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Trauma

Introduction

Psychological trauma is something that most survivors of sexual assault, sexual abuse and rape experience.


This section will look at how the body and mind reacts to traumatic experiences, what the symptoms of post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (C-PTSD) look like and contains a toolkit of coping mechanisms and support services that may help you if you are experiencing symptoms of trauma.


Please remember that trauma does not define you and it is possible to recover and heal from symptoms of trauma, dissociation, PTSD and C-PTSD, and to experience post-traumatic growth.

1 – Coping with Trauma – Survivor Stories

Click the video below to hear from survivors about their experiences of trauma and their journeys of healing.


Click the links below to watch the survivor interviews in full on YouTube:

Click the video below to hear tips and advice from survivors about what helps them to manage their experiences of psychological trauma.

You may find that your experiences of trauma as a survivor are different from the ones we describe in this section, and that is completely normal. Everyone experiences trauma in a different way.

You may find that you relate to all of the points below, some of them, or none at all. This guide may be a useful starting place for you to learn more about trauma and find some ways to learn to manage experiencing it, but it is not exhaustive. You may find the exercises and tips useful, or they might not be the right options for you at this moment in time. We are all unique in our experiences and where we are in our recovery journey, so take this section at your own pace, and explore the suggestions that feel right for you at this moment in time.

2 – The Science of Trauma

Trauma is a normal emotional response to terrifying, distressing, or prolonged stressful events from which it is hard to escape. These can include:

  • Any event that is physically or emotionally threatening or harmful
  • Unexpected, sudden and overwhelming events such as accidents and natural disasters
  • Prolonged abuse and sexual violence such as childhood physical or sexual abuse, domestic violence, rape and sexual assault.
The Survivors Trust member organisations have in-depth knowledge of how to support people who have suffered traumatic events related to rape and sexual abuse.
 
To find details about our member organisations local to you click here to visit The Survivors Trust website.

Studies have shown that people with a history of difficult or stressful childhood experiences or Adverse Childhood Experiences (ACEs) such as neglect, emotional, physical or sexual abuse, growing up with domestic violence, or a parent who had alcohol, drug, or mental health problems may also develop trauma symptoms. If you have experienced four or more ACEs you may be more vulnerable to both physical as well as mental health problems in adolescence and adulthood.

 

How we respond to danger and trauma
When we feel threatened or stressed, our bodies release hormones called cortisol and adrenaline. This is the body’s automatic way of preparing you to respond to danger, and you have no control over it. It is an involuntary response that happens outside of conscious awareness.

There are five reactions to danger:
  • Fight – fighting, struggling or protesting
  • Flight – hiding or moving away
  • Freeze  Hyper-freeze which is feeling paralysed or unable to move and Hypo-freeze which is shutting down and collapsing
  • Flag or flop – doing what you’re told without being able to protest
  • Fawn/Friend – trying to please someone who harms you.
The amygdala controls the body’s response to danger
Click the links below to read more about these five reactions to danger
  • Hyper-alert and hypervigilant
  • Fear
  • Alarmed, startled
  • Tense muscles
  • Increased heart rate
  • Raised blood pressure
  • Fast, shallow breathing
  • Dilated pupils, raised eyelids
  • Colour drained from face
  • Increased sweating
  • Rage
  • Physical aggression – attack
  • Verbal aggression – screaming, saying ‘no’.
  • Hyper-alert and hypervigilant
  • Fear
  • Alarmed, startled
  • Tense muscles
  • Increased heart rate
  • Raised blood pressure
  • Fast, shallow breathing
  • Dilated pupils, raised eyelids
  • Colour drained from face
  • Increased sweat
  • Running away, hiding.
  • Hyper-alert and hypervigilant
  • Terror, dread
  • Increased heart rate/blood pressure – tachycardic
  • Hyper ventilation – fast, shallow breath
  • Paralysed and unable to move – immobilised
  • Rigid muscles
  • Full of trapped energy
  • Eyes wide open – ‘rabbit in headlights’
  • Dry mouth
  • Very pale or flushed
  • Extreme sensation of cold or heat
  • ‘Play dead’ until opportunity to escape.
  • Hypo-aroused and shut down
  • Muscles flaccid and loose
  • Decreased heart rate/blood pressure – Bradycardic
  • Hypo-ventilation – not drawing or holding breath
  • Eyes closed or fixed in a blank stare
  • Numb
  • Pale
  • Feeling cold or frozen – cold sweat
  • Unable to speak – voiceless
  • Disconnected from thoughts and feelings
  • Detached from body
  • Detached from external and internal world
  • Faint or collapse.
  • Friend or fawn response is an instinctual survival response to avoid conflict and trauma by appeasing others
  • Often developed in childhood as a means of coping with a non-nurturing or abusive parent
  • Trying to please someone who is being abusive by agreeing to anything and everything they say, being compliant
  • Friend or fawn response involves immediately trying to please a person as a way to either avert or avoid being harmed.

Adult behaviours associated with Friend/Fawn response:

  • Trying to please a person to avoid any conflict
  • Answering only what you feel someone wants to hear
  • Ignoring own personal feelings and wishes and doing anything and everything to prevent abuse
  • Finding it difficult to identify your own emotions
  • Feeling like you have no identity
  • At any sign of conflict, responding by trying to appease the angry person
  • You may experience unusual emotional responses when issues to not involve people of importance in your life.  For example emotiona outbursts at strangers or sudden sadness throughout the day
  • Saying ‘no’ to people around you is difficult
  • You feel self-anger and guilt some or most of the time
  • You feel uncomfortable or threatened when asked to give an opinion
  • You are often taken advantage of in relationships
  • You take on more, even if you are already overwhelmed.

 

Video – Understanding Trauma – Bessel van der Kolk – YouTube
Click this link to watch psychologist Dr Bessel van der Kolk explain some of the basic principles of trauma.

 

Please note: This link will take you away from The Survivors Trust Resources website. The link is being provided for informational purposes only. The Survivors Trust bears no responsibility for any advertising content shown on external websites and videos.

Click here for a guide on how to clear your YouTube browsing history.

3 - Experiencing Trauma

Experiencing Trauma




Traumatic events can occur at any time and at any age and can cause both short-term and long- term effects. Everyone reacts differently to trauma, with some experiencing shock, helplessness and strong emotional reactions immediately after the event, while others do not experience any effects until long after the event. 

 The most common reactions to traumatic events are:

 

  • Intense, unpredictable and overwhelming feelings
  • Flashbacks – reliving aspects of the traumatic event and feeling as though it is happening in the here and now. You may see full or partial images of what happened, or notice sounds, smells, tastes, or physical sensations such as pain, pressure and not being able to breathe, and emotions that you felt during the traumatic event. Flashbacks can happen at random and can last for a few seconds, or last for several hours, or even days
  • Intrusive memories that arise at random even if you can’t remember specific details
  • Panic Attacks – heightened fear as a result of the body’s response to danger or stress
  • Nightmares and difficulties sleeping
  • Dissociation – shut down, spaced out, detached from your body and feeling the world is unreal (see section on dissociation)
  • Grief and sense of loss at how the traumatic event has changed your life and the things you have missed out on
  • Self-harm and self-destructive behaviours to cope with trauma. You may harm parts of your body that were attacked or injured during the traumatic event
  • Suicidal feelings and thoughts of ending your life and planning how you might do this. If you have suicidal feelings, you can contact Samaritans 24/7 by calling 116 123 or emailing jo@samaritans.org
  • Changes to thoughts and behaviour
  • Heightened sensitivity to noise and sounds
  • Difficulties in relationships
  • Physical symptoms such as physical pain, chronic tiredness, digestive problems and headaches.
If you are experiencing suicidal feelings and are at risk of seriously hurting yourself or taking your own life, call 999, contact your GP, or visit your nearest hospital Accident and Emergency department.
Post-Traumatic Stress Disorder (PTSD), Complex PTSD (C-PTSD) and Dissociative Identity Disorder (DID)



Trauma can lead to Post-Traumatic Stress Disorder (PTSD). Some people develop PTSD symptoms immediately after the traumatic event whilst others may not experience symptoms more than six months later which is called Delayed-Onset PTSD.

If the traumatic event happened repeatedly in early childhood and lasted for a long time, especially if the perpetrator was someone close to you, this might lead to Complex Post-Traumatic Stress Disorder (C-PTSD).

 

Some survivors experience dissociation and/or Dissociative Identity Disorder (DID) as a way for the mind to protect itself from the trauma it has experienced. For more information on dissociation and DID, click here to visit our webpage on dissociation.

Click here to read more about PTSD and C-PTSD.

PTSD Symptoms

Not everyone experiences all of the PTSD symptoms below and you may experience some, none or all of them:

 

  1. Reliving aspects of the traumatic event
  • Flashbacks which are vivid and feel like the traumatic event is happening in the here and now
  • Physical sensations such as pain, sweating, nausea or trembling
  • Intrusive thoughts or vivid images
  • Nightmares
  • Intense and overwhelming distress at real or symbolic reminders of the traumatic event.
 
  1. Alertness or hypervigilance
  • Heightened fear
  • Feeling of panic when reminded of the traumatic event
  • On edge and extremely alert
  • Being easily upset or angry
  • Feeling irritable, angry, or aggressive
  • Difficulty concentrating and focusing on simple or everyday tasks
  • Overthinking and rumination
  • Pre-empting and ‘mind reading’ (believing you know what people are actually thinking)
  • Feeling jumpy or being easily startled
  • Disturbed sleep or a lack of sleep
  • Anxiety.

 

  1. Avoiding feelings or memories
  • Feeling cut off from your feelings and/or emotionally numb
  • Feeling detached from your body and/or physically numb
  • Dissociation
  • Having to be busy all the time and unable to relax
  • Avoiding anything that could remind you of the traumatic event
  • Being unable to remember details of the traumatic event and what happened
  • Unable to express affection
  • Unable to feel pleasure or joy
  • Self-destructive or reckless behaviour
  • Using alcohol or drugs to numb the pain and avoid memories.
 
  1. Difficult feelings or beliefs
  • Unable to trust anyone
  • Feeling no one understands
  • Feeling nowhere is safe in the world
  • Self-blame, guilt and shame for what happened
  • Lack of self-worth
  • Overwhelming feelings of anger, sadness
  • Sense of powerlessness and betrayal.
 

Complex PTSD (C-PTSD)

If you experienced multiple traumas or were repeatedly abused in childhood at an early age by someone close to you, you are more likely to develop C-PTSD. This is especially the case if the traumatic event(s) continued over many years, and you were not able to escape from it.

You might also develop C-PTSD if you experienced:

 

  • Childhood abuse, neglect or abandonment
  • Domestic violence or abuse in the past or the present
  • Repeatedly witnessing violence or abuse
  • Being forced or manipulated into sexual exploitation or prostitution.

If you suffer from Complex PTSD, you might experience some, or all of the symptoms of PTSD along with some other symptoms:

  • Not able to control your emotions
  • ‘Emotional flashbacks’ such as fear, shame, sadness or despair which you originally felt during the traumatic event. These are very intense, and you might react to events in the present without realising that you are having a flashback
  • Feeling angry and distrustful towards the world
  • Constant sense of emptiness and hopelessness
  • Feeling permanently damaged or worthless
  • Shame and guilt
  • Feeling different to other people
  • Feeling no-one can understand what happened to you
  • Finding friendships and relationships frightening and difficult, and avoiding them
  • Dissociative symptoms such as depersonalisation or derealisation
  • Physical symptoms such as dizziness, chest pains, stomach aches and headaches
  • Heightened sensitivity to noise
  • Recurring suicidal feelings.

Some of the symptoms of C-PTSD are very similar to Borderline Personality Disorder, or Emotionally Unstable Personality Disorder (EUPD) and sometimes misdiagnosis can occur. It is worth discussing this with your GP, psychiatrist or mental health support worker if you suspect you have been misdiagnosed.

If you have PTSD or C-PTSD you might experience other mental health problems such as:

  • Anxiety disorders
  • Depression
  • Dissociative disorders.
Many of the symptoms of PTSD and C-PTSD are experienced by survivors with DID. For more information about dissociation and DID, please click here.
If you think that you are experiencing DID, PTSD or C-PTSD, you may find therapy or counselling helpful in your journey of recovery. You can talk to your GP about this, and they may refer you to a mental health specialist.

The impact of trauma on the mind and body Trauma can affect your body, your emotions, your mind and how you think, your behaviour, your relationships and your daily life.

Video – The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma – YouTube
Click here to watch psychologist Dr. Bessel van der Kolk give explain how innovative treatments can help the body to recover from trauma.

Video – Recognising Symptoms of Trauma – Bessel van der Kolk – YouTube

Click here to watch psychologist Dr. Bessel van der Kolk talk about signs and symptoms of trauma.


Please note: These links will take you away from The Survivors Trust Resources website. The links are being provided for informational purposes only. The Survivors Trust bears no responsibility for any advertising content shown on external websites and videos.

Click here for a guide on how to clear your YouTube browsing history.

Trauma can affect you in the following ways:
Your body
  • On constant high alert – hyperarousal and feeling jumpy
  • Racing heart
  • Not breathing fully or deeply – short, shallow, rapid breathing, or holding breath
  • Hypervigilant
  • Shut down and zoned out
  • Numb
  • Fatigue and no energy
  • Digestive problems
  • Exhausted and constantly tired
  • Recurring physical illnesses
  • Feeling decades older than you are.
Your emotions
  • Fear and terror
  • Overwhelmed by emotions
  • Denial
  • Self-blame, shame and guilt
  • Feeling scared, unsafe and insecure
  • Dread and anxiety
  • Anger and rage
  • Irritability
  • Sadness
  • Guilt, shame and feeling worthless
  • Feeling you don’t belong or are different from everyone else – alienation
  • Hopelessness
  • Dead inside and empty
  • Numbness.
Your mind
  • Frozen brain – unable to think
  • In a fog and disconnected from thoughts and feelings
  • Confused and full of self-doubt
  • Difficulty concentrating and not being able to focus
  • Lack of focus and easily distracted
  • Not able to filter out noise
  • Poor memory – difficulty remembering things and making decisions
  • Amnesia for past and present events, can be total or partial
  • Loss of time – time speeding up or slowing down
  • Low self-esteem or self-confidence
  • Depression
  • Dissociation
  • Fear of judgement from other people
  • Lack of self-compassion and self-empathy.
Your behaviour
  • Withdrawal from, or avoiding people because interacting with others is too exhausting
  • Avoidance of anything to do with the trauma or traumatic events
  • Confrontational, argumentative and aggressive
  • Lashing out at other people
  • Rebellious and problems with authority
  • Need to feel in control – inflexible, demanding
  • Self-harm and self-destructive behaviour
  • Sabotaging anything good in life
  • Excessively self-reliant and unable to ask for help
  • Constant comparison with others and feeling less than others
  • Lying to people about past experiences to avoid judgement
  • Put on a brave face and having to pretend – leading a double life
  • Dislike of and inability to cope with change
  • Reliance on alcohol or drugs.
Your relationships
  • Lack of trust – in self and others
  • Trusting too quickly
  • Pleasing others to seek approval – compliant, submissive
  • Confrontational to keep others at a distance – hostile, angry, aggressive
  • Mind reading others
  • Difficulty maintaining friendships
  • Wanting to be connected and close yet pushing others away
  • Having no family support
  • Overly loyal to others
  • Sexual difficulties.
Your daily life
  • Lack of self-care and not looking after yourself
  • Feeling apathetic
  • Problems sleeping – insomnia or nightmares
  • Not able to relax
  • Keeping busy at all times – avoiding leisure time
  • Not able to enjoy or take pleasure in activities
  • Loneliness and isolation.
Trauma and physical health problems

Prolonged stress and trauma can lead to a range of physical health problems, and you may be vulnerable to:

  • Unexplained recurring illnesses
  • Irritable Bowel Syndrome (IBS)
  • Chronic fatigue
  • Fibromyalgia and chronic pain
  • Autoimmune disorders
  • Respiratory problems such as asthma
  • Skin problems such as psoriasis or eczema.
 

If you experience physical symptoms, talk to your GP so that they can give you the right medical treatment and support.

4 - Toolkit For Coping With Trauma

Seeking support

If you are struggling with any of these trauma responses you are not alone. The Survivors Trust has over 120 member organisations based in the UK and Ireland which provide specialist support for women, men and children who are survivors of any kind of rape, sexual violence, or sexual abuse. These organisations have in-depth knowledge of how to support people who have suffered a traumatic event related to sexual abuse.

 


The Survivors Trust member agencies provide a wide range of support services, including one-to-one counselling, group counselling, advice and information, advocacy, Independent Sexual Violence Advisors (ISVAs)Sexual Assault Referral Centres (SARCs). Some of our member agencies provide support to family members and partners of survivors of sexual abuse. Some provide alternative therapies such as wellness programmes and creative group exercises, such as photography walks and craft sessions.

To find details about our member organisations local to you,
click here to visit The Survivors Trust website.

 

Self help

The first step in healing and recovery from trauma and abuse is to remember that abuse is something that happened to you not what is wrong with you. The abuse does not define who you are – it defines the abuser, not you. Your true self can get buried underneath the effects of traumatic experiences. You can recover from this and allow your true self to shine through.

Video – Healing Trauma: How to Start Feeling Safe in Your Own Body – Dr Bessel van der Kolk – YouTube
Click this link to watch psychologist Dr Bessel van der Kolk explain how you can start feeling safe in your body after experiencing trauma.

Please note: These links will take you away from The Survivors Trust Resources website. The links are being provided for informational purposes only. The Survivors Trust bears no responsibility for any advertising content shown on external websites and videos.
Click here for a guide on how to clear your YouTube browsing history.

Identifying your resilience

To help you on your journey to recovery it would be useful to identify the resilience and resources that helped you to survive the traumatic event. These could include:

  • Courage and bravery
  • Determination and tenacity
  • Skills and talents
  • Achievements
  • Friends and family
  • Spirituality or faith
 

Remind yourself of these and build upon them as you continue your recovery and healing.

Identify triggers

An important part of recovery is to identify the trauma cues that can trigger trauma reactions and symptoms. Knowing your triggers means you are forewarned and can brace yourself. These may include:

Cues

Trigger examples

Sensory

Sounds, music, smells, taste, touch, visual stimuli, texture, being in the dark

Environmental

Clothes, furniture, curtains, cars, locations

Psychological

Bereavement, loss, end of relationship, loss of job, feeling trapped, loss of control and autonomy, residential care

Physical

Medical, gynaecological or dental examinations, illness, hospitalisation

Mental health

Mental health assessments, alcohol or addiction recovery, counselling or therapy

Relational

Being in a relationship with the abuser, intimate relationships, domestic abuse, sex, having children, children leaving home

Media

Hearing about sexual abuse, reading books, watching films, listening to survivors

Re-traumatisation

Abuse, sexual assault, rape, domestic violence

Tips for coping with trauma symptoms

Everyone’s journey of healing from trauma is different. If the tips and suggestions below do not work for you, please try not to worry. It is completely understandable if you find any of these steps difficult. If you are feeling overwhelmed, try to think of one positive thing that you can achieve today, however small that might seem, as a first step. Why not try looking out of your window or at a picture that you like for 30 seconds?

 

 



When healing from trauma or abuse it can help to connect with supportive people you trust that you can talk to and who will listen to you without judgement. For more information about relationships, click here. Try to build a support network who you can contact when you are feeling scared and vulnerable. It might also help to find some specialist support (see link to resources). The most important thing is to take one step at a time and give yourself time to heal and recover. Remember to look after your physical health.

Click here to read more about helpful techniques for symptoms of trauma

You might find that some of the following techniques help you:

  • Breathing – focus on breathing slowly in and out. Breathe in to the count of four, breathe out to the count of six. Focus your attention on your breath and breathe deeply into your tummy, and focus on the sensation in the body when filling and emptying the lungs
  • Move your body to discharge trapped energy, stress or overwhelming feelings – try to tense and clench your muscles to feel the power in your body rather than relax them. Stand up straight and tall and feel how strong and powerful your body is, or move around rhythmically, or do star jumps
  • Grounding object that you carry with you at all times such as a piece of jewellery, ring or watch, or a screenshot on your mobile phone, which you can look at or touch when you feel overwhelmed or during a flashback
  • Grounding song or poem that you can sing or recite to yourself that distracts you and calms you when you feel overwhelmed. Sing or shout it out loud if possible
  • Grounding position that helps you to feel safe such curled up under a blanket with a hot water bottle, or a warm drink. Cuddle and stroke a pet, watch a favourite film to make sure you comfort yourself
  • Activating your senses such as identifying three objects or colours you can see around you, and describing these, find a soothing smell such as a favourite scent or oil, fruit, or clothing and focus on the sensation and describe it, hold something soft such as a blanket, or scarf, look at a favourite
    image, or photo, listen to soothing music, or sounds around you, have a warm drink or eat something nice and focus on the texture and flavour
  • Make a mood basket in which you can place objects for all the five senses that are soothing – sight, sound, touch, taste and smell. You can also include a tangle toy, a stress ball, some Play-Doh and some bubbles to use whenever you need to
  • Make a relaxation bag which includes a soft, or weighted blanket, some warm socks, a scented candle and something soothing to hold
  • Remind yourself that you are safe now by writing down or recording some comforting phrases on your phone and play these back to help soothe you
  • Keep a diary or journal to write down your thoughts and feelings, and record signs, patterns or triggers to trauma reactions, and how you were able to comfort yourself and keep yourself safe
  • Look after your physical health by taking regular exercise, make time to rest and sleep as well as eating healthily
  • Tell people what sort of support you would like – such as being listened to rather than asking a lot of questions or giving advice
  • Choose who you wish to share your experiences with and ask them to keep it confidential
  • Seek professional help and check that they have specialist knowledge, training and expertise in trauma. Member organisations of The Survivors Trust specialise in providing support and counselling services for survivors of sexual violence and trauma. To find out which member agencies are local to you, click here.
If you have suicidal feelings and do not feel able to keep yourself safe right now, seek immediate help:
Helping others

Many survivors of trauma find that reaching out and connecting to others can help transform trauma and turn negative experiences into good. Volunteering and becoming more active in the community are a powerful way of reconnecting to others and the world through forming positive relationships and restoring vitality.

5 – Useful Resources for Trauma

Contacts

The Survivors Trust
www.thesurvivorstrust.org
Umbrella agency for over 120 member organisations which provide specialist support to
men, women and children who are survivors of sexual violence.
Helpline: 08088 010818

 

Samaritans
www.samaritans.org
Listening support for anyone struggling to cope
Helpline: 116 123

 

ChildLine
www.childline.org.uk
Support for young people under 19 years of age.
Helpline: 0800 1111

 

Mind Side by Side
www.sidebyside.mind.org.uk
Supportive online community.

 

Emergence
www.emergenceplus.org.uk

Personality disorder website.

 

First Person Plural
www.firstpersonplural.org.uk
Survivor-led association for dissociative identity disorder and similar complex dissociative
conditions.

 

MIND
www.mind.org.uk
Mental health charity.
Helpline: 0300 123 3393

 

MOSAC Mothers of Sexually Abused Children
www.mosac.org.uk
Support for non-abusing parents of abused children.
Helpline: 0800 980 1958

 

NAPAC
www.napac.org.uk
Support and signposting for adult survivors of any form of childhood abuse.
Helpline: 0808 801 0331

 

NSPCC
www.nspcc.org.uk
Report any concerns about a child.
Helpline: 0808 800 500011

Books
  • Boon, S, Steele, K and van der Hart, O (2011). Coping with trauma-related dissociation: Skills training for patients and therapists. New York, W.W.Norton
  • Kearney, D. J and Simpson, T.L (2019). Mindfulness-Based Interventions for Trauma and Its consequences. American Psychological Association
  • Perry, B and Winfrey, O (2021). What Happened to You: Conversations on Trauma, Resilience and Healing. Bluebird Publishers
  • Sanderson, C (2015). Responding to survivors of child sexual abuse: A pocket guide for professionals, partners, families and friends. London, One in Four
  • Sanderson, C (2016). The Warrior Within: A One in Four Handbook to aid recovery for survivors of childhood sexual abuse and violence 3rd Edition. London, One in Four
  • Van der Kolk, B (2014). The Body Keeps the Score. London, Penguin.

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