The influence of the African worldview on matters of illness and trauma

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Cognitive effects of trauma

Trauma creates difficulties with focus. People who have been through trauma may be distracted by their efforts to avoid reminders of the trauma. There is a sense of being “scattered”. It may be difficult to sort out relevant and irrelevant information. The ability to distinguish between stimuli may be impaired and over time the person may react to a variety of cues with equal emphasis. Perceptions become more biased towards noticing what is anxiety provoking or alarming at the expense of noticing what is nurturing and pleasant (Naparstek 2006:81). Survivors of trauma may be distracted by these concerns and have difficulties with short term memory (Naparstek 2006:84).

Flashbacks, amnesia and nightmares

Memories for the trauma remain fixed and intense. They resist the integration and distortion that characterises every day memories. Fluctuations in the level of detachment during trauma may explain the fragmentary quality of traumatic memories (Panzer & Viljoen 2004:14). Traumatic nightmares have been known to remain fixed for a period of fifteen years. Although traumatic memories may present themselves as vivid flashbacks, amnesia for the event is also common. In the case of childhood abuse, the entire childhood may be unavailable to conscious recall (Naparstek 2006:82-83).

Unexpected gains

The changes in information processing and loss of focus seem to be linked with dissociation. When people dissociate, their ability to think clearly, see escape routes, solve problems or stay grounded is lost. Constriction of attention, withdrawal and detachment are the essence of dissociation, which enables one to cope with the fear and pain associated with the trauma. One of the benefits of this manner of coping may be the emergence of heightened intuition. Some survivors develop their intuitive abilities to help others. Some seem exquisitely sensitive to what other people are feeling or experiencing. Some express themselves in a variety of creative ways such as art, music drama or psychic phenomena (Naparstek 2006:90-94).

Emotional numbing

Dissociated experience tends to remain unnamed by thoughts and language. This results in alexithymia, meaning “having no words for feelings.” Such dream-like experiences are numbed and are not fully integrated into the life of 167 the person. These experiences are frequently accessed during stress, particularly in attachment-related contexts (Panzer & Viljoen 2004:14). Dissociation can help one cope with overwhelming threat, but, when employed as a routine strategy, a pattern evolves in which neural networks become sensitised so that less and less stress is necessary to evoke subsequent dissociative states. Once dissociated, a person is inaccessible to the external environment and resistant to bonding with others. As a result of the disturbance in a traumatised person’s ability to regulate autonomic reactions to both internal and external stimuli, the person is unable to use emotions as signals to take adaptive action.

Avoidance and isolation

Survivors of trauma may go to great lengths to avoid reminders of trauma. However, they may become sensitive to neutral stimuli that are in some way linked to the trauma (e.g. time of day, weather patterns, etc.). They may go to great lengths to avoid apparently normal activities. Survivors may feel embarrassed about their anxiety. This may make them careful to conceal their avoidant behaviour from others (Naparstek 2006:125). Survivors may become reluctant to leave the perceived safety of their own home, a condition known as agoraphobia. Some survivors who were victimised by authority figures may avoid dealing with superiors whenever possible (Naparstek 200:125-128).

Stress induced analgesia and self-mutilation

Lowered sensitivity to pain can be induced in animals by exposing them to inescapable stress such as electric shock, fighting, starvation or a cold-water swim. This is known as stress-induced analgesia (Van der Kolk 1994). The secretion of natural morphine-like substances, known as endogenous opiods reduces the body’s sensitivity to pain. These chemicals are produced by the human body as well as in animals when threatening situations are encountered. This process protects an organism against feeling pain whilst taking defensive action. It reduces panic. It also inhibits memory. This enables the organism to avoid consciously experiencing or remembering extreme stress. Impaired memory also therefore keeps them from learning from experience (Van der Kolk 1994).

TABLE OF CONTENTS :

• CHAPTER 1: BACKGROUND TO THE STUDY
  • 1 Introduction
  • 2 Motivation for the study
  • 3 Rationale for the study
  • 4 The aims of the research
  • 5 The theory
  • 6 Design
  • 7 Time frame of the research
  • 8 Sampling and selection
  • 9 Data collection
  • 10 Data analysis
  • 11 Meaning of terms
  • 12 Format of thesis
  • 13 Summary
• CHAPTER 2: THE PERSON-CENTRED APPROACH
  • 1 Introduction
  • 2 Basic principles of the person-centred approach
  • 3 Propositions relating to experiences
    • 3.1 Proposition
    • 3.2 Proposition
    • 3.3 Proposition
  • 4 Propositions relating to the self
    • 4.1 Proposition
    • 4.2 Proposition
    • 4.3 Proposition
    • 4.4 Proposition
    • 4.5 Proposition
    • 4.6 Proposition
    • 4.7 Proposition
    • 4.8 Proposition
    • 4.9 Proposition
    • 4.10 Proposition
    • 4.11 Proposition
  • 5 Propositions relating to change
    • 5.1 Proposition
    • 2 Proposition
  • 6 How change manifests according to the PCA
    • 6.1 Proposition
    • 6.2 Proposition
    • 6.3 Proposition
• 7 Chapter summary
• CHAPTER 3 RESEARCH PARADIGMS
  • 1 Introduction
  • 2 Quantitative research
  • 2 Qualitative paradigms
  • 4 Coherence between an interpretive paradigm and the PCA
  • 5 Hermeneutics
    • 5.1 Steps in a hermeneutic analysis
      • 5.1.1 Reflexivity
    • 5.2 The meaning of interpretation
    • 5.3 Steps in writing an interpretation
  • 6 Coherence between hermeneutics and PCA
  • 7 The use of quantitative and qualitative data in a single study
  • 8 Reliability and validity
• 9 Chapter summary
• CHAPTER 4 ETHNO CULTURAL CONSIDERATIONS IN THE STUDY OF TRAUMA
  • 1 Introduction
  • 2 Cultural meaning systems
    • 2.1 Culture and the meaning of trauma
      • 2.1.1 The distinction between illness and disease
    • 2.2 Culture and the self
    • 2.3 Culture and emotions
    • 2.4 Culture, illness and behaviour
      • 2.4.1 Ways in which symptoms have meaning
      • 2.4.2 Healing
      • 2.4.3 Healing that is coherent with culture
      • 2.4.4 Healing and change
      • 2.4.5 Culture specific syndromes
    • 2.5 Culture, healing and the body
    • 2.6 Paradigms
  • 3 Ethnic and emic approaches to research
  • 4 The Western world
    • 4.1 The Western worldview in individualistic
    • 4.2 The Western worldview values material possessions
    • 4.3 The Western worldview is dualistic
    • 4.4 The Western worldview is competitive
    • 4.5 The Western worldview emphasises the nuclear family
    • 4.6 The Western worldview’s concept of time
    • 4.7 The Western worldview values objectivity
  • 5 The African worldview
    • 5.1 The African worldview is holistic
    • 5.2 The African worldview is collectivistic
    • 5.3 The African worldview values the extended family
    • 5.4 The African worldview holds values of ubuntu
    • 5.5 The African worldview and sense of time
    • 5.6 The African worldview incorporates spirituality
  • 6 The influence of the African worldview on matters of illness and trauma
• CHAPTER 5 A WESTERN WORLDVIEW OF TRAUMA
• CHAPTER 6 TRAUMA IN SOCIETY
• CHAPTER 7 THE CONTEXT OF THE RESEARCH
• CHAPTER 8 THE RESEARCH PROCESS
• CHAPTER 9 RESULTS-PART
• CHAPTER 10 RESULTS PART 2 THE EFFECT OF TRAUMA
• CHAPTER 11 CONCLUSION AND RECOMMENDATIONS

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UNISA SOCIAL WORK STUDENTS’ EXPERIENCES OF TRAUMA: AN EXPLORATORY STUDY FROM A PERSON-CENTRED PERSPECTIVE