An understanding of trauma and its effects is highly relevant for counselling practitioners working with people with intellectual disability (Newman, Christopher & Berry, 2000). People with intellectual disability often develop emotional problems as a result of psychological and emotional abuse, or develop a secondary mobility disability as a result of physical abuse (Horner-Johnson & Drum, 2006).
These indicators may be helpful in identifying whether a person is experiencing depression or other mental health issues (Hollins, 2006):
- Showing less interest in activities that are usually enjoyed
- Losing or gaining weight
- Difficulty getting to sleep or waking early
- Lethargy and increased time sleeping
- Avoiding other people
- Restlessness and irritability
- Feeling bad, guilty or worthless
- Loss of confidence.
While trauma can trigger depression and anxiety, other signs and symptoms are also recognised as particular responses to traumatic events. Many of the physical and cognitive responses to trauma listed below are also common experiences for people living with intellectual disability. Additional trauma may compound these beliefs and behaviours (J. Olver, personal communication, 29 August, 2011).
Signs that a person has experienced recent or historic trauma include:
- Re-living the experience (that is, being held in the past)
- Blaming someone (showing lack of control)
- Poor problem-solving ability
- Loss of orientation
- Problems with memory, concentration and attention
- Intrusive thoughts or images
- Poor decision making
- Blaming themselves
- Sudden or gradual changes in usual behaviour
- Seeking reassurance
- Loss of skills
- Loss of bowel or bladder control
- Loss of ability to communicate
- Outbursts of anger, destructiveness or self harm
- Physical illness _ Complaining about aches and pains
- Wandering or searching.
Normalising these responses is a crucial step in supporting any person who has experienced trauma in their life. The key message is that the person is not coping because they have experienced a traumatic event, not because they cannot cope. People need reassurance that it is normal to experience these kinds of responses to trauma.