Erene Hadjiioannou is a psychotherapist specialising in trauma as a result of sexual violence, and between 2014 and 2018 set up two services in Leeds for female-identifying clients with complex needs (offenders, and survivors of sexual violence). While Erene’s priority is client work, she has always written and spoken about mental health as way to encourage people to seek support, and raise awareness too. In this blog post, Erene explores the nature of trauma and deconstructs a few of the myths surrounding it, with a view to help people understand this often misunderstood issue.
Content warning: trauma, post-traumatic stress, and sexual abuse.
One of my key beliefs as a Psychotherapist is to be vocal outside of confidential appointments in service of the people I support, and the issues they bring to our work. This is mostly because people who have experienced trauma are repeatedly misunderstood, which in itself is a huge barrier to seeking support.
My hope in doing so is to enable psychotherapy to be more effective when it’s applied to the world outside of appointments, and for survivors and the general public to better understand how the various ways that the impact of trauma is experienced is a completely normal response to what happened.
My specialist skills in working with the traumatic impact of sexual abuse were gained by coming into contact with hundreds of survivors. Here’s what I’ve learned, which I would like to pass on to you.
It’s All About Survival
We usually reference the ‘fight, flight, freeze’ response to stressful situations when it comes to animals escaping danger in the wild, like an antelope running away from a lion to try and save its own life. The truth is that the neural pathway that activates this response in life-threatening situations for animals is also present in humans. It’s just that our brains have evolved to do more complex and higher-functioning things too.
The downside of this means that it’s much harder to process the impact of traumatic experiences because it affects survivors at a neurobiological, psychological, and somatic (bodily) level. For these reasons one of the greatest injuries to us as humans is being violated, attacked and overpowered by other humans. At worst, this can make the impact of trauma last a lifetime because we have so much to piece back together at so many levels when our lives are shattered in this way.
Going through something traumatic is nearly always followed by periods of feeling scared of going out into the world, not being able to get on with daily life as usual, and having your night-time interrupted by disturbed sleep or even nightmares. Being re-triggered repeatedly brings us back to this place, too.
Survival after the traumatic experience in this sense can mean being forced to go right back to basics. This might mean not being able to cope with much which is distressing, frustrating and confusing because it means losing your sense of self, autonomy, control, and safety. Having to do this for long periods of time is hugely disempowering, but sometimes taking one day at a time is the only way we know to survive and hopefully recover.
Trauma is a Full-Body Experience
In speaking with survivors, I often refer to trauma being a full-body experience because it is literally just that. In the same way that anxiety can be felt via muscle tension and heart palpitations, trauma can pull us back into the past by making us physically feel aspects of what happened in our bodies, in addition to having memories and thoughts in our minds. This is an awful way of reliving something that we are desperate to get away from, and often it can be out of our control.
For those who can’t, or don’t want to, talk about what happened to them the idea of seeking support can be really scary. The fact is that you can be supported to work on the impact of what happened without having to verbalise it. Paying attention to particular body sensations, thoughts, and feelings are a good starting point in processing the impact of the trauma and getting back in touch with what you need to feel better. That’s not to say this is easy at all, but it can be part of the process of recovery.
I Don’t Understand My Body
Not understanding what your body is doing or how it feels is extremely common after trauma. I believe the body is the place where you live so if this feels uncomfortable or unsafe, we might react to this by trying to re-connect with our bodies in a different, less traumatic way such as self-harm. The alternate option is to leave the place where you live because it is too hard to be there all the time. One way we might do this is by using alcohol or drugs – all of which are ways to get lost in something else.
Another way our bodies allow us to separate from the trauma, sometimes out of our control, is to dissociate. This can be a survival mechanism at the time the traumatic event happened, and is one of the factors that can contribute to not being able to fully remember what happened. Simply put, it can be too traumatic to be fully present so it’s better to not be there in some way.
Wherever you find yourself in relation to your body (at the time of the trauma or afterwards) is another survival tactic, even if in the long run it might not be helpful with overcoming what happened. As much as it might feel your body is working against you, it is in fact trying to keep you going with the limited resources it has at a time of extreme stress and trauma.
Making use of the five senses to try and feel more comfortable in at least one part of your body can be a good start to generally feeling more settled, and re-finding a safe place to anchor yourself internally when the impact of the trauma gets too much.
A central feature in living with trauma is the emotions that come with being forced to hold on to something so distressing. This can be a wide range of intense feelings, or having none at all. Both can be equally confusing, make us feel out of control, and generally contribute to not having a solid sense of self because we’re being pulled in so many directions and/or can’t get in touch with ourselves.
In psychotherapy this usually gives rise to lots of question marks around what survivors are feeling (or not). I consider the questioning to be part of feeling disempowered, both by the traumatic experience and also people’s expectations of how you’re ‘supposed to’ react in the face of trauma.
The fact is that anger, irritability, and increased negative emotions, are part of the symptoms listed within the various diagnostic criteria for Post-Traumatic Stress Disorder. If you pair that with a brain that is mis-firing within the fight/flight/freeze neural pathway, and being let down by someone you trust if the trauma happened in a relational context, then of course our emotions become another place in which we don’t understand ourselves and are overwhelmed by what we are feeling.
Internalised Perpetrators, Myths & Misconceptions
When trauma occurs in the context of trusted relationships what we know about safety, boundaries, and love become less about what we need and more about the needs of others. It also becomes a way of being forced to adapt to this to try and get what we need, or avoid further contact with people. Over time, this can lead to internalising messages that challenge our sense of self, and survival.
One way of thinking about this is the idea of an internalised perpetrator who holds on to the blame, shame, and guilt about what happened. These are incredibly powerful emotions to carry, and in my experience can present some of the biggest challenges in recovery.
In the case of survivors of sexual abuse, society explicitly and implicitly reinforces the idea that being abused is due to a failing in the survivor. Messages such as ‘Women shouldn’t walk alone at night’, ‘Gay men should be available for any sexual experience’, and ‘I should have pushed them off me’ means the responsibility for what happened stays with the survivor rather than the perpetrator.
The horror of sexual abuse means society and the people within it don’t want to look at the issue, and this is part of what allows responsibility to be mis-placed so that real perpetrators can continue abusing others. In the meantime, survivors can feel disempowered, silenced, and self-destructive as they are forced to hold on to the experiences and feelings that most other people don’t even want (or can’t bear) to look at. In this way it’s easy to understand why survivors of sexual abuse experience self-harm and suicide attempts, as holding all of that is just too unbearable at times.
Sometimes the most distressing impact of the trauma is not the traumatic event itself but the context in which it occurred, or what happened afterwards. For example, finally asking for help only to not be taken seriously is sometimes the factor that is hardest to recover from, and puts people off asking for help again.
Survivors of any kind of trauma often feel as though what happened to them isn’t worth telling, and they’re not as entitled to support, as ‘other people must have been through worse than me’. This is another example of the impact of myths, misconceptions, and the internalised perpetrator. If you are impacted by trauma, then you deserve support to be understood and recover from what happened.
There Is No Right Way to Be A Survivor
One of the most significant things I can pass on to you is that there is no one right way to be a survivor. Within this blog post I have deliberately talked about trauma in a gender-neutral way as our understanding of trauma often excludes LGBTQIA+ people, refugees, asylum seekers, disabled people, and people of colour. This translates into marginalised and disadvantaged groups of people being further excluded from their right to be understood, and to navigate the already complex process of recovery with the right support.
None of the myths and misconceptions about trauma, particularly sexual abuse, validate the experiences of such people but rather seek to further erase them. Recovery from trauma should be about re-discovering and re-experiencing yourself in your own right, whoever you are.
The bottom line is: whatever you are experiencing or struggling with is absolutely normal. The truth of what happened is in your story, and the impact it’s had on you. Recovery from trauma is rarely straightforward, but there is support along the way in lots of places if you feel you need it.
Erene is available for one-to-one psychotherapy with adults in Leeds city centre, as well as writing and speaking about mental health locally and nationally. For more information and to get in touch, visit: www.therapy-leeds.co.uk.