Responses to trauma that keep a victim from being able to become resilient fall into three categories. These categories are called avoidant patterns, overactivation and underactivation. Avoidant individuals develop symptoms that keep them from recognizing and dealing with issues that have developed from the traumatic circumstance. Overactivation means that the individual is overreacting, showing high level of emotional response. Underactivation is exactly the opposite: the individual reacts as if nothing had happened at all or by finding ways of discounting or forgetting the event itself and so its impact.
Avoidant Responses
When discussing avoidant responses we have to be careful to do is not to judge the intentions of the victim who responds in this way. It is neither a conscious choice nor a moral breakdown. It is usually related to what we talked about with the inability to ego adjust. If a person cannot either express or contain him or herself in a high stress situation nor adjust personal characteristics to fit the environment then there is a tendency on some peoples’ part to internally protect themselves, unconsciously. And unconsciousness is automatically out of control of the individual until they become aware of the reaction so as to take control again.
Avoidant responses range widely. One method of avoiding pain is called dissociation. Dissociative states are a way of forgetting what occurred, either by shutdown of memory, consciousness, or self-identity. Think of this as someone who cannot remember anything about what happened in the tragedy. Their memory from just before the tragedy until much later was simply scrubbed clean.
Another form is psychophysical responses, also called somatoform responses. The person become in some way physically handicapped, whether that is becoming ill or having physical rather than emotion pain or developing other physical symptoms that have no basis in bodily function, like blindness or paralysis. Substance abuse is a form of avoidance - numbing pain. Again, working with Chinese victims of the May 8, 2008 earthquake, one man, when asked what was different in his life since the catastrophe said simply, “I have learned how to drink.” Finally, the rare individual becomes psychotic, losing touch with reality even to the point of hallucination and delusion.
Underactivation Responses
Some people wander through the suffering of others aimlessly, stare off into space, or seem to be handling things with incredible ease but without the ability or willingness to talk about what is occurring. This is a harder state of being to discern because resilient people may also “take things in stride”. However, the ability to be resilient includes not only the ability to take care of self but to seek help and not to try to do it all alone. So “taking things in stride” may simply be internalizing, which is dangerous.
When we look at stress responses that occur months after a disaster, including Post Traumatic Stress Disorder and psychosomatic disorders we almost invariably discover that the individual who develops the disorders has internalized stress rather than found safety valves for releasing the stress. The immune system has been shown consistently in studies to be directly affected by unrelenting or unresolved stress.
Overactivation Responses
Some individuals in crisis situations respond with panic, symptoms of high anxiety, judging or blaming others, seemingly irreconcilable crying or anger and other acute stress responses. It is a healthy and normal thing for a victim of tragedy to activate to the point that he or she is motivated to respond, for survival instincts to kick in, or to resolve difficulties occurring in the aftermath of a disaster suitably. But overreaction will freeze a person’s will to act in a rational fashion as the chemicals produced in the amygdala, the emotional center of the brain, overcomes the ability to produce neurochemicals that allow full thinking ability and may also worsen a situation by either hampering disaster relief worker efforts or spread panic among other victims.
Overactivated responses usually occur in one of two ways, either as an immediate response to a disaster as it occurs, or as intrusive memories of the event invade the survivor’s consciousness. Either way the reaction is likely to look the same.
Psychiatric or Abnormal Conditions of the Mind Responses
A rarely occurring reaction to disaster is a loss of orientation to reality, with a lack of ability to function or to respond to reality. Luckily these are rare occurrences, but often enough to be considered. Psychiatric responses fall into two categories, depressive or psychotic responses (loss of orientation to reality, with delusional or hallucinatory effects).
Because the victim of this type of response is incapable of regaining control without major psychiatric intervention, it is important to be able to recognize the states so as not to waste time attempting to talk a person down from the state; the importance is getting the individual help as quickly as possible.