What is a Trauma?
The term ‘trauma’ derives from Greek and its literal translation is ‘wound’.
In clinical psychology, a ‘psychological trauma’ indicates damage to the psyche, caused by a severely distressing event.
External events can cause psychological wounds. Such events include: War, natural disaster, fleeing dangerous situations, displacement, accidents, maltreatment, torture, neglect, sexual abuse, bullying, as well as witnessing such devastating events. The actual traumatic impact depends on the subjective experience of the affected person, not the intensity of the actual event (Fischer/Riedesser, 1998).
In most cases, feelings of helplessness as well as profound disturbances in self-conception and distortions of a person’s worldview follow the traumatic experience. Traumata may influence the psychological development in a negative way if they are not treated at an early stage. In these cases, the acute stress reaction after the traumatising event may manifest itself as a post-traumatic stress disorder or even lead to the development of neurotic or psychosomatic illnesses (Streeck-Fischer, 2006). Possible long-term consequences include lasting personality disorders after extreme stress, borderline personality disorders and dissociative personality disorders.
An emergency pedagogic intervention by experts, implemented soon after the traumatising event, helps counteract the manifestation of possible long-term post-traumatic stress disorders.
The potential progression of a psychotraumta can be split into four phases:
Acute Shock Phase
The acute shock phase directly follows the traumatic event. Reactions to the emergency can take place on the cognitive, emotional, physical, and behavioural level and can, like in the following phases of course of trauma, differ greatly from individual to individual. The most common ways of reacting in the acute shock phase, which can last from a few seconds up to two days, include especially fears and anxieties, but also physical symptoms like shaking, sweating or chills, pallor, nausea accompanied by vomiting, hyperventilation, urge to urinate accompanied by wetting oneself, soiling oneself, as well as hyperactivity or torpor. In addition to these come an unrealistic experience of time, loss of orientation, emotional numbness or agitation with quickly changing, strong emotional instability and memory disorders. Furthermore, disinhibition, aggressive outbursts, or demonstrative calm up to full apathy can occur (Hausmann, 2006, 35; Karutz&Lagossa, 2008, 30ff). Above all older children and adolescents experience strong feelings of shame in an emergency. Being touched by others, possibly being disrobed or observed in a helpless state by curious onlookers, causes them shame (Karutz&Lagossa, 2008, 32). Some children also have dissociative experiences in the shock phase. They feel separated from their bodies, as if they have stepped out of the flesh.
Post Traumatic Stress Reaction
After this short acute shock phase with emotional numbness or chaotic activation, a week-long phase of post-traumatic-stress reaction follows with diverse possibilities of symptom expression: psycho-somatic reactions, for example headaches, back and neck tension, eating disorders and digestion problems (diarrhoea/constipation); concentration difficulties, and memory problems, like amnesia or forced remembering of the catastrophe; not wanting to move or hyperactivity; rhythm disorders (remember-forget,
sleep disorders, eating and digestion problems), irrational feelings of guilt and shame; fears, panic attacks, nightmares, depressive moods, anger and aggression, social withdrawal, among others. Furthermore additional dissociative symptoms can occur. Because of a weakened immune system, there is also an increased susceptibility to infections. These are still not signs of a psychological illness, but rather are self-healing attempts made by the organism. They are normal reactions to abnormal experiences.
Post-Traumatic Stress Disorder
With a constructive processing of the trauma, the symptoms which occur in the phase of stress reaction lessen until they disappear completely (recovery phase). If the complaints stay or even worsen, then one can speak of a trauma related disorder, in which every symptom can theoretically develop into a separate disorder (i.e. depression, anxiety disorder, impulse control disorder, among others). One of the most commonly diagnosed trauma related disorders is post-traumatic-stress disorder (PTSD). PTSD is a mental illness that requires therapeutic interventions. The diagnosis of PTSD requires among other things the core symptomatic: reexperiencing, avoiding, and hyperarousal. Signs of hyper-arousal are sleep disorders, concentration problems, motoric anxiety state, emotional instability, tension, and impulsive outbursts. Also the diagnosis of ADHD (attention deficit hyperactivity disorder) can result from early childhood traumatisation. The symptoms of re-experiencing are intrusive, forced, and overpowering memories (flashbacks). They are brought about by specific reference stimuli (triggers), which call back memories of the stressful experience. Triggers can be picture sequences, smells, colours, tones, sounds, movements, touch, among others, though a concrete, conscious memory is often totally missing. They cause alarm reactions. With avoidance behaviours, the affected person attempts to avoid situations that could serve to trigger intrusive, overpowering memories. Dissociations also belong to the avoidance symptom group. The avoiding behaviours almost forcibly lead to social withdrawal which can result in social isolation. Learning difficulties can also be based on traumatisation. The emergency energy sets free and then freezes into the shock phase often leads to vital-emotional blockades, which then lead to developmental disorders. The emotional skin is riddled with holes. The vital power does not permeate the physical organisation enough. The child then makes a great effort to further his development, to overcome his gentle small child consciousness, and to reach to a free imaginative power with linear consciousness. Massive learning difficulties can be the result.
Lasting Personality Disorders after Extreme Stress
Chronic post-traumatic-stress disorders can eventually lead to lasting personality changes.
The affected person then usually develops significant social disorders with a massive propensity to violence against self and others. They can become delinquent, addiction prone, suicidal, and through the loss of employment and their circle of friends, they can slide ever deeper into greater social isolation. The biography threatens to break apart. The victim then often becomes themselves the perpetrator.
The development of trauma-related disorders mustn’t follow in the above presented temporal
course scheme. Symptoms of stress reaction can after a time also go away and this then
seems to indicate that the traumatic experience was overcome. After weeks, months, years, or
even decades, the symptoms can come back again. In the international diagnostic manual
(ICD-10), which many doctors and therapists use to make their diagnoses, one assumes, “that
the disorder seldom occurs later than after a latency period of a maximum of six months. This
doesn’t represent the clinical reality. There one can experience year- and decade-long time periods in which everything appears to be in order. But then some people develop PTSD after decades” (Reddemann& Dehner-Rau, 20083, 51).
Emergency pedagogy interventions are applied during the phase of the ‘posttraumatic stress reaction’; it is during this phase that affected persons are either able to process the events by their own efforts, or begin to show signs that they need support to do so. Emergency pedagogic crisis interventions help activate the self-healing processes in humans. This stabilizing phase has to precede any therapeutic treatment. The actual therapeutic trauma-management starts in the phase of the posttraumatic stress reaction.
Emergency pedagogy is not therapy, but rather pedagogical first aid for the soul.
Trauma influences Childhood Development
Waldorf education believes that human development is governed by certain fundamental principles. Thus, in the context of emergency pedagogic crisis intervention, the guiding assumption is that the damaging consequences of psychologically traumatizing events vary from each child developmental stage to the next. This means that, different methods should be used depending on the developmental stage of the traumatised child.