“Extremely well presented. Covered salient points in trauma work. Very credible presenter, obviously knows the subject matter well, is clear, informative, and was careful to ensure participant's expectations were met.”

E. HUTCHING Relationships Australia

“It was wonderful training given that all my questions and issues were addressed. It felt like 2 days of supervision.”

SYLVIA ACEVEDO Clinical and Private Practitioner

“I found the training very informative and a window to many therapies and skills to focus on in the future. The presenter was excellent and certainly demonstrated a well informed knowledge of various modalities and therapies.”


“The presenter did an excellent job! The information was interesting, profound and very relevant. The information was very clear, stimulating and I will find it very helpful when working with clients.”

WENDY METRA Counsellor/Psychotherapist

“Absolutely fantastic workshops! It was great to discuss, hear and walk away with real practical strategies and techniques to assist my clients in becoming more body aware. Excellent resources given.”


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Resources for Survivors

There are many ways in which children can be traumatised in childhood. These include being sexually, emotionally or physically abused, being neglected and/or growing up in a situation of domestic or community violence and/or being exposed to other adverse childhood experiences. It is important to recognise that even when children are not overtly abused they can experience trauma and its effects e.g. if caregivers are unable to meet a child’s emotional needs (e.g. because they have unresolved trauma histories themselves e.g. as a result of mental illness or substance abuse).

Experiencing trauma in childhood can affect a person’s health and well-being into adulthood. It can impact your self- esteem, relationships, emotional and physical health and other aspects of daily life.  

The good news is that research shows that with the right support recovery is possible, even when there’s been severe trauma early in life. It also shows that when an parent has worked through their trauma, their children benefit.

If you have experienced trauma or abuse of any sort in childhood, please look at the following resources and information. We hope they will help you better understand not only the effects of what you experienced and how you’ve coped but also where and how to find help. 

Fact sheet

Download Towards Recovery: Blue Knot Foundation's fact sheet for people who have experienced childhood trauma

“Towards recovery”

Is a short video for survivors of all forms of childhood trauma and abuse. It has been developed by survivors, as well as those who support them professionally and personally.

Further Resources

Have I been abused?

Some survivors are well aware of the trauma they experienced in childhood. They are troubled by memories of abuse, and live with the pain, confusion and feelings of loneliness they experienced as a child. They may be plagued by nightmares and flashbacks.
Other survivors may not remember that they were abused or otherwise traumatised, or they may only remember some of their experiences. They may not perceive or acknowledge that what they experienced was a form of childhood trauma, abuse or neglect. It is very common for survivors to not recognise that an experience was abusive, to deny it, or to minimise the seriousness of what happened telling themselves that 'it only happened once' or 'it wasn't so bad'.
Many survivors live with symptoms of abuse, such as panic attacks, strange body sensations, inexplicable fears, or aches and pains, that they are unable to explain. Their body remembers what happened to them, and they relive the emotions and feelings associated with their trauma repeatedly. However many survivors don't connect these symptoms to their childhood trauma and abuse.

Should you wonder whether your experiences were abusive or neglectful, or if you're unsure as to whether you are grappling with the impacts of childhood trauma please read the relevant sections on this website. Watch the videos and read the fact sheets for further information. Should you wish to discuss your personal situation further please call

Blue Knot Helpline on 1300 657 380,  9am-5pm AEST, 7 days a week for assistance.

How can abuse affect me?

Experiencing any form of childhood trauma and abuse can impact on an adult's quality of life in fundamental ways. It can make basic day-to-day activities, such as eating, sleeping, working and study difficult. Trauma and abuse in childhood can also affect your mental health, physical health, and your relationships with the people around you.

However research has established that recovery is possible. With the right help and support survivors can live healthy connected lives. Understanding the effects of trauma and abuse can help survivors connect their past experiences with their present challenges, and find pathways to a healthier future.

Effects on Feelings

Survivors are often out of touch with their feelings - confused by emotions or reactions they cannot explain. They have often been raised in environments in which a child’s normal expressions of upset or discomfort were punished or ignored. They may have been taught to attribute the negative emotions associated with childhood trauma and abuse, such as shame and anger, towards themselves. This confusion often persists into adult life, and can result  in heightened experiences of:

  • Anxiety
  • Grief and sadness
  • Shame, self blame and guilt
  • Alienation
  • Helplessness, hopelessness and powerlessness

Like everyone, survivors have a right to “a life worth living” (Linehan 1993), but instead survivors often live with chronic distress and pain. For many survivors, these emotions are so much a part of their day-to-day life that they don’t realise that there are alternatives. Unable to readily regulate their emotions they may seek to do so through alcohol, drugs, sex, gambling, or other compulsive behaviours. Many survivors also harm themselves out of a sense of despair. All of these 'coping strategies' make sense in the context of childhood trauma and abuse.

Learning about emotions – what they are, where they come from, and how to respond to them – is a crucial part of finding a path to recovery. Survivors can learn new, effective ways of regulating the intensity of their feelings, so that they don’t need to use alcohol or drugs and/or cut themselves to express their emotions. For many survivors, learning about the psychological impacts of their trauma or abuse helps them to understand why they have struggled for so long, and how they can move forward.

Acknowledging these feelings, understanding where they come from and why they are so intense is an important part of any survivor’s journey.

Effects on relationships with others and self-esteem

Survivors often find it difficult to trust others. As children they might have been betrayed by the very adults who were meant to nurture and protect them. As a result, survivors often find it difficult to form and sustain relationships. A large survey of adult survivors of child abuse in Australia found that survivors had a higher rate of failed relationships and marriages, and reported lower levels of social interaction (Draper, Pirkis et al. 2008).

When children are abused they come to believe the messages their abusers deliver, such as: 'You are worthless' and 'You have no value'. Of course, these messages are not true, but children accept and internalise them. These messages become ingrained  that, when a child who has been abused or traumatised grows up, the adult survivor will often experience feelings of low self-worth or poor self-confidence. Rebuilding self-esteem is a gradual process, but a crucial one.

Effects on physical health

Childhood trauma and abuse doesn’t just affect the mind - they can affect the body too. Children who feel perpetually in danger grow up with a heightened stress response. This in turn heightens their emotions, makes it difficult to sleep, lowers immune function, and, over time, increases the risk of a number of physical illnesses. Adult survivors are at increased risk of chronic pain and fibromylgia, gynaecological problems, irritable bowel syndrome, diabetes, arthritis, headaches, cardiovascular disease, and chronic fatigue syndrome. They are also more likely to smoke and drink more than other people in the community, and be less physically active. These factors can all affect health and wellbeing in later life.

Click here to watch Cathy Kezelman’s interview with Julie Mc Crossin from physical health forum held by MHCC  “Presentation at MHCC forumphysical health issues in mental health” October 2011

What to do in a time of crisis

Crisis numbers

  • Lifeline
    13 11 14
  • Kids Help Line
    1800 551 800
  • Men’s Help Line
    1300 78 99 78
  • Ambulance/Fire/Police
  • Poisons Information Centre
    13 11 26
  • Child Protection and Family Crisis Service
    132 111
  • Transcultural Mental Health Centre
    1800 648 911

Survivors of child abuse can experience periods of intense emotional pain, and this pain may lead to self-harming or suicidal thoughts. This section of the website includes suggestions on what to do if you, or someone close to you, is feeling suicidal.

What to do if you are feeling suicidal

If you are feeling suicidal or unsafe you need to get help immediately by contacting LIFELINE on 13 11 14.

It is a good idea to have someone with you if possible. Call a friend, family member or neighbour you trust to be with you and to help get the professional help you need.

If you are having suicidal thoughts but are not in immediate danger, let your doctor or other health care professional know as soon as possible so they can help you prepare an action plan to keep you safe.

What to do if someone else is feeling suicidal

If you believe that someone else is in danger of committing suicide then get help urgently by calling 000 for either the ambulance or the police. On the phone, stay calm, explain the situation, give the address and relevant directions while at the same time staying to comfort and protect the person who is in danger.

Remember whenever anyone talks, writes or hints about suicide, take them seriously, listen and find professional help. Individuals who have attempted suicide in the past are at serious risk of attempting suicide again in the future.

Finding care and support

Everyone can benefit from a network of supportive people around them to optimise psychological and emotional health. Many adult survivors of childhood trauma and abuse find it challenging to identify a network: they may not be able to rely on their families, and they may find it difficult to establish and maintain friendships and relationships.

An increasing number of health professionals are becoming trained to work with adult survivors of childhood trauma and abuse acknowledge in a range of contexts, from general practice, to mental health services, to alcohol and drug services, and beyond. When seeking help it is important to establish the expertise and experience of any practitioner in working with adult survivors.

This section of our website provides a comprehensive overview of your options for care and support. Blue Knot Foundation's Blue Knot Helpline - 1300 657 380 operates 9-5 Mon-Sun AEST. You can call and speak to one of our counsellors who can also assist you with options for additional help and support from a referral to its expanding national database of practitioners and agencies with expertise and experience in working with adult survivors of childhood trauma and abuse.

What is the benefit of disclosing my story?

At times, there are big hurdles and sometimes you don’t feel like dredging up any more crap. You get tired of the gut churning feelings, but the pain is just below the surface at all times anyway and facing it has really helped it to lose its powerful hold over me. Sometimes it is hard to talk about things. I just allow the emotions and pain to come up and I try to ride with it. Then when I feel comfortable enough I speak of why I am feeling the way I am… (study participant in van Loon & Kralik, 2005c).

Some professionals  feel that little is to be gained by going back over past experiences and delving into them. Others believe that telling your story relieves the burden of carrying your history around, as though it is the sum total of who you are. Your abuse is not your whole story. Talking externalises those past experiences, and disentangles the issues they invoke from who you are, making it possible to separate yourself from the experiences (van Loon & Kralik, 2005c). In relation to exploring the past, some survivors conclude that they do not need to dig too deep because the process of exploring may become re-traumatising (van Loon & Kralik, 2005b). Some survivors explain that it is important to acknowledge that the abuse happened and speak about the aspects of the abuse story that relate to the impacts of the abuse, rather than the details of what happened (van Loon & Kralik, 2005b).

It is important only to share your story when and if you feel ready to do so, and only within a safe environment, with a person you can trust. If you don’t want to talk about your abuse experiences, you may not be ready to do, in which case it might be preferable not to.

Many survivors feel that they have few people to whom they can talk, or from whom they can seek and receive support. However, it is important not to try to recover in a vacuum. Learning to trust others and to turn to them for support is a crucial step in recovery. Doing so challenges one of the basic notions arising from a history of interpersonal trauma and abuse: namely, that people are dangerous. Trust your own feelings. Choose people who are available, interested in you and who can engage with your situation.

Professional help can be of tremendous value to survivors attempting to overcome the negative impacts of their abuse. Recovery usually proceeds more quickly and more safely if you are working with a skilled professional. In a relationship with an ethical and clinically appropriate therapist, the client experiences safety, respect for boundaries, sensitivity to needs and validation of both the abuse that occurred and the role of recovery in creating a happy and meaningful life.

Disclosing your experiences can help rob the trauma or abuse of its potency. Even though the effects cannot be completely erased, they can certainly be diminished, and coped with in a healthier way.

Shopping for a therapist

Calling Blue Knot Helpline on 1300 657 380 and accessing our referral database can help you identify suitably qualified therapists and agencies in your area. It is recommended that you choose a therapist who holds a recognized qualification in counselling, psychology or a similarly skilled area. In addition, particular experience and expertise in working with survivors of childhood abuse is vital. Make sure you feel safe in the consulting rooms of the health care professional you choose and that they are sensitive and encouraging. Your chosen therapist would ideally answer any questions you have about their experience, models of working, professional memberships and qualifications. So, feel free to ask!

Once you have entered into a therapeutic relationship with a professional, if you feel yourself being pushed too hard, or you are uncomfortable with suggested therapeutic methods, try to discuss your concerns with your therapist. If the therapist’s suggestions aren't compatible with your feelings or beliefs about your abuse, then try to discuss this as well. You should be comfortable with the pace of your therapy and be able to discuss your progress openly with your therapist. If you are not comfortable after discussing your concerns consider choosing a different therapist.

Even though you may need support to reclaim your capacity to make decisions, a good therapist will allow you to keep control of your life and encourage you to join in decisions about your care. You may want your therapist to make a decision for you while you are in a state of crisis, and doing so may be necessary at times, but it is still important that you are offered that choice (van Loon & Kralik, 2005c).

Choosing a therapist can be intimidating, confusing and time-consuming. It is often advisable to ‘shop around’ before you make your choice.

The following advice might help you:

  • Seek personal recommendations from other survivors.
  • Seek recommendations from Blue Knot Helpline on 1300 657 380, 9-5 Mon-Sun AEST.
  • Prepare a list of questions to ask the therapist you have chosen, eg. What is his/her experience in working with survivors (particularly with issues that are relevant to you)?
  • What approach(es) does he/she use in therapy?
  • How much will it cost?
  • Is there any possibility of a concessional rate?
  • What are the options for payment?
  • How available is he/she?
  • What form do the sessions take?
  • How long are the sessions?
  • What are the rules about cancelling a session?
  • Is there any facility for contact between sessions?
  • What are the arrangements for holidays?
  • What process is followed when therapy finishes?
  • Will you be given the option of returning?
  • Will you be involved in the decision-making process?
  • Beware of therapists who stress a particular approach or technique, or who are dogmatic about issues such as forgiveness, confrontation, etc.
  • Beware of therapists who give hugs, shake hands too readily, or sit too close without invitation. If you do feel uncomfortable when interviewing a therapist, trust your instincts.
  • Beware if your therapist seems overly interested in your sexual history and questions you in detail, especially when the questioning appears irrelevant.
  • Beware if your therapist avoids sensitive issues and talks in generalities. Is your therapist able to handle the feelings and content that you bring to therapy?

Ask yourself the following:

  • Do I feel intimidated by this therapist?
  • Does he/she listen to me?
  • Do I believe that I can disagree with him/her?

The therapist you choose should be a good listener, who is both empathetic and non-judgmental. Your therapist needs to be a trusted partner in your process.


Psychotherapy is the umbrella term for a set of interpersonal healing techniques that support people to develop understanding about themselves and to make changes in their lives. Psychotherapy may be practiced by accredited psychotherapists, counsellors, psychologists and psychiatrists.

A limited number of psychotherapy sessions are accessible through Medicare via referral from your GP and through some private health care funds. A therapeutic alliance with a well trained and sensitive psychotherapist is an important resource for adult survivors of childhood trauma and  abuse.

Ideally, a psychotherapist working with adult survivors should have a basic understanding of abuse and trauma, or else be open to further education and training such as is provided by Blue Knot Foundation nationally. Unfortunately, many therapists complete their training without a basic understanding of the dynamics of childhood trauma and abuse. That's why it's important to access a therapist with expertise and experience in how to work effectively with adult survivors.

The strongest predictor of good outcomes in psychotherapy is not the type of therapy, but rather the ability of the psychotherapist to establish a strong rapport with their clients. The nature of the relationship is critical. At times any therapeutic process may be uncomfortable due to the nature of the issues being explored. However, it is crucial that you feel comfortable and safe with your psychotherapist, and that they are working with you to build on your strengths, and providing you with new tools to cope with day-to-day life.


Counselling is a broader term than "psychotherapy" and refers to any professional guidance in resolving personal conflicts and emotional problems. There are many different counselling approaches, and they often draw on psychological theory and techniques. Many counsellors have related qualifications and accreditations. 

Counselling and psychotherapy have both recently taken steps towards becoming a regulated field of care. Before establishing an ongoing professional relationship and in order to better understand the type and quality of the counselling approach Blue Knot Foundation recommends you check the qualifications, expertise, approach, experience and registration status (with a recognised professional body) of any counsellor or psychotherapist with whom you may be interested in engaging.  

Sexual assault services

Sexual assault services exist in all states and territories of Australia. While their main focus is on recent sexual assault victims, adult survivors of child abuse comprise approximately a quarter of clients seen by these services.

Sexual assault services are excellent resources for adult survivors of child abuse. Many such services provide phone counselling, one-on-one counselling, online counselling, as well as group programs and referral options for adult survivors of child sexual abuse. It is worth noting, however, that these services are chronically underfunded, and are often forced to prioritise services to recent victims of sexual assault.

Complementary therapy

Complementary therapies, or alternative therapies, refer to a range of practices and techniques outside of those usually practiced by accredited psychotherapists and counsellors. Complementary therapies have become increasingly popular in many different areas of health over the last thirty years, and mental health is no exception. Examples of complementary therapies in mental health include practices based on yoga, reiki and other meditative traditions, as well as techniques that incorporate dance, massage or other physical activities. Some or other of these approaches can be of substantial benefit to survivors at different times in their journey.

When investigating complementary therapies, it is important to note that practitioners are not necessarily bound by the same standards of conduct and care as psychotherapists and other accredited mental health care professionals. Psychotherapeutic techniques are regularly evaluated and tested for their effectiveness, whereas complementary therapies are often not. It is often preferable to maintain a therapeutic relationship with a qualified and experienced mental health professional whilst exploring complementary and alternative therapies.

Maintaining safety on a daily basis

An experience of childhood trauma or abuse is at its core about being and feeling unsafe. A framework of physical, emotional and psychological safety is important to enable you to progress in your recovery. Most people who have been abused need to regain their sense of safety (Briere & Scott, 2006). Feeling safe is important wherever you are: at home, with friends and lovers, at work or play.

Enjoying safe relationships can be challenging for adult survivors of childhood trauma and abuse (Henderson, 2006). Spousal or partner abuse is often linked to childhood abuse (Henderson, 2006; Krause, Kaltman, Goodman, & Dutton, 2008; Ullman, Filipas, Townsend, & Starzynski, 2007). For those who grew up with abuse in the family or domestic violence it may be a familiar background to your lives. Survivors can find themselves in abusive relationships as adults. 

The psychological or emotional impact of partner abuse on a survivor can be every bit as devastating as physical harm because it reinforces the sense of fear, threat and personal devaluation that the childhood abuse originally created. Such abuse may come in many forms: yelling, put-downs, swearing, hitting, forced sex (rape), being kept moneyless, not being allowed to be with friends, always being dominated and controlled by the other person (van Loon & Kralik, 2005c). If you are being subjected to any of these behaviours, we recommend that you seek professional help to enable you to deal with difficulties in your relationship and your current situation.

Building adaptive coping strategies

The coping mechanisms you used as a child helped you function during the times you were traumatised or abused. Even though these coping mechanisms were functional at the time, many are no longer as constructive in present life situations. As an adult you have more options than you did as a child. With support, you are now in a position to find other coping mechanisms/patterns of behaviour which will help you cope better in your current life.

The importance of self-care

It is helpful for adult survivors of childhood trauma and abuse to engage in activities to help reduce stress. These include self-caring activities, distress tolerance and arousal reducing strategies.

Research suggests that many of the long-term impacts of child abuse result from the chronic neuro-endocrine dysregulation caused by prolonged exposure to abuse and violence (Kendall-Tackett, 2001). The neuro-endocrine system refers to the interaction between our brain/ nervous system and the hormones in our bodies. This system helps regulate our moods, our stress response, our immune system, and our digestion, amongst other things. Any disruption to the neuro-endocrine system can affect a range of basic psychological and physiological functions.

Exposure to trauma, abuse and violence in childhood can cause physiological changes. The bodies of children who are being abused react and adapt to the unpredictable and dangerous environments to which they are exposed (Cozolino, 2002). Their nervous systems run constantly on high as they anticipate further danger; this floods the body with fight-or-flight hormones. This state of chronic “hyper-arousal” persists for many survivors throughout their adult years as well. Even when the trauma, abuse and violence has ceased and the environment is ‘safe’, many trauma survivors still perceive the threat to be present and remain fearful (Giarratano, 2004b).

Chronic hyper-arousal disrupts the delicate balance within the neuro-endocrine system, a state referred to as neuro-endocrine dysregulation and this can affect both the body and the mind.

The good news is that a range of interventions and skills can promote healthy neuro-endocrine function. Engaging in activities that reduce stress -- such as self-caring activities, distress tolerance strategies and arousal reducing strategies have been established to normalise the nervous system and balance hormone levels.

Self-care strategies

The term "self-care" means: looking after yourself: treating yourself as person who deserves care.

Self-care can be very challenging for adult survivors of childhood trauma and abuse. In the act of neglecting, hitting, insulting or abusing a child, an adult sends a message to that child that they are without value or worth. Many traumatised and abused children grow to adulthood believing that they do not deserve to experience love, care or warmth. Self-care requires survivors to develop  a new way of perceiving themselves as a human beings who have the right to feel comfortable, safe and worthwhile.

Self-care involves very simple, day-to-day acts. A good goal is to try to do one or two caring things for yourself every day. Acts of self-care are particularly effective at short-circuiting spirals of distress, anger or shame. If you feel yourself moving into an overwhelming emotional state, undertaking a self-care strategy can help ground you, bring you out of that state, and help you regain control over difficult emotions.

Have a think about the things that you enjoy. The list of self-care suggestions might help you choose.

  • What activities ground you in your body and encourage you to enjoy the present moment? Take a long, hot bubble bath; listen to classical music, or light candles; go for a jog or watch old movies.
  • Make sure that your bed and bedroom are comfortable so that, when you feel like retreating, you have a place that affirms your worth, makes you feel safe, and gives you pleasure.
  • Undertake activities that have no other function other than the joy that they give. Read a special book -- not one for school, work, parenting or therapy -- one just for you. Play with pets and animals. Listen to your favorite music.
  • Do something physical or acquire a new physical skill. Learn to dance, or join a club of bushwalkers or joggers. Exercise is a great way to burn off excess emotion, and it teaches us to be more comfortable in our bodies.
  • Undertake "mindfulness" meditation classes that teach you to live in, and find ways to enjoy, the present.

Many survivors live in a state in which they are coping with the burden of the past, but anxious of the future as well. The present often seems overwhelming. By finding ways to care for yourself, you can find ways to live in the present, and enjoy the moment. This in turn promotes emotional and psychological health.

Distress tolerance strategies

It is important for survivors to learn how to soothe themselves.

Alterations in the production of the stress hormone cortisol, which is associated with childhood trauma and abuse may make it difficult for many survivors to tolerate distress. Many survivors don't learn to self-soothe in childhood. Their parents are often poor at soothing themselves and, consequently, at teaching their children to self-soothe (The Morris Center, 1995). The lack of childhood ‘nurturing’ experiences, and of being taught how to look after oneself or ‘self-soothe’ also contributes to difficulties tolerating distress. Acquiring distress tolerance strategies and self-soothing techniques are important skills for survivors and us all.

It can be helpful to make a list of some pros and cons of tolerating distress (i.e. not acting impulsively)

  • Focus on long-term goals, the light at the end of the tunnel. Remember times when you have tolerated your distress (without acting out, being self-destructive or acting impulsively) and the pain has ended.
  •  Think of the positive consequences of tolerating distress. Imagine how good you can feel if you don’t act impulsively (Linehan, 1993b).

Make another list of the pros and cons of not tolerating distress – that is, of coping by hurting yourself, abusing alcohol and drugs, or doing something else impulsive. Think of the possible negative consequences of not tolerating your current distress and seek help if you are finding it difficult to manage your distress.

Call Blue Knot Helpline on 1300 657 380, 9am-5pm Mon-Sun AEST to speak to a counsellor for support.

Arousal-reduction tools

Being hyper-aroused is a common experience for adult survivors. It can include:

  • Having a difficult time falling or staying asleep.
  • Feeling more irritable or having outbursts of anger.
  • Having difficulty concentrating.
  • Feeling constantly ‘on guard’ or like danger is lurking around every corner.
  • Being ‘jumpy’ or easily startled (Giarratano, 2004a)

A state of hyper-arousal is a natural response to a dangerous situation or threat. Many survivors of trauma and abuse remain in a constant state of alarm because the fight/flight response is triggered repeatedly (Giarratano, 2004b), and without evident purpose (Cloitre, Cohen, & Koenen, 2006). Anger can also be a feature of a survivor's response to trauma and abuse as it is a core component of the survival response.  Anger helps people cope with life's adversities by providing increased energy in the face of obstacles.

Anxiety is common among trauma survivors as it is typically generated by experiences that are unpredictable, uncontrollable, or unfamiliar, i.e. the characteristics of trauma, abuse or danger. Anxiety ensures readiness for coping with an unidentified danger (Cloitre et al., 2006) and has an adaptive function. This may be because multiple, unidentified trauma reminders exist in the environment that trigger anxiety, or because trauma causes survivors to psychologically and biologically adapt to ‘living in a dangerous world’ (Cloitre et al., 2006). Teicher (2002) explains that early exposure to stress creates molecular and neurobiological changes, altering neural development so the adult brain can survive in a dangerous world.

In situations of early childhood trauma and abuse, the trauma and shock interferes with the ability to regulate emotions, causing frequent episodes of extreme/out of control emotions, including anger and rage (Linehan, 1993a).

An understanding of the neurophysiology of arousal as well as tools to help reduce arousal can help adult survivors cope better.

Distracting your thoughts and breathing techniques


When you experience anxiety and anger, something to take your mind away from your thoughts and distract you can be helpful.



Increased respiration is one of the body’s fight/flight responses. Trauma survivors can chronically over-breathe as the breathing rate normally increases in the presence of a perceived threat, causing hyperventilation and contributing to panic attacks in some people (Giarratano, 2004b).

Controlled breathing techniques slow the respiration rate. Our breathing rate has an impact on our heart rate, blood pressure and the rest of our body. Breathing at the correct rate slows bodily processes, lowers arousal, and in turn reduces tension and stress. Slowing the breathing rate is an effective method of turning off the ‘fight/flight’ response.

It is helpful to use controlled breathing techniques at the first sign of anxiety or panic. People who tend to overbreathe or suffer panic attacks should use them before tackling difficult situations, and whenever they are feeling tense or anxious.


When you experience anxiety and anger, something to take your mind away from your thoughts and distract you can be helpful.



Increased respiration is one of the body’s fight/flight responses. Trauma survivors can chronically over-breathe as the breathing rate normally increases in the presence of a perceived threat, causing hyperventilation and contributing to panic attacks in some people (Giarratano, 2004b).

Controlled breathing techniques slow the respiration rate. Our breathing rate has an impact on our heart rate, blood pressure and the rest of our body. Breathing at the correct rate slows bodily processes, lowers arousal, and in turn reduces tension and stress. Slowing the breathing rate is an effective method of turning off the ‘fight/flight’ response.

It is helpful to use controlled breathing techniques at the first sign of anxiety or panic. People who tend to overbreathe or suffer panic attacks should use them before tackling difficult situations, and whenever they are feeling tense or anxious.


When you experience anxiety and anger, something to take your mind away from your thoughts and distract you can be helpful.



Increased respiration is one of the body’s fight/flight responses. Trauma survivors can chronically over-breathe as the breathing rate normally increases in the presence of a perceived threat, causing hyperventilation and contributing to panic attacks in some people (Giarratano, 2004b).

Controlled breathing techniques slow the respiration rate. Our breathing rate has an impact on our heart rate, blood pressure and the rest of our body. Breathing at the correct rate slows bodily processes, lowers arousal, and in turn reduces tension and stress. Slowing the breathing rate is an effective method of turning off the ‘fight/flight’ response.

It is helpful to use controlled breathing techniques at the first sign of anxiety or panic. People who tend to overbreathe or suffer panic attacks should use them before tackling difficult situations, and whenever they are feeling tense or anxious.

Learning to monitor your thoughts and responses

Learning to listen to our self-talk or automatic thoughts is an important skill. If we can learn to pay attention to these thoughts, we can decide whether or not they are helpful (Giarratano, 2004b).



What and how you think influences your feelings. Positive thoughts make you feel happy and energise you, while negative thoughts make you feel sad and drain your energy. Thoughts can drift into your head uninvited and you may think you cannot control their entry. Thousands of thoughts enter and exit our mind every day; we don't pay attention to many of them. We can control our thoughts and  place them consciously in or out of our mind. How much space and time you give a thought in our mind is your choice and decision.

The core component of a model of group work for working with adult survivors of childhood abuse developed by van Loon & Kralik (2005) focuses on the ‘Look, Think, Act’ process:

  • 1. Look: What’s going on? What’s happening? What’s happening inside you? What are your responses? What are the circumstances? Describe the context: What are your thoughts ? How long did you mull over the event afterwards?
  • 2. Think: How do I feel about that? What’s the main problem? Why is this happening? What was the trigger or cause (e.g. attitudes, beliefs, past experiences)? What are the consequences? How am I behaving (e.g. are my responses defensive, grounded in my past)? Which area/s can I move forward with? How might my moving forward look? When should I begin – what order...? How should I do it?
  • 3. Act: By ‘Act’ we mean to take action, or do something. A good place to start is to think about what could/should be done differently to get the desired outcome. Then begin to action the smallest and most easily managed act that would have the most benefit.

As explained by van Loon & Kralik (2005), we all have thoughts, feelings and attitudes about our current experiences. These thoughts and feelings give rise to emotions such as love, fear, anger, hatred, sadness, sorrow and so on, which need to be recognized and acknowledged. Emotions trigger our behaviours and responses and at times these can be self-rejecting reactive responses, arising from the experiences of past trauma. Every response, whether we’ve thought it through or not, has a consequence, and these consequences impact other people and situations, or ourselves. Some consequences can be anticipated while others are unanticipated and unintentional. This process pervades everything we do every day. Our behaviours and reactions to these effects make us modify our behaviours.

The ‘Look, Think, Act’ process helps us to work out what’s going on by focusing on changing our thinking, so we can alter our behaviours and responses to influence our preferred outcomes (van Loon & Kralik, 2005).

The ‘Look, Think, Act’ process informs our choices and helps us work out what we want to modify in our thoughts, feelings, attitudes or behaviours and choose responses more thoughtfully. Even pretending nothing is happening, not responding, or running away, is a choice which has consequences. Withdrawing to think or regroup is also a valid choice and can be both safe and useful. However, ignoring or pretending that nothing is happening decreases our ability to influence the outcome, while leaving us with the consequences of doing nothing (van Loon & Kralik, 2005).

You may notice that as you become aware of your own responses and reactions, and the responses of those around you, the more you use the ‘look, think, act’ process, the better you become at controlling your reactions to another person’s response. You stop taking everything so personally and your capacity to tolerate people’s behaviour increases.

Self help resources


"Reclaiming Myself after Child Sexual Abuse" is a self-help resource developed for survivors of child sexual abuse but is also of value to survivors of all forms of child abuse.



 "It's not your fault, men talking about living beyond the effects of sexual abuse" is the culmination of years of work by men dedicated to helping others cope with the effects of child sexual abuse.

Respond SA (Relationships Australia) Andre Groome, the driving force behind the booklet said, " People hardly ever talk about the sexual abuse of young males, meaning that quite often, men who were sexually abused as children live their lives thinking they were the only one. However we know from the research that about one in six men were subjected to child sexual abuse."

"It's the isolation that intensifies the effects of abuse, such as feelings of shame and self blame"

Quotes from men who were sexually abused as children form a significant part of the booklet. One contributor, John hoped the booklet would give other survivors hope and strength.

"I want to show other men out there that they are not alone, that they can be released from the shame, the guilt, and the ongoing effects of abuse. I know a lot of people don't address childhood sexual abuse until later on, usually after devastating consequences because they don't know how to live a normal life. "

"I advise men to address the effects of abuse as early as possible and break the cycle. Just being able to speak out has healing qualities. Often survivors don't know what choices are available for them, but this booklet lays it all out."

"It's not your fault" sends a strong message that men are much more than the sexual abuse they were subjected to and the effects it has on their lives. It explains:

  • "Abuse of power that occurs during sexual abuse
  • "Effects of manipulation and betrayal
  • "Ways young people and adults have acted to protect themselves from painful effects of abuse

"It's not your fault" is also available for professionals, family members or friends who may be supporting male survivors of childhood sexual abuse. "It's not your fault" is available for download from the Respond SA website here.

Going to court

Useful advice about going to court when you are the victim

  • The decision to lay charges must be yours, as the victim. However, be prepared that once that decision is made, all further decisions about the conduct of the case will be in other hands. You will need to remember that this is not your case - it now belongs to the State.
  • Before making the decision to proceed, find out everything you can about the entire process: making a statement, the arrest procedure, bail conditions, the committal hearing, the trial and what support services are available to help you.
  • Request any available literature about the court process and read it carefully. Victims Services has an excellent website called Justice Journey which has been designed to help victims and other witnesses through the NSW court system (There are other agencies in all States similar to Courtwise).
  • Ask as many questions as you like. The more information you have the better prepared you will be.
  • Write down everything you can remember about the crime. When it comes to making a Statement take the notes with you to help you remember everything you need to include in your Statement.
  • If you cannot work with the police officer/s assigned to your case, speak to the officer in charge and request a change.
  • Make sure that you are informed about each stage in the process before it happens.
  • In sexual assault cases, if you do not wish to face the accused in Court, ask to use the CCTV room. You may have your court support assistant stay with you in the CCTV room throughout your giving evidence and being cross examined.

  • If you want a support person with you during the whole process, it is your right to do so. Demand it. Rape/incest crisis workers are usually very skilled in providing support for people. 
  • If you ever feel the need for protection from the accused, find out what can be done and demand it.
  • Find out the name of the lawyer, in the prosecution's department, who is handling your case and contact them whenever you need to, recognising that there will be periods when they do not have additional information for you.
  • Keep a diary of everything that happens, including the names of all lawyers and contact people involved, in case you need to contact them again. Then you will have a written account of what you have been told.
  • If you feel like a break during the time you are testifying in court, ask for one. That too is your right.
  • If you need a glass of water or a break, you are entitled to ask the Magistrate or Judge.
  • Remember if you make a mistake when you are being cross examined, don't worry. Once Defence has completed cross examination, the Prosecutor is able to ask you further questions and ask you to clarify anything.

Being a witness


Don't forget to ask the police for a copy of your statement before your day in court. Don't wait to receive it on the day of your court appearance. Read your statement as often as you can and especially the day before court. Remember your statement is what you will be tested on in court.

Think about the event/s you will be giving evidence about. What happened first and what happened next? Try to remember details like dates, times, descriptions, actions and exact words used. Read the statement you gave to the police. If you do not have a copy, you can ask the police officer involved in the case or the lawyer for a copy. Bring to court any statements, notes or documents you have about the case.

Arrange a meeting place at Court with the police officer in charge or your court support assistant. Try to arrive at Court on time so that you won't be flustered. It is important that you keep as calm as you possibly can under the circumstances.



When you get to the court, go to the court office or inquiry counter and ask where you should wait. Very importantly, do not discuss your evidence with any other witnesses. Be prepared to wait. If you require special care or feel threatened in any way tell the police officer or the lawyer. Courts usually sit from 9.30 am to 4.00 pm.



You will be told by the police officer in charge the court number where the case will be heard.

A court officer will call your name when it is your turn to give evidence. The court officer will ask you whether you wish to swear an oath on the Bible or make an affirmation (a promise to the court that you will tell the truth). You will then be taken into the Court room and shown to the witness box at the front of the courtroom.

The Crown Prosecutor will ask you questions about what happened. The Defence Lawyer will cross-examine you on your statement and the evidence you have just given. Remember, if you make a mistake when you are being cross-examined or wish to clarify what you've said, don't worry as the Crown Prosecutor gets to ask you questions again after you've been cross-examined. This may provide an opportunity of clarifying or amending the mistake if the Crown Prosecutor thinks it is important to do so. The Judge or Magistrate may also ask you questions about your evidence. Judges sit in the District Court and Supreme Courts and are addressed as 'Your Honour'. Magistrates sit in the Local Court and are also addressed as 'Your Honour'.



Consider each question before you answer. Don't rush. If you do not understand a question, please say so and ask for it to be repeated. Take your time so you can give a complete answer. If you are not sure about an answer, say so. Speak clearly. Keep yourself focused and your answers short and to the point.

Remember, if you need a break, ask the Judge / Magistrate. If you need a glass of water, ask for one. This is perfectly acceptable.

For support when going through the court process in NSW contact Victims and Witnesses of Crimes Support (VWCCS) through their website

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Health Direct



“Blue Knot Foundation has a key role to play in the building of community capacity in care provision to those who have experienced childhood abuse and trauma in any environment.”

NIALL MULLIGAN Manager, Lifeline Northern Rivers

“I think Blue Knot Foundation is a fantastic support organisation for people who have experienced childhood trauma/abuse, for their families/close friends and for professionals who would like to learn how to more effectively work with these people.”

Psychologist Melbourne

“It's such a beautiful thing that you are doing. Helping people to get through this.”


“It was only last September when I discovered the Blue Knot Foundation website and I will never forget the feeling of support and empathy that I received when I finally made the first phone call to Blue Knot Helpline, which was also the first time I had ever spoken about my abuse.”


"At last there is some sound education and empathetic support for individuals and partners impacted by such gross boundary violations.”


Contact Us

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PO Box 597 Milsons Point NSW 1565
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Phone: 1300 657 380
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