The agony of memories of trauma

Images traumatic experiences are stored for a lifetime

09/10/2012

Some pictures stay in our heads forever. This also applies to many witnesses of a serious traffic accident, who then often suffer trauma and have to fight because of the experience with severe mental health problems. According to the Institute for Psychological Accident Aftermath (ipu) in Cologne, the eyewitnesses of a serious accident sometimes show significant mental stress symptoms, which may also be associated with physiological disorders such as dyspnoea, cardiovascular disorders, eating disorders, impotence or gastric and intestinal disorders. The pictures of the seriously injured and possibly even the dead follow the witnesses to sleep. Insomnia and nightmares are typical consequences.

Acute mental stress reactions and posttraumatic stress disorder
Witnesses and first responders are often confronted with serious accidents in pictures that they can not forget their lives long. Moreover, they are often relatively helpless in the face of events at the scene of the accident. As an acute reaction to the experience of helplessness and the awful things that had to be watched, many first responders show a psychological state of shock in the days immediately following the accident „Fear, anger, desperation, overactivity or withdrawal“ The Institute for Psychological Accident Nursing reports on its website. These acute psychological stress reactions are to be distinguished from the so-called post-traumatic stress disorders (traumatic neuroses). According to the ipu, the latter express themselves in a repeated experience of the traumatic event, insistent memories, nightmares, emotional indifference and vegetative over-excitability. It would also avoid activities or situations that might remind you of what happened. Moreover, according to the experts, those affected may develop depression and thoughts of suicide.

Up to 30 percent of the accident witnesses are struggling with mental health problems
How many witnesses of a serious accident actually have to fight because of the experience with mental health problems, is quite controversial among the experts. Hanjo von Wietersheim said of the emergency pastoral care of the Evangelical Lutheran Church in Bavaria towards the news agency „dpa“, that most people who experience bad events process them relatively well. Although many accident witnesses suffer from so-called flashbacks and nightmares for up to two months, psychological help, according to Hanjo von Wietersheim, only requires up to four percent. The head of the Institute for Psychological Accident Rehabilitation in Cologne, Professor Wilfried Echterhoff, is here in conversation with the „dpa“ to a significantly different assessment. In his opinion, 30 percent of the trauma victims need psychological help to process the traumatic experiences.

Lifelong damage due to traumatic experiences
If the accident witnesses can not process the event, threaten „Lifelong damage: massive fears, permanent inability to work, depression and feelings of helplessness“, explained the head of the IPU. His institute has one „nationwide therapist network“ and looks after about 50 people a year. As a long-term sign of a corresponding trauma, the expert also mentions an increase in tobacco, alcohol, drug or drug use in addition to nightmares, sleep disorders and often unwanted memories. Those affected should urgently seek therapeutic help. However, this also raises the question of the assumption of costs. Because the payment of psychological help for accident witnesses and first responders is not clearly regulated, according to Professor Wilfried Echterhoff. For example, could „in the event of accidents in public, the costs are borne by the accident insurance fund of the respective federal state“, but also the polluter must take over costs, for example about his liability insurance. „Otherwise, the health insurance companies should pay, but they often cause difficulties, "said the head of the IPU.

Emergency counseling helps on the spot
Hanjo von Wietersheim stated that further difficulties often arise from the fact that „It is not clear on the ground whether an eyewitness will need help from specialists later or not.“ Immediately after the rescue operation, the adrenaline levels of the first-aiders are usually still so high that they are completely excited and only want to move on or go home as quickly as possible. „There you are often alone with his terrible memories“, explained by Wietersheim. Therefore, the staff of well-connected emergency counseling at the accident sites would distribute leaflets in 16 languages, which will tell trauma victims who to turn to if they need help later. „The emergency pastoral care in Bavaria records around 6,000 missions a year, with two to three people receiving intensive on-site support per mission“, emphasized von Wietersheim and added: „We of the emergency pastoral care do not leave people alone.“

Accident witnesses want to get away from the scene as quickly as possible
The German Coordinator for Psychosocial Emergency Care (PSNV) of the German Red Cross, Michael Steil, confirmed that eyewitnesses to severe accidents often want to get away from the scene as quickly as possible. He „I've often heard of people driving away and shaking 20 minutes later. Only then did they realize what had happened to them“, reports Michael Steil. For the witnesses, serious accidents are often very stressful, as they only give the injured people courage and can wait for the arrival of rescue workers. Sometimes this form of helplessness leads in retrospect to considerable psychological stress on the accident witnesses. They reproach themselves. „Who helped to save a life or to help an injured person“, have here „usually less problems with processing“, explained Steep. Also, good first-aid skills not only help directly in the situation, but they give the accident witnesses the security of having acted to the best of their knowledge. Every two to three years, the courses should be repeated so that they are not forgotten, according to the PSNV federal coordinator.

Significant influence of the social environment on the processing of traumatic events
The social environment also has a significant influence on how accident witnesses process traumatic experiences, explained Michael Steil. Be today „fewer and fewer people are able to deal with such situations.“ It also plays a role that „social networks are not as close as they used to be.“ According to Steil today there are many people who spend their everyday lives without the community of others. Moreover, for many, life is just for fun and career reasons. Accordingly, they would never have dealt with death. In order to process the experiences of a serious accident, the accident witnesses were to seek targeted diversion in the first few days and weeks after the event, explained the PSNV federal coordinator. It was „important to do something good when you feel the need.“ According to the expert, physical activities can also have a positive effect. For example, a lot of sports should be done in case of insomnia, because those who are physically exhausted are more likely to fall asleep“, emphasized Steeil. If the signs of a mental stress disorder persist, the experience should definitely be worked up in a therapy, the Federal Coordinator for Psychosocial Emergency Care continues. (Fp)

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Image: s.media