Coping with post-traumatic stress disorder in Aceh
Coping with post-traumatic stress disorder in Aceh
Yulia Wardhani, Jakarta
Barely a month after the tsunamis hit Aceh and parts of North
Sumatra, the people of Indonesia continue to mourn the loss of
their brothers and sisters.
What was witnessed on Dec. 26 was beyond the realms of usual
human experience and distressing to almost everyone, both
observers and survivors. For those who have experienced a deeply
stressing event, a psychological reaction often follows.
During World War I, it was called shell shock. During World
War II, it was called war neurosis, or combat neurosis. Nowadays
it is called post-traumatic stress disorder.
Post-traumatic stress disorder is characterized by depression,
anxiety, flashbacks and an avoidance of reminders of the event --
which may make it difficult to cope with everyday life. Many
people who have witnessed such an event are psychologically
scarred for life.
The death toll in Indonesia has soared, with over
166,000 people declared missing or presumed dead. Meanwhile, the
survivors face life, often without their loved ones; their homes
are gone and many no longer have jobs.
Trauma itself may result in aftereffects, either physical,
such as injuries, bleeding, fractures, brain trauma etc., or
psychological, which are particularly disabling. Survivors may
suffer horrifying flashbacks and nightmares, emotional numbness,
or personality disorders. They may have irrational fears or
experience sudden bursts of anger.
Post-traumatic stress disorder can develop as far down the
track as 30 years after the trauma. How many of the volunteers in
Aceh and Medan are at risk of developing the disorder? Those who
have observed survivors via the news may have noticed the despair
in their eyes.
So many people, our sisters and brothers, continue to suffer,
and our thoughts are with the children in particular. If we
ignore the problem, the number of people with mental disorders
will increase.
It is not just individuals who will suffer the repercussions
of this. It could lead to serious production problem due to
reduced efficiency at work and increased absenteeism. It could
also lead to increased national expenditure as heavy demands are
made of the welfare, social services and judicial systems.
Violent behavior could also increase, which would have an
adverse impact on the economy, perhaps jeopardizing prospective
foreign investment.
Rebuilding infrastructure requires money, which means
budgetary allocations for other development projects may be
reduced, thus slowing the economic growth of the nation.
What can be done?
In most cases, people who suffer from post-traumatic stress
disorder either give up or learn to organize their lives around
their disability.
Some traumatized people find it difficult to communicate, to
express their feelings, their suffering and their hopes. There
are ways to help them and you do not need to be a psychiatric or
a psychologist to do so. If you notice that someone around you is
showing signs of suffering post-traumatic stress disorder, you
can follow these steps:
1. Address immediate/crisis/medical needs.
2. Assure the person they are safe, to win their trust.
3. Debriefing; relieving. The survivors are encouraged to
express their fear.
4. Be an active and good listener. Sometimes, silence and
understanding is better than directing a conversation toward a
"result".
5. Let them cry, and shout if necessary.
6. Educate them about the causes, the process and the impacts
of the trauma.
7. Educate them about coping strategies.
8. Help them to understand that every event has a purpose.
It is enough for them just to know that you are there, and
that you will continue to be there as they move toward recovery.
The writer is a Lecturer on Psychiatric Nursing Sint Carolus
Nursing School, Jakarta.