How abuse affects survivors

All forms of abuse – emotional, physical, and sexual – bring with it many emotions for survivors and their loved ones. These feelings can range from anger, confusion and sadness, to physical pain and illness and psychiatric disorders.

Vuk’uzenzele consulted with Tshwane clinical psychologists, doctors Adel Ras and Jacques Labuschagne, to understand the psychological impact of abuse, and to find out how family, friends and communities can support survivors.  

Ras and Labuschagne explained that people respond to abuse as a result of their individual genetic make-up, life experiences and coping skills acquired throughout life, but in their work have come across common reactions and coping mechanisms.

“The brain is engaged to make fast decisions and the body reacts physically to survive. So initially when abuse occurs, the focus is on surviving the ordeal, while the ability to tend to emotions and abstract thought processes are postponed momentarily,” Dr Ras explained. 

Depending on the threat, the person’s ability to survive may be affected.

When the threat has passed, the survivor goes through a period of readjusting to their environment, to time and to their person.

“The immediate need for safety and seeking help or protection becomes a priority.  Survivors desperately seek out a place of safety, engaging people for assistance,” said Dr Ras.

Once the survivor feels safe again, their critical thinking is slowly engaged again.

“Survivors have conflicting ideas on the possible consequences of involving help, which may include: “Where do I (and my loved ones) go if home is not currently safe? Who I can trust with my story? What if people judge me? Could I be to blame for and/or perhaps have deserved what happened?” and so on.”

Ras and Labuschagne said many survivors encounter secondary trauma from how they are assisted after abuse by either first responders or the police. These can worsen the experience by expressing judgment leaving survivors to wait for long periods before attending to them or through a lack of assistance.

As time passes, survivors express feelings of numbness, helplessness, being wronged, unfairness, disgust, feeling dirty and broken, betrayal (especially if the perpetrator is someone who was trusted), feeling robbed, anger, revengefulness, fear, sadness, loss, guilt, and shame.

“Sometimes the experience of abuse fits into the person’s life story, for example, they have had similar experiences in previous relationships, or grown up in an abusive environment,” said Dr Ras.

Survivors also report unwanted feelings and reliving experiences through nightmares or flashbacks that can slow down their process of healing.
“These feelings and reliving experiences are attempts by the mind to heal itself.”

Ras and Labuschagne said that individuals also attempt to avoid dealing with their emotions altogether or try to deal with them in isolation which could lead to emotional suffering.

According to Ras and Labuschagne the most common psychiatric diagnosis that may follow abuse include acute stress or adjustment disorders, post-traumatic stress disorder (PTSD), anxiety disorders, major depressive episodes and major depression.

“The survivor may be faced with trust, intimacy and/or other relational difficulties, interpersonal isolation and/or blaming themselves, and feelings of guilt and self-esteem difficulties.”

It takes courage and high levels of trust for survivors to speak out about their experiences. Survivors fear that they will be treated differently by their friends of family once they know what happened. 

“Have empathy and give the survivor the opportunity to share their emotions. If we communicate blame or judgment, it can cause further emotional pain on the person,” said Dr Ras.

Ras and Labuschagne urged survivors, family members and friends to seek professional assistance from government via the Department of Health’s Crisis Centres and the police, and through non-government, civil society and private organisations.

*Dr Ras is a clinical psychologist at the Tshwane Medico Legal Crisis Centre, the Laudium Community Health Clinic and works in private practice. Dr Labuschagne is the Psychology Team Leader for the Gauteng Department of Health: Tshwane District Health Services.