Healing from Trauma or Abuse

As a mental health clinician, I can state with certainty that the majority of clients I have treated are survivors of some form of abuse, whether it be verbal, emotional, physical, sexual abuse or childhood neglect. Abuse can be inflicted by parents, partners, peers, bosses, colleagues, strangers, and even friends. Intimate partner violence or domestic violence is a common form of abuse where a romantic relationship is based upon dynamics of power, control, and abuse as opposed to values of mutual respect, equality, and safety. Bullying is another form of abuse that is rampant in schools and experienced by many children and adolescents at epidemic levels and are increasing with the widespread use of social media and the internet.

The fallout of experiencing acute or chronic trauma or abuse can result in a wide range of symptoms of psychological and emotional problems, health issues, attachment or relationship problems, low self-esteem or identity issues, and suicidal thoughts. Abuse can cause or contribute to symptoms of depression, anxiety, PTSD or other trauma-related disorders, bipolar, eating disorders, psychosis, dissociative disorders, personality disorders, and substance abuse. In other words, the impact of abuse can manifest in a variety of different forms based upon the intensity of abuse, length of abuse, relationship to abuser, and protective factors or buffers. Protective factors, such as a good support system, an outlet to openly process the abuse, healthy coping skills, help boost resilience in the survivor and foster continued growth and development.

When most of us hear about the diagnosis of Post-traumatic Stress Disorder (PTSD), we often picture images of soldiers coming back from war or survivors who have lived through a traumatic event like a major car accident. However, many mental health professionals are treating more and more clients who have been diagnosed with complex or chronic PTSD as a result of experiencing prolonged, repeated types of traumatic experiences or abuse, such as physical, sexual, emotional, and verbal abuse or neglect. Whereas PTSD can arise from a single traumatic event, complex or chronic PTSD can arise from repeated traumatic experiences over a period of time, but involve similar symptoms. Developmental psychology, which is the scientific study of the psychology of human beings over the human life span, has found links between acute or chronic trauma and mental health problems. Many survivors of childhood abuse, domestic violence, or intimate partner violence show symptoms consistent with PTSD or CPTSD as a direct result of abuse they have experienced.

An individual who has experienced repeated verbal, emotional, or physical abuse or life-threatening instances of neglect often carries invisible wounds from these experiences, which can negatively impact self-esteem, one’s ability to develop a healthy coherent identity or sense of self, trust in relationships, and lead to attachment problems. For an individual with PTSD or CPTSD, he or she may become hypervigilant to his or her environment, expecting danger at every turn, which elevates stress hormones, such as cortisol, adrenaline, and norepinephrine. When the nervous system and stress hormones are over-responsive and the individual is stuck in the primitive fight/flight/freeze response, this can contribute to mental health and physical health symptoms. 

The survivor of abuse might develop maladaptive or self-destructive coping skills in reaction to the abuse experienced. Some survivors might engage in self-medicating through taking drugs or alcohol to numb painful emotions or escape traumatic memories or ongoing abuse. Other survivors often internalize abuse forming negative core beliefs, such as I don’t deserve love or I am flawed and there is something wrong with me. Survivors might also suffer from low self-esteem, engage in self-harm, or even attempt to end their lives. For many survivors of abuse, the threat of continued violence, feelings of guilt or shame, as well as legal, economic, and social barriers in providing victims with justice, or the fear of not being believed might cause to the survivor to remain silent or prevent him or her from seeking professional help. Lack of professional or personal support and feelings of isolation can further compound mental health symptoms. 

For these reasons, it is important help create a supportive environment for survivors, where they do not have to fear victim-blaming, disbelief, minimizing, or further re-traumatization. Listening, offering empathy, support, and validating the survivor’s experience is often the first step in creating safety in one-on-one relationships or at school, workplace, or other organizations. Seeking professional support can be an important step in beginning to identify abusive behavior, such as gaslighting—a tactic used to manipulate an individual into questioning his or her thoughts, opinions, feelings, or memory to render the victim dependent upon the abuser. Gaslighting is often used to sow feelings of fear, self-doubt, and insecurity is often a major component of abuse. Once a survivor begins to perceive the abuse, he or she can begin to seek safety, seek support or professional help, and begin to heal.  By recognition of the impact of trauma and how trauma continues to live out in the present, clients can begin to process the full impact of trauma, re-prioritize the importance of physical and emotional safety, and begin to engage in self-care, counseling, and trauma-work.