HELPING ONESELF AND OTHERS: DEALING WITH TRAUMA

by Victor and Irina Kagan

At the conference on "Women for Life without War and Violence," Professor Kagan gave a brilliant talk on stress and conducted a workshop on the subject. Our magazine asked him to prepare something like a practical manual to help people to cope in stressful situations. Below is a brief summary of the first of four articles by Kagan and his wife Irina, a psychologist. Subsequent ones will focus on how to overcome one's own stress, helping others to overcome their stress, and how to help children in a similar situation. The authors describe four groups of stress symptoms: physiological, emotional, intellectual and behavioral. In the last category, behavioral, they identify: restlessness, avoiding dealings with other people or on the contrary an inability to stay alone, problems and conflicts in contacts with people, the desire to avoid anything that can recall a past trauma, the inability to express himself or herself orally or in writing, outbursts of anger and/or aggression, the need to knock oneself out with alcohol, tobacco, narcotics.
The first stage symptoms develop soon after the injuring event. They are usually short-lived and are known to most people. Usually they include: an acute sensation of helplessness, rapid pulse and breathing, insomnia, nightmares, fear and/or watchfulness, absent-mindedness, a sense of impending danger, a feeling of his or her guilt, or accusing
others.
The second stage begins in about six weeks after the trauma and lasts for several months. If the survivor does not speak about that event (cannot speak about it or tried, but is not listened to), the anxiety increases, sometimes a pretext for retribution appears. Even quite innocent behavior of other people might be seen as threatening and can provoke an aggressive response. In addition, a lot of things may remind the person of the trauma - a New Year's firecracker can sound like a shell-burst. What exactly could be such a reminder depends on one's experience -- what for other people is just a trifle can be a "button" triggering recollections.
A young man who fought in the war in Chechnya says: " I am afraid of women. Some of my friends married, some are going to marry, I too would be happy to marry but I cannot! I am afraid even to come close -- I feel that I could kill her." His experience included taking part in a 'routine' group rape, disgraceful and cruel. He could not see this nor put a stop to it, nor could he but do what the others were doing. And when his turn came, he killed that woman. "I had to rescue her and I hated her - just for existing, as though she made those guys what they were." Now he even cannot watch TV. As a rule, a depression with heavy feelings of extraordinary fatigue becomes a constant here. The person cannot concentrate on reality and cannot evaluate situations and that is why he or she is often the victim of an accident, crash, or other catastrophe. Alcohol, narcotics, and impulsive sex help to escape from these nightmares. A nurse relates ten years after the war in Afganistan: "I don't know what was more awful -- being down there or being back home. At first - joy! And then - the pits! I couldn't tell anything to my
parents nor my friends. It was like a Spanish boot on my soul (a medieval tool for torture - translator) For several months I drank and injected everything. It didn't matter to me whom I slept with. Eventually I met a man who just let me sleep and then listened to me for two days straight -- he broke through my defense line. That man rescued me. I never saw
him again."
If a person has not received help at this stage, then the third stage develops during the next several months. The symptoms of poststress disorder are steady. The person feels powerless in the face of soulful pain, feels unwanted, useless. But at the same time he or she does not want to admit it. The depression is intensified, physical indispositions appear. Attempts to deaden this by alcohol or drug draw him or her into a trough of dependence. The person loses control over life and strives to go far from the world of people. Some war veterans go to criminal structures not only for money, but because they think - "here is my place, there is always a war going on here."
Two years ago the newspaper "Izvestia" published a story of an officer, Vladimir Krasilnikov, who fought in Chechnya. His mother relates: "...he was such a kind, considerate son. The last time he returned covered with wounds and shell-shocked... Stuttering. At night he cries out, utters commands and swears profusely. He has such terrible headaches that he is beside himself, he flies into an awful rage over nothing. He began to drink. It is awful for me and I am frightened for him. Maybe this stems from his humiliation at having to live on my pension -- since last August (l997 - translator) they haven't been paying him his subsidy". Vladimir himself says: " Imagine - an early morning in the mountains. On one slope of the ravine it is still night and on the other the sun plays on the whole landscape. You stand between light and shadow, your tommy-gun is still burning hot, and you are still alive... I don't know what drug addicts feel but the sensation of that thin line between life and death, the incredible incandescence of all sensations, and of their sudden rupturing when the rounds of automatic bullet fire cease, when the thunder of grenade explosions stops, and then silence comes -- -- this is emptiness. A realization that you are breathing, you are alive, you aren't killed and aren't even wounded -- this awareness is unexplainable. I never felt this -- even in love. But I want to go to Chechnya once more in order to feel the happiness of home-coming. This is the greatest happiness I know." "And if you don't come home," - the correspondent asked him. "I'm sorry for my mother. She would not survive that."
The authors remind us that there are a lot of other reasons for stress besides wars -- disasters, accidents, physical and sexual violence, stressful tangles of life circumstances. The trauma of a stress NEVER is an only cause of poststress disorder. Its share in the total is 40-50%, the remaining 50-60% come from life AFTER the trauma -- a failure to find one's place in life, lack of understanding from other people, an absence of help from others. The authors underline that help comes mainly from those who are closest Of course, we need a hot-line of psychological help, crisis and counseling services, rehabilitation centers and so on. Of course, we may get and should expect help from the government. But government is neither a mother nor a father. It is a bureaucratic machine, heavier and slower in its actions than people. The next articles about this subject will appear in subsequent issues of our magazine.