There are some strategies you may be able to use to help you cope with difficulties in sleeping and controlling panic and/or sudden distress.

Coping with sexual trauma

These strategies are adapted from the self-help pack produced by ‘Fire in Ice’. Survive would like to thank them, and the Merseyside Survivors, for their kind permission to use them.

Coping with sleep difficulties

Survivors of child sexual abuse sometimes experience problems with sleep. These problems can take many forms, including:

• Nightmares about the abuse
• Waking up in a panic
• Not being able to get off to sleep
• Finding that the slightest noise or disturbance wakes you
• Finding that having sex triggers memories of the abuse.

Here are some general hints about sleep, rest and bedtime:

• Make sure the place you’re going to rest in is physically comfortable. Use whatever relaxation works for you;
• Establish some regular habits, a new ‘going to bed’ ritual, avoid emotional literature/issues just before bedtime;
• Try to get into the habit of taking exercise during the day;
• Avoid coffee and tea in the evening – it’s a stimulant and keeps you awake.
• Avoid alcohol and non-prescribed drugs.

Problems with sleep can also be a symptom of depression. If you’re depressed, your doctor may prescribe you an anti-depressant to help you sleep and lift your mood.

Survivors often experience distressing nightmares. The nightmares can include:

• Direct re-creations of the abuse;
• Children being harmed or killed;
• Scenes of death and violence;
• Being chased or otherwise assaulted;
• Being humiliated or put in a powerless position.

The emotion attached to the nightmare is often one of absolute terror. Some people suggest that you can ‘take charge’ of your nightmare. In other words, turn the tables on whoever is attacking or abusing you during the nightmare. Whilst this may be possible in some cases, it’s certainly not true for everyone. Don’t give yourself a hard time if this isn’t true for you.

If you wake up in a panic:

• Be kind to yourself immediately afterwards.
• Decide whether you need to be on your own right now.
• It can be good to talk about how you are feeling.
• If you’re on your own, is there anyone you can ring to talk it through?
• Be gentle with yourself for the rest of the day.

Nightmares are a part of the process of recovery- an unpleasant part. It takes courage and strength to experience them and reach out for support.

Controlling panic and sudden distress

These are some techniques and suggestions that survivors have found useful in managing panic attacks and/or sudden distress:

• Try to become aware, as early as you can, that you’re experiencing a panic attack/flashback/sudden memory/strange sensation. Stop whatever it is you’re doing;
• Try not to fight against it as you may just get more tense;
• Try to calm yourself. Breathe slowly and deeply;
• Avoid quick decisions. Wait until you calm down;
• Check out reality. Plant your feet firmly on the ground and hang onto something for example, the arms of a chair, anything to make sure you get the message that the abuse is not happening now;
• Decide what to do next. You could leave the situation, change the situation, continue what you’re doing slowly, breathing deeply, reassuring yourself and trying to relax;
• Accept what is happening;
• Avoid driving until you’ve calmed down.

Afterwards:

• Try to work out what happened;
• Make sure you have someone you can talk to;
• Expect to feel vulnerable afterwards;
• Be kind to yourself! It is an understandable reaction to a given set of circumstances.

Prevention and self-help:

• Try to avoid situations of overwhelming anxiety;
• Avoid caffeine. It’s a stimulant and may make you feel more hyped up;
• Avoid alcohol and non-prescribed drugs;
• Develop a plan with your G.P. about how you will use prescribed medication to help.

Remember that all of this is part of recovery.  Survive provides a place where people can access support, reduce isolation and begin to heal from the abuse they suffered.