Traumatic stress concept. The history of the formation and development of the concept of mental trauma. Traumatic stress. What is traumatic stress

The tribute that traumatic stress takes on emotional well-being are intense, confused, and intimidating experiences. And these emotions are not unique to people who have experienced a traumatic event. Breaking news is clear evidence of how we are bombarded with horrific images of natural disasters, violent crimes and terrorist attacks - almost at the same time as they occur somewhere in the world. Repetitive exposure can trigger traumatic stress and leave you feeling hopeless and helpless. Whether you were directly involved in a traumatic event or came into contact with it afterwards, there are steps you can take to restore emotional balance and regain control of your life.

What is Traumatic Stress?

Traumatic stress is a normal response to traumatic events such as natural disaster, road traffic accident, plane crash, gunfight, or terrorist attack. Such events are incredibly stressful - and not only for survivors, but also for bystanders and even those who are constantly faced with horrific images of the event circulating on social media and news sources.

In fact, while it is highly unlikely that we will ever become immediate victims of a terrorist attack, for example, we are constantly bombarded with disturbing photographs from around the world of innocent people who have been attacked. Watching these materials over and over again can overload the nervous system and generate traumatic stress. Your sense of security is eroded and you are left with feelings of helplessness and vulnerability in a threatening world, especially if the event was the work of other people - a gunfight or a terrorist attack.

Usually, anxious thoughts and feelings of traumatic stress fade as life begins to return to normal a few days or weeks after the event. You can help the process by keeping in mind:

People react differently to traumatic events... There is no "right" or "wrong" way to respond. Don't tell yourself (or anyone else) what you should think, feel, or do.
Avoid compulsive reliving of the traumatic event... Repeated rethinking or re-examining horrific images over and over again can overwhelm the nervous system, making it difficult to think clearly.
Ignoring feelings will slow down recovery... It may seem like it is best to avoid encountering feelings at times, but they exist regardless of whether you pay attention to them or not. Even keen feelings will go away if you just allow yourself to feel what you are feeling.

Signs and symptoms of traumatic stress

Whether a traumatic event directly affected you or not, it's normal to feel anxious, fearful, and uncertain about what the future holds for you. Your nervous system found itself overwhelmed by stress, which triggered a range of acute emotions and physical reactions. These reactions to traumatic stress often come and go like waves. At times you feel anxious and irritated, and at other times you feel isolated and numb.

Normal emotional responses to traumatic events

Shock and disbelief... It can be difficult for you to accept reality, to acknowledge what happened.
Fear... You are afraid that what happened will happen again, or that you will lose control and be broken.
Sadness... Especially if people you knew died.
Helplessness... The sudden and unpredictable nature of terrorist attacks, incidents and natural disasters can leave you feeling vulnerable and helpless.
Anger... You may be angry with God or other people you think are responsible.
Shame... Especially about feelings and fears that you cannot control.
Relief... You may feel relieved that the worst is over. You may also experience the hope that your life will return to normal.

Normal physical reactions to traumatic events

It's important to know what the physical symptoms of traumatic stress look like so they don't scare you:

Tremors and shaking hands
Tremors and shaking hands
Pulling sensation in the abdomen
Increased heart rate
Dizziness and weakness
Rapid breathing
Cold sweat
Lump in throat, suffocation
Galloping quick thoughts

While these responses to traumatic stress are normal, if symptoms persist and the nervous system remains numb, unable to move further away from the event, you may be experiencing post-traumatic stress disorder.

While some of the survivors or witnesses of the traumatic event sometimes regain control by watching the media of the event or observing the recovery work, for others, repeated reminders have a further traumatic effect. Excessive fascination with snapshots of an alarming event (re-watching videos, reading news sites) can even generate traumatic stress in people who were not directly involved in the event.

Limit your exposure to media related to the traumatic event... Avoid browsing the news or checking social media before bed, and refrain from re-watching disturbing movies.
Try to avoid stressful photos and videos... If you want to keep abreast of events, it is better to read the newspaper instead of watching TV or video on the Internet.
If media content is overwhelming, skip news for a while... Avoid TV and newspaper news, and stop checking social media until symptoms of traumatic stress have subsided and you can move on.

Traumatic stress can lead to a variety of experiences, from difficult to surprising, including shock, anger, and guilt. These emotions are a normal reaction to the loss of security (as well as of life, the finiteness of being and property) that comes after a disaster. Accepting the feelings and allowing yourself to experience what you are feeling is essential for healing.

Coping with the painful emotions of traumatic stress

Give yourself time to heal and mourn any loss you are facing.
Do not try to forcefully speed up the healing process.
Be patient with the rate of recovery.
Allow yourself to feel any experience of judgment and guilt.
Get ready for difficult and volatile emotions.

Coping with traumatic stress is a story about taking action. Positive action can help you overcome feelings of fear, helplessness, and hopelessness - even small actions can play a big role.

Participate in volunteer activities that matter to you. Volunteering will not only help you be with others, but it will also challenge the feelings of helplessness that contribute to trauma.
If formal volunteering means too much commitment for you, remember that simply being helpful and friendly to others can release stress-reducing pleasure and challenge feelings of helplessness. Help a neighbor bring purchases, hold the door for a stranger, smile at the people you see during the day.
Connect with others affected by the traumatic event and participate in memorials, events, and other public rituals. Feeling connected to others and remembering a lost and broken life during these events can help overcome feelings of helplessness that often accompany tragedy.

This may be the last thing you think or want when dealing with traumatic stress, but exercise can help burn out adrenaline and release endorphins that will make you feel good and uplifting. Physical activity performed in conjunction with the “total awareness” technique will bring the nervous system out of its “torpor” and help move on after a traumatic event.

Rhythmic exercises and workouts that involve both arms and legs (walking, running, swimming, basketball, dancing) are good choices.
To add an element of "awareness", focus on the body and how you feel when you move. Notice the sensation of the feet touching the ground, for example, or the rhythm of breathing, or the feeling of the wind on the skin.
Climbing, boxing, and weight loss or martial arts training will make it easier to focus on body movements - simply because if you don't, you will get hurt.
If you're struggling to find energy or motivation to exercise, start by dancing or moving to your favorite music. As soon as you start moving, you immediately feel more energized.
Aim for 30 minutes or more of workouts every day - or if it's easier, three ten-minute bursts of workouts - that's just as good.

You may be tempted to withdraw from friends and social activities after a traumatic event, but face-to-face communication with others is critical to recovery. Simple face-to-face conversation with another human being will release hormones that relieve traumatic stress. Even a simple exchange of a few words or a friendly glance can help calm the nervous system.

Reaching out to other people does not necessarily mean talking about a traumatic event. Comfort comes from a sense of connectedness and passion for the other people you trust.
Engage in “normal” activities with friends and loved ones — anything that has nothing to do with the event that triggered the traumatic stress.
If you live alone or your social environment is limited, it's never too late to reach out to others and make new friends.
Take advantage of support groups, church gatherings, and community organizations. Join a sports team or hobby club to meet people with similar interests.

While a certain amount of stress is normal and even rewarding, when faced with the challenges of a disaster or tragic event, too much stress will interfere with recovery.

Conscious breathing... To calm yourself down quickly in any situation, simply take 60 breaths, focusing on each one.
Sensory sensations... Do you feel relaxed when listening to a quiet song? Or smelling coffee? Or fiddling with your pet and it allows you to concentrate better? Each responds differently to sensory stimulation, so experiment to find what works best for you. And read our article, "How to Relieve Stress Instantly."

Take time to relax

Practice these relaxation techniqueslike meditation, yoga or tai chi.
Schedule time for activities that bring you joy - a favorite hobby or pleasant entertainment, chatting with a cherished friend.
Use idle time to relax... Read a book, take a bath, or enjoy an exciting or funny movie.
Sleep enough... Lack of sleep leads to significant stress on the mind and body, making it difficult to bring yourself into emotional balance. Aim for 7-9 hours of refreshing sleep each night.

Restructure your daily routine to calm down

Familiarity leads to calming down. After traumatic stress, returning to normal daily routines as much as possible will help minimize stress.

Even if your job or school is ruined, structure your day by eating, sleeping, exercising, and spending time with friends.
Do things that keep the mind busy (read, watch movies, cook, play with the kids) so you don't get too caught up in the traumatic event.

How to feel grounded during traumatic stress

Sit in a chair, feel your legs touch the floor and your back rests on the back. Take a look around and select six objects that have red and blue colors. This will help you feel more grounded in the present. Notice how the breathing becomes deeper and more calm. Alternatively, go outside and find a peaceful place - sit on the grass or sit on the ground.

PTSD research has evolved independently of stress research, and to date, the two areas have little in common. Focal points in the concept stress,proposed in 1936 by Hans Selye (Selye, 1991), is a homeostatic model of the body's self-preservation and the mobilization of resources to respond to a stressor. He divided all the effects on the body into specific and stereotyped nonspecific effects of stress, which are manifested in the form of a general adaptation syndrome. This syndrome goes through three stages in its development: 1) anxiety reaction; 2) the stage of resistance; and 3) stage of exhaustion. Selye introduced the concept of adaptive energy, which is mobilized through adaptive restructuring of the homeostatic mechanisms of the body. Its depletion is irreversible and leads to aging and death of the body.

Mental manifestations of the general adaptation syndrome are referred to as "emotional stress" - that is, affective experiences that accompany stress and lead to adverse changes in the human body. Since emotions are involved in the structure of any purposeful behavioral act, it is the emotional apparatus that is the first to be included in the stress response when exposed to extreme and damaging factors (Anokhin, 1973, Sudakov, 1981). As a result, functional autonomic systems and their specific endocrine supply, which regulate behavioral reactions, are activated. According to modern concepts, emotional stress can be defined as a phenomenon that arises when comparing the requirements for a person with her ability to cope with this requirement. If a person lacks strategies for coping with a stressful situation (coping strategy), a stressful state arises, which, together with primary hormonal changes in the internal environment of the body, causes a violation of its homeostasis. This response is an attempt to deal with the source of stress. Coping with stress includes psychological (this includes cognitive, that is, cognitive, and behavioral strategies) and physiological mechanisms. If attempts to cope with the situation are ineffective, stress continues and can lead to the appearance of pathological reactions and organic damage.

Under some circumstances, instead of mobilizing the body to overcome difficulties, stress can cause serious disorders (Isaev, 1996). With repeated repetition or with a long duration of affective reactions in connection with protracted life difficulties, emotional arousal can take a stagnant stable form. In these cases, even with the normalization of the situation, stagnant emotional arousal does not weaken, but on the contrary, it constantly activates the central formations of the nervous autonomic system, and through them upsets the activity of internal organs and systems. If there are weak links in the body, then they become the main ones in the formation of the disease. Primary disorders arising from emotional stress in various structures of neurophysiological regulation of the brain lead to changes in the normal functioning of the cardiovascular system, gastrointestinal tract, changes in the blood coagulation system, and disorders of the immune system (Tarabrina, 2001).

Stressors are usually divided into physiological (pain, hunger, thirst, excessive physical activity, high and low temperature, etc.) and psychological (danger, threat, loss, deception, resentment, information overload, etc.). The latter, in turn, are subdivided into emotional and informational.

Stress becomes traumatic when the result of exposure to a stressor is a mental disorder similar to physical disturbances. In this case, according to existing concepts, the structure of the “self”, the cognitive model of the world, the affective sphere, the neurological mechanisms that control the processes of learning, the memory system, and emotional ways of learning are violated. In such cases, traumatic events act as a stressor - extreme crisis situations with a powerful negative consequence, life-threatening situations for oneself or significant loved ones. Such events fundamentally disrupt the individual's sense of security, causing experiences of traumatic stress, the psychological consequences of which are varied. The fact of experiencing traumatic stress for some people causes them to develop post-traumatic stress disorder (PTSD) in the future.

Post-traumatic stress disorder (PTSD) is a non-psychotic, delayed response to traumatic stress that can cause mental health problems in almost anyone. The following four characteristics of trauma that can cause traumatic stress have been identified (Romek et al., 2004):

1. The event that has occurred is recognized, that is, the person knows what happened to him and because of what his psychological state worsened;

2. This condition is due to external causes;

3. The experience destroys the usual way of life;

4. The event that has occurred causes horror and a feeling of helplessness, powerlessness to do or undertake anything.

Traumatic stress -it is an experience of a special kind, the result of a special interaction between man and the world around him. This is a normal reaction to abnormal circumstances, a condition that occurs in a person who has experienced something that goes beyond the normal human experience. The range of phenomena that cause traumatic stress disorders is wide enough and covers many situations when there is a threat to one's own life or the life of a loved one, a threat to physical health or the image of I.

The psychological reaction to trauma includes three relatively independent phases, which makes it possible to characterize it as a process unfolded in time.

The first phase - the phase of psychological shock - contains two main components:

1. Depression of activity, violation of orientation in the environment, disorganization of activity;

2. Denial of what happened (a kind of protective reaction of the psyche). Normally, this phase is short-lived.

The second phase - impact - is characterized by pronounced emotional reactions to the event and its consequences. It can be strong fear, horror, anxiety, anger, crying, accusation - emotions that are distinguished by their immediacy and extreme intensity. Gradually, these emotions are replaced by a reaction of criticism or self-doubt. It proceeds according to the "what would have happened if ..." type and is accompanied by a painful awareness of the inevitability of what happened, recognition of one's own powerlessness and self-flagellation. A typical example is the feeling of “survivor's guilt” described in the literature, often reaching the level of deep depression.

The phase under consideration is critical in the sense that after it either "the process of recovery (response, acceptance of reality, adaptation to new circumstances) begins, that is, the third phase of normal response, or fixation on the trauma and the subsequent transition of the post-stress state into a chronic form occurs.

Disorders that develop after an experienced psychological trauma affect all levels of human functioning (physiological, personal, level of interpersonal and social interaction), lead to persistent personal changes not only in people who have directly experienced stress, but also in their family members.

The results of numerous studies have shown that the condition that develops under the influence of traumatic stress does not fall into any of the classifications available in clinical practice. The consequences of trauma can appear suddenly, after a long time, against the background of the general well-being of a person, and over time, the deterioration of the condition becomes more pronounced. Many different symptoms of such a change in condition have been described, but for a long time there were no clear criteria for its diagnosis. There was also no single term for it. Only by 1980 was the amount of information obtained in the course of experimental research accumulated and analyzed sufficient for generalization.

Natural disaster and other disasters (road traffic accident, plane crash, radiation accident, terrorist attack) are extremely stressful events for both survivors and eyewitnesses.

Such disasters can shatter your sense of security, making you feel helpless and vulnerable in the face of a dangerous world.

Common reactions in response to a traumatic event

Survivors of traumatic events experience a wide range of intense physical and emotional reactions. Emotions are often wavy in nature. At times you feel nervous and anxious, at times you cut yourself off from the world and become apathetic.

Normal emotional responses are:

Shock and denial. You may have difficulty accepting the reality of what happened.
Fear that what happened might happen again or that you might lose control and break down.
Sadness (especially when people you know die).
Helplessness. The suddenness and unpredictability of natural disasters and accidents makes you feel helpless, vulnerable.
Feelings of guilt (because you survived when other people died, or maybe because you think you could help or even prevent the incident).
Anger (at God or at people you believe are responsible for what happened).
Shame (because of your feelings and fears).
Relief that the worst is over now.
Hope that life will gradually return to normal.

Normal physical reactions are as follows:

Tremor of the limbs and the whole body;
Pounding heart;
Faster breathing;
A lump in the throat;
Feeling of heaviness or a storm in your stomach;
Dizziness or fainting;
Cold sweat;
Prancing thoughts.

A traumatic event can turn your world upside down and destroy your sense of security. Therefore, even small steps towards restoring safety and comfort matter.

Taking self-directed actions to improve your condition (instead of passively waiting for help) will help you feel less vulnerable and helpless. Focus on what makes you feel calmer, more stable, and in control.

Establish a daily routine

What we are familiar with gives a sense of comfort. Returning to your daily routine can help keep traumatic stress, anxiety, and hopelessness to a minimum. Even if your work or school schedule is disrupted, you can structure your day with regular meals, sleep, family, and relaxation.

Do activities that help distract you (read books, watch movies, cook food, play with your children) so that you don't waste all your energy and attention thinking about what happened.

Connect with other people

You may be tempted to withdraw from social activity. But it's important for you to keep in touch with those who care about you. The support of people around you is extremely important. Therefore, allow close friends and family members to be your support during difficult times.

Spend time with loved ones.
Chat with other survivors.
Do normal activities with other people that have nothing to do with the traumatic event.
Participate in memorial events and other social rituals.
Attend a support group.

Combat feelings of helplessness

Remind yourself that you have the strength and ability to get through difficult times. One of the best ways to regain your confidence is to help other people. You can:

Volunteer with a charity.
Become a blood donor.
Make a donation.

It is important to protect yourself and your loved ones from reminders of what happened, which can cause additional harm. Yes, some do manage to regain their sense of control by watching the media coverage. However, there are those who are greatly upset by such reminders. In fact, retraumatization is fairly common. Therefore:

Limit your observation of media coverage. Don't watch the news programs right before bed. And don't watch them at all if such programs cause negative emotions in you.
The desire to receive information is completely normal. However, try to avoid upsetting images and videos. It is better to read magazines and newspapers than watch TV.
Protect your children from reminders of what happened.
After watching the news release, discuss what you saw and how you feel about it with loved ones.

Accepting your feelings is a necessary part of the healing process:

Allow yourself time to mourn your losses and heal your wounds.
Don't try to force the recovery process. Be patient.
Be prepared for difficult and volatile emotional reactions.
Give yourself the right to feel what you feel. Don't judge or reproach yourself for this.
Talk to someone you trust completely about how you feel.

Tip 4: make stress reduction a top priority

Almost everyone experiences psychological stress after a traumatic event. While a certain level of traumatic stress is normal and even beneficial, too much stress can be an obstacle to recovery.

Relaxation is not a luxury but a necessity

Traumatic stress is a heavy burden for both mental and physical health. You need time for rest and relaxation to allow your brain and body to return to normal functioning.

Practice meditation; listen to music that calms you down; walk in beautiful places, visualize the places where you like to be.
Take time to do things that make you happy (hobbies, favorite pastime, hanging out with a close friend).
Use inactivity time to relax. Enjoy a delicious meal, read a bestseller, or watch an inspiring or funny movie.

Sleep and traumatic psychological stress reduction

After a traumatic event, you may have difficulty sleeping. Anxiety and fear can cause insomnia, and nightmares will force you to wake up frequently. Good rest after a traumatic event is essential, and lack of sleep creates additional psychological stress and makes it difficult to maintain emotional balance.

As you recover, sleep problems will disappear. In the meantime, you can improve your sleep with the following strategies:

It is better to go to bed and get up at the same time every day.
Limit alcohol consumption, as alcohol interferes with sleep.
Before bed, it's best to do something that helps you relax: you can listen to soothing music, read a book, or meditate.
Try to avoid consuming caffeine in the afternoon.
Exercise regularly. Just don't train too close to bedtime.

Signs that you need to seek help

By themselves, the emotional responses observed after a traumatic event should not be cause for concern. Most of them will begin to disappear relatively quickly. However, if the reactions to traumatic stress are so intense and persistent that they interfere with your ability to function properly, you may want to find a mental health professional. Get help if:

It's been six weeks now and you don't feel any improvement.
You are unable to function properly at home or at work.
You are tormented by frightening memories and flashbacks, as well as nightmares.
It becomes more and more difficult for you to contact and communicate with people.
You have suicidal thoughts.
You try to avoid anything that resembles a traumatic event.

Send your good work in the knowledge base is simple. Use the form below

Students, graduate students, young scientists using the knowledge base in their studies and work will be very grateful to you.

Posted on http://allbest.ru

General concepts of stress

Over the past decades, the number of scientific and practical research devoted to traumatic and post-traumatic stress has sharply increased in world science. The International and European Societies for the Study of Traumatic Stress have been organized and are actively working, annual meetings of their participants are held, and the World Congress on Traumatic Stress is held annually.

We can say that research in the field of traumatic stress and its consequences for humans has emerged into an independent interdisciplinary field of science. In our country, despite the high urgency of this problem, its development is at an early stage, there are separate scientific teams of psychologists and psychiatrists who are engaged in research in this area. Not only in domestic, but also in the world clinical and psychological practice, the issues of distant psychological consequences of stress caused by the experience of a serious illness, real loss of health, and the threat of death have been very little studied. Exceptions are numerous foreign studies of post-traumatic stress disorder in persons injured and traumatized during hostilities.

With all the multidimensionality of the phenomena of experiencing and the aftereffect of traumatic stress, studies of the influence of traumatic stress on the human psyche in Russian science at its present stage are one of the most urgent and promising areas in clinical psychology.

Given the insufficient development of this area, we will restrict ourselves to the presentation of the basic concepts used in studies of traumatic stress:

Traumatic situation - a situation of extreme stress (natural and technological disasters, hostilities, violence, threat to life.

Traumatic stressors are high intensity factors that threaten human existence.

Mental stress is an emotional state of nonspecific adaptation to a stressful situation, which can become chronic, continuing to affect the human psyche even after leaving a traumatic situation.

Traumatic stress is mental stress of high intensity, accompanied by experiences of intense fear, horror and helplessness.

Traumatic stress reactions are personal and behavioral reactions that occur during the experience of traumatic stress.

Post-traumatic stress reactions are emotional, personal and behavioral changes that appear in a person after getting out of a traumatic situation.

Post-traumatic stress disorder (PTSD) is a syndrome of delayed specific reactions to being in a traumatic situation, manifested in symptoms of persistent reproduction in the mind of a person of a traumatic situation or its individual elements, persistent avoidance of stimuli associated with trauma, and increased (not taking place before the injury) the level of physiological excitability.

Certain stress factors have a psycho-traumatic effect on a person - stressful events that have caused mental trauma. According to M. Horovets, who developed the theory of delayed mental reactions to traumatic stress, a person is in a state of stress or periodically returns to this state as long as information about a stressful (traumatic) event is processed.

In response to stressful events. M. Gorovets identifies a number of successive phases: primary emotional reaction; “Denial”, which is expressed in emotional numbness, suppression and avoidance of thoughts about what happened, avoidance of situations reminiscent of a traumatic event; alternation of "denial" and "invasion". The intrusion is manifested in “breaking through memories of a traumatic event, dreams of the event, an increased level of response to anything that resembles a traumatic event; further intellectual and emotional processing of traumatic experience, which ends with assimilation (assimilation of a traumatic experience based on existing patterns of behavior) or accommodation (adaptation of patterns of behavior to a traumatic situation).

The duration of the process of responding to a stressful event is determined, according to M. Horovets, by the significance (relevance) for the individual of the information associated with this event. With a favorable implementation of this process, it can last from several weeks to several months after the incident (cessation of the traumatic effect). This is a normal reaction to a stressful event. With an exacerbation of response reactions and exacerbation of their manifestations for a long time, it is said about the pathologization of the process of response, the appearance of delayed reactions to trauma.

Delayed reactions to traumatic stress according to M. Gorovets are a set of mental phenomena caused by the process of "processing" of traumatic information. In the case of their intense and prolonged manifestation, they speak of post-traumatic stress disorders related to protracted reactive states.

There are the following diagnostic criteria for post-traumatic stress:

The presence of an extreme event, combined with a serious threat to life or physical integrity to the person himself, his relatives, friends, the sudden destruction of his home or the observation of the sudden death of other people.

In the mental disorders that have arisen, it “sounds” - a traumatic event is experienced, especially in the cognitive, volitional and emotional spheres.

With the strengthening of the relevance (repeated trauma, recollection) of the traumatic situation, the psychogenic, reactive symptomatology increases. With a decrease in the relevance of psychotrauma, the symptoms decrease.

The emergence of persistent asthenic-hypothymic (depressed mood with general weakness of the body) or anxiety-affective (anxiety accompanied by strong emotional experiences) syndromes.

With the manifestation of hypervigilance, a person closely monitors everything that happens around him, as if he is in constant danger. But this danger is not only external, but also internal - it consists in the fact that unwanted traumatic impressions, which have a destructive force, will break through into consciousness. Often, hypervigilance manifests itself in the form of constant physical stress, which can perform a protective function - it protects our consciousness, and psychological protection cannot be removed until the intensity of experiences has decreased.

With an exaggerated reaction, a person flinches at the slightest noise, knock, etc., rushes to run, shouts loudly, etc.

The listed reactions to traumatic stress do not exhaust all possible mental manifestations. In the process of processing a traumatic event, various feelings and states may arise that prevent a person from realistically assessing the situation.

Repeated experiences occupy a special place among the delayed reactions to traumatic stress. Flashback (flashback) - repeated sudden experiences of the existing traumatic events, which are accompanied, as it were, "shutdown" from the present.

The most common mental complications contribute to sudden relapses of traumatic events. Fear, sleep disturbances and nightmares are a persistent and depressing triad.

According to people who have experienced traumatic stress, they experience fear even in their sleep. This fear does not have the character of a neurosis, it is closely related to experiences during a traumatic event. The victims try unsuccessfully to suppress it. From the fact that they are tormented by nightmares, they are afraid to go to bed. They do not get enough sleep, since their sleep is often intermittent, shallow and lasts 3 - 4 hours in a row. People awaken from nightmarish visions that horrify them. This horror is explained by the fact that in such dreams they feel complete defenselessness.

The occurrence of nightmares and flashbacks are often associated with everyday incidents and experiences that are associated with the past trauma. Flashback is a piercing and disturbing memory that resurrects a traumatic situation, so that for a limited time, which can last from several seconds to several hours, a person completely or partially loses touch with reality.

A. Blank (1985) identifies four types of re-experiences: vivid dreams and nightmares; vivid dreams, from which a person wakes up, shocked by the sense of reality of the recalled events and the possible actions that he performed under the influence of these memories.

Conscious "flashback" - experiences in which images of a traumatic event are vividly presented. They can be independent in nature and be accompanied by the reproduction of visual, sound and olfactory images, etc. In this case, contact with reality may be lost (partially or completely);

unconscious "flashback" is a sudden, abstract experience accompanied by certain actions.

There are three types of flashback reactions:

overplaying - a mental change in the events preceding the psychotrauma (a person who has not coped with the fire extinguishes it in a dream);

evaluators - vivid representations of the consequences of trauma;

hypothetical - the presentation of more severe consequences than they were in reality.

Delayed reactions are reactions that do not occur at the moment of severe stress, but when the situation itself is already over (robbery, rape occurred, the veteran returned from the combat zone, etc.), but psychologically for a person it is not over. Such reactions occur against the background of general well-being long after the event.

Psychological trauma is a "mental wound" that "hurts", worries, brings discomfort, worsens the quality of life, brings suffering to a person and those close to him. As with any wound, psychological trauma can be of varying severity, and, accordingly, the "treatment" will be different.

Sometimes the wound gradually heals by itself and the "sore spot" "heals" naturally. There is a certain sequence of stages of experience that leads the psyche to recovery. In these cases, there is a reaction, comprehension, acceptance by a person of what happened, not as traumatic, but as a life experience, as part of his biography.

stress psyche traumatic

Etiology(the reasons)

The general conditions for the development of traumatic stress are as follows:

The person perceived the situation as impossible:

The person could not effectively counteract the situation (fight or run):

The person could not emotionally discharge energy (he was in a state of numbness);

The presence of previously unresolved traumatic situations in a person's life.

The physiological state at the time of injury, especially physical fatigue against the background of disturbed sleep and food intake, can become a predisposing factor for receiving mental trauma.

The conditions for the emergence of emotional disorders also include the lack of social support, close emotional ties with people around them (friends, family members, colleagues) (see Table I).

Table 1

Factors affecting the degree of human exposure to a severe stressful situation

Factors that increase traumatic stress	Factors relieving traumatic stress
Perception of what happened as extreme injustice.	Perception of what happened as likely.
Inability and (or) inability to somehow resist the situation.	Partial acceptance of responsibility for the situation.
Passive behavior. The presence of previously incomplete injuries.	Behavioral activity. Having a positive experience of independent resolution of difficult life situations.
Physical fatigue.	Favorable physical well-being.
Lack of social support.	Psychological support from family members, friends, colleagues.

The person's preliminary assessment of the situation is also important. The reaction to anthropogenic (social) catastrophes, where the human factor takes place (terrorist act, military actions, rape), is more intense and prolonged than to natural disasters. The catastrophic consequences of natural emergencies are regarded by the victims as "the will of the Almighty", and if there is a feeling of their own guilt in connection with the incident, then it is most often associated with the fact that no security measures were taken.

In case of man-made disasters, the victims develop a feeling of rage and aggression, which can be directed at those who are considered to be the perpetrators of the incident. Conditionally, we can distinguish two ways of developing a situation after a very strong stress.

* A person has acquired a traumatic experience, admitted this to himself (!) And gradually lives through it, developing more or less constructive ways of coping with it.

* The person has acquired a traumatic experience, but there is no personal attitude to the incident (accident, regularity, a sign from above), tried to “forget” him, pushed him out of consciousness, launching non-constructive ways to cope with the manifestation of symptoms of delayed stress reactions.

Any delayed reaction to trauma is normal. In one case, a person gradually lives the situation on his own; in another, he cannot do it on his own. In any of these cases, suffering and strong emotional experiences cannot be avoided.

Behavior strategies

Experts distinguish between several strategies for the behavior of people who have experienced trauma.

Sufferers, haunted by intrusive memories and thoughts of trauma, over time, begin to organize their lives in such a way as to displace, avoid the memories and emotions that they provoke. Avoidance can take many forms - for example, avoiding reminders of the event, drug or alcohol abuse to drown out awareness of intense inner discomfort.

In the behavior of people who have suffered mental trauma, there is often an unconscious desire to re-experience traumatic events. This behavioral mechanism manifests itself in the fact that a person unconsciously seeks to participate in situations similar to the initial traumatic event in general or in some aspect of it. This phenomenon is called compulsive behavior and is observed in almost all types of trauma.

War veterans become mercenaries. Abused women enter into painful relationships with men who abuse them. People who have experienced sexual harassment in childhood become prostitutes as they mature.

Many victims, especially traumatized children, tend to blame themselves for what happened. Taking partial responsibility in this case can compensate for feelings of helplessness and vulnerability.

Sexual abuse victims who blame themselves for what happened have a better prognosis for recovery than those who don't take responsibility.

More constructive strategies dealing with trauma are as follows:

* An attempt to relieve the misery of others.

There are quite a few American police officers who have suffered childhood violence.

* Search for a defender. More often they are women who were mistreated in childhood. They are prone to very strong attachment and dependence on their husbands (they cannot part with them for a day, cannot sleep alone, etc.).

* Cooperation. Joining a public organization, uniting with people who have experienced a similar situation (society of veterans, society of defrauded depositors, victims of domestic violence, recovering drug addicts, etc.).

The behavioral strategies described above do not cancel out the general dynamics of experiencing a traumatic situation.

The dynamics of experiencing a traumatic situation

The dynamics of experiencing a traumatic situation includes four stages.

First step - the phase of denial, or shock. In this phase, which occurs immediately after the action of the traumatic factor, the person cannot accept what has happened on the emotional level, the psyche is protected from the destructive action of the traumatic situation. This stage is usually relatively short.

Second phase is called the phase of aggression and guilt. Gradually starting to relive what happened, the person tries to blame the incident on those who were directly or indirectly related to the event. Then the person turns aggression on himself and experiences an intense feeling of guilt (“If I had acted differently, this would not have happened”).

Stage three - the phase of depression. After a person realizes that circumstances are stronger than him, depression sets in. It is accompanied by feelings of helplessness, abandonment, loneliness, and own uselessness. A person does not see a way out of this situation, loses a sense of purpose, life becomes meaningless: "No matter what I do, you will not change anything."

At this stage, unobtrusive support from loved ones is very important. However, a person experiencing trauma rarely gets it, because others are unconsciously afraid of "contracting" his condition. In addition, a person in a depressed mood steadily loses interest in communication ("Nobody understands me"), the interlocutor begins to tire him, communication is interrupted, the feeling of loneliness intensifies.

Stage four is the healing phase. She is characterized by a complete (conscious and emotional) acceptance of her past and the acquisition of a new meaning in life: “What happened really happened, I cannot change it; I can change myself and continue my life despite the trauma. " A person is able to draw useful life experience from what happened.

This sequence is a constructive development of the situation. If the victim does not go through the phases of living in the traumatic situation, the stages are too delayed, do not come to their logical conclusion, symptom complexes appear, which he cannot cope with on his own.

Post-traumatic stress disorder (PTSD)

Post-traumatic stress disorder is a disorder associated with the experience of traumatic stress. Symptoms include vivid obsessive memories of the traumatic situation, nightmares, difficulty falling asleep and emotional instability, emptiness, and increased alertness.

The beginning of the study of this phenomenon was laid in the United States and is largely associated with the so-called "Vietnam Syndrome" experienced by servicemen who returned after the Vietnam War. In our country, they often talk about the "Chechen" or "Afghan syndrome".

War veterans also have other symptoms: explosive reactions, fits of rage, unmotivated vigilance, alcohol, drug and drug abuse, and suicidal thoughts.

It was with the study of the consequences of military conflicts that the planned study of post-traumatic stress syndrome began. Thus, it was found that in 25% of those who fought and were not injured, the experience of hostilities was the cause of the development of adverse mental consequences. Among the injured and crippled, the number of those suffering from PTSD reaches 42%.

One of the factors that support the symptoms of post-traumatic stress disorder in combatants is the contrast in their experiences of the outside world. The dissonance of a peaceful life, where “there is nothing to do with the horrors experienced by someone” and the fighting situation, reinforces and maintains post-traumatic stress, feelings of injustice, hopelessness and helplessness, and prevents social integration.

Such violations are typical not only for combat veterans, but also for people who survived catastrophes, accidents and natural disasters, as well as who took part in eliminating the consequences of such disasters.

According to research results, the level of post-traumatic stress in professional rescuers is moderate. This is due to the fact that special professional training and professional selection, coupled with constant participation in the elimination of the consequences of emergencies, leads to the formation of special mechanisms for rescuers to cope with negative experiences.

However, due to the presence of specific stress factors of professional activity (work in an atmosphere of grief and suffering of other people, contact with the bodies of the dead, work in conditions of risk to life, etc.), some symptoms of this disorder are encountered quite often among rescuers and firefighters. Because of the importance of this topic, a separate chapter is devoted to this disorder in this study guide.

Persons who were forced to change their place of residence, the so-called refugees from the zones of local military conflicts, interethnic tension and discrimination on the part of the authorities, are also at risk of developing PTSD. These are people who migrate to other countries, as they fear persecution, arrest, torture or physical destruction in their own country.

A significant number of them were subjected to torture, political or one-time discrimination. Many of them lived in poverty in a situation of chronic unemployment, many have a low educational level.

The process of emigration is an additional trauma for most of them - especially for those who enter the country illegally. During this period, many are subjected to robbery, violence, some die along the way.

It is difficult for refugees to find a stable income, many of them remain unemployed or are hired for very low wages and are regarded as undesirable elements in the host countries.

PTSD is primarily characterized by an exacerbation of the instinct for self-preservation. In this case, there is an increase in internal psychoemotional stress (excitement). This tension is constantly maintained at an unacceptably high level, supporting in turn a constantly functioning mechanism for comparing (filtering) stimuli coming from outside with stimuli already imprinted in the mind as signs of an emergency (Kekelidze, 2004). For victims of emergencies, this translates into increased anxiety and fear.

Anxiety disorder... Anyone from time to time experiences a sense of anxiety. This feeling covers us when, for example, relatives are delayed on the way from work, when the outcome of an important situation is not clear, etc.

On the other hand, anxiety, or, in medical terms, "anxiety disorder" is one of the most common consequences of experiencing a traumatic situation.

A person caught in an extreme situation loses confidence in the future, anxiety becomes his constant companion. You can talk about anxiety disorder if the following symptoms are observed for several weeks:

* actually anxiety, fears about the future, excitement, expectation of failures and troubles, difficulties in trying to distract from disturbing thoughts;

* motor tension, inability to relax, fussiness, nervous trembling, difficulty falling asleep, etc.;

* physical manifestations: sweating, heart palpitations, dizziness, dry mouth, etc.

Anxiety always tends to turn into fear.

Anxiety-phobic disorder... Fear is a common emotion found on the emotional spectrum of every person.

Any person is afraid of something - spiders, heights, darkness, loneliness, poverty, death, illness, etc. Fear of danger is useful, it protects a person from rash, risky actions, for example, it is scary to jump from a great height or cross a busy highway.

After experiencing a traumatic situation, there is a fear of ordinary, fairly safe objects and situations: fear of flying on airplanes, fear of being in confined spaces (for example, after an earthquake experienced by a person). Such fears do not have an adaptive, protective function and become harmful to a person, prevent him from living. In the language of specialists, this condition is called anxiety-phobic disorder.

Fear can be of varying degrees of intensity - from mild discomfort to horror that grips a person. Often, fear is accompanied by unpleasant bodily sensations: dizziness, heart palpitations, increased sweating, etc.

There are many ways to deal with fear. Pronounced cases require referral to specialists: psychiatrists, psychotherapists, psychologists.

Depressive states... One of the syndromes that form the basis of PTSD is depression,

We often use the word "depression" to mean sadness, bad mood, melancholy and sadness. Bad mood and sadness, from time to time are found in every person and can be associated with quite understandable reasons - fatigue, processing of unpleasant impressions, etc.

Such longing can be good for a person. It is in a state of sadness that a person solves important problems for himself or creates beautiful works of art. However, these conditions are not a state of depression.

We can talk about depression when for a long time (at least several weeks) there is a persistent decrease in mood, a person ceases to feel pleasure from what used to bring joy, energy leaves, and fatigue increases. Also, at least two of the following symptoms are observed:

* reduced ability to concentrate, problems concentrating;

* decreased self-esteem and self-doubt;

* ideas of guilt and humiliation;

* gloomy and pessimistic vision of the future;

* ideas and actions aimed at self-harm or suicide;

* disturbed sleep;

* disturbed appetite;

* decreased sex drive.

Depression is often accompanied by loss of interest, tearfulness, and feelings of hopelessness. Many remain in this state for so long that they get used to it, entering a state of chronic depression. Severe depression can lead to suicide attempts.

Suicidal behavior... The main reason for suicide is always the socio-psychological maladjustment of the personality in an unfavorable concurrence of life circumstances or in the case of a subjective interpretation of these circumstances as insoluble.

Regardless of the reasons, conditions and forms of maladjustment, the adoption of a suicidal decision presupposes a necessary stage of personal processing of a conflict situation, which is refracted through a system of personal values, attitudes, which determines the choice of one or another variant of behavior: passive, active, aggressive, suicidal, etc. ( Tikhonenko, Safuanov, 2004).

Distinguish between internal and external forms of suicidal activity.

Internal forms of suicidal activity include suicidal thoughts, ideas, experiences, and suicidal tendencies, consisting of intentions and intentions.

External forms of suicidal activity - suicidal actions - include suicidal attempts and completed suicides.

TO external factorsforming suicidal intentions include:

Unfair attitude (insults, accusations, humiliation) on the part of relatives and others;

Jealousy, adultery, divorce,

Loss of a significant other, illness, death of loved ones;

Loneliness, social isolation;

Lack of attention to caring from others;

Sexual incompetence;

Somatic diseases;

Physical suffering;

Social disorder, material and everyday difficulties.

TO internal factors include: guilt complexes, serious illnesses, real or imaginary failures, a sharp change in social status (loss of work due to disability).

A leading American suicidologist, founder and head of a number of Centers for Research and Suicide Prevention, E. Schneidman (2001) describes the phenomenology of suicide by the following characteristics:

* The overall goal of suicide is to find a solution. Suicide is always presented as a way out of the current situation, a way to solve a problem, crisis, conflict, an intolerable situation.

* The common task of suicide is to cease consciousness. Suicide is easiest to understand as a desire to completely turn off consciousness and end unbearable mental pain,

* A common incentive to commit suicide is unbearable mental pain. Suicide is not only a movement towards the cessation of consciousness, but also an escape from unbearable feelings, unbearable pain, unacceptable suffering.

* A common stressor in suicide is frustrated psychological needs (unfulfilled psychological needs for care, understanding, love, forgiveness).

From the diary of a suicide woman: “A year has passed since I did not look into my diary, it took a long time to get out of thoughts about my death. It was so convenient to hide from myself and problems in these thoughts. Under the veil of them, I could not think about what worries me, I could not remember how he left me at the moment when I was needed more than anything else, because he is a coward, and I have a serious illness and all my hair got out. I plunged into the funnel of thoughts about death in a month, and crawled out millimeter by millimeter year, I had to let in everything that happened to me. Today is the first day I don’t want to think about death. ”

* A common suicidal emotion is helplessness - hopelessness.

* A common internal attitude towards suicide is ambivalence.

People who commit suicide experience an ambivalent attitude towards life and death, even when they commit suicide. They want to die, but at the same time they want to be saved.

* The general state of the psyche in suicide is a narrowing of consciousness - a sharp restriction of the choice of behavioral options that are usually available to the consciousness of a given person in a particular situation - "all or nothing."

* A common communicative action in suicide is to communicate your intention. Many people intending to commit suicide, despite being ambivalent about the planned action, subtly, consciously or unconsciously send distress signals in the form of direct or indirect verbal messages or behavioral manifestations.

There are several types of suicide, the main ones are:

* Demonstrative, which as its purpose involves not taking one's own life, but only demonstrating this intention, although not always consciously.

* True, who has the goal of taking his own life. Death is the final result, but the degree of desire for death can be different, which is reflected in the conditions and degree of realization of suicidal tendencies.

The second form is quite common in people with PTSD. Such people seek relief from intense suffering. There is a feeling that there is no one who can help with this suffering.

10% of suicides in the Armed Forces of the Russian Federation among the officers since the time of the first Chechen campaign occurred due to post-traumatic stress disorder (Voytsekh, Kucher, Kostyukevich. Birkik, 2004).

In some cases, when a person decides to commit suicide, he calms down outwardly and tries to behave “brightly” in relation to family and friends.

The officer, a veteran of several local wars, shot himself, taking his family to a "pretentious" restaurant before that.

Often, suicide occurs impulsively when an event is the “last straw” in the “bowl of negative emotional experiences” of a person.

In modern literature, the concepts of "self-destructive" or "self-destructive" behavior are widespread. It is believed that there are a number of mutually transient forms of self-destructive behavior, the extreme point of which is suicide.

Self-destructive behavior, along with suicidal behavior, includes the abuse of alcohol, drugs, strong medications, as well as smoking, deliberate work overload, stubborn unwillingness to receive treatment, risky driving (especially driving and driving while drunk), extreme sports ...

Grief reactions

Any psychotraumatic event is accompanied by any loss (of the previous way of life, property) and a reaction of grief, when there is the death of friends, relatives and friends. Every person inevitably faces the loss of a loved one. Rescuers and firefighters, by the nature of their work, encounter people who have lost loved ones.

Grief reactions include a wide variety of clinical, emotional, and behavioral manifestations. Due to the complexity of such experiences and the need to interact with people who find themselves in such situations, the knowledge of the rescuers and firefighters of the dynamics of the grieving reaction is important for the authors. A special chapter will be devoted to this specific topic.

A grieving person is characterized by recurrent attacks of physical discomfort (spasms in the throat, choking, rapid breathing, decreased muscle tone, etc.) and subjective suffering (mental pain).

In this situation, a person can be absorbed in thoughts of the deceased or of his own death (Lindemann, 2002). Slight changes in consciousness are possible - a feeling of unreality, isolation from others.

The process of overcoming grief goes through stages that are universal for all people:

Acute grief (about 3-4 months)

Shock phase.

Reaction phase:

a) the phase of denial (search);

b) the phase of aggression "(guilt);

c) the phase of depression (suffering and disorganization).

Recovery stage (about 1 year)

a) the phase of "residual shocks" and reorganization;

b) completion phase.

The severity of grieving experiences can be exacerbated by several factors:

- “the fault of the survivor”;

An additional acute psychotrauma associated with the impossibility of identification (the body is severely damaged or not found) is the incompleteness of the relationship with the deceased, the inability to pay "the last debt" to the deceased;

Inability to say goodbye to a dying person in the last minutes of his life, at a funeral (physical remoteness, rejection of the situation, internal unwillingness to part with the person).

With prolonged grief reactions, psychosomatic reactions may appear.

Psychosomatic disorders

In medicine and psychology, the phenomenon of mutual influence of the soul (psyhe - lat.) And the body (soma - lag.) Has been studied for a long time. “In a healthy body - a healthy mind” - says the ancient Greek saying.

The opposite meaning of this statement is that if the soul is wounded, then this is reflected in the body. There are many hypotheses and explanations for psychosomatic relationships, which are supported by research.

Within the framework of psychoanalysis, in the study of somatic diseases, emphasis was placed on the study of the psychological meaning of the disease.

Psychotherapist Franz Alexander identified a group of seven "psychosomatic" diseases: duodenal ulcer, ulcerative colitis, essential hypertension, rheumatoid arthritis, hyperthyroidism, neurodermatitis and bronchial asthma.

The peculiarities of people's reaction in different life situations were highlighted and correlated with the psychosomatic diseases they have.

Thus, it is believed that the "ulcerative" type of people is characterized by "self-criticism", that is, the suppression of needs that are not consistent with social requirements. Such people reject the need for dependence, support, empathy; not sure of themselves, straightforward, categorical.

Hypertension occurs in people who are characterized by a pronounced desire for success, approval, achievement, increased responsibility. Such achievement motivation is often accompanied by aggressiveness (often suppressed, since it is not profitable to express it openly, the approval of other people is important).

Bronchial asthma occurs in people with a depressive background of mood, emotionally sensitive, sensitive, dependent. Their self-esteem is low or unstable.

Prior to the discovery of numerous allergic components of asthma, the disease was considered "nervous".

These diseases, as well as a number of others (oncological diseases, tuberculosis), in the occurrence and dynamics of which the role of the psychological factor is revealed, are referred to as psychosomatic disorders.

Psychosomatic reactions can be caused by complex (crisis) situations in a person's life:

1. Stress (intense, prolonged exposure). Studies of the "invisible" stress of radiation hazard (Tarabrina, 1996) have shown that the experience of such stress leads not only to the occurrence of PTSD, but also correlates with a higher level of psychosomatization.

Analysis of case histories of 82 liquidators of the consequences of the Chernobyl accident revealed high levels of asthenic-neurotic disorders, vascular dystonia, hypertension, gastrointestinal diseases, which corresponds to the generally accepted register of psychosomatic disorders.

2. Frustration (impossibility to satisfy the need). One of the psychological aspects of psychosomatic disorders is that a person receives a “secondary benefit”.

It can be "flight into illness" when it is more profitable for a person to be sick. In our culture, it is customary for a patient to be treated with respect and care, he is released from duties, he is looked after and he is given attention. Even if a person does not consciously resort to such methods of attracting attention, then unconsciously, through illness, he can seek warmth and affection.

A child who equally loves both parents, who, however, are hostile to each other, cannot find any other way out of the uncomfortable situation than to “go into illness”, thus “unite the parents” and switch their attention and activity to themselves.

3. Conflict of interest with non-constructive exit strategy. Medical psychology considers the phenomenon of hostility in its connection with somatic morbidity. A direct correlation was revealed between hostility and mortality in cases of severe disease. In these cases, a large percentage of the survivors are people whose "worldview" is not hostile.

4. The actual crisis period, associated with the fact that a person cannot solve the problem, cannot get away from it, as it happens in a situation of death of a loved one or a serious illness.

The psychological aspects of the crisis period are clearly traced in the situation of oncological disease.

The situation of a life-threatening disease is similar to the so-called "information" stress. It is not the situation of the disease itself that is traumatic, but subjective ideas about what may happen in the future (deterioration of the condition, death). The very news of the diagnosis can destroy a person.

The "illusion of immortality" is peculiar to people. When illness comes, there is an acute sense of the unliving life. A serious illness disrupts life plans and plans (a person was going to defend a thesis, go to rest, buy a new car), a person is angry with himself for being ill. Cancer is perceived as “betrayal” by the body (Semenova. 1997).

Severe somatic illness is accompanied by physical suffering and makes it difficult for a person's usual life. As a result of this, the quality of life changes dramatically.

The disease can be regarded as a crisis situation. In some cases, the disease can be a serious shock, but retains the chance to return to the old way of life. In other cases, the disease can become a crisis situation, canceling out all life plans: "there is no way out." When it is impossible to change the circumstances of life (advanced stages of the disease), it remains to change oneself, to become different, to change the meaning of life.

The dynamics of emotional reactions of an oncological patient is described by a psychotherapist who has worked in this area for many years - E. Kübler-Ross (2001):

1. Shock from the news of the disease, which is accompanied by the inability to move, or chaotic movements.

2. Denial of new, unbearable knowledge about yourself. Serves as a guard function for the psyche, blocks the connection of a personal resource.

3. Aggression. Feeling of injustice: "Why me?" A person searches and tries to find the causes of the disease. Blames others. This reaction is based on fear.

4. Depression. The person does not believe in treatment, does not see the point in it, expresses suicidal thoughts.

5. Acceptance or "an attempt to conspire with fate." Acceptance of the reality of illness, cooperation with others, a psychological feeling of relief, balance. New meanings appear, a feeling of liberation comes. In some cases, there is an enrichment, harmonization of the personality in the process of illness.

There are cases when, after learning that they have an incurable disease and their days are numbered, they decided to live the rest of their lives the way they dreamed, but due to circumstances they could not afford, not wasted on resentment and vanity. Allowing themselves to feel the taste and joy of life, people got rid of the symptoms of the disease and recovered.

Overcoming a crisis state includes an experience that allows a person to reasonably reduce expectations from life and adapt to a new life situation. Overcoming becomes possible if a person shows search activity with the connection of volitional self-regulation. It is especially difficult to find a way out of a situation in which it is difficult to predict whether the efforts spent will lead to any result.

Let us recall the tale of two frogs trapped in a jug of milk. Where one gave up immediately and, without trying to make an effort, went to the bottom and drowned, while the other decided to flounder until she had enough strength. As a result, she knocked the milk into butter with her paws and was able to get out.

Summarizing the above about psychosomatic reactions, we can say the following. There are periods in a person's life and the history of mankind, which are accompanied by crisis situations, catastrophes, a large number of strong or prolonged emotions. However, at these moments, the number of psychosomatic illnesses falls due to the activity that unites all people.

During World War II, a decrease in the manifestation of a number of diseases was noted - the number of attacks of schizophrenia, stomach ulcers and other diseases decreased.

After a period of activity, a period of recession follows, during which the effect of surrender, refusal to search, can occur, and at this moment the disease comes to the fore.

Researchers who have studied the frequency of mental disorders during earthquakes have come to the conclusion that after the cessation of disasters or natural disasters, a significant part of the victims have a persistent health disorder.

So, within a year after the earthquake in Managua, the number of hospitalized in a psychiatric clinic doubled, and neurotic and psychosomatic disorders in the victims were noted for a number of years.

There is a well-known “phenomenon of Martin Eden” (the hero of the book by Jack London), who dies at the peak of success, having achieved what he wanted and what he had been striving for for a long time. While a person is in search, he does not get sick. Stopping means sickness and death.

As long as a person is active, positively emotionally disposed, diseases recede. This provision indicates the basic principle of the prevention of psychosomatic diseases.

Output

If the exposure to stress was moderate and short-lived, then increased anxiety and other symptoms of stress gradually disappear over several hours, days, or weeks.

If the stressful impact was strong or the traumatic events occurred many times, the painful reaction can persist for years.

The traumatic nature of an event depends on the meaning it has for the individual. An important role here is played by the subjective significance of the event, which is formed through the attitude of the individual to the threatening situation, world perception, religious feelings, moral values, and the acceptance of partial responsibility for what happened.

A tragic incident can cause serious injury to one and almost not affect the psyche of another.

Even after experiencing similar experiences, people react differently to the situation after it ends.

If a person copes with psychological trauma and draws important experiences from their experience, they become a much more mature person. Regardless of his age, he will be psychologically more mature than someone who has never faced a human tragedy - he will understand life better and feel better about other people.

Posted on Allbest.r

...