Neurodivergence and Post-traumatic Stress Disorder from Sexual Assault: A Toolkit for Moving Forward
Edited by Fakhri Shafai, Ph.D., M.Ed. | AIDE Canada
Anonymous Contributor, Autistic Self-advocate
Anonymous Contributor, Neurodivergent Self-advocate
Introduction: This toolkit was developed in response to direct requests AIDE Canada received from autistic persons in focus groups. We recognize that this is a difficult and emotional topic. We have made every effort to avoid triggering persons while still providing relevant and useful information. There are also additional resources and suggested reading at the end of the toolkit if you would like to learn more about this topic. This toolkit is broken into two parts: 1) Understanding Post-traumatic Stress Disorder (PTSD), and 2) Moving Forward from PTSD. If you are already familiar with the symptoms of PTSD and concepts like disassociation and triggers, we recommend you skip to Part 2.
The authors recommend that you take breaks from working through the toolkit as needed. If you find this information difficult or upsetting, we also recommend seeking the support of a trained clinician for individualized therapy and/or support groups or workshops. Post-traumatic stress disorder is not easy to deal with on your own. Professional guidance from a clinician familiar with treating PTSD in neurodivergent persons can help to lower both the frequency and intensity of flashbacks.
Remember, what happened to you was not your fault and it does not define your worth as a person. With time and support you can find a way to move forward and live your life to its fullest. May this toolkit help guide you on your way.
PART 1: Understanding PTSD
What is PTSD?
Post-traumatic stress disorder (PTSD) is a type of anxiety disorder and mental health condition that develops in response experiencing or witnessing a terrifying event. Many people who experience a traumatic event will have short-term symptoms. For instance, after experiencing a terrible car accident a person may startle when they hear the sound of someone slamming on their brakes. They may also have trouble sleeping, replay the incident in their mind, want to avoid getting into cars, or have trouble focusing at work for a while.
A person’s response to a traumatic event is diagnosed as PTSD when the symptoms are causing difficulties in their personal and/or work life for more than one month. Common symptoms include:
- Flashbacks – reliving the traumatic event over and over
- Nightmares and/or difficulty sleeping
- Hypervigilance – always being on the lookout for something bad to happen
- Intrusive/frightening thoughts that increase anxiety
- Irritability and/or angry outbursts
- Memory difficulties – trouble remembering details of the event itself and/or trouble remembering everyday things
- Physical symptoms like a racing heart, sweaty palms, or dry mouth
- Feelings of guilt, blame, anger, and negative thoughts about the world and/or oneself
- Depression or a loss of interest in things previously enjoyed
- Avoidance of places, events, or objects that may remind them of the traumatic event
What is Complex PTSD (C-PTSD)?
When a person has experienced a series of traumatic events, especially if throughout their childhood, they may be diagnosed with complex PTSD (C-PTSD). While it currently is not considered a separate diagnosis in North America, it is included in the diagnostic manual used in other parts of the world. Complex PTSD (C-PTSD) includes all of the symptoms described for PTSD, but persons with C-PTSD may also have more intense emotion regulation issues and difficulty with relationships. Persons with C-PTSD can struggle with negative self-image. They may have poor boundaries with others, and allow others too much control over their lives.
What are triggers?
A ‘trigger’ is the term used to describe a place, sensory experience, event, or object that brings up the memory about a traumatic event and causes a person to relive the event (flashback). Triggers can be caused by sensory experiences like a certain sound or smell by or watching, reading, or hearing something that reminds a person about the traumatic experience.
Some triggers are easier to avoid than others. For instance, if you know a book is on a topic that could be triggering, then you can avoid reading that book. However, if a trigger is a common sound or sight outside, then avoiding that trigger becomes much harder.
There are different approaches to how to deal with triggers. These will be discussed in detail in Part 2 of this toolkit.
What is disassociation?
When a person disassociates, they feel disconnected from their body and/or their surroundings. Some people describe it as “observing themselves from outside of their body” or their mind going somewhere else. They may feel disconnected from their thoughts, feelings, or memories. It is common to “lose time” and realize that they can’t remember what happened over the past few minutes or potentially even the past few hours.
What is dissociative amnesia?
When a person has gaps in their memory and doesn’t remember an entire traumatic event or only remembers parts, they are said to have dissociative amnesia. These memories can return suddenly or gradually, although some people do not ever recover their full memories of a traumatic event. Dissociative amnesia is most common in persons who experienced trauma in childhood but can also develop in adults after a traumatic event.
What is a flashback and why do they happen?
As mentioned earlier, flashbacks occur after a person is triggered to remember the event. They may disassociate from their current surroundings and replay the memories of that event over and over in their head. A person will often experience many of the same emotions and physical sensations that they did during the actual event (e.g., extreme fear, racing heartbeat, shaking). It is common to feel disoriented, confused, and angry when coming out of a flashback.
Flashbacks happen because two structures in our brain are connected to each other- the hippocampus and the amygdala. Together, they make associations between sensory experiences of an event and memories tied to strong emotions of fear and anger. This means that when a person comes in contact with something that reminds them of that event, they may feel like it is happening right now and experience the same emotions they were feeling at the time.
PTSD and Neurodivergence
For any person who has experienced sexual assault and PTSD, the process likely is extremely unsettling and difficult. There may additional or different challenges to consider for a neurodivergent person. For instance, an autistic person with minimal verbal language may have to grapple with emotions, feelings and/or sensory responses, but not have the language to help them discern or ‘put to words’ what has happened or how they are feeling.
Given diverse ways of being and processing information, this experience may be uniquely upsetting and confusing for a neurodivergent person. Similar to others, it is important to find help that fits for you, and to know that you’re not alone!
Finding a professional therapist/supporter who is trauma-informed and also has understanding about neurodivergence, is very important.
As noted earlier, the second Part of this Toolkit will provide a focus on means to move forward.
If you have experienced sexual violence, please remember what has already been stated: You are not alone and help is available.
There are sexual assault services across Canada that can provide information, advocacy and counselling. Below are a few examples that offer a listing of resources in Canadian communities:
- The REES (Respect Educate, Empower Survivors) Community Resources page offers a listing of resources across Canada: https://www.reescommunity.com/resources/
- The Ending Violence Association of Canada offers a list of resources organized nationally and by province and territory: https://endingviolencecanada.org/resources/
If you are in immediate danger or fear for your safety, call 911.
Part 1 Summary:
PTSD has multiple symptoms, and those symptoms can fluctuate over time. Persons may experience dissociative amnesia and forget aspects of what happened to them. Flashbacks are often caused by triggers that remind a person of the traumatic event. During a flashback, a person may disassociate and feel disconnected from what is happening around them while their mind replays the traumatic event over and over again.
In Part 2 of this toolkit that will be later introduced on the AIDE Canada website, we will explore how to move forward and describe the various treatment options that a person may want to pursue.