Defining Ritual Abuse
Ritual abuse can be defined as organised sexual, physical, and psychological abuse, which can be systematic and sustained over a long period of time. It involves the use of rituals, with or without a belief system. It usually involves more than one person as abusers. Ritual abuse usually starts in early childhood and involves using patterns of learning and development to sustain the abuse and silence the abused
Most sexual abuse of children is ritualised. Abusers use repetition, routine and ritual to force children into the patterns of behaviour they require, to instil fear and ensure silence, thus protecting themselves. Sexual abuse of a child is seldom a random act: it usually involves the abusers in thorough planning and preparation beforehand
Some abusers organise themselves in groups to abuse children and adults in a more formally ritualised way. Men and women in these groups can be abusers with both sexes involved in all aspects of the abuse. Some groups use complex rituals to terrify, silence and convince victims of the tremendous power of the abusers
Some abusers organise themselves around a religion or faith, or otherwise utilise spirituality and repetition to coerce and control the people that they are abusing
Most sexual abuse of children is ritualised. Abusers use repetition, routine and ritual to force children into the patterns of behaviour they require, to instil fear and ensure silence, thus protecting themselves. Sexual abuse of a child is seldom a random act: it usually involves the abusers in thorough planning and preparation beforehand
Some abusers organise themselves in groups to abuse children and adults in a more formally ritualised way. Men and women in these groups can be abusers with both sexes involved in all aspects of the abuse. Some groups use complex rituals to terrify, silence and convince victims of the tremendous power of the abusers
Some abusers organise themselves around a religion or faith, or otherwise utilise spirituality and repetition to coerce and control the people that they are abusing
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Ritual Abuse - History
Click to read more about the known history of ritual abuse
Throughout the 1970’s and 1980’s survivors of abuse began writing accounts of their lived experiences of ritual abuse (RA) including Michelle Remembers in which a woman gave an account of the sadistic RA she experienced while growing up in Canada. This, and other accounts by survivors were widely read and many sceptics blamed their influence for the increase in people claiming to be RA survivors and the many cases involving large numbers of children and adults that began to attract media attention.
The 1980’s onwards spawned a wealth of articles and books most of which argued for, or against, the existence of RA. Early reports of organised abuse in the 1980s were met with wide disbelief and such allegations were often believed to be moral panic and/or false memories created by therapists (Salter, 2017).
Currently, there is no universal definition of ritual abuse with terminologies varying across countries. In the USA such abuse is referred to as ritual abuse/mind control (RA/MC) or satanic ritual abuse (Miller, 2018), while in the UK it is called ritual abuse (Matthew & Barron, 2015), and in Germany it is named as organised ritual abuse (ORA: Schroder et al., 2020). Organised abuse within a belief system including religious or supernatural connotations is sometimes referred to as ritual abuse (Salter, 2012).
Lack of agreement of a definition, and research limited mainly to the existence of ritual abuse and validity of survivors’ stories has led to many survivors defining their own identities (Noblitt & Boblitt, 2014; Salter, 2012). Self-definitions, not surprisingly, are more varied, however, they tend to incorporate the ritualised nature of abuse and the pervasive impact of harms (Matthew & Barron, 2015).
The debate on RA Is complex and highly charged with many taking extreme and opposite positions within it; on one hand denial of its existence while on the other an almost religious quest for evidence. Prevalence rates remain unknown. Like other forms of abuse without clear definitions, prevalence cannot be known. It has been argued that, In addition to CSA, RA IIes different and extreme types of abuse, for example sadistic abuse (Faller, 1990; Sinason, 1995), pornography (Schmuttermaier & Veno, 1999) and mind control.
Some go even further and include cannibalism (Young, 1992), animal and child sacrifice and extreme torture. Authors such as Coleman (1994) talked about Satanism, mind control and sadistic practices carried out against young children as part of RA. Others explore the additional complexity of forcing children to behave like abusers towards each other and increased difficulties of survivors disclosing (Sinason et al, 2008) due to this, coupled with the extreme sense of guilt (Riseman, 2008) that survivors feel.
On the other hand, Lotto (1994) dismissed RA as fantasy and several authors constructed RA as a witch-hunt searching for something that doesn’t exist (Lotto 1994; Nathan and Snedeker, 1995). La Fontaine (1994) described it as a social construction arising out of CSA and dismissed accounts from children as false Satanism used by abusers to frighten children. Many academics deny the existence of RA (Frankfurter, 2006) and some dismiss survivors’ stories as false memory syndrome (FMS) (Loftus & Ketcham, 1994).
According to Frankfurter (2006), if RA existed, there would be physical evidence to back up claims. These sceptics dismiss survivors’ voices and claim that only expert scientific knowledge based on what can be seen and measured counts. This absence of measurable scientific proof of the existence of RA renders it non-existent. Given some of these sceptics come from a Christian perspective e.g. La Fontaine, this is an interesting position to take.
For some, RA is regarded as being constructed from mental health problems. Accounts from survivors are dismissed as imagined, fantasy and brain disorders by such as Lotto (1994). Some sceptics, including Loftus & Ketcham (1994), blame therapists for misdiagnosing and introducing false memories into vulnerable clients. The creation of the False Memory Foundation in 1992 led to the introduction of FMS. According to Loftus & Ketcham (1994) those survivors who recovered suppressed memories were suffering from FMS. Though there was no empirical evidence that FMS was a recognised medical condition or even possible, this syndrome cast further doubt on RA.
By way of counter argument, Barstow (1993) pointed out how unlikely was the notion of thousands of therapists suddenly and inexplicitly deciding to implant false memories into patients. Tamarkin (1994) offered hard evidence of pornography being discovered by police showing images of children involved in RA. Several researchers (Kelly, 1998; Weir & Wheatcroft, 1995) cited discoveries of real objects used in rituals as evidence of existence of RA. However, FMS has now been thoroughly discredited as disinformation (Salter, 2021) yet the harm done to survivors through the myths that persist about it continues. This possibly makes it harder for survivors to disclose and seek help.
Rather than getting into the debate about whether RA exists, some therapists, researchers and supporters have chosen to accept survivors’ stories and belief systems and work with them from where they present. The issue of proving facts or existence of RA is not important, rather some accept the possibility there may be many different truths. According to Bottoms & Davis (1997), working with absolute truth is not necessary for successful treatment of survivors. This view was echoed by Fraser (1997) and is supported by many survivor organisations.
According to Scott (2001), feminists failed to develop an analysis to deal with diverse forms of abuse such as RA. Feminists in women’s refuges and on rape crisis helplines had begun to hear ritual abuse survivors’ stories but,
“Not only did they fail to fit readily into the dominant paradigms of child sexual abuse framing practise in those contexts, but also they embodied a number of challenges to the paradigm.” (Scott 2001, p32)
RA was a challenge because it did not fit the feminist model, and the failure of feminists to rise to the challenge of exploring this complex issue in part contributed to the construction of RA as a moral panic, rather than the discovery of RA as an existing problem within society. Scott also explored the discourse of disbelief, which arose at the same time as the False Memory Foundation was established and continues to colour how people perceive RA to this day.
According to Salter (2008), the politics of disbelief persists with its focus on men as victims of lying women and children who have been brainwashed or coerced by feminists or fundamental Christians into making up unbelievable stories. Women and children are defined either as deliberate and evil liars or pathetically suggestible. This coupled with media hysteria and the creation of FMS while ignoring fully documented cases with convictions continues to dominate and render survivors invisible, mad or liars.
“Over the last thirty years, that framework (of disbelief) has been in ready supply, stemming both from the long‐standing medico‐legal tradition of denial, and from the activism of lobby groups of people accused of sexual abuse.” (Salter, 2008 p 266)
MacDonald and Sarson (2003) adopted the terminology Ritual Abuse Torture (RAT), which they claim is a more accurate name for RA and they suggest abusers deliberately use the façade of religion to divert society away from the truth and reality of survivors’ story. They suggest that belief in male domination, power and a deep hatred of women and children are at the heart of RAT. Interestingly, McDonald and Sarson, unlike many researchers, utilise voices and experiences of survivors extensively in their research.
Most literature on RA seems to be polarised with each side claiming to hold the truth of existence or non-existence of RA. Exaggerations of numbers involved as victims and as perpetrators are almost certainly made by both sides but, according to Victor (1993), exaggerated claims of RA and other abuse have fuelled the backlash against CSA and are unhelpful. Victor suggests that without an agreed definition, we cannot know or understand the scale of the problem.
The 1980’s onwards spawned a wealth of articles and books most of which argued for, or against, the existence of RA. Early reports of organised abuse in the 1980s were met with wide disbelief and such allegations were often believed to be moral panic and/or false memories created by therapists (Salter, 2017).
Currently, there is no universal definition of ritual abuse with terminologies varying across countries. In the USA such abuse is referred to as ritual abuse/mind control (RA/MC) or satanic ritual abuse (Miller, 2018), while in the UK it is called ritual abuse (Matthew & Barron, 2015), and in Germany it is named as organised ritual abuse (ORA: Schroder et al., 2020). Organised abuse within a belief system including religious or supernatural connotations is sometimes referred to as ritual abuse (Salter, 2012).
Lack of agreement of a definition, and research limited mainly to the existence of ritual abuse and validity of survivors’ stories has led to many survivors defining their own identities (Noblitt & Boblitt, 2014; Salter, 2012). Self-definitions, not surprisingly, are more varied, however, they tend to incorporate the ritualised nature of abuse and the pervasive impact of harms (Matthew & Barron, 2015).
The debate on RA Is complex and highly charged with many taking extreme and opposite positions within it; on one hand denial of its existence while on the other an almost religious quest for evidence. Prevalence rates remain unknown. Like other forms of abuse without clear definitions, prevalence cannot be known. It has been argued that, In addition to CSA, RA IIes different and extreme types of abuse, for example sadistic abuse (Faller, 1990; Sinason, 1995), pornography (Schmuttermaier & Veno, 1999) and mind control.
Some go even further and include cannibalism (Young, 1992), animal and child sacrifice and extreme torture. Authors such as Coleman (1994) talked about Satanism, mind control and sadistic practices carried out against young children as part of RA. Others explore the additional complexity of forcing children to behave like abusers towards each other and increased difficulties of survivors disclosing (Sinason et al, 2008) due to this, coupled with the extreme sense of guilt (Riseman, 2008) that survivors feel.
On the other hand, Lotto (1994) dismissed RA as fantasy and several authors constructed RA as a witch-hunt searching for something that doesn’t exist (Lotto 1994; Nathan and Snedeker, 1995). La Fontaine (1994) described it as a social construction arising out of CSA and dismissed accounts from children as false Satanism used by abusers to frighten children. Many academics deny the existence of RA (Frankfurter, 2006) and some dismiss survivors’ stories as false memory syndrome (FMS) (Loftus & Ketcham, 1994).
According to Frankfurter (2006), if RA existed, there would be physical evidence to back up claims. These sceptics dismiss survivors’ voices and claim that only expert scientific knowledge based on what can be seen and measured counts. This absence of measurable scientific proof of the existence of RA renders it non-existent. Given some of these sceptics come from a Christian perspective e.g. La Fontaine, this is an interesting position to take.
For some, RA is regarded as being constructed from mental health problems. Accounts from survivors are dismissed as imagined, fantasy and brain disorders by such as Lotto (1994). Some sceptics, including Loftus & Ketcham (1994), blame therapists for misdiagnosing and introducing false memories into vulnerable clients. The creation of the False Memory Foundation in 1992 led to the introduction of FMS. According to Loftus & Ketcham (1994) those survivors who recovered suppressed memories were suffering from FMS. Though there was no empirical evidence that FMS was a recognised medical condition or even possible, this syndrome cast further doubt on RA.
By way of counter argument, Barstow (1993) pointed out how unlikely was the notion of thousands of therapists suddenly and inexplicitly deciding to implant false memories into patients. Tamarkin (1994) offered hard evidence of pornography being discovered by police showing images of children involved in RA. Several researchers (Kelly, 1998; Weir & Wheatcroft, 1995) cited discoveries of real objects used in rituals as evidence of existence of RA. However, FMS has now been thoroughly discredited as disinformation (Salter, 2021) yet the harm done to survivors through the myths that persist about it continues. This possibly makes it harder for survivors to disclose and seek help.
Rather than getting into the debate about whether RA exists, some therapists, researchers and supporters have chosen to accept survivors’ stories and belief systems and work with them from where they present. The issue of proving facts or existence of RA is not important, rather some accept the possibility there may be many different truths. According to Bottoms & Davis (1997), working with absolute truth is not necessary for successful treatment of survivors. This view was echoed by Fraser (1997) and is supported by many survivor organisations.
According to Scott (2001), feminists failed to develop an analysis to deal with diverse forms of abuse such as RA. Feminists in women’s refuges and on rape crisis helplines had begun to hear ritual abuse survivors’ stories but,
“Not only did they fail to fit readily into the dominant paradigms of child sexual abuse framing practise in those contexts, but also they embodied a number of challenges to the paradigm.” (Scott 2001, p32)
RA was a challenge because it did not fit the feminist model, and the failure of feminists to rise to the challenge of exploring this complex issue in part contributed to the construction of RA as a moral panic, rather than the discovery of RA as an existing problem within society. Scott also explored the discourse of disbelief, which arose at the same time as the False Memory Foundation was established and continues to colour how people perceive RA to this day.
According to Salter (2008), the politics of disbelief persists with its focus on men as victims of lying women and children who have been brainwashed or coerced by feminists or fundamental Christians into making up unbelievable stories. Women and children are defined either as deliberate and evil liars or pathetically suggestible. This coupled with media hysteria and the creation of FMS while ignoring fully documented cases with convictions continues to dominate and render survivors invisible, mad or liars.
“Over the last thirty years, that framework (of disbelief) has been in ready supply, stemming both from the long‐standing medico‐legal tradition of denial, and from the activism of lobby groups of people accused of sexual abuse.” (Salter, 2008 p 266)
MacDonald and Sarson (2003) adopted the terminology Ritual Abuse Torture (RAT), which they claim is a more accurate name for RA and they suggest abusers deliberately use the façade of religion to divert society away from the truth and reality of survivors’ story. They suggest that belief in male domination, power and a deep hatred of women and children are at the heart of RAT. Interestingly, McDonald and Sarson, unlike many researchers, utilise voices and experiences of survivors extensively in their research.
Most literature on RA seems to be polarised with each side claiming to hold the truth of existence or non-existence of RA. Exaggerations of numbers involved as victims and as perpetrators are almost certainly made by both sides but, according to Victor (1993), exaggerated claims of RA and other abuse have fuelled the backlash against CSA and are unhelpful. Victor suggests that without an agreed definition, we cannot know or understand the scale of the problem.
Click here to read about human trafficking
Human trafficking is a global public health problem involving exploitation and abuse. It includes slavery, child sexual exploitation (CSE), forced marriage, debt bondage, organ trafficking, and other linked activities and overlap between different forms of abuse (Greijer & Doek, 2016). Child sex trafficking in the past was thought to occur only in low-income countries but it is now known that it can take place within any country and can be classified into domestic sex trafficking and international sex trafficking (Greenbaum, 2018). Child sexual exploitation involves forced prostitution, production of commercial sexual materials, survival sex, forced marriage, and any kind of forced sexual performance (Barnert et al., 2017).
Sexual exploitation and human trafficking are problems that are largely hidden from society but, due to a variety of reasons including the increasing numbers of people suffering from drug addictions, they have become of greater interest to many people and agencies in the UK. This heightened visibility has increased both community and media interest and has led to greater demands for a solution to deal with the problems.
Solutions that simply move the problems around or drive them underground do not really solve the problems, but often the public and politicians demand quick fixes such as increased police activity in known problem areas. This, unfortunately, rarely achieves anything. Longer-term strategies, good planning and close working partnerships between agencies, plus evidence-based prevention work in schools are surely the more effective solution.
Child sexual exploitation (CSE) and trafficking are even more hidden from society than exploitation involving adults, and includes both boys and girls, with some as young as 10 being at risk according to a report from Barnardo’s (2011). A more recent report from Barnardo’s (2012) highlighted the lack of prevalence studies in Scotland, despite the growing recognition of the risks to young people, with studies showing as many as 1 in 7 young people are at risk of exploitation. According to a Home Office consultation in 2004 the average age for women first becoming involved in sexual exploitation is 12 years old and vulnerable young people living in care homes are particularly at risk.
Very little research has been carried out on the involvement of males in prostitution, trafficking, or exploitation. The research that is available indicates that the average age of boys getting involved is younger than girls (Palmer, 2001). According to Moynihan, et al. (2018) there is a severe lack of information concerning CSE of males, which prohibits identification of them and, when seen, they are often considered to be troublemakers rather than being regarded as victims. There are few quality evaluations of programmes and policies to prevent CSE (Felner and DuBois, 2017) though educational programmes aimed at young people are essential for prevention of CSE (Rizo et al., 2018).
Additionally, due to the social stigma of perceived homosexuality and of men selling sex, the exploitation of young males is very much hidden (Donovan, 1991) with many young men simply below the radar of child protection services. Overall, there seems to be far less interest in exploring the involvement of boys in sexual exploitation or in providing services to support and help them. This lack of interest will surely continue to cover up the extent of the problem.
Sexual exploitation and human trafficking are problems that are largely hidden from society but, due to a variety of reasons including the increasing numbers of people suffering from drug addictions, they have become of greater interest to many people and agencies in the UK. This heightened visibility has increased both community and media interest and has led to greater demands for a solution to deal with the problems.
Solutions that simply move the problems around or drive them underground do not really solve the problems, but often the public and politicians demand quick fixes such as increased police activity in known problem areas. This, unfortunately, rarely achieves anything. Longer-term strategies, good planning and close working partnerships between agencies, plus evidence-based prevention work in schools are surely the more effective solution.
Child sexual exploitation (CSE) and trafficking are even more hidden from society than exploitation involving adults, and includes both boys and girls, with some as young as 10 being at risk according to a report from Barnardo’s (2011). A more recent report from Barnardo’s (2012) highlighted the lack of prevalence studies in Scotland, despite the growing recognition of the risks to young people, with studies showing as many as 1 in 7 young people are at risk of exploitation. According to a Home Office consultation in 2004 the average age for women first becoming involved in sexual exploitation is 12 years old and vulnerable young people living in care homes are particularly at risk.
Very little research has been carried out on the involvement of males in prostitution, trafficking, or exploitation. The research that is available indicates that the average age of boys getting involved is younger than girls (Palmer, 2001). According to Moynihan, et al. (2018) there is a severe lack of information concerning CSE of males, which prohibits identification of them and, when seen, they are often considered to be troublemakers rather than being regarded as victims. There are few quality evaluations of programmes and policies to prevent CSE (Felner and DuBois, 2017) though educational programmes aimed at young people are essential for prevention of CSE (Rizo et al., 2018).
Additionally, due to the social stigma of perceived homosexuality and of men selling sex, the exploitation of young males is very much hidden (Donovan, 1991) with many young men simply below the radar of child protection services. Overall, there seems to be far less interest in exploring the involvement of boys in sexual exploitation or in providing services to support and help them. This lack of interest will surely continue to cover up the extent of the problem.
Abuse - the Impact
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Impact of Abuse
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Trauma
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Flashbacks
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Panic Attacks
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PTSD
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The following has been taken from the website of The National Child Traumatic Stress Network.
“A traumatic event is a frightening, dangerous, or violent event that poses a threat to a child’s life or bodily integrity. Witnessing a traumatic event that threatens life or physical security of a loved one can also be traumatic. This is particularly important for young children as their sense of safety depends on the perceived safety of their attachment figures.
Traumatic experiences can initiate strong emotions and physical reactions that can persist long after the event has ended. Children may feel a range of feelings such as terror, helplessness, or fear, as well as having physiological reactions such as heart pounding, vomiting, or loss of bowel or bladder control. Children who experience an inability to protect themselves or who lacked protection from others to avoid the consequences of the traumatic experience may also feel overwhelmed by the intensity of physical and emotional responses."
Traumatic events can include physical, sexual, emotional abuse, natural disasters, family violence, bereavement, war, serious accidents, or illness. Any of these situations can lead to symptoms of child traumatic stress. Children who suffer from traumatic stress have usually experienced one or more traumas over the course of their lives and they can develop symptoms that affect their daily lives. Reactions vary but can include intense emotional upset, depression, anxiety, behavioural changes, inability to self-regulate, incontinence, attachment difficulties, regression, school or academic difficulties, nightmares, sleep difficulties, eating problems, and physical symptoms, such as aches and pains. Older children may turn to drugs or alcohol, engage in risky behaviour or unhealthy sexual activity.
There is no age limit on traumatic stress and even infants and toddlers can experience it. Without treatment, repeated exposure to trauma can affect development, change the brain and nervous system and increase problems such as eating disorders, self-harm, substance misuse, and high-risk activities. Trauma can also lead to long term mental health problems and suicidal feelings.
How individuals will react to traumatic events varies widely. Some people can recover quickly while some are affected for a short time and others can be badly affected for a very long time sometimes their whole life. Even for those people who experience the same traumatic event there are differences in how each person is affected depending on their life experiences, resilience, personality, and a myriad of different things. There is currently no way of knowing how a trauma will impact on any individual.
Acute trauma is defined as trauma that has occurred due to a single traumatic event. These are situations such as the death of a close family member, an accident, or a single abuse event. Due to the way our brains operate, our minds try to kick into survival mode when anything overwhelming happens; this is how we stay alive and don't fall into complete psychological collapse despite terrible events occurring. When something is really overwhelming however our nervous system in the brain can become "stuck" in survival mode, thus producing the symptoms of trauma, which can sometimes remain for years after the event.
Chronic trauma occurs when a person experiences a multitude of traumas, for example situations of long-term childhood abuse, war, long-term abusive relationships, or sometimes when someone goes through a repeated series of unrelated traumas. For instance, someone who has lost family in an accident suddenly experiencing a life-changing medical diagnosis, followed by homelessness, the loss of their job or financial troubles. Whether physically living in a war zone or in the home, a person dealing with overwhelming situation after situation is experiencing chronic trauma.
Finally, complex trauma, is the type of trauma that remains ongoing for months, years, or even decades. This form of trauma is most often associated with extreme abuse or extreme ongoing traumatic events leading to illnesses such as post-traumatic stress disorder (PTSD), which produces symptoms such as dissociation, anxiety, nightmares, panic attacks, flashbacks, and phobias.
“A traumatic event is a frightening, dangerous, or violent event that poses a threat to a child’s life or bodily integrity. Witnessing a traumatic event that threatens life or physical security of a loved one can also be traumatic. This is particularly important for young children as their sense of safety depends on the perceived safety of their attachment figures.
Traumatic experiences can initiate strong emotions and physical reactions that can persist long after the event has ended. Children may feel a range of feelings such as terror, helplessness, or fear, as well as having physiological reactions such as heart pounding, vomiting, or loss of bowel or bladder control. Children who experience an inability to protect themselves or who lacked protection from others to avoid the consequences of the traumatic experience may also feel overwhelmed by the intensity of physical and emotional responses."
Traumatic events can include physical, sexual, emotional abuse, natural disasters, family violence, bereavement, war, serious accidents, or illness. Any of these situations can lead to symptoms of child traumatic stress. Children who suffer from traumatic stress have usually experienced one or more traumas over the course of their lives and they can develop symptoms that affect their daily lives. Reactions vary but can include intense emotional upset, depression, anxiety, behavioural changes, inability to self-regulate, incontinence, attachment difficulties, regression, school or academic difficulties, nightmares, sleep difficulties, eating problems, and physical symptoms, such as aches and pains. Older children may turn to drugs or alcohol, engage in risky behaviour or unhealthy sexual activity.
There is no age limit on traumatic stress and even infants and toddlers can experience it. Without treatment, repeated exposure to trauma can affect development, change the brain and nervous system and increase problems such as eating disorders, self-harm, substance misuse, and high-risk activities. Trauma can also lead to long term mental health problems and suicidal feelings.
How individuals will react to traumatic events varies widely. Some people can recover quickly while some are affected for a short time and others can be badly affected for a very long time sometimes their whole life. Even for those people who experience the same traumatic event there are differences in how each person is affected depending on their life experiences, resilience, personality, and a myriad of different things. There is currently no way of knowing how a trauma will impact on any individual.
Acute trauma is defined as trauma that has occurred due to a single traumatic event. These are situations such as the death of a close family member, an accident, or a single abuse event. Due to the way our brains operate, our minds try to kick into survival mode when anything overwhelming happens; this is how we stay alive and don't fall into complete psychological collapse despite terrible events occurring. When something is really overwhelming however our nervous system in the brain can become "stuck" in survival mode, thus producing the symptoms of trauma, which can sometimes remain for years after the event.
Chronic trauma occurs when a person experiences a multitude of traumas, for example situations of long-term childhood abuse, war, long-term abusive relationships, or sometimes when someone goes through a repeated series of unrelated traumas. For instance, someone who has lost family in an accident suddenly experiencing a life-changing medical diagnosis, followed by homelessness, the loss of their job or financial troubles. Whether physically living in a war zone or in the home, a person dealing with overwhelming situation after situation is experiencing chronic trauma.
Finally, complex trauma, is the type of trauma that remains ongoing for months, years, or even decades. This form of trauma is most often associated with extreme abuse or extreme ongoing traumatic events leading to illnesses such as post-traumatic stress disorder (PTSD), which produces symptoms such as dissociation, anxiety, nightmares, panic attacks, flashbacks, and phobias.
Flashbacks are like a waking nightmare where the person relives a traumatic event repeatedly. It is an unprocessed memory that recurs. A flashback is the brain's way of working to try to process a trauma so that the experience can be properly filed away as a past memory (rather than a current threat). Sometimes a memory is so traumatic that the brain struggles to process it and it gets stuck sometimes as fragments in other parts of the brain.
People are often triggered into a flashback by a reminder of a past traumatic event though sometimes they recur for no apparent reason. The flashbacks can be so intense that it can feel like the traumatic event is happening again but in the present time. They can be very distressing and extremely debilitating.
The person who is experiencing them can feel like the original trauma is happening all over again and it can feel very real while it is happening. Often the person can feel the original pain, smell the original smells and hear what they heard in the past during the traumatic event. They can believe that they are back in the place where the trauma happened and can lose touch with the present time. Though flashback can be very debilitating there are many things’ people can do to help survivors get through flashbacks and survivors can also learn how to deal effectively with the flashback and in time can process them.
Helping with flashbacks
Focus on breathing normally and suggest that the person breathe along with you. When frightened, people instinctively breathe faster and shallower and this can increase the fear response. Suggest that the survivor mirror breathing with you and talk them through breathing in deeply for a count of four, holding their breath for a count of five then breathing all the way out for a count of six.
Encourage survivors to practice breathing exercises at other times so that they can get used to using breathing exercises.
Using all the five senses can help too. Touching something like a stone or feather or keyring; sniffing a flower, soap, perfume; looking at the surroundings to check out where they are now, tasting something and listening to the sounds around them. Supporters can really help by talking calmly to the survivor and suggesting that they use their different senses including looking at and focussing on something in the room or outside and listening to the birds or the music that is playing.
Remind the survivor that they are safe now and tell them that what is happening is a trauma memory and it is no longer happening to them. Remind them that they can hear your voice and you were not there when the trauma was happening therefore it is in the past. A gentle soothing calm voice can make a massive difference during a flashback. Offer comfort in the shape of a cushion, teddy or cosy blanket.
If there is a pet which could be touched and petted suggest it but do not touch a survivor who is having a flashback without their permission. Offer a hug if this is something you have previously agreed with the survivor but do not assume that is what is wanted or needed at that time. Sometimes the supporter is the person more in need of a hug but it is important not to impose on the survivor.
Encourage the survivor to try to think about different things, almost like playing mental games, for example: counting backwards in sevens from one hundred, thinking of ten different animals, ten blue things, one animal or country for each letter of the alphabet, saying the alphabet slowly, saying the alphabet backwards etc. This can help focus the mind on the here and now and help stop the flashback. Ask the survivor what day it is, what the date is and try to get them to start talking to you about the things around them and what they can see, hear, smell or touch.
Do not encourage the survivor to talk about the traumatic memory while having a flashback as this can make things worse. Talking about a traumatic memory is best done when the survivor is ready and wanting to do so. Or talking about it can help while in therapy and when feeling safe rather when feeling unsafe. If the survivor wishes to talk about the actual memory, encourage them to think through the best way to do this without having further flashbacks. If the survivor chooses to start talking about it though, that is their choice.
People are often triggered into a flashback by a reminder of a past traumatic event though sometimes they recur for no apparent reason. The flashbacks can be so intense that it can feel like the traumatic event is happening again but in the present time. They can be very distressing and extremely debilitating.
The person who is experiencing them can feel like the original trauma is happening all over again and it can feel very real while it is happening. Often the person can feel the original pain, smell the original smells and hear what they heard in the past during the traumatic event. They can believe that they are back in the place where the trauma happened and can lose touch with the present time. Though flashback can be very debilitating there are many things’ people can do to help survivors get through flashbacks and survivors can also learn how to deal effectively with the flashback and in time can process them.
Helping with flashbacks
Focus on breathing normally and suggest that the person breathe along with you. When frightened, people instinctively breathe faster and shallower and this can increase the fear response. Suggest that the survivor mirror breathing with you and talk them through breathing in deeply for a count of four, holding their breath for a count of five then breathing all the way out for a count of six.
Encourage survivors to practice breathing exercises at other times so that they can get used to using breathing exercises.
Using all the five senses can help too. Touching something like a stone or feather or keyring; sniffing a flower, soap, perfume; looking at the surroundings to check out where they are now, tasting something and listening to the sounds around them. Supporters can really help by talking calmly to the survivor and suggesting that they use their different senses including looking at and focussing on something in the room or outside and listening to the birds or the music that is playing.
Remind the survivor that they are safe now and tell them that what is happening is a trauma memory and it is no longer happening to them. Remind them that they can hear your voice and you were not there when the trauma was happening therefore it is in the past. A gentle soothing calm voice can make a massive difference during a flashback. Offer comfort in the shape of a cushion, teddy or cosy blanket.
If there is a pet which could be touched and petted suggest it but do not touch a survivor who is having a flashback without their permission. Offer a hug if this is something you have previously agreed with the survivor but do not assume that is what is wanted or needed at that time. Sometimes the supporter is the person more in need of a hug but it is important not to impose on the survivor.
Encourage the survivor to try to think about different things, almost like playing mental games, for example: counting backwards in sevens from one hundred, thinking of ten different animals, ten blue things, one animal or country for each letter of the alphabet, saying the alphabet slowly, saying the alphabet backwards etc. This can help focus the mind on the here and now and help stop the flashback. Ask the survivor what day it is, what the date is and try to get them to start talking to you about the things around them and what they can see, hear, smell or touch.
Do not encourage the survivor to talk about the traumatic memory while having a flashback as this can make things worse. Talking about a traumatic memory is best done when the survivor is ready and wanting to do so. Or talking about it can help while in therapy and when feeling safe rather when feeling unsafe. If the survivor wishes to talk about the actual memory, encourage them to think through the best way to do this without having further flashbacks. If the survivor chooses to start talking about it though, that is their choice.
Panic attacks can come on very suddenly and can be very frightening to the survivor. They are often caused by trauma, stress or bereavement. There are usually both physical and mental symptoms. During a panic attack, the physical symptoms can build up very quickly. These can include: a pounding or racing heartbeat, feeling faint, dizzy or light-headed, feeling very hot or very cold, sweating, trembling or shaking, nausea (feeling sick), pain in the chest or abdomen, struggling to breathe or feeling like choking, legs shaking or turning to jelly, feeling disconnected from the mind, body or surroundings, which are types of dissociation.
During a panic attack survivors might feel very afraid that they are losing control, going to faint, having a heart attack or going to die. Panic attacks can be absolutely terrifying to the person experiencing them and sometimes they can be mistaken for having a heart attack. Survivors can learn how to recognise and deal with panic attacks and with support these can be reduced over time. Sometimes when panic attacks are not dealt with they can lead to other serious problems such as survivors stopping going to places where they had the panic attack, for example certain shops or into town or even over time stopping going outside at all.
Helping with a panic attack
The most important thing when someone is having a panic attack is to recognise that is what it is and to stay calm. Ask the survivor to concentrate on what you are saying. If you are aware of what has caused the panic attack e.g., seeing a dog if they are afraid of dogs, try to steer them away from the cause of the panic attack. If you don’t know what caused it stay with them and remind them to take deep slow breathes and count with them while breathing in and out slowly yourself to mirror and to help them to slow down their breathing.
If you can, offer the survivor a paper bag to breathe into as that can sometimes help slow down their breathing. Get them to sit down preferably is a quiet space and make them aware that it will pass and that they are safe. Try to get them to focus on their surroundings and to think about positive and peaceful things. Stay with them and keep reminding them that they are safe and that it will pass. As the panic attack begins to pass the survivor may be embarrassed or upset so let them know its ok and normal and that they are now safe. Offer to help them to get home if they fear having another panic attack.
During a panic attack survivors might feel very afraid that they are losing control, going to faint, having a heart attack or going to die. Panic attacks can be absolutely terrifying to the person experiencing them and sometimes they can be mistaken for having a heart attack. Survivors can learn how to recognise and deal with panic attacks and with support these can be reduced over time. Sometimes when panic attacks are not dealt with they can lead to other serious problems such as survivors stopping going to places where they had the panic attack, for example certain shops or into town or even over time stopping going outside at all.
Helping with a panic attack
The most important thing when someone is having a panic attack is to recognise that is what it is and to stay calm. Ask the survivor to concentrate on what you are saying. If you are aware of what has caused the panic attack e.g., seeing a dog if they are afraid of dogs, try to steer them away from the cause of the panic attack. If you don’t know what caused it stay with them and remind them to take deep slow breathes and count with them while breathing in and out slowly yourself to mirror and to help them to slow down their breathing.
If you can, offer the survivor a paper bag to breathe into as that can sometimes help slow down their breathing. Get them to sit down preferably is a quiet space and make them aware that it will pass and that they are safe. Try to get them to focus on their surroundings and to think about positive and peaceful things. Stay with them and keep reminding them that they are safe and that it will pass. As the panic attack begins to pass the survivor may be embarrassed or upset so let them know its ok and normal and that they are now safe. Offer to help them to get home if they fear having another panic attack.
Post-Traumatic Stress Disorder (PTSD) is a mental health problem which can be caused by experiencing traumatic events such as childhood sexual abuse. It has been recognised as a condition that war veterans can suffer from and is increasingly being diagnosed for abuse survivors. It is common for anyone experiencing trauma to suffer from numbness, sleep disturbances, intrusive thoughts, and stress but for many people these symptoms soon disappear. For some survivors though the symptoms might be delayed or increase in intensity to the point where the person cannot function. Symptoms can include vivid recurring flashbacks, intrusive thoughts or images, nightmares, intense distress, physical sensations such as pain, sweating, nausea or feeling on edge all the time. Sometimes the survivor is hyperalert, paranoid, aggressive or panicky. Because the condition is well recognised these days survivors can be encouraged to go to their doctors and be referred to mental health specialists for help.
Helping with PTSD
Supporters can help by being there for the survivor and being prepared to listen when they want to talk. No one should ever feel pressured into talking but it is important to let the survivor know that someone is available to listen to them. It is important not to make assumptions about how they are feeling or what they are going through. Everyone is different and everyone experiences abuse and trauma in their own way. People also recover at different paces and there can be many setbacks to recovery. Some people find medication helpful in aiding recovery, others do not.
Being there for the survivor and letting them know you care even though you may not be able to understand what is going on for them can make a big difference to them. If they do start to open-up and talk to you, listen, and don’t minimise their lived experiences by suggesting that it wasn’t too bad or could have been worse. It is also important to not question why they did something a certain way at the time of the event as this implies blame. When trauma happens, people are often in shock and react instinctively. Often it comes down to basic survival instinct rather than clear thinking and in the case of children and young people they also lack experience, and many have often been groomed by abusers.
People with PDSD can recover though no one can ever say just how long recovery will take. If they are able and willing to get professional help then this can greatly help recovery. Supporters of the survivors often must be very patient and understanding and can sometimes feel helpless. It can make a massive different though to survivors with PTSD to know that someone is there for them and cares about them.
Helping with PTSD
Supporters can help by being there for the survivor and being prepared to listen when they want to talk. No one should ever feel pressured into talking but it is important to let the survivor know that someone is available to listen to them. It is important not to make assumptions about how they are feeling or what they are going through. Everyone is different and everyone experiences abuse and trauma in their own way. People also recover at different paces and there can be many setbacks to recovery. Some people find medication helpful in aiding recovery, others do not.
Being there for the survivor and letting them know you care even though you may not be able to understand what is going on for them can make a big difference to them. If they do start to open-up and talk to you, listen, and don’t minimise their lived experiences by suggesting that it wasn’t too bad or could have been worse. It is also important to not question why they did something a certain way at the time of the event as this implies blame. When trauma happens, people are often in shock and react instinctively. Often it comes down to basic survival instinct rather than clear thinking and in the case of children and young people they also lack experience, and many have often been groomed by abusers.
People with PDSD can recover though no one can ever say just how long recovery will take. If they are able and willing to get professional help then this can greatly help recovery. Supporters of the survivors often must be very patient and understanding and can sometimes feel helpless. It can make a massive different though to survivors with PTSD to know that someone is there for them and cares about them.
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