CHAPITRE 2: LITERATURE REVIEW
2. 1 Introduction
The implementation of psychological services in Rwanda have
focused on the most urgent and pressing requirements; the great need to from
trauma. Since the mid 1990s, counseling services in Rwanda have almost
exclusively focused on trauma counseling. Significant efforts and resources
have been directed towards enhancing awareness and sensitivity to trauma
related issues. Inputs have focused on helping key adults in the child's life
recognize the symptoms of trauma and then facilitate recovery and
adjustment.
Reviews of the methods used in trauma counseling indicate
that techniques used have been largely external oriented requiring the client
to express internal emotional states verbally or non-verbally. This is the
classical approach to help a person process grief and come to terms with the
loss. The objective is to move the client through the stage of shock and
denial, with the ultimate therapeutic goal of finally reaching the stage of
acceptance. These interventions are essential. However, it is vital to remember
that therefore important that the impact of the trauma counseling provided be
accessed through carefully structured outcome studies. Furthermore, the use of
the self-mediated psychological techniques has been minimal. Interventions that
address trauma would do well to adapt and incorporate these techniques into
counseling framework.
It is important that the passage of time since traumatic
events of 1994 is taken into consideration. It is well known that the highest
frequency of trauma counseling is achieved when inputs are provided as close to
the traumatic events as possible. It is certainly true that some children and
young people could continue to be met. The majority however are likely to have
moved on. Continued focus on the past could undermine psychological
development.
The time is well nigh for counseling in Rwanda to take a
boarder perspective and begin to address the many other psychological needs
that children and adolescents present as a part of their normal development.
(UNESCO: 2003)
2. 2 Trauma
Trauma is the result of extraordinarily stressful events that
shatter your sense of security, making you feel helpless and vulnerable in a
dangerous world. Traumatic experiences often involve a threat to life or
safety, but any situation that leaves you feeling frightened and alone can be
traumatic, even if it doesn't involve physical harm. Experiences involving
betrayal, verbal abuse, or any major loss can be just as traumatizing as a
life-threatening catastrophe, especially when they happen during childhood.
Whether the threat is physical or psychological, trauma
results when an experience is so overwhelming that you freeze, go numb, or
disconnect from what's happening. While this automatic response protects you
from the terror you feel, it also prevents you from moving on. Despite being
cut off from your trauma-related feelings, you can't escape them completely.
They remain outside of conscious awareness in all their original intensity,
influencing the way you see the world, react to everyday situations, and relate
to others. (
http://www.helpguide.org/mental/emotional
psychological trauma.htm)
2. 2. 1 Post-traumatic stress disorder (PTSD)
Post Traumatic Stress Disorder (PTSD) is defined as the
development of characteristic symptoms following exposure to an extreme
traumatic stressor involving direct personal experience of an event that
involves actual or threatened death or serious injury, or other threat to one's
physical integrity of another person; or learning about unexpected or violent
death, serious harm, or threat of death or injury experienced by a family
member or other close associate (APA: 1996 cited by Eric 2001)
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