While a physical attack can amount to fleeting moments of physical pain, the psychological scars can linger forever.

Untreated people suffering from post traumatic stress disorder can lose jobs and relationships.

The symptoms are legion said Dr. Philip Brownell, a registered clinical psychologist, who counsels violence victims referred to him by doctors and Police. It can manifest itself in insomnia or nightmares every night, eating disorders or avoiding contact with the place it happened or people it happened with.

Panic attacks or a tendency to become a recluse are also signs while concentration and effectiveness on the job can suffer. He said some expatriates had lost their jobs and have had to leave the Island because of lingering problems from attacks.

Dr. Brownell said: “A person’s life gets changed and disrupted because they cannot fully process it or ground themselves coming out of this experience. “It’s like they are continually stuck back in it. They can’t say ‘that was then and this is now and I can take care of myself like this’.

“They lose the self support and periodically get re-traumatised — they relieve the experience. Something triggers it and they recycle through the experience.”

In extreme cases people can have a ‘body memory’ where they re-feel the physical pain of the attack. “Something in the environment can re-trigger that — maybe the person who attacked them had a plaid shirt and the person who attacked them had a plaid shirt.

“Before they realise what’s on they are back in that.”

The early days of post traumatic debriefing would see debriefers try to get people to talk about their experience.

“But what they found was these people were not actually being helped. It was all making things worse — talking about it — because they were re-traumatising themselves and magnifying the trauma.”

Now the therapy has been refined for people to focus on the difference between “then” and “now”.

Getting people to move on usually involves psychotherapy and enforcing the message it’s in the past. Sometimes it involves revisiting the circumstances. “If a person was stabbed at a gas station, go to the gas station and be there to calm yourself down and relax.

“The person has a corrective experience — ‘I didn’t get hurt again.’”

Another radical, albeit weird-sounding technique, involves the violence victim thinking about the painful memory and blinking their eyes really fast — known as Eye Movement Desensitisation and Reprocessing technique.

“They have done studies on it because it sounds so weird they have to prove themselves as people who practice this technique.

“It’s been effective. It clears away the anxiety in many cases person move on.”

But the technique also involves a lot of counselling.

Sometimes agonising over what lead to the violent situation can lead to people blaming themselves for being in circumstances where they were attacked.

People say if ‘I hadn’t been gone to the party I wouldn’t have been attacked’.

In response patients are told to look for the positives of what they did in the situation such as ‘If I hadn’t have put my hands over my head, I could have been really hurt’.

Generally people’s responses to being attacked vary between fight, flight or freeze.

“The fight or flight are the more healthy responses. The freeze response is not good — it’s the ‘deer in the headlights’ kind of thing.

“A lot of people do that when being attacked — they just stop and go through with it. The people who freeze will often experience the ‘stuckness’ later on.”

He said children who were bullied but fought back were the more psychologically healthy ones who wouldn’t experience as much damage — but their response might give them more immediate problems. “It’s ironic the most healthy thing for the bullied child is the thing that gets him into trouble and they are often called into counselling, the parents are called in.

“It’s ‘Johnny’s got a problem with fighting’. What you find out is Johnny is being picked on and he’s fighting back.

“If he keeps fighting back he will come out ahead emotionally — he might have a few teachers have a bad opinion of him but with regard to the violence he will be better off. “There are children who do not fight back who develop serious emotional problems — depression being one big one.”

Dr. Brownell, who has been practising here for more than two years, said it was sometimes possible to de-escalate potentially violent situations by not coming across as a threat.

“But sometimes there is nothing you can do — because the person won’t be reassured or appeased. At that point its useful to know how to defend yourself.”

Asked what led to random attacks he said: “I don’t know exactly — it relates to the social and cultural conditions of any particular place. Here we are talking about race.”

Gangs were also a factor and Dr. Brownell urged people to be aware of their situations.

“People in groups do things that people outside of groups don’t do. People in groups are more dangerous. Individuals can lose themselves in a group and think things they wouldn’t do if they were on their own and thinking independently and critically.

“They feed off of each other, encourage each other and fan each other’s flames. They squelch dissent.”

Asked if it was possible to feel the same again after a particularly violent attack, he said: “No, you can’t go back in time and eradicate an experience.

“You can’t go back as if it never happened but you can go on to thrive in spite of it happening.

“In fact a lot of people might say you become a stronger person, a more sensitive person because it happened and because of the way you dealt with it.”