Trauma

Types of trauma

Many experiences can be traumatic. And we all experience trauma in unique ways. But some experiences or events that lead to trauma are sometimes grouped together and given a name.

These terms normally describe how trauma affects people from certain groups, or in specific situations. This section explains some of these terms:

Childhood trauma

You may have experienced trauma during your childhood. These experiences could make you more likely to have mental health problems as an adult. This is especially if you didn’t have support to manage the trauma. Or if you experienced trauma continuously, over a long period of time.

Collective trauma

Collective trauma is when a traumatic event happens to a large number of people at the same time.

This doesn’t mean that everyone who experienced the event feels the same way about it. Or that they all feel it was traumatic for them. Everyone still copes with it in their own way.

Experiencing collective trauma can mean you experience personal symptoms and ‘social symptoms’. Social symptoms can include how society has dealt with or reacted to the trauma. For example:

• If it isn’t socially acceptable to talk about the event, or only being able to talk about it in certain ways
• If people avoid or discriminate against certain groups that might be unfairly blamed for the trauma

The anniversaries of a collective trauma might lead to events such as memorials and media coverage. You might find these events comforting ways of managing collective trauma. Or you may find them very difficult. How you feel about these anniversaries can also change over time.

This information on coping with distressing events in the news might help if you’re struggling with media coverage of trauma.

Generational trauma

Generational or intergenerational trauma is a type of trauma that’s experienced across generations of a family, culture or group. For example, there’s some evidence that shows children and grandchildren of people who survived the Holocaust experience higher rates of mental health problems.

Trauma that happened in the past has an impact on the mental health of current generations. But it’s not always clear how. Some researchers think trauma may affect our genes. But it’s more likely that trauma affects the environment we grow up in. This can be through things like:

• Stories or warnings older generations have passed on about the trauma they experienced. This could make you wary of the world around you
• The legacy of trauma continuing to impact your wellbeing and safety, such as the ongoing effects of colonialism on the health and wellbeing of people of colour
• Trauma affecting how older generations have raised and looked after us. For example, if your parent avoided certain places due to their experience of trauma, you might also feel anxious in those places. This might be more likely to happen if older generations haven’t had support for their traumatic experiences when they needed them

Moral injury

Moral injury means how you feel when you’re put in a situation that goes against your morals, values or beliefs. It’s often seen in people who have been in situations where they need to make big decisions about other people’s lives.

Moral injury might happen because of:

• Lack of resources provided by a workplace, government or ruling body to treat everyone equally
• Poor safety practices
• Regulations or orders from people in charge that don’t seem to be in people’s best interests
• Unsafe or immoral behaviour from others, particularly those in charge
• Working in a system you see as failing, but have no power to fix

This kind of trauma can impact your view of the world, your government, or the organisation you work for. Along with other effects of trauma, you might:

• Feel a lack of purpose in your personal or professional life
• Feel disconnected from people around you
• Feel betrayed, alienated or ashamed
• Question your moral codes and ethics

If the moral injury happened in the workplace, you might also have difficult feelings about continuing to work there. It can be difficult to seek help in the workplace in these situations. This is because the people running the workplace can be part of the cause of moral injury.

If you need to talk to someone about wrongdoing in your workplace, the charity Protect provides confidential support.

Racial trauma

The impact racism can have on your mind and body is sometimes described as racial trauma.

There’s no universal definition of racial trauma. Some people use it to mean all the effects that encountering racism can have on how we think, feel and behave. Others use it to describe a specific set of symptoms. Find out more about racial trauma.

Secondary trauma

Secondary trauma is when you witness trauma or you’re closely connected to it. But you don’t experience the trauma directly. It’s sometimes called vicarious trauma.

For example, if you’re a journalist who often reports on traumatic events. Or if you’re a medical professional working in an accident and emergency department.

Effects of secondary trauma are similar to general trauma. But you may find you also begin to feel detached from the trauma. Or treat it as a very separate part of your life.

Experiencing secondary trauma is as valid as any other kind of trauma. It can impact you just as much.

How could trauma affect me?

This page covers:

• How our bodies respond to danger
• How trauma makes us feel
• Experiences we might have after trauma
• Can trauma cause mental health problems?
• How else might trauma affect me?

Trauma can affect everybody differently. So you might recognise some of the experiences listed on this page. But you might also have experiences or reactions that aren’t mentioned here.

How our bodies respond to danger

When we feel stressed or threatened, our bodies release hormones called cortisol and adrenaline. This is the body’s way of preparing to respond to danger, and we have no control over it.

This can have a range of effects, which are sometimes called:

• Freeze – feeling paralysed or unable to move
• Flop – doing what you’re told without being able to protest
• Fight – fighting, struggling or protesting
• Flight – hiding or moving away
• Fawn – trying to please someone who harms you

If we experience trauma, our body’s reactions can continue long after the trauma is over. For example, when we’re in a situation that reminds us of the trauma. This might affect how we think, feel and behave, especially if recovering from the trauma has been difficult.

How trauma makes us feel

Some of us who go through trauma may have these feelings, during or afterwards:

• Anger
• Numbness or difficulty feeling any strong emotions
• Like you have lost your identity or a sense of who you are
• Scared or panicked
• Grief
• Worried
• Irritable
• Confused
• Restless
• Unsure of what you need or want
• Hypervigilance – which is when you are very alert and aware of your surroundings because you feel something bad might happen
• Shock or horror
• Shame

But not everyone feels the same way during or after trauma. And how we feel can change over time, even months or years after the event. Remember that any feelings are valid – even if you aren’t sure why you’re feeling that way.

Self-blame

When we go through trauma we might feel as if we’re to blame. This can cause very strong feelings of shame or guilt, even if it wasn’t our fault.

Reasons for feeling self-blame include:

• Your mind trying to make sense of what’s happened, and to avoid overwhelming feelings of anger, grief or betrayal
• Finding a way to survive in an unsafe or stressful situation, such as living with someone who’s harmed you
• Wishing you could have done something differently at the time, even though you couldn’t have
• Someone else blaming you for what happened or acting like it was your fault
• Being made to feel responsible for someone else’s actions, even when they had power over you

Self-blame can be very hard to cope with. But it can be a way your mind tries to protect you. So it might take time and support to be able to start feeling differently.

You might feel confused or overwhelmed if someone else says it wasn’t your fault. Although hearing this can also be a relief.

Physical effects of trauma 

Trauma can also affect our bodies physically. We might experience:

• Headaches
• Aches and pains around the body
• Shaking
• Tiredness
• Sweating
• Changes to how often we eat or what we feel like eating
• Memory problems
• Dizziness or changes in vision

This can also lead to other long-term physical health problems that are linked to stress. See our information on the physical signs of stress to learn more.

Experiences we might have after trauma

The physical and emotional effects of trauma can lead to certain experiences such as:

• Flashbacks – reliving aspects of a traumatic event or feeling as if it’s happening now. It could involve seeing images of what happened, or experiencing it through other senses like taste, sound, or physical sensations in your body
• Panic attacks – a type of fear response. They’re an exaggeration of your body’s response to danger, stress or excitement
• Dissociation – one way your mind copes with overwhelming stress. You might feel numb, spaced out, detached from your body or as though the world around you is unreal. See this information on dissociation and dissociative disorders
• Sleep problems – you might find it hard to fall or stay asleep, feel unsafe at night, or have nightmares. See our information on sleep problems
• Self-neglect – this is when you’re not able to look after yourself and meet basic needs like eating, keeping clean or keeping your home safe. You might neglect yourself because of low self-esteem, or because you’re having trouble adjusting to life following a trauma. Trauma might disrupt your regular routine. This can make it harder than usual to look after yourself. Some trauma might put us in situations where we have limited resources to meet these basic needs
• Self-harm – when you hurt yourself as a way of dealing with very difficult feelings, painful memories or overwhelming situations and experiences. See our information on self-harm
• Suicidal feelings – including being preoccupied by thoughts of ending your life, thinking about methods of suicide or making plans to take your own life. To find out more, see our information on coping with suicidal feelings. You can also contact Samaritans any time on 116 123or jo@samaritans.org
• Alcohol and substance misuse – a way you might try to cope with difficult emotions or memories. See our information on the mental health effects of recreational drugs and alcohol. You can also get confidential advice about drugs and alcohol on the FRANK website

For tips on coping with the effects of trauma, see below.

Can trauma cause mental health problems?

Trauma is a possible cause of many mental health problems. It can make us more vulnerable to developing them. But for most mental health problems, there are usually other factors involved as well as trauma.

When does trauma become PTSD?

Some mental health problems can develop directly because of trauma. These include post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (complex PTSD).

Just because you’ve experienced trauma, it doesn’t mean you will always develop these problems. The symptoms of trauma can be very intense. But these feelings will often fade over time.

You may be experiencing PTSD if these symptoms don’t go away after a month. Or if you find that they’re significantly affecting your day-to-day life. This might mean you need extra support with your mental health.

See this information on PTSD and complex PTSD to learn more, including where to get help.

How else might trauma affect me?

The effects of trauma can last for a long time. Or they can come and go. You might find you have difficulty with day-to-day aspects of your life, including:

• Looking after yourself
• Holding down a job
• Trusting others
• Maintaining friendships or relationships
• Remembering things
• Making decisions
• Your sex life
• Coping with change
• Understanding your traumatic experience alongside your religious beliefs
• Simply enjoying your leisure time

In some cases, trauma can have a serious impact on your ability to work. See Mind’s pages on how to be mentally healthy at work for information on how to cope.

Some of us might find faith a way of coping with the trauma. But some of us might find it hard to understand our traumatic experience alongside our religious beliefs. Our useful contacts page below lists some organisations you could get in touch with.

How you’re affected may depend on other things too, such as:

• Previous experiences of trauma
• Other stresses or worries at the time or later on
• Being harmed by people close to you
• Whether anyone helped or supported you

Coping with trauma

Trauma can cause strong feelings and difficult experiences. It can take time and support to be able to cope. But there are things you can try that might help with how you’re feeling.

If you feel unable to keep yourself safe, it’s a mental health emergency. Get emergency advice.

Caring for yourself after a traumatic experience

Looking after yourself straight after a trauma might not be possible. You might not realise you’ve been through something traumatic. Or you might not have time or space to care for yourself. Your mind might be in a survival mode, or you might not have full control of your actions.

But if it feels possible, there are things you can try to care for yourself. You may also be able to get support from other people in your life, or helpful organisations, see below.

Keep yourself safe

If the trauma has made you feel unsafe or threatened, it can help to go to a safe space. This could be a friend of family member’s home, a refuge, a hospital, or just somewhere away from the trauma. If this isn’t possible, our useful contacts page has organisations who can support you.

Get medical help if you need it

If your body has been harmed, get any medical help you need. When we experience trauma we can go into shock. So you might not realise you’ve been harmed right away.

If it feels urgent, call 999 or visit A&E. For anything less urgent, you can contact NHS 111 England.

Try to look after your basic needs 

After trauma, we might forget to eat, sleep and look after ourselves. These things might feel very difficult. But resting and hydrating ourselves gives our mind the energy it needs to process the trauma. And can help us think what we need to do next.

If sleeping is difficult, giving yourself some time to sit or lie down can help. Sleep when you need to, even if this isn’t when you’d normally sleep. These relaxation tips might help.

If you’re finding it difficult to eat, try to snack throughout the day. Or change your meal times to when you feel more hungry.  Bland foods might feel easier to eat, rather than food with lots of flavour. Mind’s information on food and mental health has some tips that may help.

Prioritise what to decide now and what can wait 

After trauma, you might need to make some decisions for your safety and wellbeing. But trauma can make us feel confused. This can make it harder to make decisions.

Where you can, try and think of whether you need to make a decision now. Or whether it can wait a while.

If there are important decisions that you don’t feel you can make, some of these organisations might be able to help:

• Citizens Advice – free support for issues such as benefits, debt, employment and housing
• Shelter – free support on housing problems
• Bereavement Advice Centre – practical advice on what to do when someone dies
• Refuge – support and information about your rights if you’re experiencing domestic abuse
• Scope – help with your rights if you have a disability. And access to things like disability benefits and adaptations to your home
• PALS – help with complaints and issues with NHS care

Feel your emotions

You might feel like you need to be strong. Or that showing certain types of emotions is a sign of weakness. You also might find the way you feel is not what others expect.

It’s ok to cry, be angry, or laugh. Try and speak with someone you trust so you can express how you’re really feeling.

If people are being judgemental, you could show them our page below on trauma for friends and family. It might help.

Focus on your breathing and ground yourself

When we experience trauma, we can become very anxious and overwhelmed. You might feel like your heart is beating fast, you’re struggling to breathe, or you’re shaking. In these moments, try to focus on your breath. Breathe in and out slowly.

You can also try some grounding techniques. These can help to bring you back to the current moment. And can help you do what you need to right now – such as getting somewhere safe.

Dissociation during trauma

In some situations, we might dissociate during or straight after a trauma. Dissociation is when you feel disconnected from yourself and the world around you. It’s a way our minds might react to keep us safe.

In some situations, it might not always be safe to experience the current moment. Dissociating can separate our mind from this. It doesn’t always mean you’re unable to move or do anything. You might actually be doing a lot that you don’t realise or remember. What’s important is that you’re safe.

Coping with difficult feelings after trauma

The effects of trauma can last a long time. They might go away and come back. Or they can show up for the first time, long after the trauma has happened.

We might experience overwhelming, distressing feelings related to the trauma at random times. This can happen even if we’re feeling happy and well overall.

These are some tips for coping with difficult feelings in the moment.

Flashbacks 

• Tell yourself that you’re safe and the trauma isn’t happening now
• Touch or hold an object that reminds you of the present
• Describe your surroundings out loud, count your footsteps while walking, or try to remember the lyrics to a song to distract yourself
• Count objects of a certain type or colour

See this page on self-care for PTSD for more tips.

Panic attacks

• Breathe slowly in and out while counting to five. There are videos online and apps you can use to help pace your breathing
• Stamp on the spot
• Taste mint-flavoured sweets or gum, or something sour
• Touch or cuddle something soft
• Wrap a blanket around you. A weighted blanket can help, if you find a sense of pressure comforting

Dissociation or feeling spaced out 

• Breathe slowly while counting
• Hold an ice cube or splash cold water on your face
• Touch something with an interesting texture or sniff something with a strong smell
• Imagine a place that feels safe to you

See this page on coping with dissociative disorders for more tips.

Having nightmares

• Remind yourself that you’re safe
• Do something calming before you try going back to sleep. This could be out of bed, if it helps you feel calmer
• Have an object next to your bed that helps ground you or makes you feel calm
• Try to avoid drinking, eating or smoking things that keep you awake and alert.
• Try a relaxation exercise

Feeling sad, depressed or lonely

• Write down your feelings or keep a journal
• Do something creative
• Talk to someone you trust. Or try peer support, to share how you feel with people who have similar experiences
• Spend some time in nature. This could be going outside, or just opening a window for some fresh air

See our page on self-care for depression for more tips.

Feeling like you want to self-harm

• Rub ice over where you want to hurt yourself
• Massage your hands or the place you want to hurt yourself
• Stick sellotape or a plaster on your skin and peel it off
• Take a cold bath or shower

See our page on helping yourself cope with self-harm for more tips.

Helping yourself in the long-term

If you experience long-term effects of trauma, you may want to find ways to support your mental health. This might include finding ways to deal with negative feelings, or open up to others about your experiences.

These tips can help:

Get to know your triggers

Some experiences, situations or people might trigger reactions like flashbacks, panic attacks or dissociation. These can include reminders of past trauma, such as smells, sounds, words, places, or books and films.

You might find things difficult on significant dates, such as the anniversary of a traumatic experience. Or some seasons or times of year might be hard, such as Christmas.

You might not always be able to avoid your triggers. But understanding them can help you be prepared and help manage them when they do happen.

Recording your moods in a diary could help you spot patterns. Or it might help you to notice early signs of your feelings changing.

Talk to someone 

Some of us who’ve been through trauma can find it hard to open up to others. This might be because we feel unable to share what has happened or can’t remember it clearly.

If you struggle with this, you can still talk about how you feel right now. This doesn’t mean you have to describe the trauma itself.

It could help to talk to someone who you trust. This might be someone you know. Or a professional, like your doctor or a trained listener at a helpline.

Give yourself time

Everyone has their own response to trauma. It’s important to take things at your pace. Try to be gentle and patient with yourself.

You might feel pressure from people around you to move on. But coping with trauma often takes time. It’s not a straight-forward process.

Find ways to relax

Finding ways to relax can help with our wellbeing, especially when we feel stressed, anxious or overwhelmed. These pages on relaxation have tips you could try.

It may also help to spend time in nature. Being outside in green space can help us feel more in touch with our surroundings. See Mind’s pages on nature and mental health for more ideas.

Make a self-care or sensory box

A self-care box can contain things that make you feel calm, relaxed or comforted during difficult times. They can help with anxiety, low mood and depression.

A sensory box is similar, but is filled with things that can help ground you in the moment. They can help manage experiences like panic attacks, dissociation, or flashbacks.

Some things you might include in a self-care box could be:

• Favourite books, films or CDs
• A stress ball or fidget toy
• Helpful sayings or notes of encouragement
• Pictures or photos you find comforting
• A notebook and pen to write down your thoughts
• Puzzles or colouring books to distract yourself
• A soft blanket or cosy slippers
• A nice smelling candle or lavender bag
• Something with an interesting texture or feel

Try peer support

Peer support brings together people who have had similar experiences. To find peer support, you could:

• Ask your doctor or healthcare team
• Try an online peer support community, such as Mind’s Side by Side
• Find a local support group through an organisation such as the National Survivor User Network (NSUN), Together UK or Rethink
• Contact an organisation specialising in trauma, such as those listed on our useful contacts page, to see if they offer trauma-informed peer support
• Contact Mind’s Infoline or a local Mind to see what support there is in your area

If you’re seeking online peer support, it’s important to look after your online wellbeing. This Mind page on looking after your mental health online can help.

Find specialist support

It may help to contact an organisation that specialises in supporting trauma. Or with expertise in the type of trauma you’ve experienced. See below our page of useful contacts for trauma for organisations which can help.

If you’re experiencing difficult physical or mental health effects of trauma, speak to your GP. They may be able to refer you to specialist support, or suggest things that can help.

Build a routine

Trauma can disrupt our usual daily routine. This might be because of how trauma makes us feel. Or because a traumatic event has changed a big part of our lives.

Building a new routine can help us adjust to the changes in our lives after trauma. And help make sure that we aren’t always focusing on the trauma.

In your routine, you might want to consider things like physical activity, food, and spending time with others. These things can feel difficult to do after trauma, especially if they aren’t part of our routine.

These pages on wellbeing have more ideas that you could build into your routine.

Managing sleep problems

Many of us who’ve experienced trauma have problems sleeping. You might find it hard to fall or stay asleep, or feel unsafe during the night. Or you may feel anxious or afraid of having nightmares.

It may help to try these tips:

• Keep a light on. This may help if you struggle to sleep in complete darkness
• Comfort yourself. For example, you could curl up in a soft blanket or cuddle a pet or soft toy
• Play soothing sounds. If silence makes it harder for you to sleep, you could try listening to something as you fall asleep. For example music, nature sounds or people talking, such as podcasts
• Plan a relaxing bedtime routine. This can help to manage anxiety that might make sleeping difficult. It could involve reading, using a hand cream, or doing breathing exercises. The routine can be as long or short as you need it to be

See our page on coping with sleep problems for more information.

Try something creative

Expressing yourself creatively can help to process traumatic experiences. You could join a group or do something creative on your own. It doesn’t have to be something you show other people if you don’t want to.

You could try:

• Dancing
• Acting and theatre
• Writing, such as poetry or short stories
• Singing or playing music
• Painting, drawing or making sculptures
• Knitting, crochet, embroidery or cross stitch

You can find groups for creative activities in places like libraries, or websites like MeetUp. Some local Minds also offer creative workshops for wellbeing.

How I deal with panic attacks with doodling

Watch Stuart’s vlog on how he uses doodling to cope with panic attacks. Our thanks to Mind for allowing us to share this vlog.

Treatment and support for trauma

This page is about treatments that may help with the mental health effects of trauma. It covers:

• Talking therapies
• Arts and creative therapies
• Medication
• Crisis services
• Accessing treatment

Everyone has their own response to trauma. Not everyone will feel they need treatment.

If you’re looking for treatment, what you’re offered will depend on your symptoms and diagnosis (if you have one), and on your needs. It also depends on what services are available in your area.

What helps is different from person to person, and can change over time. It can help to keep an open mind and explore different options.

The treatments for trauma are not always the same as recommended treatments for PTSD or complex PTSD. See our page on PTSD treatments to learn more.

Talking therapies

Talking therapies give you space to explore difficult feelings and experiences with a trained professional. You might find this helpful if you’re struggling to process or understand your trauma. Or if you want to talk about your experiences confidentially.

There aren’t guidelines recommending certain types of therapy for trauma. What works best will be personal to you. But research shows that therapy may be more helpful if the therapist:

• Has a good understanding of trauma – this doesn’t mean they need to have experienced trauma themselves. But that they understand how it affects people
• Understands your cultural or religious background – and knows how this might affect our response to trauma
• Can work with you over a long period of time – time-limited therapies often don’t give enough space to build trust

Arts and creative therapies

Arts and creative therapies are treatments involving activities like art, music or drama. They happen in a therapeutic environment, with a trained professional. You don’t need to have done these activities before. Or have any particular skills or knowledge.

These therapies can help to address difficult feelings and experiences without using words.

They can also help you represent and approach your trauma in different ways. Find out more on Mind’s page on arts and creative therapies.

Medication

Some of us may find medication helps to manage the symptoms we experience after trauma.

The type of drug you’re offered will depend on the symptoms you’re experiencing. And any other health needs you might have.

Before you decide to take any medication, make sure you have all the facts you need to feel confident about your decision. This information on psychiatric medication has guidance on what you might want to ask your doctor. This includes information about your right to refuse medication.

Benzodiazepines and trauma

Benzodiazepines are a type of sedative medication that slow down the body and brain’s functions.

Benzodiazepines are not recommended if you have recently experienced trauma. Evidence suggests that they can affect your ability to recover. But they are sometimes prescribed to treat severe anxiety and insomnia. These are symptoms you might experience following a traumatic event.

If you feel medication could help with severe anxiety or insomnia, you could ask your doctor about:

• Non-benzodiazepine anxiety mediation
• Non-benzodiazepine sleep medication

Complementary and alternative therapies

Complementary and alternative therapies include many different types of therapy, such as body-based or meditation-based therapies.

There are different levels of evidence on what therapies are effective. But some research suggests these therapies might help with symptoms of trauma:

• Acupuncture
• Aromatherapy
• Hypnotherapy
• Massage
• Mindfulness
• Using a weighted blanket
• Yoga

These pages on complementary and alternative therapies have more information on these treatments, including how they work and their safety.

Crisis services

Crisis services can help if you’re going through a mental health crisis. For example:

• Samaritans are open 24 hours a day, 365 days a year. You can call 116 123 for free, email jo@samaritans.org or visit some branches in person
• Local support services may be available in your area, including day services, drop-in sessions or issue-specific support
• Crisis teams can support you at home during a mental health crisis
• Crisis houses offer intensive, short-term support to help you manage a mental health crisis in a residential setting, rather than in a hospital

Accessing treatment for trauma

These are some ways you could access treatment and support for trauma:

• Your GP – for advice on preparing for a GP appointment, see this page on talking to your GP about mental health
• Self-referral – some areas run services which you can contact directly to refer yourself for talking therapy. Your GP might give you information about this. If you live in England, you could try the NHS talking therapies finder on the NHS website
• Specialist organisations – see our useful contacts page for organisations that may offer therapy or other support for particular types of trauma. They may also be able to put you in touch with local services
• Local trauma services – some organisations offer free or low-cost trauma therapy. Your local Mind may have information about services in your area
• Private therapists – finding a private therapist is another option some people choose to explore. But it can be expensive so isn’t an option for everyone. Find out more on this page on finding a therapist

The National Institute for Health and Care Excellence (NICE) – which produces guidelines on best practice in healthcare – recommends treatments for particular mental health problems rather than for trauma overall. This could affect what treatment you’re offered on the NHS.

To find out about treatments for particular mental health problems, see Mind’s mental health A-Z.

Trauma-informed care

Trauma-informed care is now very common in the NHS. If a service says it’s trauma-informed, this means all staff should:

• Understand how trauma can affect people, including how mental health problems can be reactions to trauma
• Ask sensitively about past trauma, and offer appropriate support if you disclose it
• Understand how mental health services can cause harm if they aren’t trauma-aware
• Understand your strengths and recognise what has helped you survive and cope
• Be trustworthy, transparent and involve you in your care

What if I’m not offered the right type of treatment?

The NHS should provide care and treatment that is appropriate for you, and meets your needs and preferences. If your mental health problems relate to trauma, this should include receiving trauma-informed care. Visit these pages on seeking help for a mental health problem for information on accessing the right treatment for you.

If you don’t feel like you’re offered treatment that is right for you, you could talk to the provider and explain this to them. If you’re finding it hard to access support, this page on overcoming barriers has some suggestions that could help. If speaking to your provider about what you want doesn’t work, you could make a complaint.

And if receiving the wrong kind of care has caused you harm, this could be clinical negligence. You would need to show that a healthcare professional failed in their duty to take care of you, and you experienced damage or loss as a result of that failure.

Overcoming barriers to getting help for trauma

This page has information about:

• Barriers to opening up about trauma
• Barriers to seeking help for trauma
• How can I overcome these barriers?

These are just some of the barriers people may experience when seeking help for trauma. You might face others that aren’t listed here.

Barriers to opening up about trauma

Recovering from trauma can often include talking about what happened. And developing our own way of thinking about what happened.

This can be a difficult process. You may find that certain things make it harder to open up. For example:

Experiencing stigma and blame

There can be stigma around certain types of trauma and experiences. This can make it difficult to talk about what’s happened to you. You might worry that people will blame you for the trauma. Maybe this happened to you in the past. This can make it hard to trust people.

Feeling unsafe

You might not be able to tell anyone about your trauma because you’re scared for safety. For example, if you’re experiencing abuse from a family member or someone you’re living with.

If you’re experiencing abuse from a partner, family member, or someone in a position of power, help is available. See our useful contacts page for who to contact when you are unsafe.

Struggling to talk or cope with what happened

Talking about a traumatic experience can bring up very strong feelings. It may trigger reactions like panic attacks, dissociation or suicidal feelings.

You may also not remember what happened or know how to understand your experiences. This can make it hard to talk about.

And there might be times when you feel like you just can’t cope, or it all seems too hard. This can make it feel much harder to open up about what you’re going through.

People misunderstanding trauma

Some people might not understand trauma like you do. This might mean they don’t understand your strengths or what’s helped you survive. For example, you might feel that your coping mechanisms are being judged or criticised.

Family or community members may be hostile or critical if you seek help. Or they may deny or dismiss what you’re going through.

Some people might not understand why you found a certain experience traumatic. This is especially if they experienced something similar and feel differently about it.

Barriers to seeking help for trauma

Seeking help for the effects of trauma can be difficult. You might sometimes face barriers to getting the support you need. For example:

Bad experiences of seeking help

This may include professionals not listening to you or helping you. Or if you’ve been harmed by poor healthcare. If you try something and it doesn’t help, it can feel harder to try again.

Explaining things to many people

You may talk to several healthcare professionals before you can get the right support. This could mean you’re asked the same questions a number of times. You may have to recount your traumatic experiences more than you feel comfortable doing.

Getting the right help for you

Some professionals may emphasise treatments that don’t feel right for you, such as medication. You might prefer them to address the causes of the trauma you’re experiencing.

Too much focus on trauma

Some professionals may try to define you by your trauma. They might use it to explain everything you do or feel, even if you don’t feel like it’s related. You might also be given a diagnosis you don’t agree with because of your trauma.

Professionals don’t recognise your trauma

Some professionals may not recognise your experiences as traumatic. This could be because they have a different idea of what they think trauma is. This can be a very distressing experience.

Some professionals might also believe harmful stereotypes about certain groups of people. These stereotypes could lead them to dismiss experiences of trauma. For example, women being dismissed as overly emotional or overreacting, rather than their experiences and symptoms being taken seriously.

If you’re unhappy with how professionals are treating you, you can complain. See our pages on care to learn more.

If you’ve been abused by health and social care professionals, this page on abuse has some organisations that can help.

How can I overcome these barriers?

If you’re facing barriers like these, here are some things that could help:

• Write things down – this could help if it’s too hard to say things out loud or you don’t want to repeat them
• Focus on safety – if you’re restricted in what you can talk about, focus on making sure you’re safe. Having a safety plan could help keep you safe, even if you can’t leave home straight away. End the Fear has a safety plan template you can download and fill out
• Choose what you share – what you tell people about your experiences is up to you. You don’t need to tell your whole story, or even any of it. Your feelings are valid and you deserve support
• Tell people what sort of support you would like – for example, asking someone to listen and not give you advice
• Ask professionals about their expertise – you can ask if they have specific training and experience of working with trauma. And about anything else that concerns you
• Show people this information – it may help them to learn more about trauma
• Anyone can try therapy – some people think you can only get help from a therapist if you feel ready to open up. But this isn’t true. Therapists who understand trauma should support you and help you cope, regardless of how much you can share
• Make choices where you can – for example, you might be able to request a therapist of a particular gender. Or choose to sit facing the door if that feels safer for you
• Focus on how you feel now – it doesn’t matter whether you remember or understand what happened. You can still seek help for how the trauma has affected you, and for what you’re experiencing you now
• Talk to Mind – Mind’s Infoline can help you explore options for support near you. And Mind has local Mind branches which provide a range of helpful services

If you’ve tried something and it hasn’t helped, try to be gentle and patient with yourself. Coping with the effects of trauma can be difficult. It can take a lot of time and energy. But many people find that when they have the right combination of treatments, self-care and support, it is possible to feel better.

Helping someone else with trauma

It can be hard if someone you care about is struggling with the effects of trauma. Or if they’re in a long term, traumatic situation. But there are things you can do that might help.

This page has some suggestions for ways you can support them while also looking after your own wellbeing:

• Be a good listener
• Manage your expectations
• Learn their triggers
• Try not to judge
• Offer practical support
• Respect their privacy and boundaries
• Help them set boundaries
• Engage in fun and relaxing activities
• Help them find support
• Look after your own mental health

Be a good listener

When someone experiences trauma, it’s important that they know the people close to them are there to listen. You don’t always need to be able to give advice or have the answers to everything. Just being a good listener is a big help.

These are some tips:

• Give them time – let them talk at their own pace – it’s important not to pressure or rush them
• Focus on listening – try to respect what they’re choosing to share, rather than waiting for your chance to talk
• Accept their feelings – for example, allow them to be upset or angry about what’s happened
• Don’t blame them or criticise their reactions – you might wonder why they didn’t do something differently. But they survived however they could at the time
• Use the same words they use – people vary in how they prefer to describe their experiences. For example, it’s their choice whether to talk about being a ‘victim’ or ‘survivor’ of trauma
• Don’t dismiss their experiences – for example, don’t tell them not to worry about things or that they’re lucky for getting through it. Usually this isn’t helpful to hear. Try to remember that people can’t choose what they find traumatic or how they’re affected
• Only give advice if you’re asked to – they might prefer to simply hear that you believe them and are there for them
• Allow them to express themselves how they need to – some of us might find it easier to express ourselves through writing or creative outlets. Supporting these ways of expressing feelings is just as valid

If someone talks to you about trauma, they might seem unemotional or casual. This could be even if they’re talking about stressful or upsetting events. They might even smile or laugh. This can seem strange or confusing. But it’s a normal reaction. These responses can be part of a coping mechanism or physical response.

Hearing about trauma can be really hard, whether or not someone shares specific details. For example, you might feel upset or angry about what they’ve told you.

Manage your expectations

We might have our own ideas about what is traumatic. Or how someone should react to trauma, and how long it should take to get over it. But everyone is unique in how they experience trauma. And there’s no right way to manage it or right amount of time to process it.

Experiencing effects at different times

Trauma doesn’t affect everyone right away. Some of us may not feel it’s impacting us until months or years later. We might feel like talking about it sometimes, but not at other times. This is perfectly normal.

Everyone works through trauma at their own speed. It’s important to not have expectations about when someone should be ‘better’. Or expect it to stop having an impact on their life.

Changes to who they are 

Experiencing trauma can change how someone thinks and feels, and their goals in life. It’s important to understand that this change is normal. And not to pressure someone into returning to how they were before the trauma.

You might need to find new ways to spend time together. Or discover new, shared interests. Try not to think about this as ‘losing’ the person they were. We all change over time, and this could be a great way to try something new together.

Stigma and trauma

Some people feel unable to escape or talk about traumatic situations. This could be because of the stigma or beliefs of people around them. You may hold certain beliefs about what people should do in certain situations, such as beliefs about whether people should get divorced.

Everyone deserves to be free from harm and have a safe space to process their experiences. Try to think of someone’s safety as the main priority and accept their needs. This is even if they don’t make complete sense to you or match your beliefs.

Struggling with faith or spiritual beliefs

Trauma can lead some of us to struggle with our faith or spiritual beliefs. This could be the person who went through the trauma. Or you, if you’re supporting that person.

Someone you know may have experienced trauma within a religious or spiritual community. To leave a traumatic environment, they may have to do things that are considered against certain religious teachings or beliefs. But this doesn’t make them a bad person. Or mean you can’t support them.

If you’re struggling with this, there are people you can talk to. This could be someone from within your religious community, or outside of it. Our useful contacts page has organisations you could contact.

Try not to judge

It can be hard to understand why someone can’t seem to ‘move on’ from trauma. Especially if you’ve not gone through trauma yourself. Or you feel differently about shared experiences.

It’s understandable to wish things could improve. But it’s important not to blame them or put pressure on them to get better without the time and support they need.

It’s also important not to judge people if they don’t react to trauma as strongly as you’d expect. Everyone has different reactions to trauma. And some of us may not be that affected by it.

Don’t assume that someone needs professional help or certain types of support. And don’t judge their reaction as them not having felt the impact of the trauma.

Learn their triggers

It might help to ask if any situations or conversations might trigger flashbacks or difficult feelings. For example, they might feel distressed by loud noises or arguments.

Understanding their triggers could help you avoid these situations. Or help you support them when they do happen.

Tips on helping someone with flashbacks

Flashbacks are vivid experiences in which someone relives aspects of a traumatic event. It can be hard to know how to help during a flashback. But you don’t need special training. It could help if you:

• Try to stay calm
• Gently tell them that they’re having a flashback
• Avoid making any sudden movements
• Encourage them to breathe slowly and deeply
• Encourage them to describe their surroundings
• Reassure them that they’re safe

These pages on post-traumatic stress disorder (PTSD) explain more about what flashbacks are. There are also tips for coping with flashbacks.

Offer practical support 

Someone may need practical support following a traumatic event. Trauma can impact our ability to think clearly and organise. Doing things like cooking or cleaning can help.

But it’s important to make sure that the person you’re supporting still has control. And has a say in what happens around them. Try not to take over.

If you’re worried about someone, it’s understandable to want to help them improve things. Or to feel frustrated if they disagree about what to do. But traumatic experiences usually involve being powerless or having control taken away from you.

If you pressure them or tell them what to do, this might add to their feelings of powerlessness. Instead, try to encourage and support them to make their own choices.

Respect their privacy and boundaries

Don’t share details of what they’ve gone through unless you have their permission. For example, they might not want you to tell mutual friends or family members about what has happened to them.

They might also not want to discuss their experience with you at all, even if you’re close. Try not to take this personally. Reassure them that you’re there if they need you.

This doesn’t mean you need to keep everything to yourself and not get support. Our useful contacts below have some suggestions of where you can get help.

Help them set boundaries

Someone who has experienced certain forms of trauma might have difficulty saying ‘no’ to things they don’t want to do. This might come from a time during the trauma when they needed to please people to say safe. Or they may feel they need to say ‘yes’ to everything to keep people close to them.

Reassure them that it’s ok to say ‘no’ to things. Give them time to respond and process the request, rather than demanding an answer right away. Talk to them about what things they do and don’t like doing. Allow them to help plan events with their needs in mind.

Engage in fun and relaxing activities

Someone recovering from trauma might have a lot of difficult things to manage. When you spend time with them, try to include activities that are enjoyable to do and separate from the trauma.

They might not always want to do this. You’ll need to consider their boundaries. But finding ways to engage them in fun and relaxing activities can be very helpful.

Help them find support

If they want you to, you could help them find support. For example:

• You could look through the list of relevant organisations in our useful contacts for trauma
• Our pages on supporting someone who is self-harming can help if someone is harming themselves. We also have pages on supporting someone who feels suicidal, if they’re struggling with thoughts of suicide

See these pages on helping someone else seek help for more suggestions, including what you can and can’t do if someone doesn’t want help.

If you believe someone is unsafe

Someone who’s in a traumatic environment might not be able to leave it on their own. For example, they might not have the money to leave a home that is unsafe. Or they may be being forced to stay in unsafe relationships.

You might not always be able to help them get somewhere safe. Or they may choose to stay in situations for reasons you don’t understand.

Try not to judge the decisions they are making. Reassure them that you’re there to provide support.

If you believe that someone is at serious risk of harm, you can call 999. Or you could report it to your local authority’s safeguarding team.

Look after your own mental health

It’s important to remember that your mental health matters too. You can find lots of information and tips for looking after yourself in these pages on:

• Supporting someone else to seek help
• How to cope when supporting someone else
• Managing stress
• Maintaining your wellbeing

Support options for you

A traumatic event can have a major impact not just on those who lived through it, but also on people around them. If you experience effects of trauma while supporting someone else (sometimes called secondary trauma), it might help to try some of the tips from our page on coping with trauma above.

You might also want to talk to your GP about how you’re feeling, and ask if they can offer you any treatment or support.

Useful contacts 

Contacts if you’re currently unsafe

If you are in immediate danger you can contact the police on 999. If it is not safe to talk, you can make a silent 999 call. If you have a mobile, call 999 and then dial 55. This page has more information on silent 999 calls.

Ask for Ani

enough.campaign.gov.uk/get-support/ask-for-ani
Ask for ANI (Action Needed Immediately) is a codework scheme. You can use it at pharmacies and jobcentres to let people know you’re experiencing abuse. You can use the Ask for ANI postcode checker to find the nearest participating pharmacy or jobcentre.

National Domestic Abuse Helpline

0808 2000 247
nationaldahelpline.org.uk
Free 24-hour helpline for women who have experienced domestic abuse and violence, with all female advisors. Also offers a live chat and can help to find refuge accommodation. Run by the domestic violence charity Refuge.

Abuse and bereavement services 

If you’re experiencing or have experienced abuse, we have a guide to organisations providing abuse support.

If you’re experiencing a bereavement, we have information on organisations that can support with bereavement.

Other organisations

ASSIST Trauma Care

assisttraumacare.org.uk
Information and specialist help for people who’ve experienced trauma or are supporting someone who has.

BAATN (The Black, African and Asian Therapy Network)

baatn.org.uk
Provides a list of therapists from Black, African and Asian backgrounds, and signposts to local mental health and advocacy services.

Bayo

bayo.uk
Bayo is a space to find collectives, organisations and services from across the UK that offer mental health and wellbeing support to the Black community.

Birth Trauma Association

birthtraumaassociation.org
Support for anyone affected by birth trauma, including partners.

British Association for Counselling and Psychotherapy (BACP)

bacp.co.uk
Professional body for talking therapy and counselling. Provides information and a list of accredited therapists.

British Medical Association (BMA)

bma.org.uk
Provides a wellbeing support directory for doctors and medical students.

Climate Psychology Alliance

climatepsychologyalliance.org
Information on climate change and mental health including how to get support for difficult feelings surrounding the climate crisis.

Combat Stress

0800 1381 619
combatstress.org.uk
Treatment and support for armed forces veterans who have mental health problems.

Disaster Action

disasteraction.org.uk
Information and support for people affected by major disasters in the UK and overseas.

FRANK

0300 123 6600
talktofrank.com
Confidential advice and information about drugs, their effects and the law.

Freedom Programme

01942 262 270
freedomprogramme.co.uk
Free support programme for people affected by domestic violence.

Galop

0207 704 2040 (LGBT+ hate crime helpline)
0800 999 5428 (LGBT+ domestic abuse helpline)
0800 130 3335 (Conversion therapy helpline)
help@galop.org.uk
galop.org.uk
Provides helplines and other support for LGBT+ adults and young people who have experienced hate crime, sexual violence or domestic abuse.

Hub of Hope

hubofhope.co.uk
UK-wide mental health service database. Lets you search for local, national, peer, community, charity, private and NHS mental health support. You can filter results to find specific kinds of support.

Jami

020 8458 2223
jamiuk.org
Provides mental health support for the Jewish community through online services, community hubs, recovery support plans and education.

Karma Nirvana

0800 5999 247
karmanirvana.org.uk
Supports victims of forced marriage and honour-based abuse. Also offers a face-to-face advocacy service for people in West Yorkshire.

Migrant Help

migranthelpuk.org
Information and support to people affected by displacement and exploitation

Mind

Mind’s helplines provide information and support by phone and email.

Local Minds offer face-to-face services across England and Wales. These services include talking therapies, peer support and advocacy.

Side by Side is Mind’s supportive online community for anyone experiencing a mental health problem.

Mind Recovery Net

mindrecoverynet.org.uk
Publishes information on recovery colleges, including a searchable list of providers.

MindLine Trans+

0300 330 5468
mindinsomerset.org.uk/our-services/adult-one-to-one-support/mindline-trans/
Free, confidential listening service for people identifying as trans or non-binary, and their friends and families.

Muslim Community Helpline

020 8908 6715 or 020 8904 8193
muslimcommunityhelpline.org.uk
Provides listening and emotional support for members of the Muslim community.

The National Association for People Abused in Childhood (NAPAC) 

0808 801 0331
support@napac.org.uk
napac.org.uk
Supports adult survivors of any form of childhood abuse. Offers a helpline, email support and local services.

National Survivor User Network (NSUN)

nsun.org.uk
Independent, service-user-led charity for people with experience of mental health issues. Provides information, networking opportunities and peer support.

NHS Services Finder

nhs.uk/service-search (England)
Searchable database of NHS services.

Nurse Lifeline

0808 801 0455
nurselifeline.org.uk
Listening service for nurses, midwives, healthcare support workers, nursing student and their families.

One in Four

0800 121 7114
oneinfour.org.uk
Offers advocacy services, counselling, and resources for adults who have experienced trauma, domestic or sexual abuse in childhood.

Protect

020 3117 2520
protect-advice.org.uk
Advice and support for people concerned about wrongdoing in the workplace.

Rape Crisis England & Wales

0808 802 9999
rapecrisis.org.uk
Support for women and girls affected by rape, sexual abuse or any form of sexual violence. Provides details of local centres.

Rethink Mental Illness

0808 801 0525
rethink.org
Support and information for anyone affected by mental health problems, including local support groups.

Safe Spaces

0300 303 1056
safespacesenglandandwales.org.uk
Free and independent support service for anyone who has been abused by someone in the Church or as a result of their relationship with the Church of England, the Catholic Church of England and Wales or the Church in Wales.

Samaritans

116 123 (freephone)
jo@samaritans.org
Freepost SAMARITANS LETTERS
samaritans.org
Samaritans are open 24/7 for anyone who needs to talk. You can visit some Samaritans branches in person.

The Survivors Trust

0808 8010 818
thesurvivorstrust.org
Lists local specialist services for survivors of sexual violence, including advocates and Independent Sexual Violence Advisors (ISVAs).

Together UK

together-uk.org
Supports people with mental health problems, including through peer support.

UK Psychological Trauma Society

ukpts.co.uk
Forum for professionals to share ideas and knowledge about trauma, including a list of dedicated NHS and private trauma services in the UK.

Victim Support

0808 168 9111 
victimsupport.org.uk
Provides emotional and practical support for people affected by crime and traumatic events.