Rehabilitation & healing

Overview
Different forms of help
Trauma and trauma reaction

---

We will look at elements that may assist survivors in taking the first steps to move on in life. We will look at different forms of help, at what trauma is and how it may affect the body and the mind, and common trauma reactions that people may experience after severe abuse. This knowledge may give a sense of control and provide some hope for the future, both for survivors and those of you who are supporting a survivor.

The rehabilitation and healing process after having experienced severe human rights violations may take different forms for different people. It also depends on the context and the support the survivor may receive. Some survivors recover relatively quickly and experience less trauma related reactions after a couple of weeks or months. Other survivors may have trauma related reactions for a longer time, sometimes many years or even their whole life. Often, reactions become less strong with time, and many survivors will experience moments in their life with little or no trauma related reactions at all. Sometimes reactions can disappear and then come back again. They can manifest themselves in different ways, in the body and/or in the mind. The most important thing to remember is that the survivor is not crazy! These reactions are common reactions to trauma.

Receiving support does not necessarily mean that survivors need to tell people what happened to them. There can be many reasons why survivors do not want to talk about what happened, it can be too difficult, painful, survivors may want to protect people from the horrible story and sometimes it is even dangerous to tell someone about what happened. It is always the survivor who decides whether he or she wants to talk about what happened and what he or she wants to tell about it.

If the survivor decides to tell you what happened, or parts of it, make sure to demonstrate that you believe what the survivor says and that you never put any shame, guilt or blame on the survivor. Remember that perpetrators are the only ones guilty and that human rights violations are illegal. The survivor has survived a crime perpetrated against him or her.

In many cases, there are other ways in which people who are close to a survivor may provide care and support. Making sure that the survivor is as comfortable and safe as possible, respecting the survivor’s needs and reactions, and being there for the survivor are good ways of showing love and support. You as someone who is close to a survivor can assist the survivor in creating a relatively “safe place” (meaning that you feel relatively safe when you are together) and that you try to focus on the here and now, that you use your senses to feel present in the current moment. One way of doing is, is to practice grounding exercises together, which can also be beneficial for people who are close to survivors. You can find more information about how to do this under the heading Self-care: grounding exercises. It is always the survivor who decides if she/he wants to practice grounding exercises or not.

In order to be able to care for and support the survivor, it may be helpful to know a little bit about what type of mental and physical reactions that are common among survivors. Severe abuse, especially when life-threatening, can seriously harm a person in various ways. The person you are close to who has survived severe abuse, may seem different from before – like as if the person is not entirely herself or himself. The survivor may, among other things, experience an acute stress reaction (which may last some hours or days after the abuse), deep sadness, have nightmares or bad dreams, frightening thoughts, flashbacks (meaning that the person feels like the abuse is happening again), dissociation (meaning that the mind of the person “leaves the body”), avoidance symptoms (meaning that the person avoids anything that might recall memories of the traumatic event), depression (a lack of energy and deep feeling of sadness, meaninglessness and/or lack of hope for the future) anxiety (feelings of strong fear), and/or be physically injured or have pain in different body parts.

It is very important that you are patient and respect the survivor’s fear and withdrawal. Openly accepting that the survivor reacts in such ways is very important. Keep in mind that most of these reactions usually are temporary and are a consequence of the abuse. The reactions are common reactions and the survivor is not “going crazy”.

It is important to understand that reactions vary from person to person, and that they may also vary over time. Maybe the survivor has various symptoms or reactions in the beginning, then for a while seems to be coping well, and then some months or even years later symptoms or reactions come back. And sometimes reactions may change over time. Give the survivor enough time and be patient. Healing and recovering from severe abuse and trauma may take a long time.

In general, it is very important to let the survivor decide how you can support him or her. Letting the survivor make as many decisions herself or himself as possible is very important for restoring the survivors’ dignity and integrity, and a sense of control in her/his own life.

Therapy 

Therapy is a form of psychological support with a mental health specialist, either a psychologist or a psychiatrist. There are different forms of therapy that have demonstrated to be effective for treating trauma reactions. Therapy is often on a one-to-one basis, between the survivor and the therapist, but sometimes group therapy may also be an option. Therapy may last for a shorter or an extended period of time, sometimes many years.
In most countries some form of therapy may be available somewhere in the country, but unfortunately it is not uncommon that there is a huge lack of specialist mental health professionals who can offer this type of support. Perhaps you can consult with somebody you trust, for example a social worker or primary health care worker, whether there are options for therapy available to you?