especially if one is not getting enough sleep. The arousal reactions are due to the fight-orflight response in one’s body. People who have been traumatised often see the world as filled with danger, so their bodies are on constant alert, always ready to respond immediately to any attack. Increased arousal is useful in truly dangerous situations but becomes very uncomfortable when it continues for a long time even in safe situations. Another reaction to danger is to freeze, and this reaction can also occur during a trauma. Avoidance symptoms Thinking about a traumatic experience and feeling as if you are in danger is upsetting; hence people tend to try to avoid reminders of the trauma. The most common symptom is avoiding situations that remind you of the trauma, such as avoiding conversations and staying away from places, activities or people that might remind you of everything. Actively avoiding trauma-related thoughts and memories and shutting down emotionally or feeling emotionally numb are also common avoidance symptoms. Trying to avoid thinking about the trauma and avoiding treatment for trauma-related problems may keep a person from feeling upset in the short term, but avoiding treatment means that, in the long term, the trauma symptoms will persist. > Case study / ‘Post-traumatic stress disorder’ Letty was with her best friend Anna at the marketplace when a bad thing happened. A group of young men rushed through the marketplace shouting and waving sticks and metal rods. Letty had no idea why they were doing this and she was afraid. They ran towards her and Anna and beat them severely. No one stopped these men, who continued beating other people. When they had finished, Letty got up. She was very hurt and had trouble standing. She went to her friend, who was still lying on the ground. Anna did not move and it took Letty a while to realise that Anna was dead. Since then, Letty keeps thinking of what happened to them. She has bad dreams that the men will come back and attack her at home. She has trouble sleeping, has no appetite and feels restless all the time, looking out the window for the crowd of men. Letty avoids the marketplace now and in fact all places where there are lots of people. She has lost interest in her church and the sewing she used to enjoy. Most of all, Letty feels so much guilt that she survived the attack and her best friend Anna did not. UNDERSTANDING MENTAL ILLNESSES (Mini lecture and discussion) Causes of mental illness Mental illness is a medical condition which has several causes. The three main causes are: 1. Stressful life events – these are events that disrupt or change a person’s life and cause emotional pain, such as divorce, losing a child, being ill or losing one’s employment; 2. A medical condition that changes brain activity; and 3. A person’s personality and way of coping. 112 Community Healing: A training manual for Zimbabwe