3. Secondary or vicarious trauma. This includes bearing witness to another’s trauma, an example being the transformation in the self of a trauma worker or helper that results from empathic engagement with traumatised clients (Pryce, Shackelford & Pryce, 2009). As traumatic as single-blow traumas are, the traumatic experiences that result in the most serious health problems are prolonged and repeated, sometimes extending over years of a person’s life. Natural trauma as opposed to trauma caused by people Trauma can be caused by natural disasters and accidents or by human beings. Prolonged trauma deliberately inflicted by people (e.g. assault, rape and torture) is more difficult to bear than one caused by accidents or natural disasters. Most people who seek health treatment for trauma have been victims of violently inflicted wounds dealt by a person. COMMON REACTIONS TO TRAUMA (Group exercise, discussion and mini lecture) A traumatic experience produces physical, emotional and behavioural reactions. Because people respond differently to traumatic events, one person may have some of the reactions listed below more than others, while another person may have none at all. Most of these reactions are normal after a traumatic experience. In fact, most people who directly experience major trauma have severe problems in the immediate aftermath of such trauma. Many people then feel much better within three months after the event, but others recover more slowly – and some do not recover enough without help. Physical reactions • • • • • • • • • • Aches and pains such as headaches Chest pains and stomach aches A pounding heart or trouble breathing Trouble falling or staying asleep Feeling shaky and sweaty Becoming easily startled by loud noises or by something or someone coming up on one from behind when one does not expect it Feeling agitated and constantly being on the lookout for danger Poor appetite (sometimes some individuals will eat too much) Little or no interest in sex Often becoming sick with colds, etc. – the person’s body cannot fight off illness as well. Emotional reactions • Upsetting memories such as images of, or thoughts about, the trauma • Feeling as if the trauma is happening again (flashbacks) • Bad dreams and nightmares; trouble concentrating or thinking clearly • Depression • Emotional swings – laughing then crying • Always on the alert and checking for danger • Being anxious and fearful • An unreal, detached feeling • Anger or aggressive feelings and feeling the need to defend oneself • Remembering past traumas 108 Community Healing: A training manual for Zimbabwe