David T. Mwangi
23 February 2008
Nairobi — Since the December 27 elections, people all over the world have either read newspaper articles or watched images on television of Kenyans who have been brutalised, killed or displaced from their homes. Official estimates put the death toll at 1,000 and 400,000 displaced.
There have been mixed feelings about and reactions to the accounts and images, ranging from fear, vulnerability and helplessness to anger, rage and bitterness.
Many newspaper articles have been written on the economic cost of the crisis, including loss of jobs, revenue and foreign aid.
What has not received as much media attention, however, is the emotional cost in terms of trauma and the likely consequences of the people's experiences.
Psychologists have established that exposure to traumatic experiences can adversely affect victims' emotional wellbeing. One possible reaction to severe trauma is the onset of post-traumatic stress disorder (PTSD).
According to experts, PTSD consists of particular symptoms following exposure to an extreme traumatic stress that involves actual or threatened death or physical harm to oneself or someone else.
Traumatic experiences
Such traumatic experiences include military combat, physical attack or robbery, kidnap, torture, a car accident and separation from a loved one.
While the effects may be more severe if one experiences the trauma directly, PTSD symptoms could develop from learning about events experienced by others through watching TV or reading newspapers.
Reactions to PTSD normally occur in three areas. First, victims may find that they continue to experience distressing recollections of the events through, for instance, images, thoughts, dreams and flashbacks even after the initial trauma has ceased.
For example, a person who witnesses others being killed and homes being burnt may have dreams and nightmares of them or others being attacked, or of being at a home that has been set on fire.
Young children may have frightening dreams or re-enact their traumatic experiences as they play with peers.
To many people, continuing to re-experience distressing images and dreams that they cannot let go of can be very disturbing and lead to such strong emotional reactions as may create the sense of going crazy or losing control.
The second area where PTSD symptoms may occur involves persistent avoidance of events or activities associated with the trauma, as well as numbing of general responsiveness.
In some people, this may involve efforts to avoid thoughts, feelings or conversations associated with the trauma, as well as those to avoid activities, places or people that remind them of the experience.
It is not unusual for people suffering from PTSD to have difficulty recalling particular aspects of the trauma.
They may also find that they no longer want to participate in previously enjoyed activities, and may feel detached or emotionally distant from friends and loved ones.
Some people may also have difficulty expressing their feelings to spouses, children or friends.
A third area involves increased arousal and agitation not experienced before exposure to the traumatic event.
This could manifest itself in difficulty falling or staying asleep, irritability or outbursts of anger, concentrating or sticking to tasks, hyper-alertness and exaggerated startled response.
Associated symptoms
There are other associated symptoms. For instance, people with PTSD may describe remorse or guilt feelings about surviving the traumatic events where others did not survive.
Being emotionally distanced and feeling isolated from loved ones may lead to marital or family conflicts.
In addition, some people may attempt to numb their emotional pain by using alcohol or drugs.
Other possible symptoms may include self-destructive or impulsive behaviour, shame, despair, hopelessness, hostility and feeling of constant threats.
Having any of the symptoms or associated features does not automatically mean that one has PTSD, and that only a qualified counsellor or medical health worker can diagnose one with the condition.
However, experiencing or observing any of them, especially if they did not exist before the trauma, may show that one needs to seek help before the condition worsens.
What should you do if you noticed one or more of the symptoms either in oneself or in someone else?
First, it is important to seek the necessary attention from a qualified counsellor or medical health worker who could either organise treatment or refer one to a health centre.
Second, it is important to seek help and support from caring people whom you can trust and depend on. These may be family, church or community members who are willing to listen to your feelings. In fact, experts point out that people who have good and close family and social ties often suffer fewer negative results as a result of exposure to trauma than those who are isolated and alone.
Work through the experience and share with other people as much of it as possible. Isolating yourself or refusing to talk about the experience could actually lead to unresolved trauma and make the problem worse. Third, look for the support of people who are also recovering from trauma, especially if they live nearby. It is important to talk about what has happened and hear others express their feelings, as this could help you to articulate yours.
Some people may also find it helpful to write their experiences down in a journal or a letter to a newspaper editor.
Fourth, avoid over-exposure to images of violence on newspapers and television. Many people who have suffered trauma may be retraumatised. This is especially critical for children who are often more emotionally fragile than adults, and who may not have the emotional capacity to cope. Fifth, if you are a parent and your children have been exposed to direct trauma or images of violence on TV, you may need to cope with whatever frightening feelings your children have and not minimise or downplay the feelings.
Parents in general will need to protect their children and avoid exposing them to newspaper articles and TV images. During times of crisis, children look up to their parents or other caretakers to help them to cope with trauma, and often internalise whatever feelings the parents have.
Sixth, if you are a teacher, you should help your students to cope with and express feelings or fears that have previously not been expressed. You will need to acknowledge openly that the situation is frightening.
At the same time, you should express the confidence that leaders are working hard to resolve the crisis. As much as possible, teachers should maintain normal daily routines and activities if it is safe to do so, as this provides children with the much needed structure.
Giving assignments such as what is your greatest fear and what would you say to families of those killed? could help children to express their feelings or fears.
Finally, you should set up medical and mental health structures where people suffering from trauma and related psychological disorders can find the much-needed help to cope and heal.
It is important to note that while many NGOs and other humanitarian organisations are doing the fine job of providing food, water and medicines to displaced victims, a large number of Kenyans have psychological and emotional problems that are yet to be addressed.
We should work together to help our brothers and sisters to cope and recover from their trauma and minimise its long-term impact.
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