Recovery tips for survivors and loved ones.

When someone experiences one traumatic event while painful it is often possible, with support, to heal in ways that restore safety, sense of self, and trust. But when trauma is repeated, chronic, interpersonal, or occurs early in life (think of abuse, neglect, repeated sexual assault, systemic violence), it often leads not just to standard PTSD, but to complex post-traumatic stress disorder (cPTSD). cPTSD adds layers: disturbances in self-organization, difficulties regulating emotions, disrupted relational patterns, often shame, guilt, identity confusion.

For survivors of sexual assault, the risk is elevated. Sexual assault is one of those interpersonal traumas that deeply wounds trust, boundaries, sense of bodily safety, and can shatter one’s belief in justice and self-worth. When sexual assault is repeated, or compounded by other forms of trauma (neglect, ongoing abuse, or exposure to violence), survivors are more likely to develop cPTSD, or at least a more severe and complicated PTSD.

What the Numbers Say About Increased Risks

Here are some findings (drawn from recent research) that illustrate just how much greater the vulnerabilities are for sexual assault survivors, especially when trauma is complex, and how suicidality and substance use become more likely.

Why Complex Trauma Deepens the Risk

As a result of these studies, here are reasons cPTSD (especially in sexual assault survivors) tends to increase vulnerability for suicidality and substance misuse:

1. Emotion dysregulation: stronger, more frequent mood swings; high shame, guilt, self-loathing; difficulty tolerating distress. Survivors may turn to substances to manage or “numb” overwhelming feelings.
2. Self-worth and identity harm: repeated violations of trust, boundary, safety often lead survivors to believe they are to blame, that they are somehow “less than,” which fuels depression, hopelessness, risk for suicidal ideation.
3. Relational distrust / isolation: PTSD/cPTSD symptoms can make trusting others hard; shame or fear of judgment can silence survivors. Isolation amplifies psychic pain.
4. Cumulative trauma and overlap: sexual assault often doesn’t happen in isolation there may be childhood abuse, neglect, repeated assaults, discrimination, etc. Each layer adds risk.
5. Co-occurring disorders: depression, anxiety, substance misuse, sometimes eating disorders or personality features. These comorbidities escalate risk for suicidal thoughts or behaviors.
6. Self-medication: alcohol, drugs, other intoxicants or behaviors may temporarily relieve symptoms flashbacks, nightmares, hypervigilance but also worsen mental health over time, reduce impulse control, increase risk.
7. Hopelessness and impaired forward vision: many survivors feel stuck, unable to see a future beyond suffering. Hopelessness is a well-known predictor of suicide risk, especially when paired with high trauma load and low support.

Recovery Month & Suicide Prevention Month

• National Recovery Month reminds us that healing is possible and that recovering from trauma, PTSD, substance use, or complex overlapping challenges is a process, often non-linear, but worthy and necessary.
• National Suicide Prevention Month underscores that suicidal ideation, behavior, or intent are serious and real for many survivors, especially those with complex trauma or cPTSD. It reminds us to support, intervene, and prevent.

Together, the two months highlight both the urgency (suicide risk) and the hope (recovery is possible).

Tips & Tools for Parents, Caregivers & Loved Ones

You are often part of the healing network. What you do can make a significant difference. Here are tools to help:

1. Listen with compassion, validate
   • Believe the survivor. Do not minimize or question their memories.
   • Let them tell their story at their pace; don’t push for details prematurely.
2. Educate yourself on cPTSD
   • Learn what cPTSD is: symptoms beyond classic PTSD (emotion regulation, interpersonal difficulties, identity issues, etc.).
   • Understand that triggers may be many and may differ from person to person.
3. Create safety, predictability
   • Structure, routines, consistency help.
   • Physical safety is foundational, but also emotional safety: avoid re-victimization, judgment, or blame.
4. Support access to trauma-informed therapy
   • Therapies like EMDR, trauma-focused CBT, Somatic Experiencing, Dialectical Behavior Therapy (DBT) can help.
   • Support their search for therapists who understand sexual assault, cPTSD, and comorbid substance use if present.
5. Watch for signs of suicidality
   • Increased isolation, talking about hopelessness or being a burden, sudden calm after depression, giving away possessions, self-harm.
   • Know how to respond: stay with them, get professional help, don’t leave them alone in crisis.
6. Encourage and support healthy coping
   • Mindfulness, grounding exercises, breathing techniques.
   • Creative outlets: art, music, writing.
   • Physical movement (walks, yoga) when possible.
   • Healthy social connection: trusted friends, peer support groups.
7. Manage loved-one self-care
   • You cannot fully heal others, but you can be supportive. Maintain your own boundaries, seek support for yourself (therapy, peer groups), to avoid compassion fatigue.

Tips & Tools for Survivors with cPTSD / Substance Misuse / Suicidality

If you are walking this path, know: you are not alone, and there are tools you can use. Healing isn’t straight-line, but each small step counts.

1. Reach out / safety planning
   • If suicidal thoughts are present, reach out to crisis lines, therapists, trusted friends.
   • Make a safety plan: list people you trust, places you feel safe, things that soothe you, emergency contacts.
   • Remove or reduce access to means (if possible) for self harm or overdose.
2. Grounding & self-regulation practices
   • Use 5-4-3-2-1 method (name five things you see, four you can touch, etc.) to bring awareness to the present.
   • Breathing exercises, meditation, progressive muscle relaxation.
   • Somatic practices to help reconnect with body safely.
3. Therapeutic work
   • Trauma-informed therapy is essential. EMDR, CPT, DBT, Somatic Experiencing, etc.
   • If substance use is present, integrated treatment is ideal (treat PTSD/cPTSD and substance misuse together).
4. Peer support & community
   • Survivors’ groups (online or local), support groups for sexual assault, groups for PTSD or cPTSD.
   • Substance recovery groups that understand trauma history.
5. Building resilience and positive identity
   • Reconnect with what matters to you: values, passions, creativity, purpose.
   • Journaling or art to reclaim voice, self-story.
   • Mindfulness, compassionate self-talk, affirmations.
6. Healthy lifestyle supports
   • Sleep hygiene (consistent schedule, limiting screens, creating restful environment)
   • Nutrition and movement (they won’t erase trauma but help the body feel safer)
   • Reducing or quitting substances that worsen symptoms – with professional help when needed.
7. Know when to ask for help
   • If symptoms worsen (e.g. suicidality, psychosis, self-harm), reach mental health crisis services immediately.
   • Use hotlines (in the U.S., 988 for suicide prevention).
   • Use local resources, walk-in clinics, trauma-specialized centers.

Hope & Recovery: What We Can Hold On To

• Healing is possible. Many people who carry complex trauma go on to lead lives filled with meaning, connection, joy.
• Recovery is not about forgetting or “getting over” but about learning to live with what was done to you transforming painful experiences, sometimes integrating them into a sense of self that is stronger and wiser.
• With therapy, community, support, and time, symptoms can improve, relationship quality can heal, substance use can reduce, suicidality can be prevented.

What You Can Do Right Now

• If you are a caregiver/loved one: offer a safe space, believe, assist in finding help.
• If you are a survivor: reach out talk to someone. You deserve help, care, healing.
• Advocate: better trauma-informed mental health services, access to care, destigmatization of sexual assault and mental health, funding for recovery programs.

As a survivor of both substance use, sexual abuse and suicide attempts, my story is the embodiment of cPTSD. But also because of this, my story is also the embodiment of hope, healing and possibility. You Can Recover.

Take the first step in seeking help today.

Crisis & Support Resources

U.S. National Hotlines

• 988 Suicide & Crisis Lifeline: Dial 988 or chat via 988lifeline.org
• RAINN National Sexual Assault Hotline: 1-800-656-4673 | rainn.org
• SAMHSA National Helpline (Substance Use & Mental Health): 1-800-662-4357 | samhsa.gov/find-help/national-helpline
• National Domestic Violence Hotline: 1-800-799-7233 | thehotline.org
• Crisis Text Line: Text HOME to 741741

Specialized & Additional Resources

• Trevor Project (LGBTQ+ Youth): 1-866-488-7386 | Text START to 678-678
• NAMI HelpLine: 1-800-950-6264 | nami.org/help
• Veterans Crisis Line: Dial 988, press 1
• StrongHearts Native Helpline: 1-844-762-8483