Coping with Trauma: Finding What Works

What exactly is trauma and how can it affect us? In this week’s podcast, we explore trauma’s impact on the brain and different tools to help

A great number of us will experience a traumatic event in our lives. For some, it will be something we’re able to process and move on from, for others, there may be lasting effects. On today’s podcast I speak to yoga teacher, Reiki practitioner and author Sarah Wheeler about her lived experience and tools that helped her. Joining the conversation is clinical psychologist Dr Joe Barker who shares the science behind trauma and therapeutic approaches.

Together we discuss what trauma can look like, different supportive strategies and the importance of trauma-informed care throughout the health and wellbeing industry. Listen to the conversation below, or wherever you get your podcasts.

Transcript:

Edited for clarity and brevity.

Kat: Hello everyone, welcome to another episode of Happiful: Finding What Works. Today we'll be discussing trauma, its effects, and coping strategies. With this topic in mind, I encourage listeners to please take care of yourselves. Don't hesitate to press pause and return later if it's too much. Helping me navigate this topic today are my guests, Sarah and Joe. Sarah, could you introduce yourself and tell us about your work?

Sarah: Sure. Thank you so much, Kat. It's nice to be here with Joe as well. Like you said, it's an important topic, and definitely one where it’s kind of, listener self-care advised. I am a yoga teacher, Reiki teacher, and author of a couple of books. I live in Hove, not Brighton as I previously mentioned to Kat! I am a dedicated lover of hummus. When not teaching yoga, giving a Reiki session, or writing, I often enjoy a sauna, which is nice, but not…. Eating hummus in the sauna, that’s gross, isn’t it?

Kat: I mean, that could be really great, but…. 

Sarah: It could, but I think maybe just, maybe that's a little bit grimy, not for me! [laughs]

Kat: Perfect. Thank you so much, Sarah. And Joe, yourself, could you tell us a bit more about your work and anything else about yourself? 

Joe: Of course. Hello. My name's Dr Joe Barker. I'm a senior clinical psychologist in the NHS, supporting people living with trauma and HIV across East Anglia, including Cambridge, Peterborough, and Bedfordshire. I'm also the clinical director of Connect Clinical Psychology, a service supporting people with trauma and neurodiversity. I also work at the University of East Anglia, training psychologists on our doctoral training course. It's great to be here.

Kat: Brilliant. Thank you so much, Joe. And I'm going to come to you for this first question as well because I think it'd be really great for us to understand a bit more about what trauma actually is. Could you tell us what it is and perhaps what types of events can cause trauma for people? 

Joe: Sure. Trauma is an emotional response to an overwhelming or distressing event or series of events. The majority of us will experience a traumatic event at some point in our lifetimes. A traumatic event might be a natural disaster, accident, conflict, or an ongoing series of events. One type of event with a high instance of post-traumatic stress disorder is interpersonal trauma. This includes relational traumas like physical abuse, emotional abuse, coercive control, manipulative behaviour, and gaslighting. It can also encompass consistent interpersonal traumas such as childhood neglect, lack of emotional stimulation or attention, and a general feeling of unsafety. Trauma can be an overwhelming single instance or a range of instances over time, all stemming from the emotional response to an overwhelming experience or threat.

Kat: That's what I've heard before when researching this topic. As you said, trauma can result from something happening too fast, too soon, or too much either as a single event or ongoing trauma. With that in mind, trauma might not be immediately obvious to people. Could you share more about the symptoms of trauma someone might experience, especially if they haven't recognised they've gone through a traumatic experience?

Joe: Sure. It's important to note that the reaction to a traumatic event is a normal and natural response, something everyone does as human beings to keep themselves safe. One central tenet of surviving a traumatic event is that the trauma itself feels overwhelming and puts us in a position where we feel out of control. 

When discussing trauma, it’s useful to touch on how memories are normally formed, because this is really what we’re talking about when we talk about trauma - memory. Normally, we experience an event in a sensory way, gathering data from our five senses. 

For instance, when eating an ice cream, you taste its cold sweetness and might identify the flavour of strawberries. This sensory experience is accompanied by an emotional response, which can be either pleasant or aversive based on your feelings towards strawberries.

Our brain tags the memory with a time, place, and date before filing it away. As it moves from the amygdala, our brain's sensory short-term storage vessel, to the hippocampus, the memory is desensitised and its intensity reduces. Once neatly stored, recalling the memory is a bit like taking out a library book: we can choose to take it out, read it and put it back. For instance, eating ice cream in the future might remind us of a past ice cream experience, but we can tell it’s a memory. This happens in a really clever part of our brain developed over millions of years.

When we experience something overwhelming and traumatic, our filing system goes offline. Our fight or flight response, our trauma response, takes over. This core, old part of our brain focuses solely on keeping us safe, not on processing memories. It’s just interested in helping us survive that moment. We essentially don’t have the brain capacity to neatly file the memory, so the memory becomes disjointed and doesn't get tagged with time or place. Instead, it remains in our amygdala, a sensory part of our brain. If something reminds us of it, the memory doesn't stay neatly stored; it’s like the whole library spills out, making us relive it as if it's happening again. Due to its traumatic nature, we often have a strong emotional response, finding it terrifying. We might experience the same sensory aspects like sounds, smells, and sights, leading to flashbacks, nightmares, or even tactile sensations of pressure or pain. Because the memory remains in the amygdala, its intensity doesn't fade over time.

Kat: That is such a helpful analogy. The analogy of the library and memories, being able to review them at will versus having the library spill out during trauma – that’s really helpful. Thank you for sharing that. Now that we understand more about trauma, what it can involve, and some symptoms like flashbacks. Sarah, I'd love to come to you now and ask how trauma has touched your life.

Sarah: Yeah, thank you, Joe. It's always good to hear explanations from the clinical side about how trauma actually works and its ongoing process. For myself, I was diagnosed with post-traumatic stress disorder (PTSD) in late July 2016. I was fortunate enough to be able to have really brilliant clinical contact time with a therapist at the Havens in London. The Havens specialises in recovery for victims of sexual crime. Unfortunately, in early July 2016, I was sexually assaulted at a music festival. Through the police, I was referred to the Havens. I arrived at the Havens still in the same month as the attack.

Understanding things later on, it's quite unusual for a person to receive a PTSD diagnosis within the same number of weeks that they suffered a trauma. Usually, it’s something that is diagnosed later, around six, seven, or eight weeks if trauma symptoms persist. My diagnosis came about as I began discussing background information with the therapist, detailing the state of my nervous system before the attack. Prior to the assault, I frequently felt anxious, stressed, and experienced panic that would creep up from nowhere. She diagnosed PTSD because I’d also disclosed that prior to this attack, I was in a narcissistic abusive relationship. This relationship wasn't connected to the sexual assault but I had been in that relationship for almost two years and I didn’t understand what was happening to me was a systematic violation of my relationship with myself, my boundaries, and the trust I once had in myself, which was getting ebbed away, day after day.

Also as background to that, which fed into the diagnosis, I had experienced trauma previously, though I didn't recognise it at the time. All I felt somatically in my body was being all over the place frequently. Before the narcissistic abuse relationship, I had been involved in what we can call cults or high-demand organisations. These experiences occurred quite quickly after one another. As a teenager, I'd also struggled on and off with an eating disorder, which became more pronounced in my late twenties during the narcissistic relationship. 

There was an awful lot going on in my life, but I didn't realise that occasional singular events were part of a larger context, compounded by the day-to-day emotional abuse I was experiencing. I didn't know I was being traumatised. When I relayed this information to the clinical psychologist at the Havens and put on top of that I very recently suffered a quite - I mean, all sexual assault is frightening, but the context of it was especially frightening, being amongst people at a music festival, she was clear that I was experiencing trauma, compounded by the recent event. 

Unfortunately, in 2017, you think lightning isn’t going to strike twice, but unfortunately, I was raped after a night out in London. I like to see it this way: I was already in contact with the Havens and had an amazing team of people I could call whenever needed. I was beginning to understand and name some of the symptomology and the biology, chemistry, and physics of what was happening in my body during trauma.

So obviously that's a terrible thing that happened and I had a bit of recovery under my belt already. When it came to dealing with that second, some people use the term "big T trauma", I felt like I'd taken many steps backwards. However, there was this tiny shiny glimmer of hope for me: I've done this before and I can do it again. I can continue recovering and it's going to be okay. It feels like s**t now, let's be real, but it's going to be okay in the long run.

Kat: Thank you so much for sharing. That is really interesting to hear as you said, how it can all kind of come to a head after one specific event and then you look back and you reflect on what has actually happened before and how it culminates. 

Sarah: Exactly. Just to interject, during my initial conversation at the Havens, I didn't realise the organisations I'd been involved with were abusive. However, many symptoms I experienced after leaving those groups were trauma-related. I walked around with a constant feeling of unease, couldn't feel my feet on the ground, and doubted my decisions. I felt somehow at fault for past and ongoing events in my life. Later, with the help of a skilled therapist, I began to understand and work through the dynamics of cults and high-demand groups. I knew things were wrong, but I didn't recognise A) they were cults and B) that I was being abused at the time.

Kat: I think that's a key point you made about getting support and direction from a therapist and going to Havens to put language to and name these issues before starting to process and work through them. With that in mind, you mentioned a few things, but could you tell us more about what personally helped you move through those traumas and cope better, perhaps also mentioning the role of holistic therapies?

Sarah: Mmm, definitely. Trauma can be challenging to speak about. I'm more adept at talking about it now, which speaks to the effectiveness of the therapies I've had. It's not like the library falls out all over me anymore, to use Joe's analogy. I can take out bits, examine them more objectively, and then put the book back on the shelf. Initially, when I first received the diagnosis, I didn’t believe I could navigate through it, feeling overwhelmed by too many heavy, scary books that had fallen on me.

So I'd say, if people are exploring ways to cope with trauma, they should seek out experts who truly understand the field. Start by consulting a fully medically trained clinical psychologist or psychiatrist with a deep background in trauma—not just someone who's trauma-informed, but someone who specialises in it. 

While at the Havens, I tried talking therapy, but what benefited me most was EMDR, which stands for Eye Movement Desensitisation and Reprocessing. It helps organise and file those "books" in the brain, as Joe mentioned. And I'm sure Joe could speak more expertly than I could about how it works, but I can definitely vouch that it does work. Later on, I had somatic experiencing therapy. It operates on a similar premise to EMDR, addressing the stuck motor trauma response that hangs out in the body. Besides addressing memory, somatic experiencing tackles the physical trauma response, whether it's fight, flight, freeze, or even the tendency to constantly please someone who's harming you in a prolonged abusive relationship. 

Somatic therapy helps refile the stuckness these experiences have imprinted on one's nervous system. So I found that incredibly helpful. I initially wanted to see a different therapist, but he was booked up for two years in advance. Fortunately, he referred me to someone in the same country, as he was in the States. 

What's great about somatic experiencing is that you don't talk too much about the actual traumatic event. Discussing it extensively can be re-traumatising, especially in the early stages of recovery. Instead, you provide a brief explanation of what you've experienced and what you want to work on. And then the therapist, I was going to say does their magic, but it's not actually magic. It's proper science. That's why it works. They guide you through experiencing that sensation within your nervous system and ask you to recall when you first felt similar feelings. They encourage using imagination and visualisation to reclaim power. 

Much of trauma revolves around a predator and prey dynamic. For a long time, I felt unsafe, like someone else's prey. When I mention power, I don't mean seeking revenge or exacting some vendetta against someone. It's powerful to truly feel your feet on the ground. For a long time after experiencing sexual assault and rape, I couldn't feel grounded or connected to my body. Somatic experiencing was a great one for me, and I recommend it for other survivors. In a gentle, guided manner, it helps you connect with your body without delving too deeply into the traumatic event. 

Also, my budding yoga practice from the onset of these experiences has been invaluable. When people try yoga, whether they're beginners or have dabbled before, they sometimes say, oh I’m not really sure I like it, I find it challenging, it’s this and that. Trust me, I hated yoga initially. Finding the right teacher is key, someone with whom you feel safe and can connect in class. 

There's a lot to unpack about the unsafety ingrained in the wellness and yoga community, which could be a topic for another podcast. It frustrates me because there's so much potential good within these practices. However, some power-hungry individuals, masquerading as gurus, don't have people's best interests at heart. They exploit their roles because they have a power complex.

Unfortunately, in an unregulated industry like yoga and wellness, establishing boundaries is challenging, and identifying problematic individuals can be difficult. Thankfully, people do come forward with their stories. Returning to yoga, I initially found it boring, possibly due to being in a trauma response without realising it. I struggled with feeling grounded, being still, and taking up space. 

When yoga is taught with kindness, curiosity, and a relaxed approach, it's about embodying who you are in each moment. Just accepting. I found Downward Dog challenging today. Maybe it'll be easier tomorrow. Even if it isn't, I can still accept where I am. Yoga isn't solely about Downward Dog, after all. Many aspects often aren't covered in a typical hour-long yoga class. The commodification of yoga in the West has led to an emphasis on perfecting poses. Discussion about alignment and cues didn't really emerge until the 1980s. Some might dismiss these aspects, especially if they found them challenging when first starting yoga.

After trauma, my cognition really changed. In my younger years, I was a quick learner, but I felt I couldn't process information as rapidly anymore. In yoga class, instructors would call out cues, directions, and positions, making me feel overwhelmed. I'd think, "This feels like a frantic game of Twister I don't want to play. Can we slow down?" Slow, embodied movement practices, not just yoga, but also dance, Tai Chi, and Qigong, are beneficial. 

I also can't speak highly enough about experiencing Reiki. After a few years, I became a Reiki teacher to share its benefits with others. Being able to lay your hands on your body is an act of self-compassion and grounding. You tap into the innate energy within, which isn't truly invisible because you can feel it. Through various therapies and self-care, we can calm our heightened nervous system or trauma state, feeling the energy flow within our bodies. This realisation is calming, grounding us in our organic existence. Connecting with our inner world helps us not to be overwhelmed by external experiences. I know I've spoken for a long time, but these are some things that truly helped me.

Kat: No, it's all really, really helpful. It's great to hear the range of different things as well, and I think it does take a range of different things to help with something as complex as trauma. There's not going to be one thing to fix it, is there? It's going to be an ongoing thing. It's something you're probably going to live with, but there are things that can help you cope better. 

Sarah: For sure. 

Kat: And that's what this podcast is all about exploring. So thank you for sharing that. I would love to come back and do another podcast sometime about the wellness industry and the safety there because there's so much to say on that!

Sarah: … oh man!

Kat: But what you said about being embodied, it sounds like with trauma there can be a lot of disassociation from yourself. You're often flashing back and bringing yourself into the present moment sounds like it's a really important part of that. And being, as you said, an organic being, knowing you're here, you are real, you're in the present and you are safe is key 

Sarah: For sure. 

Kat: You mentioned a couple of talking therapies there, so Joe, I'm going to come back to you on this to ask about psychological therapies that can help with trauma. We mentioned EMDR there, somatic experiencing – whether you want to explain a bit more about those or other therapies, we'd love to hear. 

Joe: Sure. In terms of psychological therapies for trauma, they broadly work on the same principle. To explain what that is - if it’s OK to go back a step - when we experience a traumatic event, our cognitive processing system becomes overwhelmed, and the memory gets stuck in the amygdala. This means the memory remains current, making it re-triggered when we experience something in the present that resembles it. So, instead of being in the present moment, we relive the past, disconnecting from our surroundings. This disconnection can be terrifying, leading us to avoid reminders of the trauma. This is a fundamental human coping mechanism and it tends to work in the short-term.  

The issue is our brains can become more sensitive over time, seeking more triggers. To stay safe, we often resort to avoiding these triggers more and more. The memory remains stuck in the amygdala, appearing as if it's happening in the present. The intense fight or flight response arises because our brain perceives danger and signals an immediate response. This can temporarily disrupt our cognitive processing system. This reaction is commonly referred to as fight, flight, freeze, or even flop. 

Many are familiar with the concepts of fight, flight, and freeze. We either attack the danger, escape from it, or freeze. In nature, consider a rabbit facing a fox a couple of fields away. Fighting won't help, and running might alert the faster fox. The best option is to pause, hope the fox doesn't spot you, and plan your next move. In interpersonal traumas, two additional responses emerge: the fawn response, where we aim to be compliant, friendly, and kind, hoping the threat diminishes. If we can keep them happy, it's a human response to ensure our safety in the moment. In situations where fighting or fleeing isn't an option and freezing doesn't help, we employ an evolved response to minimise danger. 

There's also a flop response when other strategies fail, leading us to emotionally disconnect and drift away from the present moment. These responses serve as coping mechanisms for humans. However, after the trauma or danger has passed, if the memory remains ingrained in our brain, our natural inclination is to continue using these five F's responses for self-protection. 

This essentially is what makes up trauma symptomology. The trauma symptoms we might notice include re-experiencing symptoms like flashbacks, nightmares, dissociation, intense emotional and physical responses such as rapid heartbeat, fast breathing, sweating, shaking, and complete dissociation. Our thought processes can mirror those from the traumatic event, persisting over time. Our belief systems might shift, causing us to view ourselves or the world as unsafe or fault-ridden. This perspective prompts our brain to signal danger, indicating we're not safe. 

If we think things are our fault, we may adopt this form of response, trying to reduce threats by pleasing others or being overly accommodating. The belief systems and thoughts remain as they were during the traumatic event, and the memory stays stuck in the amygdala due to avoidance of triggers and re-experiencing. Going back to the core of your question, trauma treatments aim to unstick these memories, making it safe for the brain to process them and learn that trauma responses are unnecessary. 

As Sarah aptly describes, it's about empowerment and control. By regaining control in the present, we reclaim our lives and reduce the need for avoidance as we become better equipped to cope.

So what trauma therapy aims to do is help the memory pass from the midland of the hippocampus. To do that, we need to go back into the memory, unpack it, and reprocess it. An analogy that is often helpful is either a wardrobe or a waste paper basket. I've just moved house, so I currently have about seven bags of clothes. If I stuff them into my wardrobe, they'll just about fit. But every time I open my wardrobe, they spill out, creating a mess that impacts my life. That's similar to what happens with trauma. When a big overwhelming event occurs, naturally, it's horrible. We want to get away from it and get rid of it as fast as we can, so we stuff it back into the wardrobe. We stuff it back into our minds. But every time something reminds us of it, the door bursts open and it spills out, impacting us. 

What trauma therapy does instead is take all the stuff out of the wardrobe, have a good look at each item of clothing, fold it, and carefully package it before putting it back in the wardrobe. So the clothes haven't gone anywhere, the memories haven't gone anywhere, but when we recall the memory, we can open the wardrobe doors and put each item of clothing back after we're done with it. The memory hasn't changed, but our response to it has. 

Similarly, if you write every memory down on a piece of paper, scrunch it up, and throw it in a waste paper basket, it'll soon be full. However, if you take all those scrunched-up pieces of paper out, fold them neatly, and place them carefully back in, we can be really clever about organising them. Then, when we're reminded of them or want to look at them, we can pick one out, examine it, fold it up, and put it back. And it sits neatly in the waste paper basket. That's what trauma therapy aims to do in a nutshell. 

There are two therapies currently recommended by national guidance: EMDR, which stands for Eye Movement Desensitisation and Reprocessing. It uses bilateral stimulation to encourage our brain to shift from the left hemisphere to the right hemisphere. This can be achieved through tapping or following a light to encourage eye movement. The central premise is the same: allowing the memory to pass from the amygdala to the hippocampus. 

The other recommended therapy is trauma-focused CBT, which works in a similar way. We revisit the trauma, deliberately reprocess it, and deliberately re-experience it. The core of these therapies revolves around creating safety, so we proceed slowly. So rather than feeling overwhelmed, we often do a period of stabilisation. We encourage people to learn skills and feel safe enough in the moment while we're doing this work, building it up gradually. If there are multiple traumas, instead of addressing the most severe one first, we might start with a less intense one, like a five out of 10 or six out of 10, and reprocess them gradually, one by one, until we reach the most challenging ones at the top. We can't change what's happened to people or erase their memories, but we can change how we relate to them, turning them into events of the past. 

I also wanted to address two other points Sarah mentioned. The reason we don't typically diagnose PTSD within six weeks of the trauma is that the trauma response is a natural, normal human reaction.

If you survive an earthquake, we'd expect you to be anxious, on edge, hypervigilant, and have physical symptoms. It's your brain and body's way of protecting you, asking, "What if there's another earthquake?" Over time, we hope this response fades because we don't need it anymore. With PTSD, however, this response lingers. If it persists for six weeks or longer, we tend to diagnose it as PTSD. This doesn't make the initial experience any easier. We refer to that initial period as an acute stress response, which can be just as intense as a PTSD diagnosis. That's why there's often a specific time frame before diagnosing PTSD. 

Another point Sarah mentioned is the distinction between "big T" and "little t" traumas. "Big T" traumas are what we typically associate with PTSD: conflicts, assaults, rape, witnessing a murder – significant, single events. On the other hand, "little t" traumas might include consistent bullying, discrimination, neglect, being shouted at, or controlling relationships, which can be just as damaging over time.

Does that roughly answer your question? 

Kat: It really does, thank you. What I found especially helpful was you mentioning the stabilisation process. People don't immediately dive into their biggest trauma. That could be reassuring for listeners. Seeking support might feel intimidating, and there might be avoidance tendencies to stay safe. However, knowing it'll be handled with care and at a gentle pace is crucial.

With that in mind, are there specific things people seeking support should look out for? I've often heard the term "trauma-informed." Could you explain what that means and guide people on what to look for when seeking support?

Joe: Sure. It’s probably worth saying that there’s two different schools of thought that exist in the stabilisation phase. The central aim of treatment is enabling trauma reprocessing and reprocessing it as soon as possible often yields quicker benefits. The goal is to make it safe, allowing individuals to maintain control. The stabilisation phase involves learning coping skills and strategies. However, focusing solely on stabilisation can delay addressing avoidance and reprocessing, potentially reinforcing avoidance behaviours.

So there's this important consideration around consent when starting reprocessing work. Trauma-informed care, pioneered in Scotland, aims to make healthcare services, including psychology and other services, aware of the prevalence of trauma. Most people will experience trauma in their lifetime, but not all will develop clinical symptoms leading to a PTSD diagnosis. 

Trauma-informed care provides a framework for professionals to respond compassionately to those experiencing PTSD, complex PTSD, or acute stress responses. The approach is grounded in four Rs: realisation (an understanding of trauma's impact across cultures), recognition (identifying trauma symptoms), response (there should be mechanisms in place to respond in a trauma-informed manner), and resisting re-traumatisation (healthcare professionals should act in ways that are helpful, containing trauma, allowing individuals to maintain control, and avoiding retriggering or re-traumatising them). If retraumatisation occurs, it's crucial to recognise it and respond appropriately. 

For instance, in a situation where someone's experienced ongoing assault within a relationship in the past, they come into a medical setting where a diagnosis isn't particularly well explained or there's a difference of opinion about what the best form of treatment could be, that conflict or difference of opinion becomes a trauma trigger because, in that person's past, disagreements escalated to violence. The individual becomes angry and overwhelmed. Professionals see the person swearing, shouting, standing up, pacing the room. The temptation for professionals is to escalate, take control, ask the person to sit, and use medical expertise to guide the conversation. 

The trauma-informed response is to recognise this as a trauma response. The person reacts in a way that helped them survive before. They may not need this strategy now, but that's why it's happening. It's a normal human response. A trauma-informed approach involves being calm, kind and compassionate, and giving the person space to respond emotionally. Respond to emotion with emotion.

Once the person regains contact with the present moment, perhaps with support or strategies, a cognitive rational conversation can resume. But trying to respond on a cognitive level when the person isn't present rationally and cognitively isn't effective. It's a disservice to the individual and not helpful from a professional standpoint. Trauma-informed care equips professionals to recognise and respond to trauma, ensuring the person has the best chance of finding the medical environment supportive and beneficial to their healing journey.

Kat: I love what you said about responding to emotion with emotion. That's a simple phrase, but it's so important. It's helpful to hear more about trauma-informed care and how it’s being rolled out. Hopefully, more healthcare professionals are becoming aware of this. Thank you for explaining the different therapies and highlighting the balance between stabilisation and reprocessing and its importance. I appreciate your sharing...so…Oh, sorry, carry on!

Joe: Yeah, can I add an extra bit? National Guidance recommends trauma-focused CBT and EMDR. Different people have varied trauma experiences and healing journeys. Trauma therapy is about empowerment and regaining control, reclaiming aspects of our lives. Many individuals might find other things helpful outside of these two therapies. There's a difference between clinical guidance and people's lived experiences of what's helpful. As a psychologist on the podcast, my role is to provide clinical expertise. However, treating people as individuals and determining what works for them in their journey forward is most important.

Kat: Absolutely. Our podcast is named Finding What Works and that is the premise – that we're all individuals needing different solutions. It's valuable to hear expert opinions and guidance, but personal experiences, like Sarah's, about what worked are equally important. 

Sarah, I'd like to come back to you to revisit the topic of your books, as these relate to the topics we’ve talked about. I’m curious as to whether or not writing them helped you in any way. Could you share more about what they’re about and how they can support readers?

Sarah: Sure, when Joe was speaking, I was nodding my head like a nodding dog on my seat. Helpful explanations, Joe. I appreciate as a clinician pointing out national guidance, but also acknowledging other empowering and helpful approaches. Some of these influenced what I've written in my books. Thank you, Kat, for providing a platform to discuss these topics. I wrote my first book, Shadow and Rose: A Soulful Guide for Women Recovering from Rape and Sexual Violence. Initially released as an ebook, it's now available in paperback since 2021.

I wrote that book, starting with scribbling journal entries during my recovery from the sexual assault in 2016 when I was first diagnosed with PTSD. My therapist suggested keeping a diary to note how I felt. It helped me connect with the present, as Joe mentioned. I realised I was feeling a certain way due to past events, but in the present, I was experiencing something different. It kept me grounded rather than dwelling on past attacks or previous life events.

So, "Shadow and Rose" began as me writing a diary to help myself. Within those journal entries, I was writing what I found helpful and wanting to get things off my chest - I actually say, get it off my heart because my heart felt burdened by the sexual assaults in 2016 and 2017. I had this feeling that what I was writing wasn’t just beneficial to me, but it would be helpful to other people at some stage as well. But those first writings were very much just for me. My pen became my private space to process what was going on.

I think it's really powerful to write down one's thoughts or share them with someone else. There's nothing wrong with the thoughts we have; they're our own. Dr Ramani Durvasula, a psychologist renowned for helping people heal from narcissistic abuse, emphasises that we aren't wrong for having various thoughts about our experiences. Thoughts serve as our personal, private space to process what's happened to us. On a related note, due to my past involvement with high-demand organisations or cults, a key control tactic they use is using thought-terminating clichés to prevent individuals from exploring certain thoughts or ideas.

In these high-demand organisations or cults, they often push you to obsessively monitor your thoughts and navel gaze about what’s wrong with you. They discourage you from daydreaming or letting your mind wander freely, which is a natural and healthy process. They were like, you have to be present all the time and if you’re thinking about something, you’re probably thinking about something that is not helpful to your spiritual development. I wasn’t used to being able to have a space to just complete my thoughts, let alone write and journal them. That was massively healing for me.

So Shadow and Rose began as journal entries and writings on napkins in cafes while waiting for therapy. I'd ask strangers for paper and borrow pens since I often didn't have one on hand. I wanted to write down something that was firstly a benefit for me and then for other people. Eventually, I organised these thoughts into something that was going to resemble a book. 

After discussing with friends and therapists about my writings, I considered turning them into a book. So that’s what I did. I explored several topics in the book related to setting boundaries for individuals recovering from trauma, especially sexual trauma. Finding the real power of saying "no" became significant for me, no is one of my favourite words now. I aimed to identify and debunk harmful myths about individuals who've experienced long-term childhood sexual abuse or one-time incidents like sexual assault, rape, and even street harassment. Many don't recognise comments about the clothes you’re wearing or being told to "smile" on the street as forms of sexual harassment. That's unwanted attention that the recipient didn't ask for. That can have a huge impact on a person's self-perception, their day, and their interactions with the world at large. 

These seemingly minor incidents can have lasting impacts. It's essential to recognise misconceptions about survivors of sexual abuse, things like – they were "asking for it" based on their clothes or behaviour. In reality, no one is ever "asking for" or deserving of such violations. The responsibility for these actions lies solely with the perpetrator. It's not on the victim/survivor at all. And that was a real turnaround of thought for me. Coming from a background informed by high-demand organisations, I was made to believe that I was the centre of everything negative, implying I was to blame for all misfortunes because I was the common factor. I wanted to dispel these lies and harmful beliefs that can colour a person's opinion of themself, especially when dealing with shame during recovery. 

Shame really rears its head in recovery, leading you to question if you might have done something to cause the trauma. What if it was my fault because I was drinking or taking drugs that night? It's important to clarify that regardless of the circumstances if you're the one who's been attacked, your actions leading up to the event don't justify the assault. It’s not on you, it’s on the person who attacked you. Writing those journal entries initially helped me realise that the assault wasn't my fault, and I didn't deserve it or ask for it. These messages were really amplified during therapy at the Havens. I wanted to ensure that people who might benefit from reading a book like Shadow and Rose had access to it. Early and ongoing recovery is challenging, and not everyone can access therapy due to its high demand or cost.

I wanted readers to have a supportive companion they could carry in their handbag, keep by their bedside, and feel like this girl’s got your back. While we might never meet, I wanted them to know I hear them, and there's a path forward. As I mentioned earlier, it's essential to become the centre of your own universe, not because you're to blame, but because focusing on yourself is crucial for healing. My second book, Enough! Healing from Patriarchy's Curse of Too Much and Not Enough — which came out last year — really grew out of me writing Shadow and Rose.

For me, and probably other people as well, sexual violence and rape is the ultimate wound that’s inflicted on women because of patriarchy. We need to be real about the fact that sexual violence is a gendered crime. While it can also affect men, predominantly, women are the victims, and men are often the perpetrators. This issue stems from patriarchal systems where men use their perceived power to override women's rights. While writing "Shadow and Rose," I encountered various power plays imposed by patriarchy against women. Although I didn't include all of them in the book to avoid overwhelming readers, these observations inspired me to delve deeper into the topic, leading to the creation of Enough.

I found myself writing in two distinct notebooks, essentially crafting two separate books simultaneously. I wanted to create another supportive companion for women who've felt the impacts of patriarchy, from developing unhealthy relationships with their bodies to feeling unworthy of seeking help. We often face the relentless pressures of life, and society, especially women, are told we can "have it all." However, this can come at the cost of our well-being.

My personal experience of burnout from being excessively overworked, particularly during my time in a demanding cultic organisation, gave me firsthand insight. It taught me how easy it is to become overwhelmed by life's demands, compounded by the constant mental chatter we all navigate daily. So, yeah, Enough has a bunch of chapters detailing my lived experience, alongside reflection exercises. For both books, I've developed online materials, including guided relaxation meditations, gentle bodywork yoga, and yoga nidra sessions. 

I should've mentioned this earlier; it slipped my mind. Yoga nidra has been incredibly helpful for me, allowing me to embrace stillness and find inner calm. Listening to yoga nidra recordings was comforting as there was always a guiding voice. This prevented me from being left alone with my often tumultuous thoughts during the initial stages of my recovery. 

For those unfamiliar with yoga nidra, it's often translated as "yogic sleep." But focusing more on it, the term yoga means "union" in Sanskrit and Nidra combines two words meaning "to draw forth the void" in Sanskrit. Thus, yoga nidra represents a union with the void we evoke. This void, the deep state of relaxation achieved through guidance and body relaxation in yoga nidra, became a sanctuary for me. 

I talk about that at length in both books, discussing how to practise yoga nidra and create a conducive environment, or "nest," for it. This involves preparing a space worthy of a goddess. Going back to the mythology and original yogic texts on yoga nidra, it's not just a modern practice or technique. In ancient times, Yoga Nidra was a goddess summoned to awaken the gods from slumber and resolve disputes between them. This powerful narrative aligns well with the themes of Enough: Healing from Patriarchy's Curse of Too Much and Not Enough.

Kat: Amazing. I have to say from someone who has made a nest and done some yoga nidra before, I definitely second that. It's an incredible and lovely thing, something I haven't done in a long time. So this is a great reminder. I need to do that! And thank you for sharing more about your books as well. I will ensure we pop links in the show notes so people can pick them up and learn more about them. 

Sarah: Thanks for asking, I appreciate it. 

Kat: No problem at all. So actually Sarah, I'm gonna st- Oh, sorry, Joe, go ahead. 

Joe: Can I just jump in? Because much of what Sarah said is so important and so powerful. Trauma is inherently complex, right? Our individual experiences are intertwined with societal, cultural, and moral contexts. After undergoing a traumatic event, we evaluate our feelings and thoughts about it, known as appraisal. 

How our thought processes develop around the trauma is deeply connected to our early experiences and societal backdrop. In societies that pressure women to persevere without acknowledging their needs or well-being, there's a stressor there for such appraisal to be internally motivated. So - it's my fault, I should be okay. I'm not allowed to focus on myself, my own journey, and position. This belief persists for years. Then we face trauma or ongoing traumatic experiences. Are these experiences themselves the trauma? This means our appraisals of this overwhelming event, which isn't our fault, shift internally, leading to shame. By shame, I mean feeling not just that a bad thing happened, but that I am inherently bad. Thus, it logically follows that it's my fault, I deserve this, I don't deserve recovery or healing, I don't deserve my life back.

This context is integral to our experience of trauma. A common aftermath of trauma is feeling silenced. This can manifest in various ways. The societal and cultural backdrop is crucial when discussing interpersonal trauma, often linked to power imbalances. For lots of different reasons, we might possess or lack privilege in certain situations. Discrimination based on race, sexuality, gender, culture, or creed can all hinder our ability to seek treatment, support, and feel heard. This can also influence how we appraise traumatic events, potentially leading to ongoing harm.

Kat: Thank you for sharing that. The societal context is always important in understanding its impact on your experience and finding the right kind of support. With this in mind, on this podcast, we aim to explore both sides: what works and what might not be helpful. So, I wonder – Joe, could you tell us more about anything that might be unhelpful when seeking support for trauma or anything else to consider?

Joe: It's a real double-edged sword, right? While it's helpful to frame our responses to trauma as normal and natural, our bodies and brains are trying to protect us. Often, responses to trauma are doing the same thing. We want to help, but sometimes we miss the mark. This can lead people to tread on eggshells. We aim to support, but uncertainty about how to do so can create a culture of silence. 

You might have a friend who has experienced something traumatic, and you're unsure how to discuss it with them. This can leave the person feeling that those around them aren't interested. They don't want to know or can't handle it, leading to separation or disconnection. This not only intensifies the trauma but also results in a loss of relationships afterwards. 

However, one of the healing factors for trauma is connection. Connection is the antidote to shame. Shame isn't just about feeling that you've done something wrong or that something bad has happened to you; it's believing that there's something inherently wrong with you, that you are the problem. This internal belief pushes people to keep things inside – that sharing such feelings might lead to rejection and loss of connections. 

From an evolutionary standpoint, humans need to be connected. Being in a group provides safety and security. And if we're alone outside, we're going to get eaten. So, we have an innate evolutionary response to seek out groups and connections. 

However, shame, the belief that there's something inherently wrong with us, prevents us from sharing this core aspect of ourselves with others. What heals shame is vulnerability and shared vulnerability. It's sharing the deepest parts of ourselves, believing that we'll be accepted completely, which reconnects us. This reduces shame and allows the trauma response to be healing rather than a barrier. Instead of isolation, we find reconnection. Thus, how we communicate after trauma is crucial. 

We aim for a trauma-informed care approach. While we may not be professionals, we can create a supportive space for others. We can show genuine interest and readiness to listen when they're ready to talk. Recognising challenging responses, such as personality changes, irritability, or silence, as trauma responses are important. We need to acknowledge these emotional reactions and pair them with our own empathetic responses. This might mean simply being present and allowing someone to sit in silence without pushing them to talk. It could be reassuring them that we're there whenever they're ready to open up. 

For instance, if someone keeps cancelling plans, it could be because the planned activities trigger trauma, leading to flashbacks or other traumatic associations. So, are there workarounds in the short term? Can you move the plan somewhere that feels safer for them? It'd be lovely to address it directly. Is there a genuine difficulty preventing this? Essentially, making alterations and adaptations ensures that the person receives the right support. Hopefully, the responses change over time, and the person wins more and more back in their lives. If you genuinely care about someone and want to support them through trauma, can you accompany them on this recovery journey whilst maintaining that connection? 

Being aware of triggers is crucial. Depending on the trauma, the closer things are to the initial event, the more challenging and likely they are to trigger re-experiencing. Being aware of alternate voices, raising counterarguments, and intense emotions is important. It's not necessary to avoid these things but have an awareness of the response they might elicit and why. In terms of repair, if someone's reliving an experience, recognise that their emotional arousal levels are likely to be high. Therefore, that person might need a short or longer period of recovery. 

This comes back to basic people skills: being kind, compassionate, empathetic, giving people time, and creating environments that feel safe. Two simple ways we can help people feel safe are through predictability and control. If we can predict everything that's going to happen in the next five or 10 minutes, we know we'll be safe for that period. There's nothing unexpected. We can anticipate all dangers and feel safe. 

Similarly, if there are ways we can help people feel in control of how much they're disclosing, when, where they want to go for lunch, or where the activity is, the more control we can give back, the more empowerment we provide, and the more skills and tools they have to deal with other uncontrollable factors. So, putting that all together, it's not about an overwhelming list but is really about empathy, kindness, compassion, predictability, and control.

Kat: Those are really helpful ideas for our listeners if they have someone in their life struggling and how they can support them. I think it comes back to the phrase "responding to emotion with emotion" and tapping into our people skills. Thank you. That was really helpful. 

Sarah, I'll come to you on this question too. Was there anything particularly unhelpful for you in your journey? Any red flags you'd recommend people look out for? Also, how did your friends and family support you?

Sarah: Yeah, on the red flag front, if you feel therapy isn't working for you, you don't have to stay. You can leave or cancel sessions. If it's not benefiting you or you don't feel safe, trust that feeling. Often, it's a somatic response. Our minds might try to convince us otherwise, especially if we're prone to people-pleasing or dealing with shame. It's essential to differentiate between something bad happening to you and feeling like you are the bad thing.

If you feel uneasy in a situation, whether it's therapy or any other setting, remember it's not all on you. If your body signals discomfort or a desire to leave a conversation or place, trust that feeling. You're not obligated to stay to make someone else comfortable at your own expense. Regaining power can be done in small steps. You can simply excuse yourself, saying you remembered an important task or that you need to leave. You don't have to explain your discomfort explicitly. It's not always necessary to confront uncomfortable situations directly, especially if it might lead to conflict, which can be triggering for many. Trust your instincts and don't feel obligated to stay where you don't want to be. 

Regarding friends and family, Joe's advice about being there for someone without pressuring them to share their experiences is invaluable. Recognising signs like mood swings, irritability, or passive-aggressive behaviour is important. Personally, after experiencing attacks and past traumas, I didn't realise the extent of my internal rage. Expressing anger was something I found challenging. Sometimes, my anger would just boil over uncontrollably, leading to unpleasant experiences for both me and others. Also, that passive aggressivity would come out and I didn’t really know I was doing it. 

For friends and family of trauma survivors, it might seem like their loved one has changed temporarily, almost as if they've been "taken over" for a while, a bit like an invasion of the body snatchers until they get their feet back on the ground and find that stabilisation. If a person is spinning out, they are going to come back, but we don’t need to rush them to get them to that place. Offering space, patience, and understanding can be helpful. Simple gestures like suggesting a break for a cup of tea and then to come back to this thing in 10 minutes or when they’re ready can make a big difference.

Going back to finding things that work – and other people may disagree, but in my experience, I've personally felt safer and found benefit from one-to-one therapy for trauma compared to group therapy. That could be beneficial for others, but I didn't find it helpful. It's important to remember that therapy is subjective, and what works for one person may not work for another.

If you find that a particular approach or setting isn't helping, it's okay to switch or try something else. On the other hand, if you feel that you would benefit from connecting with fellow survivors in a supportive, compassionate, and boundaried space, that's also a valid choice to explore. But again, I didn’t find groups helpful to start with but I think it also feeds into the context as well. It's helpful to consider the context of a person's life leading up to a significant traumatic event, as smaller "t" traumas can accumulate over time. I didn't find group therapy beneficial, likely due to previous negative experiences with large group settings. In certain large group awareness training sessions, participants are encouraged to share personal experiences in front of a large audience, which wasn't helpful for me post-trauma.

When considering participation in activities involving many people after experiencing trauma, it's crucial to be discerning and trust your instincts. Even if an event claims to be supportive and beneficial, if you feel uncomfortable or your intuition signals unease, it might be best to reconsider or step back. Always prioritise your well-being and listen to your body's signals.

Kat: That's helpful. As you said, it's about tuning into yourself, listening to what your body and mind are telling you. If something doesn't feel right, it's okay to try something different. I think that's an important takeaway. 

Before we wrap up, the last question I'd like to ask both of you is what you would say to someone listening to this podcast, recognising some of these things, realising they want support. What would you say to someone who thinks they might be going through trauma right now?

Sarah: There are a lot of things I'd say, but to keep it simple: you deserve help. You didn't deserve what happened to you. It's not your fault. Speaking from my own experience of surviving sexual violence and narcissistic abuse at some stage, whenever it is, it doesn't need to be rushed. You can realise, maybe even somatically feel in your body, that shame you've been carrying doesn't belong to you. It's not yours. It should be put back onto the perpetrator, and maybe it's also a wider societal problem. If something like sexual assault or rape happens, that's society's issue, not yours. You're not alone; many people unfortunately go through the same thing. There's a way through, and while you might feel stuck now, you will be okay. There are good people who can help.

Kat: Amazing, thank you. Those are really good reminders for our audience to take away. And Joe coming to you on this as well. Is there anything you would say to anyone listening currently struggling? 

Joe: So, firstly, I've used the word 'safe' a lot. I want to be clear about what I mean by that. For me, it's about finding places where we feel safe enough to express our authentic selves. This feeling of safety isn't necessarily about the absence of emotion. It's not about finding places where we don't feel anxious, stressed, or low. It's about finding environments where we feel safe enough to express those feelings, to share them, and to experience them without them becoming catastrophic or overwhelming. If they become too much, and that sense isn't contained, it isn't safe. It might be judged by people around us, and we might struggle to cope. An environment of safety allows us to experience overwhelm, anxiety, stress, tension, and dissociation, and for that to be okay. What Sarah said was powerful about finding a therapeutic space where it's okay to feel that way and to feel held and contained.

Similarly, there's no one way to react to trauma. We're all human beings, all individuals. We've all been brought up in different contexts with different experiences, and even within the same context, we'll experience things differently based on various factors. So, going back to what you said earlier about whether there's an unhelpful way to respond to trauma, it's this: if you're trying to support someone, don't dictate how they should react. This applies both personally and professionally. There's no prescribed way people should respond to trauma. Their brain and body will find ways to help them cope and survive that moment. Professionals, textbooks, or society shouldn't dictate how people should respond. It's their fundamental right to respond in their own way.

Then, in terms of actions to take, if there are ways to rebuild your life bit by bit, give yourself permission to start slowly. Do things you can just about cope with. Put one foot in front of the other, work out what brings meaning to your life, and slowly make a plan to move towards that. If you love running and you're struggling to leave the house, consider starting with just a minute at a time down the garden path, then a bit further, and continue to build on that experience. It might be small steps, even smaller than that. If trauma keeps you stuck in the past, are there ways we can expand our lives around it?

It might be that currently, we don't have the capacity to fully reprocess that trauma. Instead of therapy feeling like pouring salt into a glass of water and trying to sift through to find that one grain we need to address, we can focus on adding more water. This way, we end up with a drinkable glass of water. This is about growing our lives around the trauma, providing ourselves with resources and strength. When we're ready to address the trauma, we can do so in a context where we have enough going on to support us through the process.

And then, in terms of professional support, you don't need a diagnosis of PTSD for trauma support. You can refer yourself to talking therapy services which offer both CBT and EMDR. You can either see a GP or self-refer; there's no need for a diagnosis or medication. There's also a vast amount of helpful third-sector support through charities, though this may vary by local area.

One common feature of these talking therapy services is signposting. If trauma-focused therapies feel too challenging at the moment, access to third-sector services or connecting with survivors and peers might be more beneficial. Remember, recovery, like trauma response, is an individual journey. What works for one person might not work for another. Prioritise what makes you feel safe and supported, rather than adhering to expected responses or solutions. You are an individual.

Kat: Thank you, Joe. Your insights are really valuable, especially highlighting that a diagnosis isn't necessary and there isn't a single right way to respond. We can all find the support that suits us best. Thank you both for sharing so openly today.

Before we wrap up, could you let our listeners know where they can connect with you online? Sarah, could you go first and share your contact details?

Sarah: Sure, I'm on Instagram and I have a sporadic and love-hate relationship with social media, so I might be there or not. You can find me at Sarah Wheeler, Reiki Rege. "Rege" is R-E-N-G-E, which is the Japanese word for Lotus. The Lotus has to journey through the mud to bloom at the top, always rooted in its experiences. I also have another account, Sarah Wheeler, you are enough, yoga. There's a link there to join a mailing list but rest assured, I won't spam you and only write when necessary.

Kat: Perfect. Thank you. And Joe, yourself, where can our listeners connect with you online? 

Joe: So I don't do social media, I don't find it productive for my mental health. So for me, I can be found by Googling Konnect clinical psychology with a K and people will be able to find my blog and links to my media pages, and you will be able to see other stuff that I've been in and spoken about. And I imagine you'll be able to put a link to my website somewhere in the notes and people will be able to find me. 

Kat: Absolutely. I'll put the links to all of those things in the show notes as well for anybody who does want to learn more. Thank you again, really appreciate your time and a huge thank you to anyone listening. If you are looking for support, you can find a range of support including connecting with counsellors and holistic therapists at Happiful.com. We'll be back next week with the exhale episode where we'll be exploring this topic a little further. But until then, please take care.