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Reclaiming Your Health & Power After Trauma: The Real Deal

"You may write me down in history with your bitter, twisted lies. You may trod me in the very dirt, but still, like dust, I rise." - Maya Angelou A popular image and quote these days. Photo credit unknown.

"You may write me down in history with your bitter, twisted lies. You may trod me in the very dirt, but still, like dust, I rise." - Maya Angelou
A popular image and quote these days. Photo credit unknown.

Trigger warning: this article deals with the topic of sexual violence and abuse. If you just want resources and solutions to heal, scroll halfway down for a list, beginning with "TOOLS FOR EMPOWERMENT."

As more women come forward with allegations of sexual harassment and assault by Hollywood film mogul, Harvey Weinstein, their collective voice has carried across thousands of miles, encouraging some of us living in the more restrained social climate of Southeast Asia to say, #MeToo. Over a few short days, millions of women and men are now galvanizing to weaken a culture that profoundly impacts countless people not only during the acts of violence, but over the years and decades following their traumas. Admittedly, I broke my “no social media” rule this week after ten months of (mostly) scroll-free living to read through the various headlines and hashtags for some promising indication of change. As a behavioral health professional and another #MeToo, I’m compelled to believe that we have finally reached a point in history where we will no longer tolerate the shame, silence, and predatory environment that has contributed heavily to skyrocketing rates of drug and alcohol addiction, mental illness, and physical pain.

Sexual violence IS a public health issue, and it’s one that coaches, fitness specialists, and medical professionals must be able to compassionately discuss with the people they serve because invariably, all of us in the helping professions will end up working with people who have bodies that speak the language of trauma. 

In Singapore, awareness of sexual abuse and assault is finally growing due to organizations like AWARE, an increase in high-profile cases, a global spotlight on human trafficking in the region, and the brave survivors willing to speak out about their own experiences. While Singapore is comparatively safer than the US, violence and abuse regularly occurs here across all racial and economic backgrounds. Voyeurism, up skirting and the sharing of intimate digital images are commonplace. Assault, rape and child sexual abuse (CSA) are regularly in the news. One study carried out in 2014 surveying young adults in Singapore found that 1 in 3 had experienced sexual violence of some form, “from verbal and cyber-harassment to non-consensual touching and rape.”[1] The Harvey Weinstein’s of the world straddle class, race and economic lines. Many of them— as hard as it is to accept— were also victims of sexual violence and adopted a maladaptive coping strategy of false power to bandage their psychological wounds. That in no way means that they should not be held accountable- quite the opposite. Sexual violence is a cycle, and in order for the cycle to discontinue in our world, we must understand all of the moving parts.

Sexual violence lingers. It’s a toxic mold in the body and a stain on the mind, eventually abrading the fibers of both.

This undeserved experience— one that a third of women and fifteen to twenty percent of men are directly impacted by— manifests in multiple pernicious ways, including:

Time is understanding, and peace comes with time.

Time is understanding, and peace comes with time.

o    Eating disorders: About half of those with anorexia and bulimia have endured some form of sexual trauma. Binge eating and body dissatisfaction are also linked to histories of sexual abuse.

o   Depression & PTSD: Victims of sexual assault are three times more likely to suffer from depression, and six times more likely to suffer from post-traumatic stress disorder, or PTSD. [2]

o   Obesity: Children who were sexually abused are far more likely to struggle with their weight as adults.[3]

o   Sexual dysfunction: Women and men who’ve endured sexual violence are more likely to experience vaginismus, erectile dysfunction, and arousal disorders. Intimacy becomes a struggle.

o   Self-harm: Adolescents and young adults who attack their own flesh through cutting have extremely high rates of sexual abuse in childhood (CSA). In one group of self-harmers, 93% were CSA survivors.[4]

o   Autoimmune Disorders: The amazing ACE Study— a retrospective study of over 15,000 adults— offers fascinating insight into the link between CSA and various autoimmune conditions, including Crohn’s disease, lupus, fibromyalgia, IBS, and endometriosis. [5]

o   Addiction, particularly to alcohol and opiates, is rampant among people living with sexual trauma. Dr. Gabor Mate, a sage in addiction medicine, found that nearly all of his female patients hooked on heroin had a severe trauma history. Women with alcohol use disorders frequently report instances of sexual violence in their path. And, as much as we don’t wish to admit, alcohol consumption is directly linked to sexual assault. [6]

o   Anxiety and low-self esteem: many people who’ve been violated are then subject to victim blaming, labelled by their perpetrators as liars, crazy, attention-seeking, and bad or evil. This leads to a collapse in self-esteem and self-belief, and may contribute to self-internalizing disorders like anxiety.

Trauma significantly impacts our physical and emotional wellness, and recovery is often like peeling an onion slowly; each new layer reveals raw memories, sensations, emotions and challenges. The health impacts of an assault occurring in college, for instance, may end up expressing itself as C-PTSD, depression, an addiction or a pain condition when the person is well into her thirties or forties. The truth of the experience becomes visible only when we are grounded and ready to handle it, although it may not feel like that at the time.

This unfolding can be incredibly upsetting, and survivors are often left wondering why they must bear the consequences of someone else’s violence over years and decades. Many have no idea why their bodies are suddenly rebelling or what’s caused a decline in their moods.

Health and trauma are inextricably connected; we simply cannot talk about mental health, disease and addiction any longer without talking about trauma as well.

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Now, the good news. With enduring and healing, we discover an unexpected upside. Thriving beyond abuse means alchemizing hypervigilance into intuitiveness and anger into empathy. It means embodying the truth of forgiveness, unchaining oneself from the offender by no longer demanding something that the perpetrator cannot offer. It means learning to rest in the quiet of your soul instead of racing toward the next distraction. It means being able to believe in and define who you are, rather than handing over your identity to others. With healing and recovery, we’re offered powerful protection against perfectionism, victimhood, narcissism, hopelessness and rage.

Survivor resources are still quite limited, particularly in Singapore. However, I’ve compiled a list of what I’ve found helpful to women who are ready to thrive after sexual abuse or assault. These are not explicit endorsements and I have nothing to gain by recommending them. While our voices are, in this moment, unified, our experiences are all unique. Find what works for you.

TOOLS FOR EMPOWERMENT:

Self-defense
classes can dramatically reduce the potential for future assaults while strengthening one’s ability to identify and avoid potential predators. I’m a fan of the brutal Israeli self-defense system, Kapap, as well as basic survival defense using found objects and tools like tactical pens. If you’re willing to endure a few bruises, Kapap Singapore is run by seasoned martial artist and former psychologist, Master Teo Yew Chye. His protégé, Yunquan, is the first and only martial artist to be conferred by Her Majesty the Queen of England for saving lives through self-defense. She’s also a bodyguard and behavioral consultant, skilled at detecting deception and interpreting body language (and a total badass). Boxing and MMA are two other options, but you’ll want to feel completely comfortable with the coach and class, and a testosterone-fuelled environment can sometimes be a challenge for trauma survivors, although often the best way to overcome our fears is by facing them head on, venturing into the dragon's lair.

Yoga is beneficial in releasing physical and emotional symptoms of sexual trauma while encouraging the practitioner to remain in her body, thereby decreasing episodes of detachment, or disassociation, both during and following the session. Look for trauma-sensitive yoga, which embraces a hands-off teaching style and avoids poses that may trigger a fight-or-flight response, like happy baby pose and downward facing dog. Forrest Yoga is a discipline that emphasizes moving shame out of the body while reinforcing the mind-body connection through what its founder, Ana Forrest, calls “synaptic bridging.” While I’m not aware of any trauma-specific practices in Singapore, a good yoga instructor should be able to tailor the class and offer alternative poses if you’re willing to be open with him or her about your specific needs. At least one yogi in Singapore currently offers Forrest Yoga- check their Facebook page for class information. 

Weightlifting is an exceptional tool for battling depression and PTSD, and an apt metaphor for the experience of moving into thriving. You learn that what you once believed you could not handle becomes easier to carry, and you stop asking for a lighter load, instead strengthening yourself to face whatever may come. In the bodybuilding community, I’ve met an incredible number of women who have healed from eating disorders, addictions and mental health challenges- for good reason! Weightlifting puts you back in touch with your body and builds your strength in multiple ways. There are many options in Singapore, both at gyms and with private coaches. Three excellent fitness specialists in Singapore are Roz Alexander, Yan Huang, and Cheryl Lin. They are supportive, encouraging, and they know their way around the weight room!

Self-Care is an antidote to depression, stress and self-flagellation, reinforcing that one’s needs and feelings are valid and important. Prioritizing your well-being— getting enough sleep and exercise, nourishing your body with whole foods, setting aside time for play, and creating a supportive routine in your life, for example— will help your body and heart cope with the aftermath of trauma, whether days or years after the incident. Self-care is deliberate, scheduled and controlled solely by you- it’s claiming the driver’s seat in your life and honoring your internal messaging system.

Journaling, particularly structured journaling, provides a private space for mental purging so you can move beyond your past and build a purposeful, rock-solid future for yourself. Pen and paper work well for most, and research shows that writing by hand calms the mind while improving memory and creativity. If you’re looking for something with structure and an end goal, Jordan Peterson’s Self-Authoring course is well worth the money and time it will take you to thoughtfully finish it (around 3 months or so to complete).

Meditation and Prayer: Mindfulness has become this decade’s cure-all, and for good reason- it works! However, for trauma survivors in the earlier stages of recovery, a meditation practice can backfire with highly negative results, including re-triggering and the onset of mental illness as well as psychosis.[7] If you’re going to give meditation a try, having a supportive therapist and an experienced mindfulness teacher is a smart idea. Start S-L-O-W-L-Y, no more than perhaps a few minutes per day. The Kadampa Meditation Center offers daily sessions and longer courses on modern Buddhist meditation, and there are several options for Christian meditation in Singapore as well, including weekly classes at Saint Bernadette’s Church. Prayer is another path of healing from sexual trauma, and one of the most powerful— albeit personal— I’ve found. Infusing your life with a daily prayer practice has been proven in numerous studies to heal deeply and profoundly.

THERAPIES AND COACHING:

Eye Movement Desensitization Reprocessing, or EMDR is a radical and somewhat mysterious psychotherapy approach to alleviate stress and bodily discomfort from traumatic memory by enhancing the processing and forming new adaptive memories. Developed accidentally by American psychologist, Francine Shapiro, EMDR has become a popular yet controversial treatment for PTSD resulting from combat, rape, child abuse, and physical accidents. EMDR tends to work best for single traumatic incidents, but can also be effective for complex PTSD.

Gestalt Therapy is a client-centered experiential therapy emphasizing a focus on the present life rather than interpreting the past, and views people as a “whole” comprised of body, mind and soul. Techniques combine bodywork, drama, dance, role-play, dream work and art as a path to experiencing how something feels in the moment. Because Gestalt respects and supports the individual’s understanding of oneself, it’s particularly well-suited to people who have been told by external parties how they should interpret their trauma, or who are dealing with gaslighting— manipulation to make one doubt one’s sanity and reality— which is a particularly common experience for trauma survivors.

Tension, Stress and Trauma Release Exercises(TRE)  is a system of physical exercises that shakes the muscles to increase body resiliency and relax the nervous system while shedding trauma. This is similar to the natural mechanism to discharge excess energy used by many animals after they’ve encountered a predator. This therapy is also helpful for people in addiction recovery, and those with PTSD.

Comprehensive Resource Model (CRM) is a completely new therapy that, to my knowledge, is not yet offered anywhere in Asia, and helps with the remembering and releasing of traumatic material while re-establishing one critical foundation in Maslow’s hierarchy—  a sense of safety and security. It targets the most primitive aspects of the self through connection to the natural world and reawakens the imagination to new possibilities for the future. Based on what I’ve read, I’m really excited about this approach and hope to one day bring it over to Singapore or adapt it for coaching.

Cognitive Processing Therapy (CPT) is perhaps the most basic and widely available therapeutic approach to treating trauma, and involves weekly sessions of talking with a trained clinician about your memories, interpretations and feelings, as well as completing short writing assignments. This eventually increases a sense of safety and self-control while encouraging the release of unhelpful beliefs that may lead to self-sabotage.

Sexual Health: Sexual violence can be so detrimental to one’s sexual sense of self and ability to physically connect in relationships. Be gentle with yourself in the healing process and prioritize maintaining an open dialogue with a trusted partner. Conditions like painful sex can be treated through psychotherapy, physical therapy and the use of tools like dilators and pelvic wands. The book, Heal Pelvic Pain, has a series of daily physical "Letting Go" exercises that can also retrain muscular response. Two sexual health coaches in Singapore are Dr. Martha Tara Lee and Christina Low, so if you’re in the region, you may wish to reach out to them.

Coaching for health, life and recovery focuses on values-based rebuilding with an eye toward the future, and draws on the natural strengths and abilities of the client. It’s a motivational and insightful journey of self-discovery, and an opportunity to rewrite the story of one’s life for a more joyful, resilient and meaningful existence. I am, of course, biased about practitioners, so I won’t recommend any particular integrative coach :-). One specialist who works specifically with sexual abuse survivors is Rachel Grant, and she has a worthwhile newsletter and guide on recovery, as well as one-on-one and group programs offered online.

BOOKS:

“The Body Keeps the Score” by Bessel van der Kolk is a lifesaver for anyone healing from trauma or working in the field, and explains how trauma rewires the brain and alters our capacity to enjoy life, as well as outlining how to reverse those detrimental impacts. This tome is best read slowly with a highlighter in hand.             

“The Gift of Fear” explains the predatory mind in detail, imparting wisdom to help women physically protect themselves from potential attacks. It also tackles the tricky business of saying “no” and is a must read for people-pleasing nice girls. The author, Gavin de Becker is a top expert in personal security and has a company focused on the protection of high-profile individuals and prevention of violence.  

“Women Who Run With the Wolves” is a manifesto for the wild woman archetype and explores feminine expectations and roles in history and mythology. It’s an incredibly empowering and enlightening book for women who are ready to reclaim their true nature and intuition, and shed those cultural norms that perpetuate our victimization and second-class status.

“The Courage to Heal” by Ellen Bass is the Bible for recovery from childhood sexual abuse in particular. I would be remiss not to include this book and it’s particularly suitable for those on the beginning of their journey. However, if you’ve already done some therapy and are looking for deeper healing, it may ring a little basic for you. 
 
“Waking the Tiger: Healing Trauma” by Peter Levine explores the trauma continuum through the lens of the animal kingdom, and includes a series of body exercises to reduce unpleasant sensations. This book is applicable to any type of trauma or jarring life event and is somewhat similar to “The Body Keeps the Score,” although more specific and less robust in its content.

“Life, Reinvented” by Erin Carpenter, LCSW is a simple book that addresses how to move beyond sexual trauma and rebuild one’s life, and can be particularly helpful to other supportive loved ones as well. If you’re not ready for therapy, this is a good start. 

And, three bonus books which don’t relate specifically to trauma, but explore setting boundaries and standing up for yourself are:

The Nice Girl Syndrome,” by Beverly Engel provides a 10 point plan to stop being abused by spouses, friends, family members, dates, and dudes on the street. Engel’s an expert in treating emotional and sexual abuse, and has been practicing psychotherapy for 35 years.

“Boundaries,” by Dr. Henry Cloud & Dr. John Townsend is about taking control of one’s life and learning to advocate for oneself- something that too many women really wrestle with. "Boundaries" is biblically-based and filled with epiphanies that challenge “turning the other cheek” in specific circumstances, like abuse. If you’re a boundary-injured Christian, I cannot recommend this read enough. There’s a workbook as well; get them both!

Another Christian-specific book is Battlefield of the Mind by Joyce Meyer, a minister who transformed her CSA trauma and now counsels survivors through her ministry and books. She’s an inspiring figure who’s transcended shame to help thousands, and if you're feeling hopeless about your own situation, look up her life story. She's proof that severe betrayals can be overcome. Rumination and obsession are two after effects of violence, and Joyce does an excellent job of explaining how to overcome that from a Christian perspective. Both “Boundaries” and “Battlefield of the Mind” may not resonate for secular folks or those practicing other faiths.

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GROUPS & HOTLINES:

Support groups can be tremendously powerful for survivors of sexual trauma. As #MeToo proves, we overcome in fellowship and safe, mutual sharing.

I only know of one support group in Singapore that specifically serves adults dealing with sexual trauma, but I’ve found that 12 Step groups (AA, NA, Al-anon) are generally helpful if you’re also wrestling with an addiction and you’d like a space to express abuse-related trauma among others who can empathize.

Two online groups you may wish to check out are Pandora’s “Rape and Sexual Abuse Online Support Community” and Reddit’s Adult Survivors of CSA. Online groups provide some level of anonymity. Remember to proceed cautiously in online communities, as bullies and trolls enjoy targeting the vulnerable online and moderators aren’t always quick enough to protect the group, however hard they may try.

AWARE is a gender equality advocacy group in Singapore that offers several services for victims of violence, including a support group, counselling, a legal clinic, hotline and research-based advocacy.

RAINN is an organization based out of the US and perhaps the world’s largest anti-violence network. They also have a support helpline and offer multiple online resources for children and adults in the US and abroad.


ONLY YOU own your story, your experiences and your path to healing. As more women and men (let's not forget the men here, please) come forward in the weeks and months ahead, you may feel pressured to do the same, even if you’re not quite ready. One of the most important steps in building strength is being able to advocate for yourself while doing what will be most supportive for your soul. If you want to stay silent, do so. If you want stillness over action, embrace that. If you’re feeling anger instead of togetherness, feel that. If you’re not ready to forgive and move forward, don’t. If you feel like shouting your history from the rooftops, go for it! It’s your body, your truth, your walk, and your transformation.

Thanks for reading. If this article has helped you or may help someone else, share it! A few of your connections may appreciate that.

As you may have noticed, I’ve been rather quiet, at least online. I am focusing on my current clients and slaying some goals with my awesome accountability group. Tangram will continue to exist as a platform for advocacy and information, and I plan to update my professional services  early next year. If you’d like to join the next accountability group in April, sign up for the newsletter for more information!


References:

[1] https://www.theonlinecitizen.com/2015/03/31/survey-1-in-3-young-people-have-faced-sexual-violence/

[2] http://rapetraumaservices.org/resources-2/statistics/

[3] https://www.theatlantic.com/health/archive/2015/12/sexual-abuse-victims-obesity/420186/

[4] https://www.ptsd.va.gov/PTSD/public/problems/self-harm.asp

[5] https://www.americannursetoday.com/long-term-health-outcomes-of-childhood-sexual-abuse/

[6] https://www.teenvogue.com/story/alcohol-most-common-date-rape-drug

[7] http://www.archivespp.pl/uploads/images/2015_17_3/48Dyga_ArchivesPP_3_2015.pdf

 

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