October 24, 2011

Cut #3

Traumatic experiences shake the foundations of our beliefs about safety, and shatter our assumptions of trust.

Because they are so far outside what we would expect, these events provoke reactions that feel strange and “crazy”. Perhaps the most helpful thing I can say here is that even though these reactions are unusual and disturbing, they are typical and expectable. By and large, these are normal responses to abnormal events.

The issue, the after effects of killing — personal killing — I believe isn’t understood. I don’t think the military understands how to deal with it. It is the effects of personal responsibility for taking another life. How do people react to that? How do they look at the spiritual issues? How do they look at the societal issues? How do they look at their family values?

“Village X” is only a few kilometres away from the almost inadequately named “House of Horror” across the Danube in the nearby Lower Austrian town of Amstetten. It was at Amstetten’s Ybbsstrasse number 4 that Elisabeth Fritzl spent 24 years of her life being held like a caged animal in an underground cellar where she was raped an estimated 3,000 times by her father, “Incest Monster” Josef Fritzl.

There are three categories of symptoms. The first involves re-experiencing the event. This is the main characteristic of PTSD and it can happen in different ways. Most commonly the person has powerful, recurrent memories of the event, or recur-rent nightmares or flashbacks in which they re-live their distressing experience. The anniversary of the triggering event, or situations which remind them of it, can also cause extreme discomfort. Avoidance and emotional numbing are the second category of symptoms. The first occurs when people with PTSD avoid encountering scenarios which may remind them of the trauma. Emotional numbing generally begins very soon after the event. A person with PTSD may withdraw from friends and family, they may lose interest in activities they previously enjoyed and have difficulty feeling emotions, especially those associated with intimacy. Feelings of extreme guilt are also common.

Trauma symptoms are probably adaptive, and originally evolved to help us recognize and avoid other dangerous situations quickly — before it was too late. Sometimes these symptoms resolve within a few days or weeks of a disturbing experience: Not everyone who experiences a traumatic event will develop PTSD. It is when many symptoms persist for weeks or months, or when they are extreme, that professional help may be indicated. On the other hand, if symptoms persist for several months without treatment, then avoidance can become the best available method to cope with the trauma — and this strategy interferes with seeking professional help. Postponing needed intervention for a year or more, and allowing avoidance defenses to develop, could make this work much more difficult.

In that dank subterranean warren, Elisabeth bore Fritzl seven children without any medical help whatsoever. Three of them were sent “upstairs” as small children and lived comparatively normal lives being looked after by Fritzl’s unwitting wife, Rosemarie. She had been duped into thinking that Elisabeth had run away from home to join a religious sect and had only returned to dump her newly born children on her mother’s doorstep. Incredible as it seems, the Austrian social services believed the story. But the other four children Fritzl fathered through his incestuous relationship were never allowed to leave the cellar. One of them, a baby boy, suffered severe breathing problems after birth, so Fritzl let the child die rather than call a doctor because he was afraid of being found out. He burned the infant’s body in a wood-burning stove.

The silence is really the damaging part, and I would strongly encourage people to talk to people that they trust about it. And if that isn’t possible, then they need to figure out who they can begin to trust with [it]. Because they shouldn’t just sit on it. They shouldn’t just try to make it go away. It won’t go away.

We create meaning out of the context in which events occur. Consequently, there is always a strong subjective component in people’s responses to traumatic events. This can be seen most clearly in disasters, where a broad cross-section of the population is exposed to objectively the same traumatic experience. Some of the individual differences in susceptibility to PTSD following trauma probably stem from temperament, others from prior history and its effect on this subjectivity.

We have been always taught not to hurt others. I know when we go to war, we’re taught to kill directly. The current war, in particular, will have a profound effect on people. Because of the very nature of the directness of the killing. We’re not talking about distance killing. We’re not talking about a firestorm, [like the one] in Dresden that killed 200,000 in a night. We’re talking about disintegrating someone in front of you. That needs to be addressed by acknowledging that it does have an affect on people. That is what it means to go to war. But, that person will [need] some support in understanding themselves better and not to have a silence about it.

But psychiatrists such as Dr Adelheid Kästner say that Elisabeth’s second and probably most significant catharsis occurred at her father’s trial almost exactly a year ago. The press and public were banned from the court to allow a videotaped recording of Elisabeth giving evidence to be played. Elisabeth crept into the court in person to witness her father’s reactions. Then Josef turned round and saw her for the first time since her escape. He broke down and wept. At that moment Elisabeth knew she had won.