TRAUMATIC
STRESS
IN
SOUTH
AFRICA


LAUNCH
ADRESS
BY
DEBRA
KAMINER


As
both
clinicians
and
academics
or
researchers,
Gill
and
I
have
to
wear
two
hats
at
the
same
time,

and
I
can’t
speak
for
Gill
but,
during
the
process
of
writing
this
book,
these
dual
roles
led
me
to

experience
many
feelings
of
ambivalence
and
conflict
in
myself.
The
academic

in
me
really
wanted

to
carefully
unpack
and
think
about
what
we
know
about
trauma
in
South
Africa,
while
the
clinician

in
me
wondered
if
this
wasn’t
a
really
indulgent,
pointless
exercise
–
shouldn’t
we
just
be
DOING

something
about
trauma
and
violence,
not
just
sit
around
thinking
and
writing
about
it?
How
is
that

helping
anyone?
I
think
that
trauma
in
particular
tends
to
evoke
a
sense
of
urgency,
a
need
to
ACT,

or
REACT,
quickly
to
make
things
better,
to
feel
that
one
is
being
helpful
to
people
in
distress.

Sometimes
it
can
be
hard
to
just
hold
that
impulse,
take
a
step
back,
and
think
carefully
about
what

one
is
doing,
and
why.



Recently
I
was
reading
an
interview
with
the
author
Jonathan
Franzen,
who
has
just
spent
no
less

than
nine
years
working
on
his
new
novel,
Freedom.
He
said
that
in
a
very
technological
age,
where

we
are
engulfed
by
a
constant
barrage
of
information,
such
as
daily
media
reports
of
trauma
and

violence
happening
both
very
close
to
home
and
very
far
away,
the
place
of
stillness
that
you
have

to
go
to
to
either
write
a
book
or
read
a
book
creates
quite
a
rare
opportunity
for
mindfulness
and

reflectiveness.
And
mindfulness
and
reflectiveness
allow
us
to
reach
a
space
where,
instead
of
just

acting
or
reacting
from
a
sense
of
urgency,
we
can
actually
make
responsible
decisions,
and
engage

productively
with
an
otherwise
scary
and
unmanageable
world.





One
of
the
examples
we
talk
about
in
the
book
is
a
finding
from
an
investigation
by
the
Human

Rights
Commission
into
school
violence
in
the
Western
Cape,
which
reported
that
young
children
in

the
school
playground
commonly
play
games
called
“hit
me
hit
me”
or
“rape
me
rape
me”.

And

naturally
an
understandably
there
was
a
huge
public
outcry
about
this,
a
lot
of
concern
about
how

our
children
are
being
brutalised
and
traumatised
by
the
violence
they
see
around
them,
and
an

urgent
sense
that
something
must
be
done
to
stop
this.
But
in
this
emotive
response
it
can
be
hard

to
just
step
back
and
perhaps
think
more
carefully
about
all
the
possible
meanings
and
functions
of

this
kind
of
play
for
children
–
before
we
rush
in
to
delivering
interventions
for
these
children,
how

can
we
find
out
more
about
what
these
games
mean
to
them,
and
whether
they
might
be
more
than

just
a
symptom
of
trauma.
If
we
had
to
take
the
time
to
ask
these
children
how
and
why
they
play

these
games,
might
we
learn
something
we
didn’t
expect,
something
that
might
help
us
to
formulate

a
more
meaningful
way
of
supporting
these
children
and
their
families?




So
I
guess
that’s
what
Gill
and
I
have
hoped
to
provide
with
our
book.
A
space
to
carefully
unpack

and
reflect
on
what
we
know
about
traumatic
stress
in
SA
and
where
these
knowledges
and

understandings
have
come
from,
and
perhaps
just
as
importantly,
to
reflect
on
what
we
don’t
yet

know
or
understand
very
well,
what
the
gaps
and
silences
are.
In
this
book
we
have
tried
to

synthesise
all
the
clinical
and
research
knowledge
that
has
been
generated
over
the
past
three

decades
of
trauma
work
in
South
Africa,
including
those
local
knowledges
that
have
not
always
been

published
–
because
many
trauma
service
providers
in
this
country
do
not
have
the
time,
space
or

resources
to
write
up
and
distribute
their
work.


I
wanted
to
give
you
a
brief
idea
of
the
kind
of
content
that
is
covered
in
the
book,
before
Gill
goes

on
to
say
something
about
what
we
learned
or
discovered
through
the
process
of
writing
the
book.

The
book
starts
with
some
reflections
on
the
history
of
trauma
research
and
practice
in
this
country,

locating
it
in
the
broader
context
of
our
political
history
and
political
transformations.
It
then
goes

on
to
try
and
systematically
explore
the
popular
notion
that
SA
is
one
of
the
most
violence
or

traumatised
countries
in
the
world
–
does
all
the
research
consistently
support
this
idea?
And
you’ll

have
to
read
the
book
to
find
out
what
our
conclusion
was!


The
next
part
of
the
book
looks
at
the
more
psychiatric
consequences
of
trauma,
in
particular
the

well
known
diagnosis
of
PTSD.
We
look
at
both
the
international
and
local
literature
to
evaluate
the

usefulness
of
this
diagnosis,
and
some
of
its
limitations,
and
we
explore
some
other
common

responses
to
trauma
that
don’t
really
fit
with
PTSD
–
in
particular,
the
effects
of
prolonged,
chronic

conditions
of
trauma
and
violence,
which
characterise
many
communities
in
SA
today.

We
also
tried

to
go
beyond
the
more
obvious
psychiatric
impact
of
trauma
to
explore
the
ways
in
which
trauma

affects
our
meaning
and
belief
systems,
the
more
profoundly
personal
impact
of
trauma,
and
again

we
tried
to
bring
together
both
local
and
international
research
about
this.


We
then
go
on
to
review
the
literature
on
trauma
interventions,
including
what
the
standard
of

practice
is
internationally
and
the
ways
in
which
SA
trauma
practitioners
have
adapted
these
ways
of

working
to
suit
our
particular
context.

We
also
tried
to
move
beyond
a
focus
on
just
working
with

individuals
to
look
at
ways
of
working
with
groups,
and
also
community
level
interventions
in

response
to
mass
trauma.
And
then
we
also
wanted
to
devote
a
chapter
to
thinking
about
the

impact
of
trauma
on
children,
at
different
stages
of
their
development,
and
how
best
to
offer

support
to
children
who
have
experienced
trauma
or
abuse.









































And
lastly
we
have
also
tried
to
indicate
some
fruitful
directions
for
the
future,
ways
in
which
we
can

try
to
enhance
our
understanding
about
the
impact
and
meaning
of
trauma
and
violence,
ways
in

which
we
can
work
towards
ever‐increasing
improvements
in
the
work
that
we
do
with
individuals

and
communities
that
have
experienced
extremely
stressful
events.

So
we
hope
that
this
book
will

offer
a
mindful
and
reflective
space
for
people
who
have
an
interest
in
this
area,
whether

professionally
or
perhaps
more
personally.


Lastly,
I
just
want
to
say
something
about
my
co‐author.
When
I
was
doing
my
training
in
the
mid‐
1990s
and
then
in
my
first
few
years
in
practice,
I
had
a
particular
interest
in
the
area
of
trauma,
and

there
were
two
South
Africans
whose
work
really
stood
out,
really
led
the
way
in
thinking
about

trauma
work
within
the
very
specific
context
of
SA
–
that
was
Gill
Straker
and
Gill
Eagle.
So
having
an

opportunity
to
collaborate
with
this
Gill
on
a
book
about
trauma
in
SA
is
something
I
feel
very

honoured
to
have
had,
and
it’s
been
an
immensely
rewarding
and
satisfying
experience.
Gill
and
I
co‐
authored
this
book
largely
through
email
and
phone
correspondence
between
CT
and
JHB,
and
we

only
met
for
the
first
time
once
the
first
draft
of
the
manuscript
had
been
completed
and
then
got
to

know
each
other
in
person
–
given
the
long‐distance
nature
of
our
relationship,
it
was
surprisingly

easy
to
work
together,
and
I
thank
Gill
for
that.