What Comes After Trauma

Everyone reacts differently.

That was the overriding message from Laurie Charles, clinical assistant professor of nursing at Texas A&M, at last week’s Fast Track session, “The Neurobiological Aftermath of Trauma.”

Because people have different reactions to trauma, whether it is from personal violence, childhood abuse or neglect, death of a parent, serious accidents, natural disasters, war, terrorism or medical trauma, it is not surprising victims’ memories of the events can sometimes be jumbled, temporarily blocked or even forever lost.

Charles talked about the physiological reaction to trauma and how hormones can affect memories and emotional disposition.

During a traumatic event, stress chemicals and hormones turn off the victim’s ability to respond normally. Primitive brain structures take over, leaving a human’s higher functioning brain impaired. Events for the trauma victim become jumbled.

Sexual assault, in particular, is typically remembered in fragments, Charles explained. It is infused with intense emotions and recollections of sensations, she said. Timelines can become mixed up. Some victims have difficulty identifying the source of the feelings and sensation.

She identified the four major symptoms to look for in sexual assault: patients reliving the experience, social withdrawal, avoidance behaviors and increased physiological arousal.

Charles advised attendees to provide trauma therapy as well as physical health care for sexual assault patients. She urged them to establish a supportive environment and an atmosphere of trust, acceptance and safety.

“Use active listening and value the patient’s voice in every aspect of your care,” she said.