If Tina’s mind managed to successfully block out the trauma of being sexually abused in childhood she remained ‘numb’ either she had no awareness memory of her abuse at all, or maybe she suspected 'something.'
As this Tina grows up she is likely to have had a history of depression as keeping those memories frozen takes energy that is then not available for her for living. She may have had a history of poor sleeping/insomnia.
She is likely to suffer from stress or anxiety as she encounters reminders of her abuse (triggers) out of her awareness which activate the flight or fight response. When this happens she may have panic attacks. She may often feel like she is ‘not there’ or ‘zoned out.’ People may say ‘she lives in a ’world of her own’ (see dissociation).
She may have developed phobias and/or obsessive thoughts and behaviours to control her symptoms that make no sense to her such as a fear of water or spiders, obsessive bathing or hand washing. (This is because spiders and water were used in her abuse and she is trying to remove feelings of ‘dirtiness’ or ‘badness’ of sexual abuse but she doesn’t know this). These symptoms may have become so severe it interferes with her function and becomes OCD and/or a major phobia such as agoraphobia or claustrophobia.
She may have responded to her anxiety by becoming a very controlled person, placing rigid boundaries on her own behaviour and limiting her thinking. She may develop an eating disorder. She might self-harm to feel in control. Others might call her a ‘control freak,’ or describe her as ‘anally retentive.’
Survivors predisposed to domestic violence
Her need to control may extend to other people so she could be seen as ‘very strict’ with her child or potentially verbally and/or physically violent - she may become a perpetrator of domestic violence.
She might fight her anxiety with aggression which may be verbal or could lead to violence.
She may have felt powerless and become overly submissive in relationships which may result in becoming a victim of domestic violence.
Survivor Tina:- Dissociative singleton Survivor Response to the Accident Trauma.
Imagine Tina has the same accident but this time her dormant memories are activated (triggered). Her early response is to go numb, but when she starts flashing she also flashes memories of being hurt by the child minder’s son and her stepfather. She has nightmares about it. She cannot make sense of this because she doesn’t remember what happened when she was a child. She doesn’t want to believe it because she now has a good relationship with her stepfather who she calls ‘dad.’ Her mother is still married to her stepfather and the child minder is her mother's best friend. She feels guilty and ashamed with herself for having these thoughts about people she cares about. She cannot move beyond ‘disbelief,’ blaming herself she withdraws into depression.
After the accident
After a month Tina has not processed the accident. Her symptoms have increased and now includes the sexual abuse from childhood. She is suffering from delayed shock which develops into Post Traumatic Stress Disorder (PTSD).
The past won’t go away
As her flashes and nightmares increase Tina is unable to put together the jigsaw of snippets of memory from her flashbacks and nightmares with strange sensations on her body (body memories) and emotions that feel overwhelming. She feels anxious all the time.
She breaks into sweats often and struggles to control her temperature sometimes.
She feels angry for no reason so she shouts at people a lot, especially her daughter - then she feels guilty and ashamed of herself.
She starts avoiding things, like the cinema she used to regularly attend with Amy because it’s close to where the accident was but she doesn’t realise what it's about and thinks she has just gone off going out.
She can’t rationalise.
She has got stuck in flight/Fight (PNS) so no matter how hard she tries to make sense of it she can't. She develops a head ache and blames herself for not recovering. She has a bottle of wine to help her sleep to ‘block out’ the pain of the memories, in time this develops into alcoholism. She cleans the house a lot, this develops into OCD, she gets caught in a 'loop' and stops going out. She's afraid social services will find out she's drinking and take Amy away. She feels ashamed.
She jumps at sounds she was comfortable with before developing hyper vigilance where her startle reflex is overactive.
A year later
On the anniversary of the accident Tina is still suffering. She hasn’t been well enough to return to work and is living on savings and/or sickness benefits. Her GP referred her into mental health, she's been diagnosed with PTSD and given medication but there is a long waiting list for counselling, she has never heard of EMDR.
She has not felt able to drive so she doesn’t go out much. She just doesn't feel like herself. She doesn't feel safe anywhere, especially out of the home so she's becoming reclusive. She has developed OCD spending all day cleaning when Amy is at school and shouting at her when she comes home for making mess. She doesn’t understand why she can’t recover and neither can her friends and family. They have forgotten about the accident and got on with their lives, no one asks her to do anything anymore. Tina becomes increasingly isolated, so does Amy who feels like she has lost her mother.
Tina wonders if she was sexually abused and tries to discuss it with her mother. Her mother doesn’t believe her, she says is she's ‘sick’ threatening to disown her if she mentions it again. Tina isn’t sure what happened. She feels guilty and confused. The past won’t go away.
The experience of delayed PTSD is always frightening. Memories can resurface months, years or decades after the event. Sometimes the longer they take to resurface the more difficult they are to make sense of even when we know we have been sexually abused PTSD throws us into turmoil.
It is common for memories of historical abuse in childhood to be triggered by a later event such as:-
- Another trauma
- Death of a parent and/or abuser
- Hearing another Survivors story
- The birth of a child
- An injury to your child
- An operation
- Loss of a partner/job/home or something other significant to you
- Extreme stress at home or at work
- Diagnosis of an illness
- And a myriad of other triggers that could only be ultimately be understood by that Survivor
The solution is to work through the trauma, but often the traumatic event is so long ago evidence is lost or explained away in the family history.
Why Tina doesn’t recover
Tina’s recovery from the car accident is blocked by previous unprocessed memories of child sexual abuse. She can’t process the memory of the car accident because she needs to talk through the historical sexual abuse to make it ‘real’ but she can't as there is no one available to listen to her. When she attempted to discuss it with her mother the mother reinforces her disbelief leading to further guilt and self-blame. There is no evidence for the abuse as she has no visible injuries so she has nothing to prompt external confirmation from strangers that the trauma happened. Tina is 'stuck.' She thinks she's ‘going mad.’
It is appalling that this situation replicates the response to the original trauma. She couldn't tell as a child and as she is unable to talk about it now, whatever beliefs she had back then are reinforced. Her processing has been frozen at age 8 and 9-11, but adult coping she has developed since is unavailable to her - effectively she re-experiences being abused again.
Thrive Therapy at I et al
As trauma therapists working with Survivors of child abuse we're familiar with clients with delayed PTSD desperate to make sense of what is going on in their heads. We offer specialist trauma therapy and EMDR where we will help you make sense of your symptoms in the context of your experience and help you take control.
In our trauma therapy practice I often hear.....
'Everything was OK, but all of a sudden I have fallen apart. I can't sleep, when I do I wake up sweating from nightmares I can't make sense of. I have pictures in my head that are really so disturbing I'm starting to wonder if I'm sick in the head. I can't think straight, I forget things. I'm jumpy and I just can't calm down. I snap at everyone, my kids have had enough........have I gone mad?
I tell them not to panic and explain PTSD. As we go through their symptoms they understand that they are not mad as there are psychological and physiological reasons for the body symptoms and dissociation. This understanding is usually really helpful. Thrive therapy is a trauma therapy, PTSD clients recover with trauma therapy and EMDR.
Click here to see how we can help
It is useful to understand trauma bonding, the essential building block for dissociative disorders.
In the last of these pages exploring how PTSD and DID develops find out how multiple trauma leads to Complex PTSD and DID.
1. Bowlby, John (1988a) A Secure Base: Clinical applications of attachment Theory, London: Routledge In Homes, Jeremy, (1993) John Bowlby and ttachment Theory, Routledge (2002)