Survival responses fall into four general categories:
Feeling responsible for the traumatic event: This results from a feeling of having lost all sense of personal power and serves to help the trauma survivor feel a sense of power over the event. Frequently they feel guilt and shame associated with the event. They spend much of their time reviewing the events and trying to anticipate, prepare for, and prevent future trauma.
Denial or loss of recollection that the event occurred: This serves to protect the traumatized individual from dealing with the horrific reality of the event. They may experience a total loss of memory, or they may forget significant details of the event. This may last for days, months, or even years. They most likely will recall the trauma at some point, and the memory may be triggered by a random event which may seem unrelated to the event itself. A milder form of denial is a minimization of the severity of the trauma which aids them in continuing to ignore the emotional pain and the torn identity.
Harming self or others: This group of survival responses is much less socially acceptable and much more harmful. It serves the purpose of taking the focus off the internal pain and placing it on external objects or people. They want the pain to end, but they do not know how to make it stop. Self-injurious behaviors, such as cutting, substance abuse, eating disorders, and other types of self-harm may be attempts to make the pain stop or to feel something. Frequently, suicide is not intended to end the life but to end the pain. They respond to confrontation as an invitation to fight, which seems to bring some relief. Because of the nature of this type of response, it has the potential for permanent damage to self and others.
Helping self and others: This form of survival response has no stigma attached and may not show any outward sign that they are actually attempting to cover internal pain and loss. Instead, most of these responses are applauded and strongly reinforced. They may focus on others’ problems so much that they do not seem to have time to deal with their own pain.
The problem with these survival responses is that they serve two opposing purposes. They seem to provide some measure of relief while at the same time reinforcing the problem.