Trauma impacts severely on the person’s assumptions of the world as a meaningful, predictable place, as well as about the personal omnipotence and invulnerability, about personal value.
There is a multitude of types of traumas that impact the person’s functioning at various levels, but interpersonal trauma, produced by another human, is the most severe, leading to most important symptoms and affecting victims the most. Such trauma is even more severe when it affects the social support of the family. Some of the types of severe trauma are: hostage taking, kidnapping, rape, incest, crime, human-made disasters and other tragedies that happen because of violations of moral standards.
One of the main and most difficult problem that appears as a result of trauma exposure is Post-Traumatic
Stress Disorder (PTSD). This is a pervasive problem, occurring in a percentage of 0.5 – 1.3% of the US population. However, in special populations, namely those exposed to adversity, trauma, hazardous risks, its incidence is much higher.
Trauma impact severity can be established based on several factors:
- Degree of life threat and bereavement
- Speed of onset
- Duration of trauma – the more prolonged the exposure, the higher the risk for complications, as hypervigilance, a high state of arousal, becomes the usual state of the exposed person
- Degree of displacement of home continuity
- Potential for recurrence
- Degree of exposure to death, dying and destruction
- Degree of moral conflict in the situation
- Role of the person in the trauma
- Proportion of the community affected
The age at trauma exposure is also important, with more immature persons holding higher risks of complicated symptomatology. Childhood trauma has important effects on child development and physical and psychological health. In order to survive, victims employ various psychological mechanisms, which besides their function as defences also become the fertile ground for Post-Traumatic Stress Disorder (PTSD).
One of the most severe and challenging disorders of human kind, PTSD still raises the attention of specialists in various fields due to its low rate of cure and its high risk of reoccurrence once symptoms have been alleviated. The main symptoms of the disorder are:
- Intrusive, repetitive thoughts: usually visual images from the moment that trauma occurred, experienced in the form of flashbacks or nightmares, that are triggered by reminders, such as smells, sights, sounds or tactile reminders. In time, triggers can become more subtle, more generalised
and not necessarily connected to the trauma. The person’s reactions when confronted with these reminders of trauma is similar to that when trauma occurred, for example, a strong need to defend against a high danger, which puts the person at vital risk or at risk for homicide
- Avoidance: takes various and complex forms. The strong emotional, cognitive and physiological reactions to disturbing thoughts related to trauma urge the person to resort to desperate measures in order to keep them out of awareness. Alcohol and drug use have a relieving effect on symptomatology, but once returned to sobriety the person feels even more severe intrusions. Thus, a vicious cycle is being maintained, substance use becoming a constant way to deal with symptoms and this leads to addiction. In the desperate attempt to cope, the traumatised person becomes either passive or active, the most common reactions are freezing, flight and denial (numbing).
These mechanisms help the person feel that control was not totally lost, but in time numbing and repression have important negative consequences, because unprocessed emotions are not healed and they can generalise to other life aspects
- Increased arousal of the nervous system: refers to the perceived threat that trauma victims tend to infer to various stimuli that in fact do not represent a threat at all. Startle response, concentration problems are the result of hypervigilance without any immediate threat, but the person’s difficulties to process messages cause them to either overreact or withdraw whenever a perceived threat is around (e.g., a sound, a smell, a sight, etc.)
Five most common patterns of PTSD are:
- Death Imprint: high awareness of own vulnerability or mortality as a result of confrontation with actual biological death of others around
- Survivor’s guilt: guilt over surviving while others did not, as well as over not doing everything possible to prevent that loss of other person
- Desensitisation: paradoxical reactions, such as laughing or feeling pleasure when exposed to physical violence against others, shifts between calm and violent reactions, leading to general hostile and defensive mood
- Estrangement: Severe interpersonal difficulties, rejection of others who are perceived as cold, possible secondary trauma in institutions that are supposed to offer assistance and care, feelings of degradation that make the establishment of relationship almost impossible.
- Enmeshment: Aberrant behavior in relationships, lack of meaning and significance in life, emotional fixation
This training manual is designed to be used by those who come into contact with vulnerable migrants. It aims to promote good practice in the identification and prevention of abuse and exploitation, including human trafficking, female genital mutilation and forced labour, whilst equipping those who use it with basic training skills. The exercises are developed from the lessons learnt and experience of ECPAT trainers. It is designed to be adapted and delivered easily without the need for extensive resources.
This manual is aimed at identifying people entering or living in a country where they were not born who are vulnerable to exploitation. It is important here to define which people we are targeting through this manual. These are short definitions which are explored further throughout the manual.
Asylum Seeker is someone who is fleeing persecution and has lodged an application for protection on the basis of the Refugee Convention or Article 3 of the European Convention on Human Rights, ECHR. http://rightsinfo.org/the-rights-in-the-european-convention/
Human Trafficking is the movement or harbouring of a person, through the use of force or coercion for the purpose of exploitation, typically for work, sexual exploitation, criminal purposes or organ removal.
For the full definition, refer to: UN Protocol to prevent, suppress and punish trafficking in persons, especially women and children, 2006. https://ec.europa.eu/anti-trafficking/legislation-and-case-law-international-legislation-united-nations/united-nations-protocol-prevent_en
Internally displaced persons (IDPs) are people or groups of individuals who have been forced to leave their homes or places of habitual residence, in particular as a result of, or in order to avoid the effects of, armed conflict, situations of generalised violence, violations of human rights or natural or man-made disasters, and who have not crossed an international border.
Refugee is a person who ‘owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group, or political opinion, is outside the country of his nationality, and is unable to or, owing to such fear, is unwilling to avail himself of the protection of that country.’ (Definition quoted from the 1951 Refugee Convention) http://www.unhcr.org/uk/1951-refugee-convention.html
Third Country National (TCN) refers to individuals who are in transit and/or applying for visas in countries that are not their country of origin (i.e. country of transit), in order to go to destination countries that is likewise not their country of origin.