Psychological First Aid (PFA) pada Korban Kekerasan Seksual

Saat jari terluka, ada kotak P3K yang menyediakan berbagai kebutuhan sebagai pertolongan pertama. Namun, bagaimana jika yang terluka adalah mental atau psikologis  yang diakibatkan peristiwa traumatis? Adakah pertolongan pertama untuk menangani luka yang tidak kasatmata? 

Untuk menjawab pertanyaan tersebut, Komunitas Perempuan Berkisah (PB) menyelenggarakan diskusi publik berseri yang mengangkat tema besar “Keberpihakan Ruang Aman Berbasis Komunitas dan Upaya Pemulihan Korban Kekerasan Seksual dalam Pendampingan Berbasis Etika Feminisme.” Diskusi ini terselenggara atas dukungan Yayasan Humanis dan Inovasi Sosial (Hivos) serta Yayasan Perempuan Indonesia Tumbuh dan Berdaya (Pribudaya) yang sama-sama memberi perhatian pada isu pencegahan penanganan kekerasan seksual serta penerapan UU Tindak Pidana Kekerasan Seksual.

Para calon anggota Komunitas Perempuan Berkisah (PB) kelak memang akan melakukan berbagai kegiatan yang bersinggungan dengan korban-korban Kekerasan Berbasis Gender (KBG). Niat baik mendampingi  para korban tersebut tentu tidak bisa dilakukan tanpa perbekalan. Itu sebabnya, PB mengagendakan kegiatan untuk meningkatkan kapasitas para calon anggota PB lewat kegiatan diskusi publik berseri.

Seri kedua diskusi publik ini bertajuk Psychological First Aid (PFA) pada Korban Kekerasan Seksual.” PFA sendiri merupakan pertolongan pertama yang dapat dilakukan pada korban yang mengalami luka dalam konteks psikologis. Materi ini melengkapi diskusi seri pertama yang berfokus pada etika dan tahapan melakukan konseling kepada korban Kekerasan Berbasis Gender (KGB). Dipandu oleh Angelino Vinanti, seri kedua diskusi ini difasilitatori oleh Psikolog dan Konselor Ruang Aman Perempuan Berkisah yakni, Naila Kamaliya, M.Psi., Psikolog; Farah Sarayusa, M.Si.; dan Fitria, S.Psi.  

Psychological First Aid (PFA), P3K untuk Trauma

Seperti telah disebutkan sebelumnya, Psychological First Aid (PFA) adalah serangkaian keterampilan yang bertujuan mengurangi dampak negatif stress dan mencegah timbulnya gangguan kesehatan mental yang lebih buruk. Sederhananya, PFA bisa disamakan dengan P3K yakni sebagai pertolongan pertama pada kecelakaan atau luka dalam konteks kesehatan mental. Namun, berbeda dengan luka yang tampak, praktik PFA tentu memiliki tantangan tersendiri. Luka tidak kasatmata bisa saja tersembunyi atau bahkan sengaja disembunyikan oleh korban. Itu sebabnya, sebelum melakukan PFA, seorang pendamping korban haruslah memahami reaksi yang umum dialami korban setelah peristiwa traumatis, terutama kekerasan seksual. 

Menurut Naila, ada empat aspek yang bisa diamati pendamping pada korban yang mengalami trauma. Dari aspek fisik, korban bisa saja menunjukkan kondisi pusing, mual, keringat dingin, gangguan makan atau tidur, maag, dan jantung berdebar. Sementara itu, dari aspek emosi, korban juga biasanya terlihat takut, cemas, sedih, marah, merasa tidak berguna, bahkan merasa hina. Pendamping korban juga seharusnya memaklumi jika korban tampak bingung dan kehilangan orientasi. Trauma yang dialami dari peristiwa kekerasan seksual memang berpotensi membuat korban tidak bisa berpikir jernih dan realistis. Terima juga tingkah laku korban yang mungkin terlihat mudah marah, menangis, dan resah akibat peristiwa traumatis tersebut.

Reaksi yang timbul pada korban memang tidak bisa disamaratakan. Korban yang minim dukungan bisa jadi menunjukkan reaksi yang lebih intens. Latar belakang korban pun berpengaruh besar pada reaksi-reaksi tersebut. Jika korban menunjukkan reaksi trauma yang intens, tentu proses konseling akan semakin menantang. Di sinilah PFA berperan sebagai pertolongan pertama kepada korban. 

“Bayangkan jika banyak orang yang paham PFA dan berpihak pada korban, berapa banyak korban yang tertolong.”

(Naila Kamaliya, M.Psi., Psikolog di Ruang Aman Perempuan Berkisah)

Pentingnya peran PFA sebagai pertolongan pertama pada korban sejalan dengan salah satu tujuan PFA, yakni mengurangi dampak negatif pengalaman traumatis. Selain mengurangi dampak negatif pengalaman traumatis, penerapan PFA juga dapat membantu korban untuk lebih adaptif dan bisa melakukan aktivitas sehari-hari. Selain itu, PFA akan mengakselerasi proses pemulihan korban hingga menjadi penyintas.

Bukan Sekadar Teori, Pahami Prinsip dan Tahapan Mempraktikkan PFA

Seperti halnya P3K, PFA memang bisa dilakukan oleh siapa saja. Meski begitu, ada tahapan dan prinsip yang mesti dipahami untuk mempraktikkan PFA dalam penanganan korban KGB. Misalnya, dalam penanganan luka, kita tidak seharusnya memberikan obat pada luka yang belum dibersihkan karena hal tersebut berpotensi menimbulkan infeksi yang justru membahayakan. Begitu pun cara melakukan PFA. Meski siapa pun bisa melakukannya, niat baik melakukan PFA mesti diiringi dengan ilmu yang tepat terkait PFA.

Pada dasarnya, ada tiga prinsip dasar dalam melakukan PFA yang mesti dipahami konselor atau siapa pun yang akan mendampingi korban. Prinsip dasar tersebut bisa disingkat menjadi 3L yakni Look (Amati), Listen (Dengarkan), dan Link (Hubungkan). 

Look atau amati bertujuan untuk memenuhi kebutuhan dasar konseli. Pastikan konseli sudah dalam kondisi aman, nyaman, dan tidak terluka secara fisik. Jika konseli adalah orang terdekat, kita bisa amati perubahan perilaku yang mungkin timbul. Namun, jika konseli berada di lokasi berbeda, kita bisa melakukan pengamatan lewat media sosial atau media komunikasi lainnya. Pekalah pada pilihan kata yang digunakan konseli untuk memahami kebutuhannya. 

Dalam praktiknya, prinsip look ini bisa dilakukan dengan menanyakan kabar konseli. Terkait hal ini, Farah memberikan beberapa rekomendasi pertanyaan yang tepat untuk dilontarkan kepada konseli, di antaranya adalah, “Bagaimana keadaanmu saat ini?; Apa ada yang bisa aku bantu?; Apakah saat ini kamu sedang dalam keadaan aman?; Apa yang kamu butuhkan saat ini?” Lewat pertanyaan sesederhana itu, konseli akan merasa kita benar-benar hadir serta perhatian kepadanya. Farah pun mengingatkan untuk berhati-hati dalam menanyakan detail kronologi kasus, bisa jadi konseli belum siap untuk menceritakannya. Hindari juga pertanyaan yang bersifat menghakimi apalagi jika penghakiman tersebut berdasarkan asumsi pribadi.

Setelah mengamati, prinsip kedua adalah listen atau dengarkan. Prinsip dengarkan dalam PFA sejatinya seiring sejalan dengan prinsip pendampingan korban beretika feminisme. Pendamping disarankan untuk menerima konseli seutuhnya, menerapkan proses mendengar aktif, serta tidak memberikan saran tanpa diminta. Naila mengatakan bahwa sebaiknya pendamping tidak menyangkal luapan emosi konseli. Terima semua emosi dan tindakan konseli selama hal tersebut tidak berbahaya. 

Farah juga menjelaskan bahwa mendengarkan dengan aktif dan empatik dapat dilakukan dengan memberikan respons yang menguatkan. Bantu konseli menyadari bahwa dirinya berharga dan layak dicintai. Konseli juga sering merasa semua kejadian ini adalah salahnya sehingga respons yang diberikan jangan sampai kembali menyalahkan korban. Yakinkan konseli bahwa ia memiliki teman untuk melewati masa-masa ini bersama. Jangan pula mengecilkan perasaan dan kerentanan konseli.

“Jika seseorang bercerita biasanya posisi korban sedang rentan. Menjadi rentan adalah hal yang menakutkan, (maka dari itu) apresiasilah keberanian korban untuk bercerita.”

(Farah Sarayusa, M.Si., Konselor di Ruang Aman Perempuan Berkisah)

Prinsip yang ketiga adalah hubungkan atau link. Perlu diingat bahwa PFA adalah pertolongan pertama dan tidak dapat menggantikan konseling dan/atau terapi. Meski begitu, dalam praktik konseling dan/atau terapi sangat mungkin mengintegrasikan PFA di dalamnya. Itu sebabnya, penting untuk memahami bahwa konseli tetap membutuhkan penanganan lebih lanjut. Di sinilah peran konselor untuk membantu menghubungkan konseli dengan berbagai penyedia layanan sesuai kebutuhan korban. PFA juga tidak dapat menangani gangguan psikologis seperti depresi, PTSD, dan lainnya. 

Naila menambahkan, jika konseli menunjukkan reaksi emosi yang intens, konselor juga dapat menerapkan prinsip hubungkan ini dengan memperkenalkan konseli pada teknik relaksasi sederhana. Hal ini bertujuan untuk membantu konseli agar bisa lebih tenang. Teknik relaksasi pertama dapat dilakukan dengan cara tarik nafas dalam-dalam sambil menghitung mundur 5-4-3-2-1. Cara lainnya adalah menginjakkan kaki di lantai sambil merasakan tekanan tubuh. Bisa juga ajak konseli melakukan peregangan otot sederhana untuk meredakan emosi negatif.

Dahulukan Menolong Diri Sebelum Menolong Orang Lain

Menjadi konselor atau pendamping korban memang memiliki banyak tantangan. Bukan hanya tantangan yang datang dari luar atau dari sisi konseli, pihak konselor pun bisa jadi menghambat proses konseling. Hal tersebut mungkin terjadi karena konselor juga manusia biasa. Konselor bisa saja memiliki trauma dan masih dalam proses untuk menyembuhkannya. Itu sebabnya, penting bagi konselor untuk melakukan mitigasi risiko sebelum melakukan pendampingan, termasuk praktik PFA, kepada konseli.

“Jangan paksakan untuk memberikan PFA hingga yang terluka jadi dua, korban dan penolong. Jagalah diri sendiri pastikan bahwa kita siap memberi bantuan secara fisik maupun mental.” (Fitria, S. Psi., Konselor di Ruang Aman Perempuan Berkisah)

Narasumber ketiga, Fitria, yang merupakan seorang penyintas KGB dan juga aktif sebagai konselor di Ruang Aman Perempuan Berkisah, berpesan agar para konselor selalu menolong dengan bertanggung jawab. Maksudnya adalah, konselor tetap harus menjaga kepentingan diri sendiri dulu sebelum menolong orang lain. Secara mendalam, menolong dengan bertanggung jawab berarti konselor telah melakukan empat hal, yakni:

1. Menghormati keselamatan, harga diri, dan hak-hak korban

2. Memahami nilai dan budaya yang dianut oleh konseli

3. Mengatakan dengan jujur jika kita tidak sanggup atau merasa belum memiliki kapasitas untuk mendampingi dan melakukan PFA

4. Menjaga diri sendiri

Sejalan dengan Fitria, Farah pun selalu mempersiapkan diri sebaik-baiknya sebelum melakukan konseling. Biasanya, ia akan melakukan hal-hal yang disukai untuk memulihkan energinya terlebih dahulu. Farah pun mengingatkan agar para konselor tetap memberikan batasan yang sehat agar tetap bisa menjaga diri dan menikmati kehidupan. 

Jika konselor belum pulih dari trauma pribadinya dan tetap memaksakan diri melakukan PFA, hal ini berisiko untuk melukai konseli dan konselor sekaligus. Konselor pun akan merasa stres karena harus membuka luka lama. Kegagalan proses konseling juga rentan membuat konselor menganggap dirinya tidak kompeten. 

Jadi, penting bagi konselor untuk jujur pada diri sendiri. Lakukan juga analisis pada situasi pribadi saat mendengar kisah dari korban. Jika konselor sudah mulai merasakan ketidaknyamanan, tidak apa untuk mengarahkan konseli kepada layanan bantuan atau tenaga profesional lainnya. 

Setelah ketiga fasilitator memaparkan materi, diskusi berlanjut dengan hangat lewat pertanyaan-pertanyaan yang diajukan para peserta. Sebagian besar peserta menunjukan antusiasmenya untuk memahami PFA hingga diskusi berlangsung lebih lama dari jadwal yang tertera. Lewat serial diskusi ini, semoga harapan Perempuan Berkisah agar semakin banyak yang menerapkan praktik baik pendampingan korban berbasis etika feminis dapat terwujud.

Simak diskusi selengkapnya hanya di Youtube “Perempuan Berkisah”

Media Pemberdayaan | Katalisator Perubahan | Ruang Aman Berbasis Etika Feminis

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Redaksi Perempuan Berkisah

Media Pemberdayaan | Katalisator Perubahan | Ruang Aman Berbasis Etika Feminis

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