What is trauma?

Trauma is the physical, psychological and emotional effects on victims and survivors of violence

Sexual violence can cause very distressing psychological, emotional, and physical effects.

These effects are different from person to person and there is no right or wrong way to react.

Common effects of trauma:

• Intrusive thoughts (not being able to stop thinking about something);
• Self blame or shame;
• Being frightened;
• Having nightmares or not being able to sleep;
• Not wanting to go out;
• Feeling suicidal or wanting to self harm;
• Wanting to use drugs or alcohol to numb the pain;
• Feeling angry, sad or numb;
• Physical responses to reminders of the violence or threats to safety.

Recovery from sexual assault will happen.

Learning more about these effects and how to cope with and manage them is an important step in recovery.

Trauma and recovery

Recovery from sexual assault is difficult.

In the early stages after a sexual assault, people describe feelings of shock, confusion and fear. They might be worried for their safety and whether they will be believed or blamed for what happened.

They may not know what to do, what options they have and how to get help. Many will worry about who to tell. Do they need to go to a doctor, the hospital or the police? Whether they will be believed, and what will happen if they tell someone, are really common questions.

For some there is also injuries and pain. Deciding what to do and doing it will take up time.

Once this is done, the person can then take their next steps toward recovery In the early days, they might be very busy going to the hospital or talking to police. But eventually they will face dealing with the next part of their recovery.

Recovery is a process over time. It means feeling safe. It also means knowing the responsibility for what happened is totally with the offender.

Coping with trauma over time

We all develop methods of coping with stress and trauma. But some ways of coping or avoiding thoughts and feelings arising out of trauma can create more problems.

Working out some ways to manage these experiences can help. An effective coping strategy can help prevent someone becoming overwhelmed by intrusive thoughts, emotions or physical responses.

Each person is different and the right coping strategy for them depends on their personality, their usual coping style, whether they've had other experiences of trauma, the support they have, and plenty more.

Talking to a trusted person

Many people find it helpful to talk to a trusted person about what has happened.

A trusted person or people might be a family member, friend, neighbour, colleague or helping professional.

To figure out who might be a trusted person, it can be helpful to ask these questions.*

Would this person:

• Respect my privacy?
• Listen and not blame me?
• Let me decide what to do?
• Be prepared to support me during this difficult time?

It can also be very helpful to speak to a professional with experience supporting people who have been sexually assaulted or raped.

Talking to a professional support person like a social worker, doctor or counsellor can help to build an understanding about what has happened. They can also suggest ways to manage distressing thoughts and feelings.

Some strategies that survivors of sexual assault find helpful include:

Deep breathing and relaxation exercises

As simple as it may sound, focusing on the breath and taking long, slow and deep breaths can be very helpful in managing feelings of anxiety or overwhelm. These muscle tension and relaxation exercises tell the part of the brain that is responsible for relaxation (called the parasympathetic nervous system) to take over.

When someone takes very deep breaths, their stomach rises with each breath rather than their chest or shoulders. This alone can help the body to relax by slowing the heart rate and sending more oxygen through the body, allowing the muscles to relax. It can be even more helpful to count the breaths. 'One, two, three, four deep breaths in, and four long, slow breaths out.'

If particularly overwhelmed or experiencing panic, it might be helpful to add another layer to this relaxation exercise. Examples of ways to add to deep breathing could be:

• Focusing on an image or colour in the room, or adding a 'grounding' tool like holding something cold or warm.
• After taking four breaths in and out, tense all of the muscles from the face and head to the toes. Hold them as tight as possible before letting go and allowing the body to relax. In a public place, tense the muscles in the legs and/or bottom instead.
• After taking a very deep breath, filling up the lungs as much as possible, breathe out heavily, using the voice during the exhale, like a deep sigh.

Grounding

Grounding is a strategy that can be helpful when experiencing trauma symptoms like flashbacks, anxiety, dissociation, nightmares, insomnia, panic etc. These are reactions we would call 'hyerparousal.' Grounding can also be helpful when you feel numb, flat, cut off or disconnected. These are responses that might be called "hypoarousal' or it may be dissociation which is another common impact from trauma. These responses will usually settle over time.

There are many different ways to do 'grounding' at home. The important thing is to identify activities that draw the attention to the immediate environment and which realign the mind and your body to the present. The following are some examples of grounding activities.

'Five things'

This five things exercise involves: noticing five sounds in the room, followed by five things to touch or feel, five things to smell or taste (if possible), five things to see, five things to hear. Then starting again but noticing four things, then three, two and one.

'Sensorimotor' strategies

People who have experienced sexual assault describe feeling very disconnected from their body and/ or environment. It can be helpful to reorientate through physical sensations.

Some people describe holding a cube of ice in their hand, walking, moving to a new location (going outside, changing rooms), taking a hot or cold shower or bath, patting a pet, having an ice cold or hot drink, listening to music, or talking to a friend or neighbour.

This muscle-tension exercise is a form of sensorimotor grounding:

While sitting in a comfortable position, focus on deep breathing, counting the breaths in and out.

After a few repetitions of deep breaths, tense all of the muscles from the face and head to the toes. Hold them tight before letting go and allowing the body to relax. In a public place where this isn't possible, instead tense the muscles in the legs and/or bottom.

These muscle tension and relaxation exercises tell the part of the brain that is responsible for relaxation to take over (the parasympathetic nervous system).

A similar exercise is a progressive muscle tension exercise:

Rather than tensing all the muscles at once, isolate different parts of the body and tense the muscles for 8-10 seconds before relaxing. For example, start by progressively squeezing then relaxing the muscles in the feet, then calves/shins, thighs, bottom, tummy, back, arms, shoulders, face, neck and head

Other options

• Using an object. Some people who use our services have special items they use to 'ground' themselves. For example, they might use photos of their family or of special places, treasured keepsakes, a silky scarf or a stress ball.
• Reminding yourself who and where you are. For example, writing down or saying out loud something like: "My name is Jane. I am 40 years old and I am in my apartment in Marrickville. My dog is sleeping on the sofa and I hear a plane flying overhead. I feel very anxious and I am breathing deeply to help my body calm down. When I am able to, I will go for a walk to the supermarket to buy bread and milk. After that I will come home and watch my favourite tv show...

Dealing with intrusive memories

Memories of sexual assault, especially memories that intrude on us when we least expect or need them, can be very distressing. It is normal to experience these intrusive memories in the early days, weeks and months after sexual assault.

It can be helpful to find ways to contain these intrusive memories in order to learn to cope with them better over time.

A simple exercise to help with this involves imagining a container of some type: a box, safe, chest, drawer, suitcase etc. Whatever the container is, it should have a door or lid that to open and close. The container should be big enough and strong enough to hold anything that is causing distress.

When something distressing comes up and it is not possible to address whatever is coming up in that moment, imagine letting the traumatic material go into the container temporarily, until it can be addressed at a later time.

Some other strategies people have described involve imagining blowing the thoughts, feelings or memories into a balloon and imagining the balloon floating away.

Imagining the memory, thought or flashback is playing on a video and pressing pause on the video.

The purpose of this process is to contain those memories to a time and space where they can be safely dealt with, for example after finishing work or school, stopping driving, getting off the bus, having some sleep and so on.

Exercise and rest

As the body responds to trauma along with our minds, it is important to remember that exercise can be an important tool in recovery.

It can be very hard to be motivated to do exercise during flatness or depression, so simple, gentle movement may be all that is possible. This might be simple stretches or yoga, gentle rocking or self-massage.

It is very common for people who have experienced violence to complain of fatigue. The body and brain are working hard. They are trying not only to recover from a very frightening experience which activated their 'fight and flight' responses, but also to process the trauma they may be experiencing.

It is very common and normal to need more sleep and rest. People recovering from trauma should allow themselves to rest when they feel they need it.

Mindfulness

Many people find mindfulness helpful in managing stress and anxiety, but it is not necessarily for everyone.

Some people who’ve experienced sexual, domestic and family violence find mindfulness helpful in connecting mind and body and bringing their focus to the 'here and now' as part of their recovery.

Others find that mindfulness can actually make their symptoms feel worse. This is because for some, focusing on their breath and the body ends up with them feeling overwhelmed by flashbacks, intense emotions or uncomfortable feelings. That is not to say that it will not be helpful, but it is important to be aware of this possibility in considering using mindfulness or meditation.

An example of a mindfulness exercise might be noticing where in the body is feeling discomfort or emotion, and responding to that sensation.

Another example is to imagine that the breath has a colour and that the breath travels to the places in the body that might feel as though they are holding feelings, tension, or pain.

There are many apps and websites that provide guided mindfulness and meditation that can be helpful.

Talk to us

To identify some strategies that might help cope with the effects of trauma, it may be helpful to speak to one of our trauma specialist counsellors.