Surviving the Holidays

The holidays are often a difficult time for trauma survivors. Family activities, while joyous times for some people, are often difficult reminders of the past and can cause distress. For some survivors, the holidays are anniversaries of traumatic experiences. For other survivors, it may mean being in the presence of the sexual perpetrator or the abuser.

Survivors may not always be aware of how they are being triggered or may feel guilt and shame for not being able to rise to the same level of excitement and anticipation that others feel during this period. Even if they seem to have recovered well from past trauma, they may begin to have more problems with sleeping, over or under eating, increased anxiety, and a sense of impending disaster.

Here are some tips to help survivors manage stress during this time:

1. Have an exit strategy. Some survivors are able to say “no” when expected to attend family gatherings where a perpetrator may be present. A sense of obligation to other family members may make it difficult to stay away. If someone is planning to attend a family gathering where a perpetrator is present, it is good to limit the amount of time spent in the situation. Arriving late, having one’s own form of transportation, having an agreement with another family member to assist in maintaining distance are all possibilities.

2. Good self care. With all the stress of the holiday season, immune systems become compromised. Illness and fatigue can increase susceptibility to triggers and make it more difficult to manage reactions and heightened emotional vulnerability. High intakes of sugar through this time can also reduce the ability to combat infection, increasing vulnerability. Any activities that increase a sense of well being such as support groups, mindfulness activities, exercise, and creative projects can help fight off depression.

3. Support. Isolation is often a strategy for managing this time of year that can end up being very unproductive. Existing support groups or informal support of understanding friends may help alleviate some of the loneliness that occurs during the holidays.

4.  Limit alcohol intake.  Alcohol is a depressant and can also affect the immune system.  It also decreases inhibitions and affect sleep patterns which can then lead to increased vulnerability to the effects of trauma or additional trauma. 

Moderation in consumption of food, alcohol, and activity can be a very valuable for surviving the holidays.

Please feel free to add any other ideas you may have in the comment section below.

Forgiveness and Recovery from Trauma

I recently had a discussion with a few advocates on the idea of forgiveness and its place in healing the effects of trauma. I have had a few incidences in my work over the years to discuss this with both survivors and advocates and thought that it would be meaningful to generate some more thoughts on the subject.


The idea of forgiving the perpetrator for many survivors is an abhorrent idea. When presented with the idea in a support group curriculum or self-help book a survivor may have many responses. “Why would I forgive him? He hasn’t apologized!” “If I forgive him, that means I have to let him in my life again?” “What? Forgive? That would mean I would have to condone what happened? I can’t do that. First you tell me it was wrong and now I have to forgive?” “I must be a horrible person if I can’t forgive.”

Healing from trauma is a process and so is forgiveness. The process of recovery from trauma has many stages and forgiveness is only a part of one of those stages. Forgiveness may also be something that occurs further along in the healing, after there has been separation from the perpetrator and more manageability of one’s life and emotions.

In Trauma and Recovery, psychiatrist Judith Herman (1997) defines trauma as a disease of disconnection. In her book she describes a three-stage model for recovery – safety, remembrance and mourning, and reconnection.

Early in recovery a survivor is primarily working on issues regarding safety. Forgiving the abuser can often feel unsafe. It may feel as if a crack is being opened in a door that the survivor is working very hard to keep shut. If she is still experiencing feelings of love toward the abuser she may feel that forgiveness would increase her vulnerability and decrease her safety. During this early stage, controlling the environment, both internally and externally, is the most important task. Being able to establish appropriate boundaries with everyone in her life is a part of this task and forgiveness may blur that boundary. This stage is focused on the present and lasts as long as necessary for the survivor to develop skills to reduce the impact of triggers, alleviate anxiety and depression, and negotiate safety in the greater world.

During the remembrance and mourning stage the women is stabilized and begins to focus on the past. She often begins to acknowledge her losses and mourns the loss of the relationship or the dreams that were associated with her relationship. She is using the skills learned in the first stage to self-soothe while she comes to term with the impact of the trauma on the life she thought she would have. It is during this time that she may need to start to forgive herself – not for the abuse – but for what she may perceive her role to have been in the trauma. Many survivors carry a sense of guilt and shame in regards to their abuse and how they may have handled the situation. Hopefully, she will be able to recognize that she did the best she could under the circumstances and can now move on, stronger in knowing that she survived.

If forgiveness of the perpetrator is going take place, it is probably during the third stage – reconnection. This reconnection refers to developing a new self and creating a new future. It does not mean reconnecting with the perpetrator. Forgiveness is often described as a state of “letting go,” a process of releasing the past and moving forward into the future with a light load. It is not an action toward the abuser, but is rather an internal process of living life without resentments, anger or indignation. It is the recognition that until we “let go” the abuser still has power over us. Forgiveness is really not about what it does for the other person, but what it does for the survivor. The perpetrator never needs to know.

Forgiveness is also an action that cannot be forced onto the survivor. It is not to be a prescribed or demanded expectation. This is a process that the survivor comes to of her own choosing and in her own time. She will be able to let go of the past when she feels safe stepping into the future.

New Resource Added to Valuable Links - Stop the Storm

I would like to introduce you to  the blog http://stopthestorm.wordpress.com/ It is a wonderful resource.  This blog is written by a 59 year old survivor of childhood maltreatment who is also a cancer survivor.  She has done extensive research on trauma and how it has affected her ability to be in the world.  She does an excellent job of describing her responses to triggers and how trauma has influenced her relationships.  I highly recommend that you check it out.

Effects of Maltreatment on Brain Development

There have been a few requests lately for more information on how trauma affects a child’s brain and the child’s ability to form attachments and learn. The following is a summary of an article, Understanding the Effects of Maltreatment on Brain Development, published by the US Department of Health and Human Services’ Child Welfare Information Gateway www.childwelfare.gov/pubs/issue_briefs/brain_development

Thanks to the relatively recently developments in the study of brain development including functional magnetic resonance imaging, there is now evidence to show that brain function is altered significantly. “…genetics predisposes us to develop in certain ways. But our experiences, including our interaction with other people have a significant impact on how our predispositions are expressed. In fact, research now shows that many capacities thought to be fixed at birth are actually dependent on a sequence of experiences combine with heredity. (Shonkoff and Phillips, 2000).”

An infant is born with almost all of the brain neurons that it will ever have. As the brain developed in the fetus these neurons began to specialize, developing specific tasks for the lifespan of the person. This development continues after birth and on into adulthood. The first regions to develop are those concerned with bodily functions and maintaining life. “But the majority of brain growth and development takes place after birth, especially higher brain regions involved in regulating emotions, language and abstract thought. Each region manages its assigned functions through complex processes that involved chemical messengers (Perry, 2000a).”

Plasticity is the term used to describe the brain’s ability to change in response to stimulation. This is dependent on the stage of development and the specific region of the brain that is affected. The part of the brain that is “wired” to respond to the human voice or facial expression anticipates the exposure and when this does not happen, the brain will discard these pathways. The brain will discard pathways that are not being used and develop other pathways that are needed for survival.

There are sensitive periods for the development of certain capabilities. “For example, infants have the genetic predisposition to form strong attachments to their caregivers. But if a child’s caregivers are unresponsive or threatening, and the attachment process is disrupted, the child’s ability to form any healthy relationships during his or her life may be impaired )Perry, 2001a).

Babies are born with implicit memory which means they have a perception of the environment that can be recalled in unconscious ways (responding to the sound of mother’s voice). Explicit memory is tied to language development and provides children around the age of 2 with the ability to talk about themselves in the past or future or in different places or circumstances. However, children who have been abused or suffered other trauma may not be able to retain the explicit memories that they need to be able to tell about their trauma. Instead, they will experience the implicit memories such as bodily or emotional sensations that manifest as nightmares, flashbacks or other uncontrollable reactions.

Children can learn to tolerate moderate stress and greater amount of stress can be tolerated if he/she has a positive relationship with an adult caregiver. However, without this positive interaction in significant amounts at critical periods, the brain can be altered by the toxic stress. Specific effects depend on the age of the child, whether the trauma was one-time or chronic, the identity of the abuser, and whether there is a dependable nurturing adults present, the type and severity of the abuse, the intervention, and how long the maltreatment lasted.

“Altered brain development in children who have been maltreated may be the result of their brains adapting to their negative environment. If a child lives in a threatening, chaotic world, the child’s brain may be hyperalert for danger because survival may depend on it. But if this environment persists, and the child’s brain is focused on developing and strengthening its strategies for survival, other strategies may not develop as fully. The result may be a child who has difficulty functioning with a world of kindness, nurturing, and stimulation.”

Children who are exposed to long term and severe abuse, either emotional or physical/sexual, will develop responses such as a persistent fear response, hyperarousal, dissociation and disrupted attachment (inability to form relationships). The neural pathways have formed these responses as a means of surviving the impact of the trauma. However, these responses also result in increased susceptibility to stress, excessive help-seeking and dependency or excessive social isolation, and the inability to regulate emotions. The effects are cumulative and can lead to life long difficulties in interpersonal relationships.

“Some of the specific long-term effects of abuse and neglect on the developing brain can include (Teicher, 2000): diminished growth in the left hemisphere, which may increase the risk for depression; irritability in the limbic system, setting the stage for the emergence of panic disorder or posttraumatic stress disorder; smaller growth in the hippocampus and limbic abnormalities (areas of emotions and memories in the brain), which can increase the risk for dissociative disorders and memory impairments; impairment in the connection between the two brain hemispheres, which has been linked to symptoms of attention-deficit/hyperactivity disorder.

The U.S. Department of Health and Human Services Children’s Bureau (2009) encourages professionals to promote five “protective factors” that can strengthen families, prevent abuse and neglect, and promote healthy brain development: nurturing and attachment, knowledge of parenting and of children and youth development, parental resilience, social connections, and concrete support for parents.

For additional information go to www.nhcadsv.org to access the recent publication, The Mental Health Needs of Children Exposed to Violence in their Homes.