Olga’s trauma has deepened (INTEGRA-03-EN)

Olga is a 65-year-old lady, a three-year resident of a home for the elderly, where she came after the death of her husband, with whom she had no children. For a number of years, she has been treated for depression (in the early 50s she was retired on disability because of this), and in her home placement she often refuses most group activities. Since she is financially well provided for, she has her own room in this institution, from which she rarely comes out. He also often refuses food, especially being in the dining room at meals. In addition to the doctor's home treatment and therapy, she is also often visited by a social worker, who is actually the only one with whom Mrs. Olga has established a slightly closer verbal contact. The conversation is almost always based on past work career and successes in it. Sometimes also about the time when she was still married.

Like other older people, Ms. Olga never talks about her youth and turns any possible communication around, or overhears it, and most often shows sudden severe fatigue. The social worker has noticed this pattern many times, and she also saw that after each conversation in this direction, the resident's depression deepened, she refused food for several days, during this time she did not even visit the home library, even though, as a librarian, she loved to read, she rejected any form of socializing in general. She also did not want to accept the social worker during this time, which usually lasted two weeks or more. Just a few days ago, the same sequence of events happened again when, in conversation, the mention of personal youth injected an immediate emotional distance and detachment.

At the regular weekly meeting of the multidisciplinary team, the social worker again highlighted the case of Mrs. Olga.

Based on the above, the Residential Home medical doctor concluded that there is a very possible presence of unresolved trauma in the resident, which only deepens over the years.

In doing so, she pointed out quite a few symptoms, on the basis of which we could conclude on emotional numbness, such as loss of interest, avoidance, unhealthy coping behaviours:

• Avoiding access to own feelings;
• Preferring isolation rather than being with others;
• Having difficulties with experiencing positive thoughts;
• Experiencing an inability to fully participate in life.

As possible support, the team suggests connecting a social worker (who is the only one who has closer contact with Mrs. Olga) with a community trauma-informed practice, which has been working in the community for some time, and community psychiatric help with the aim of being able to approach the Ms. Olga's recovery.

In an empathic interview with Mrs. Olga, the social worker will try to establish a basis for the cooperation and connection of qualified therapists (initial phase) and psychologist (continuation phase) while ensuring her presence in the initial stages of the process (establishing and strengthe-ning trust). individual combined treatment that could best contribute to strengthening her strength (art therapy, occupational therapy, psychological treatment).

Until she recovers from the trauma, it would be recommended for Ms. Olga to undergo Cognitive Behavioural Therapy with a licensed psychotherapist. The primary goal of psychotherapy is to stimulate an understanding of the problem and expose viable and effective problem-solving alternatives. Psychotherapy supports learning and the use of productive coping tools. Mrs. Olga may learn to allow feelings to emerge and to process them in the safe environment of therapy, which could alleviate her long-standing depression.

There are a variety of treatment options available that can help to reduce the extent to which person with PTSS try to escape, disengage from, or avoid own emotions.

From now on, a multidisciplinary team will regularly update and monitor the process. 

Integra Institute, Sonja B. Eisenreich