In February 2012, we were privileged to hear an address by Dr Rony Berger about the causes of Post Traumatic Stress Disorder, its nature and some tips on how to begin treating it.
Dr Berger said that most people are under an illusion of safety. If asked about their plans for their day few would say they would suffer a catastrophic car accident or that a large object would fall out of the sky and crush them.
After a significant trauma this illusion is broken and it will take time before one can be convinced that it is safe to function normally again. In the meantime, flashbacks, abnormal breathing, muscle tension and insomnia are normal responses.
People who suffer trauma respond in four ways. Chronic, Recovery, Resilient, and Delayed Responses. Chronic Responders experience acute disruption to their ability to function but fail to recover even after a year. Usually about 5-15% of the population fall into this group. Recovery Responders experience significant disruption to the ability to function but over the course of a year, their functional ability recovers. 50-75% of the population fall into this category on average. The Delayed responders experience mild functional disruption but after a year or more they begin to experience significant disruption. 3-8% fall in this category. Finally there are the resilient who never experienced much disruption at all, and never do. About 15-20% of the population fall into this lucky category. There is no test that can determine beforehand how an individual will respond to trauma.
Those who are more likely to be effected by PTSD:
- Those who are exposed to a traumatic event. This can be first hand or seeing it on TV. This is why television networks need to be careful about what they show.
- Those with past trauma
- Those with prior psychological problems.
- Those who experience a severe initial reaction. The three usual responses to a traumatic event is fight, flight or freeze. It is the third group who are at risk.
- Those who use avoidance as a principal coping mechanism in life.
- Those without support such as the elderly.
Apparently just before being run down by a Cheetah, the Gazelle will faint. It is an instinctive defense mechanism. Cheetah’s will not attack corpses, they will only attack moving animals. Furthermore, if the Gazelle is unconscious then it will not feel the pain of death. If the Cheetah leaves the Gazelle alone, the Gazelle will regain consciousness but it will shake uncontrollably for several minutes. Human beings will also experience this too but because of cultural mores we try to prevent ourselves from experiencing this natural recovery process from trauma. As a result of these studies, Dr Berger uses body motion exercises as part of trauma recovery treatment.
If suffering from trauma, Dr Berger advised members
- Not to stay at home and watch TV
- Go out and do something
- Be active and exercise regularly
- Deep, slow breathing will activate the part of the nervous system that stops the body’s survival response from continuing.
- Guided imagery such as imagining a safe place can help to persuade the body to stop activating a survival response.
He also went through some of his work on treating the citizens of Sderot in the face of ongoing rocket attacks from Gaza. Dr Berger explained that many of the inhabitants are of lower socioeconomic strata and cannot afford to move away. Here is a fascinating video of Sderot’s plight.
Dr Berger also discussed some of the psychological factors which contribute to ongoing cycles of violence in the Middle East. Following the Stanford Prison Experiment in the 70s and other research which has built on Zimbado’s work, and without absolving individuals from personal responsibility, a lot more scrutiny is being placed on what environmental factors might lead to crimes against humanity, such as those perpetrated at Abu Grahib Prison.
Other research showed that those suffering from trauma tended to stereotype others and justify violent acts in order protect their societies or kindred groups. No matter what one thinks about the justification for the cycle of attacks and reprisals, there is no doubt that young people on both sides of the Middle Eastern conflict are traumatized by each other’s actions.
His desire to break the cycle has led him to develop courses for youth on diversity and tolerance.
ABOUT THE SPEAKER
Dr. Rony Berger is a senior clinical psychologist and a family and child therapist who is an internationally recognized expert in dealing with the psychological preparation for and aftermath of terrorism and other major disasters. Dr. Berger is on the faculty of Emergency Medicine at Ben Gurion University as well as on the faculty of the Stress, Crisis and Trauma program at Tel Aviv University. He is the Director of Disaster Relief and Rehabilitation Unit at Brit Olam, an International Relief organization, and also a Fellow in Psychology Beyond Borders, a humanitarian organization which aims at alleviating the psychological suffering in the aftermath of traumatic events.
Dr. Berger has been on the advisory board of the Center for Compassion and Altruism Research and Education at Stanford University where he helped design compassion cultivation programs as well collaborate with Prof. Philip Zimbardo (The Stanford Jail Experiment) on developing manuals to enhance community resiliency, promote pro-social behavior and tolerance toward the other.
From 1999-2010 he was the director of the community services at Natal Trauma Center where he designed community programs to deal with the impact of war and terrorism and trained thousands of professionals in treating trauma survivors.
During the period of 1997-2000, Dr. Berger was a Visiting Professor of Psychology and Behavioral Medicine at Al Quds University where he taught medical and graduate students and co-directed the Palestinian Center for Traumatic Stress Studies. Additionally, he served as a senior researcher at the Harry Truman Center for the Advancement of Peace at the Hebrew University of Jerusalem.
In training professionals and in leading emergency relief and medical teams, Dr. Berger has been involved in many major disasters including the Oklahoma City, 9/11, Katrina, the Tsunami in Asia, the terror attacks in Sri Lanka and Thailand, and the earthquakes in Turkey, Indonesia, China, Samoa, Haiti, and most recently in Japan.
