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dreams, social withdrawal and, even as an adult, an inability to get
and hold a job. Combat experiences in which buddies are blown up
seem to "cause" nightmares, flashbacks, and a variety of long-term
health problems requiring repeated VA hospitalizations. Sexual abuse,
with threats of death if the "secrets" were told, from 8 to 12 certainly
might "cause" social anxiety, an avoidance of men, and a very
negative self-concept resulting in suicidal depression and self-injury in
middle age. The original trauma in these cases is assumed all too often
to provide a full explanation of all that happens, almost like magic
stretching over months or years. There must be processes that
mediate between the traumatic events and the long-range
psychological consequences. The better we understand the precise
processes, the better we can cope with prolonged trauma reactions.
This section discusses the internal dynamics--the mental processes
making adjustment better or worse, the emotional/physiological
reactions, the development or lack of coping skills--that play an
important role in the way we handle traumas over time.
Research by Goenjian (2000) shows that very serious, life
threatening events are more likely than lesser events to produce long-
lasting traumatic reactions (time doesn't abate some intense post-
traumatic stress symptoms but depression tends to fade). Yet, most
victims, perhaps 70% to 95% or more, recover from trauma in time
without any treatment. We don't yet know exactly how they recover,
they seem able to "put it behind them." But because people have this
resilience, many crisis workers believe that psychological
interventions--debriefing, telling what happened, counseling--do not
do much good for most people in a crisis. Often trauma victims are too
concerned with finding their family, surviving, grieving deaths, getting
away from their abuser, etc. to be involved in therapy and telling a
stranger their experiences. Yet, the people who will continue to have
psychological reactions for months or years can be helped by a
therapist helping them repeatedly confront the distressing memories,
according to Richard Bryant at the University of New South Wales. He
has found that two warning signs indicate a high possibility of PTSD
later: (1) high physiological arousal, such as a heart rate over
90/minute, and (2) psychological reactions of high agitation and re-
experiencing the trauma. Only 1 in 4 victims show these warning signs
and if they are given brief (re-exposure) therapy, 85% or so of the
high-risk group will never have PTSD. So, for that 25%, therapy is
very beneficial. However, debriefing of everyone exposed to certain
disasters may be unnecessary.
Keep in mind, over half of us by the time we are 20 have suffered
at least some trauma. Researchers estimate that at least 60% of men
and 50% of women experience a serious trauma, yet only between 5%
and 10% of us have diagnosable PTSD or DID or other disorders
years later as a result of a specific trauma. While we largely recover,
there are so many traumas in life that lots people are carrying scars
from old traumas and, at the same time, still hurting somewhat from
more recent distresses. Repeated trauma may toughen some but old
hurts sensitize many others. That is the human condition. Only a few
of us continue to suffer greatly from the same traumas others recover
