Post-traumatic Stress

Post-traumatic Stress Jodie Fleming

One morning a few weeks ago as I ate my breakfast in front of The Today show, a story about the investigations of the Royal Commission into Childhood Sexual Abuse and the responses of the Catholic Church came on.

Several survivors of the child abuse had flown along with their supporters, to Rome to witness Cardinal George Pell give his evidence in Vatican City on February 29th. In case you've been off-grid or avoiding this news item, George Pell said he has been too sick to travel to Australia to give evidence and so, Australia has gone to him. After all, they're all well and healthy, right?


I found a transcript of what I found most poignant about the brief interviews with the survivors as they landed at the airport in Rome, on the ABC news website. Find the transcript here ABC news link.

Andrew Collins, who was abused from the age of seven by four different men, said being in Rome would be hard.

"Growing up Catholic we're going to walk there, see all these sites and we'll be in awe," Mr Collins said.

"Then we'll see all the crucifixes and collars and we'll be triggered. So we'll have the highs and the lows, and that's before we've even
seen Cardinal Pell."

"... and we'll be triggered."

Spoken like a man who is fully aware of his disorder and the ghosts that continue to haunt him.

What is a trigger?

A trigger is any sensory thing in a person's internal or external environment that activates a trauma memory. They can occur both consciously and subconsciously and could be something visual (a landmark, a facial expression, an item of clothing etc.), a scent, a taste, a feeling (a texture or an emotion etc.), or a sound (music, loud noise, siren etc.).

In order to understand how triggers work, it helps to have a basic understanding of what post-traumatic stress disorder is.

Post-traumatic Stress Disorder has been described as a normal reaction to an abnormal event where the symptoms of stress remain longer than one month after the traumatic event.

Bessel van der Kolk is a psychiatrist and leader in the field of trauma, someone who I've been lucky enough to learn from in one of his many international workshop tours. In 1994, he wrote a landmark paper called "The Body Keeps Score" which changed the landscape and the filter
through which we viewed trauma and our reactions to it.

In it he describes how traumatic events impact on our stress-hormone systems, disrupting the entire nervous system, which in turn, stops people from processing and integrating memories of the traumatic event into the usual conscious mental frameworks. Imagine it like filing information into a filing cabinet only to be opened again when a future need arises.

In trauma, the memories aren't filed. Instead they, for all intents and purposes, are imprinted, stuck, in the non-verbal, non-conscious parts of our brain (like the amygdala, thalamus, hippocampus, hypothalamus and the brain stem) where they can't be accessed by the understanding, thinking, reasoning, story-telling, verbal parts of the brain (the frontal lobes).

Without the 'story' they can't be placed in time - in the past - and so, whenever a trigger activates the trauma memory, the person's body reacts as if the trauma is occurring again, then and there. Their freeze/fight or flight system becomes active and the person re-experiences the trauma in a very physical and emotional way.

What symptoms does someone with PTSD experience?

People with PTSD typically relive the trauma through nightmares and sensory flashbacks - often like visual post-cards. Their bodies respond emotionally and physically when they are reminded of the traumatic events.

They generally have symptoms similar to severe anxiety. They can't concentrate and are hyper-vigilant and easily startled.

It's common for them to try to avoid reminders of the traumatic events, including avoidance of conversations about it.

Social isolation and disconnection is also another significant part of the disorder including lack of interest and enjoyment from activities they previously enjoyed.

One of the most difficult factors is that these triggers, particularly the subsconscious ones, are unpredictable which means it's impossible to be able to prepare for them one hundred percent of the time. It's not a giant leap then to imagine the impact all of the above has on the person's ability to work or study, socialise or function well with typical day-to-day activities.

Going back to the news story today...

My heart went out to Andrew Collins and all of the other survivors both in Rome and here, in our towns.

For decades they have had to endure the physical and emotional consequences of the infinite triggers for the horrendous abuse they suffered. Maybe the triggers activated their trauma memories when they walked past a church, or a school, or watched a certain television show, a heard the word 'Father'. Maybe it was less obvious than that.

What I know for sure is that in recent months and years, every newspaper article on the Royal Commission's investigations, every news story on the television, every time they had to stand up in court and give their evidence and hear the evidence of others, a large proportion of the survivors would have been reliving their nightmares.

And so like Andrew Collins said, here they are in Rome and they'll be spending time in Vatican City - raised as Catholics - indoctrinated to worship the symbols of the Catholic Church. They've just arrived in their Mecca.

But will they join the queues to walk through the 6km of Vatican Museum to see the Sistine Chapel with the same anticipation as the others who travel the world to see it? Will they excitedly hope for a mass with the Pope in St Peter's Square? Maybe. But then like Mr Collins said, "... and we'll be triggered."

Four men robbed Mr Collins of the opportunity to travel to one of the most fascinating and historical significant cities on the planet with openness and innocence like so many of us can. But they also robbed him of so much more, of that I am sure.

There are many effective treatments available for PTSD and we will discuss some of these in future articles.

Let's hope that once the investigation is complete, that justice will be served and these survivors can find some semblance of the peace they deserve.

You can read more about PTSD on the Beyond Blue website www.beyondblue.org.au

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