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Violent crime: learning to recover
3. The withdrawal phase
Then there is the withdrawal phase. Hossack explains: 'People remove themselves from places, people and environments associated with the event. If the crime involved a car, they might refuse to drive. Or they might refuse to be a passenger. If it was a man who hurt them, they avoid men. If it was youngsters, they cross the road when they see a group of kids. They stay away from social events because in social events, they can't predict what will happen. It's a way of dealing with their loss of control.
'They swing like a pendulum between the intrusive and withdrawal phase. Either state is dysfunctional. The idea of therapy is to get them to a mid-point where they can cope.'
Hossack is keen to stress that the size of the trauma is not significant; it's the individual's response that matters. 'I had a case of a 75-year-old who fell down a pothole in the road. She wasn't physically hurt but she went on to develop post-traumatic stress disorder. The key here is that as she fell, she truly believed she was going to die.
'If someone has their handbag snatched and develops anxiety about going outside the house, friends might not understand that it was a serious event for them. Most people feel bad that they can't get over something that they think is minor. And yet their feelings are entirely normal.'
The role of therapy
The good news is that about half of all victims of crime repair themselves, says Hossack. For the others who may go on to develop an anxiety disorder, it's important to remember that this is a very treatable condition and it doesn't necessarily mean a long time in therapy. The average number of sessions is between six and ten.
However, he advises that after a traumatic event, you can't do any formal therapy until a month has passed. 'You can't make a diagnosis until then,' he says. 'In the meantime, people need a listening ear and a helping hand. The sort of thing you get from a good friend.'
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