Lecture
In the dynamics of the development of an extreme situation, three periods are observed, which are closely connected with the organization of rescue operations and the provision of material, medical, and psychological assistance to those affected. The periods in the development of an extreme situation and the psychosomatic consequences of exposure to an extreme situation are presented in Tables 7 and 8, based on an analysis of materials by R. I. Mokshantsev . Let us consider each period, highlighting the main traumatic factors and typical mental reactions of the participants (Table 7).
Table 7. Periods in the development of an extreme situation.
|
Period |
Traumatic factors |
Mental reactions of participants |
|
First period — acute. Lasts from the onset of the situation's impact until the organization of rescue operations |
A suddenly arising threat to one's own life. Physical injuries to the victim. Physical injuries to or death of relatives. Severe damage to property, loss of material assets |
Non-pathological neurotic reaction (the person experiences fear, mental tension, a feeling of anxiety, while adequate behavior is retained). Acute reactive psychoses in the form of affective-shock states with motor excitation or inhibition. Loss of control over one's actions among those affected. A change of state from "numbness" to aimless movements, screaming, flight, and a state of panic |
|
Second period — organization of rescue operations. From the beginning to the end of rescue operations |
Expectation of repeated physical and mental impacts in connection with the loss of relatives and loved ones. Separation of the family, loss of property. The need to identify the bodies of deceased relatives. A discrepancy between expectations and the results of rescue operations |
Non-pathological neurotic reactions with a predominance of emotional tension. Preservation of adequate self-esteem and the capacity for purposeful activity. Gradual weakening of affective-shock states, a decrease in the depth of their manifestations. Inadequate character of the behavior of those affected. Poorly purposeful motor actions. A state of numbness. Manifestations of phobic neuroses, for example a fear of enclosed spaces (those affected refuse to enter a car or a tent) |
|
Third period — evacuation of those affected to safe areas |
A change in the customary way of life. Fear for the state of one's own health and the health of loved ones. The experience of the loss of loved ones, the separation of families, and material losses |
Psycho-emotional tension, giving way to an asthenodepressive state. Sharpening of characterological traits. Phobic neuroses. Neurotic development of the personality. "Somatization" of neurotic states. |
End of Table 7
|
Period |
Traumatic factors |
Mental reactions of participants |
|
Psychopathization of the personality. The appearance of somatogenic mental disorders. Protracted reactive psychoses with a depressive or paranoid syndrome |
Table 8. Psychosomatic consequences of exposure to an extreme situation
|
Name of the stage |
Duration of the course |
Psychological level |
Social level |
|
Non-pathological psychophysiological reaction |
Several days |
Characterized by emotional tension, sharpening of personality accentuations, and sleep disturbance |
The person retains a critical assessment of what is happening and purposeful activity |
|
Psychogenic adaptive reaction |
Up to six months |
A neurotic level of disorders appears, along with asthenic, depressive, and hysterical syndromes |
A decline in the critical assessment of what is happening and in the capacity for purposeful activity, and the emergence of interpersonal conflicts |
|
Neurotic state |
Three to five years |
Characterized by neuroses of exhaustion, obsessive states, and hysteria. The neurotic state is transformed into a neurotic development of the personality. Psychopathy is formed |
Loss of critical understanding and of the capacity for purposeful activity, a high degree of inconsistency and disorganization of the values in the structure of the personality, interpersonal conflicts |
|
Pathological development of the personality |
Manifests after three to five years of stable neurotic disorders |
Characterized by acute affective-shock reactions, motor excitation or, conversely, inhibition, and mental disorders |
Leads to a general disintegration of the structure of the personality, a personal catastrophe |
As behavioral reactions in the case of fixation on experiences connected with loss, those affected may show changes in behavior: increased use of alcohol, tobacco, medication, and drugs; heightened interpersonal contacts; and increased conflict situations. In the case of a favorable outcome, a normalization of emotional coloring in speech and a restoration of dreams are observed. The psychosomatic consequences of exposure to an extreme situation on a person can be examined from the standpoint of the main dynamic stages (Table 8).
People who have survived an extreme situation experience various pathological changes in the mental sphere for a long time afterward (post-traumatic syndrome). Among the psychopathological changes after trauma, the most common in people are disturbances of memory and concentration, intrusive memories, nightmares, hallucinations, insomnia, and "survivor's guilt." In such cases, qualified psychological and psychotherapeutic assistance is necessary.
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