For example, holding a toy gun to his teddy's head, or tying up a doll. This can also emerge through games, drawings and stories.
- An older child may have frightening dreams, without being able to say exactly what they dreamed about. Reassure him that it was just a dream, and that you are there for him.
- He might complain of physical symptoms, or become irritated or aggressive.
- He may experience fear or anger which are not necessarily related to the experience.
How does this affect you as an adult?
David Rosenstein is a clinical psychologist who is completing his doctoral thesis at the University of Stellenbosch. His thesis includes the influence of childhood trauma on the development of Social Anxiety Disorder (SAD).
"Over the years, through my work with the South African Depression and Anxiety Group, I have dealt with many patients with SAD," he says. "SAD, also sometimes known as social phobia, is definitely one of the most common types of Anxiety Disorders. It is estimated that approximately 15% of all people will develop SAD at some point in their lives.
"SAD is characterised by a heightened fear of what people think of you, fear of embarrassment, fear of negative social evaluation, avoidance of – and negative preconceptions about - social situations. It is a common and often destructive social disorder. An individual can have a specific SAD – such as a fear of one or two defined social situations – or a general SAD, which involves fear of many differing social situations.
"There are several factors which play a role in the development of SAD, but trauma in early childhood is identified as a significant factor. It seems to have an influence on the development of the emotional systems in the brain. Not only is it a precursor for emotional disorders, it also contributes to their earlier development, heightened convergence with other conditions such as depression and Post Traumatic Stress Disorder (PTSD), as well as reduced effectiveness of therapy.
"It is evident in research that children who are exposed to trauma are more susceptible to disorders -such as obsessive compulsive-, panic-, and social disorders – and PTSD later in life."
Claire puts additional focus on the consequences of trauma:
- It influences our thoughts and belief systems, and is carried with us into adulthood.
- It has an influence on our self-esteem. Children who are abused feel worthless, useless and unloved, and grow up as adults with low self-esteem.
- Children protect their parents – if the parents say, "we don't talk about it," then the child will not talk about it.
- Children learn to adapt in order to survive. If they have to be sweet to stop dad from getting angry, then that is what they do. This echoes in their adult lives as well. They never complain, are always helpful and never disagree, because they are afraid of making people angry.
Kerry Swarts is the owner of Brain Harmonics. She explains that any trauma has an impact on the quality of your brainwaves, and thus also on the way you function.
"Whenever someone experiences trauma, your brainwaves cushion it in the temporal lobe, where trauma is stored, to protect you against it. This has a direct influence on your coping mechanisms in conflict situations. You can choose to fight, flight (run) or freeze. If these imbalances in the brain are corrected, it will enable to person to cope with life situations in a productive manner. This makes you more receptive to therapy to cope with the trauma."
Can It Be Resolved?
Jimmy emphasises that trauma requires immediate counseling from a qualified person.
"A school or parents can't deal with it. If it's not quickly and properly dealt with, it can lead to PTSD, among other problems. Therapy can help the person cope with the trauma, and give them back control over their lives. This involves changing their thoughts about the incident."
David is very excited about the fact that SAD is being treated very successfully these days mainly using behavioural therapy. This helps people develop certain mechanisms to reduce anxiety in social situations, confront their fear and develop another, more empowering perspective.
Claire said that trauma always affects a person when it happens, but that they don't always realise it...