What Causes Trauma?

A life-shattering event shocks the body and mind and leaves a person changed. The feeling and impact in the aftermath of such an event are known as “trauma.” Though trauma is an experience that all people can share, each person experiences it differently. Even if two people experience the same traumatic event, they will each respond to their trauma differently. If one person has access to plenty of support and gets the care they need, they may have an easier time healing than a person who  does not have any support and doesn’t get care. 

Here are some factors that can cause trauma and have particular significance in the aftermath of sexual assault:

BETRAYAL causes trauma. Most people expect that we won’t be hurt by the people who we love and trust. When people violate those expectations by harming us, we may feel betrayed. If that kind of betrayal has happened, a survivor might feel less comfortable trusting people in the future. 

EXTREME FEAR or TERROR causes trauma. If a person experiences extreme fear or terror, like being afraid for their life or unable to control what is happening to their body, they are likely to carry that feeling with them for a while. It’s like the experience is imprinted on their mind, maybe for a period of time and maybe forever. In the aftermath of such an experience, a survivor might be reminded of what happened by what is sometimes called a “trigger.” “Triggers” are different for every person, but generally they might be certain sensory reminders (like a smell or a feeling) that cause the person to relive their assault. 

SURPRISE ATTACKS cause trauma. Imagine you are walking down the street when a piano falls out of a building and crashes onto you. You had no way to expect that you would be hit by a falling piano — there were no warnings, no signs, nothing. You don’t want that to ever happen again, so you might start to feel afraid to go back to that same street, or even to similar streets. You know that getting hit by a falling piano is unlikely to happen again, but since one impossible incident already happened to you, you start to feel like it can happen again any time. You feel agitated any time you leave your house, and whenever you walk down the street, you feel like you have to be alert to any possible pianos. Your belief that you are safe walking down the street has been damaged. The same might be true for a person who is surprised by a sexual assault.

SELF-BLAME causes trauma. People are often harder on themselves than anyone else could be, and this is especially true after a sexual assault. Survivors may blame themselves for what happened or beat themselves up for how they acted or looked, what they said or didn’t say, what they did or didn’t do, and more. Unfortunately, self-blame or beating ourselves up takes away one of the biggest possible sources of support, which is ourselves. It also reinforces the message that they did something wrong or that there is something wrong with them. Re-framing or changing this message of belief can lessen the trauma. Remember: the only person to blame is the perpetrator.

INVALIDATION causes additional trauma. Unfortunately, many people minimize the trauma a survivor is experiencing, saying “it’s not that big of a deal” or “you need to get over it.” The survivor’s mind and body know that they are in pain and have experienced a great trauma; when others doubt or invalidate those feelings, this can lead to increased self-blame, guilt, and confusion for the survivor. Minimizing or invalidating sends the message that they don’t deserve support, that they’re to blame, and that their feelings don’t matter. 

CULTURAL BELIEFS cause additional trauma. There are many cultural norms and beliefs that shame and blame survivors. These messages exist in movies, music, and advertising and they also play out in interactions between people. For example, we may have been taught that sexual violence only happens to women and girls. While this isn’t true, it can affect how survivors feel about what happened to them. Recognizing how these norms affect us can help us take steps to change them. 


Impact

Every sexual assault experience is different and every person is unique, so there is no one way that a person will respond to theire experience(s) of sexual violence. The impact of the assault on someone’s life will depend on many factors. Some things that may affect how a person is impacted include:

If there had been crises in the survivor’s life before the assault. It is likely that, if someone was already having a difficult time and then experienced sexual violence, the addition of new stressors upon older stressors may make the burden that person is carrying seem unbearable.

If a survivor already had coping skills. If the survivor had previously developed positive coping mechanisms that helped when they were working through other crises, those skills would likely be beneficial to their healing from the sexual assault. 

If the survivor has a supportive and validating support system. When survivors have people in their lives who validate their feelings, help them access care, and never blame them, they will likely be better able to heal from and cope with sexual trauma.

If survivors blame themselves or hold themselves responsible. When survivors blame themselves, believe negative cultural myths, feel shame, and take responsibility for the assault, they are experiencing additional trauma.


Post-Traumatic Stress and the Process of Healing

Post-Traumatic Stress Disorder (PTSD) is a very common diagnosis for people who have experienced many forms of trauma, not just sexual trauma. Having PTSD does not mean that a person is “crazy,” “damaged,” or “broken.” It simply means that their brain is coping with their trauma. Many people experience these feelings and responses, whether or not they receive an official diagnosis of PTSD. Many people with PTSD symptoms heal and recover over time; some people will continue to experience those symptoms to some degree throughout the rest of their life. 

Whether or not a person has a diagnosis of a disorder, studies have shown that survivors of trauma consistently report stress symptoms, some of which can be described as stages. These stages, or phases, often overlap and vary from person to person; people don’t experience each of these stages in order, one at a time, or only once. A person’s experience of these symptoms will depend on many factors, such as their lifestyle, stressors, support system, coping skills, and how often the survivor may be triggered. There is no timeline for healing – no “right” way or single way to process the trauma. 

No matter what our assumptions about the survivor’s feelings may be, it is important to support them in their own process.  Not every survivor experiences PTSD. You may think you know what is best for them, but they are the experts in their own feelings and deserve to have control over their recovery.

The descriptions of these stages of healing from trauma may serve as a loose guideline for survivors or their loved ones in the aftermath of sexual assault. 

An Acute Stage 

An acute stage may start during the assault and last for several weeks or longer, or reappear at any point during a survivor’s healing process. During an acute phase, the most common feeling is a heightened sense of fear – for example, fear of the perpetrator returning, fear of people of the same gender as the perpetrator, fear of being alone, or fear of the dark. Specific fears related to the assault may also develop. For instance, someone assaulted in their bedroom may fear sleeping alone in a bedroom. The survivor may also feel guilty, ashamed, embarrassed, confused, and angry — or perhaps all of those feelings at once. These are common reactions.

Other feelings or symptoms associated with this phase may include:

  • having “flashbacks” of what happened during their assault(s) and/or feeling “triggered” by reminders of their experience
  • feeling sad or depressed
  • feeling confused or bewildered 
  • experiencing shock — a person might have a hard time keeping warm, might shake or shiver, and might have a hard time focusing their eyes or thoughts
  • having dulled senses — a person might describe this as not being able to take in their surroundings or “food doesn’t taste like anything”; a sensation of feeling frozen
  • feeling significant anxiety — this may be expressed physically, i.e. a person’s heart might pound or their pulse might race, even if they are not aware of a particular thought that is causing anxiety
  • feeling numb or being less alert — a person might describe this as “being in a haze”
  • seeming collected and calm 
  • having short term memory loss or inability to remember particular things
  • having disorganized thoughts or difficulty concentrating
  • feeling or seeming detached from other people or from reality (sometimes called being dissociated) — a person might describe this as “nothing seems real”

Remember that not everyone exhibits outwards signs of their pain and trauma. Some survivors may appear unaffected by the assault. This does not mean that they are experiencing less trauma nor does it call into question the truth of the situation.

It is common for sexual assault to disrupt the survivor’s typical routine. Some people continue with their usual obligations, but may be unable to do more than what is essential. Others may work all the time or volunteer for every activity or assignment possible, feeling that keeping busy helps them block the memories of the assault. Some survivors quit all activities and stay at home, only feeling comfortable leaving the house when someone else goes with them. Sexual assault is often a life altering experience. Survivors often report feeling “changed” by the experience of sexual assault.

Some of these changes may include:

  • their personal sense of security and/or safety may be damaged, so they now respond to perceived risks differently
  • they might feel less able to trust people, even those that they already had relationships with, and/or they might hesitate to initiate new relationships (both friendships and romantic or sexual partners) 
  • they might create new restrictions on their life and activities, no longer wanting to engage in the activities, hobbies, or communities that they used to enjoy
  • they may develop phobias or excessive fears, such as fear of crowds, being alone, the dark, or sleeping, that cause them to behave differently
  • they may develop specific fears related to specifics of their assault(s) or assailant(s), such as fear of people with facial hair of specific hair color, fear caused by the smell of alcohol or cigarettes, or fear of going to specific places
  • they may develop a distrust of strangers, of all people of the gender identity of their abuser, or of everyone
An Outward Adjustment Stage

During an outward adjustment phase the survivor may feel depression and experience a general sense of loss; for some people, this can be similar to the experience of grief. They may have once felt a sense of well-being, security, and control over their life, which were taken away by the assault, and they may be mourning the loss of those feelings. These feelings may be very apparent to others or the survivor may cover up these feelings. 

Other survivors cope by ignoring their feelings or convincing themselves that they are not affected by their experience. They may deny that the assault has affected them and will assure everyone that they are fine. They may bury their feelings to avoid feeling pain; conversely, they may avoid expressing their feelings because they worry that people will grow tired of hearing about them or because they worry about being a burden on others; or, expressing their feelings may not be safe. The survivor may withdraw from social relationships or personal interactions with friends and relatives. They may spend considerable time and energy distracting themselves from feeling or thinking. During a phase like this, the survivor may change eating and sleeping patterns and experience a lot of anger. 

Other feelings or symptoms associated with this phase may include:

  • continuing to feel anxiety, perhaps even being diagnosed with an anxiety disorder
  • feeling a sense of helplessness or hopelessness
  • feeling persistent fear
  • feeling depressed, perhaps even being diagnosed with depression
  • having mood swings, where a person might have their mood shift rapidly between feelings like happiness, depression, and anger
  • being defensive or guarded, or being more quick to anger than they used to be
  • having changes in their sleep, either sleeping all the time or struggling to sleep
  • having vivid dreams or recurrent nightmares
  • having physical symptoms like tension in the shoulders, neck, or jaw, frequent headaches, or feeling fatigued no matter how much rest they are getting; they may have pain in area(s) where they were touched or harmed during the assault 
  • having changes in eating or appetite, such as nausea, vomiting, undereating, or overeating

In particular, many survivors experience significant changes in their sexual relationships and comfort engaging in sexual contact. Some survivors report that they were scared to engage in sexual contact because of flashbacks. Others feel unsafe being vulnerable with a partner and don’t feel comfortable with nudity. Some no longer feel attracted to people who remind them of their assailant. Some survivors have shared that they no longer feel that they are sexually attractive or desirable, like they are “damaged goods.” Many survivors experience shame about how their bodies responded during assault — experiencing physiological arousal even when a person does not feel emotionally aroused is a common physical response, and can contribute to feelings of shame or embarrassment. Allowing space for a survivor to reestablish their comfort with their body and their sexuality is essential, particularly for the survivor’s romantic or sexual partner(s). 

An Integration Stage

During an integration phase, survivors integrate their feelings about the assault into their lives so that the incident is no longer a central focus. They may be able to go through their daily activities without constantly reliving memories or feeling that the assault is at the forefront of their mind. The changes to their behaviors or feelings that they experience in other stages may persist, although not as strongly or as often, or they may dissipate.

During integration, the survivor may also begin to deal with potentially harmful coping strategies that they had developed in earlier stages. For example, if the survivor self-medicated through the daily use of substances, they may now realize that they want to learn to cope without those aids. 

Just as in other stages, survivors may continue to have unpleasant physical reminders of their experience. They may still be “triggered” by sounds, smells, or sights that remind them of their traumatic experience, causing them to relive those feelings. They may still experience “flashbacks” of visual memories, which might feel like watching a movie of the event in their minds and cause them to feel the same level of fear or terror. 

Healing isn’t linear:

No matter what, it’s important to remember that healing from trauma is not a linear path. Survivors may think that they are “recovered,” only to have something bring up those feelings all over again. This is common and natural. Some people like to think of trauma as a chronic condition: it’s something that they know they’ll always have to manage, but much of the time they aren’t directly affected. If they have a flare up of symptoms, they can treat themselves with care, confident that they know how to cope.


Taking Care

Survivors of sexual violence deal not only with the trauma of the actual assault, but also with the many ways it impacts and changes their sense of self, of others, and of the world around them. The world is no longer the same; it will take time for them to adjust to the changes and to heal.

While survivors may want to “get on with their life,” “get back to normal,” or “forget anything ever happened,” avoiding their feelings can often make things worse. Coping, finding ways to take care of ourselves, and processing might not be easy, especially when they might be struggling to make it through each day. Survivors may try out many coping strategies, self-care techniques, and nurturing practices over time.

Here is a list of nurturing activities that other survivors have found helpful:

Listen to music or make some music: learn or practice an instrument, do karaoke, sing in the shower, make a drumset from your pots and pans!

Do an art project: draw or paint, play with clay, start a journal, make something beautiful.

Relax outside and enjoy nature: listen to the birds since, feel the sun, smell the trees, watch a sunrise or sunset, dip your feet in the water. Even just taking a walk around your block and being outside can be healing.

Connect with your body in ways that feel comfortable and safe: take a warm bath, have a solo dance party, do exercise that makes you feel good, stretch. Take a nap! Cook yourself a comforting meal that you can savor.

Rethink your living space: rearrange a room, paint a wall, or organize your closet. Put art on the walls that makes you smile, write affirming messages and place them around your room, or change up your bedding.

Nurture something that grows: create a garden or plant some houseplants. Play with children. Spend time with a pet, whether that’s offering to take a friend’s dog for a walk, fostering a kitten, or getting your own pet.

Meditate: practice calm breathing, scan your body and notice how it feels, take a walk while noticing what each step feels like.

Do something that you know makes you smile or laugh: watch a funny movie or youtube video, rewatch your favorite TV show, read some comics, get goofy with a friend.

Reach out for support: pet your favorite animal, say yes when someone offers support that you want, find someone who you feel comfortable hugging and let them hug you, get a massage (your health insurance may cover this), join a support group.

Make time for yourself: take yourself on a date. Go on an adventure. Visit a place that is meaningful to you. Take a trip. Go window shopping, or to your favorite museum, or buy yourself a special gift. Sign up for a workshop and learn something new.

Make plans for your future: check in with your goals and work towards them. Make to-do lists. Journal and imagine what you want next in your life. Try new recipes, take up a new hobby, or start a new exercise program. Nourish yourself.