EXPLORE THE IMPACTS
Any Abuse By Someone Charged With Your Care
When abuse comes from a person who is meant to protect and nurture, the damage reaches far beyond the emotional wound. It alters the brain’s structure, reshapes the body’s stress response, and leaves lasting imprints on how a person processes the world. These changes can disrupt memory, coordination, emotional regulation, and even the ability to feel safe in everyday situations. For those living with these effects, moments of disconnection, sudden fear, or strong reactions to unseen triggers can feel impossible to control. By understanding what’s happening beneath the surface, we can better respond with the compassion, patience, and strategies that foster true healing.
Brain
Decreases size of corpus callosum ( which is responsible for integrating motor, sensory and cognitive functions of the brain between the two hemispheres).
Abuse decreases size of the hippocampus (which is in charge of learning and all types of memory).
Abuse disrupts the HPA axis (impacting the sensitivity of the stress response).
Abuse decreases the volume of the prefrontal cortex (impacting behavioral and emotional regulation, balance and perception).
Abuse contributes to an overactive amygdala (in charge of processing emotions and activation of the stress response).
Abuse decreases size of cerebellum (impacting motor skills and coordination).
Body
The cortex is offline, and the left side of the brain is shut down. Life feels unreal. A person can feel disconnected from the world. They may describe floating out of their body and watching things happening to them vs. experiencing those feelings/sensations in the moment. They feel numb and have a decreased ability to feel pain. If in a rage, this makes them abnormally strong and they will have no memory of aggressive outbursts.
Behavioral Patterns
The fear cascade is set off often from a visceral (unconscious memory felt in the body, not connected to narrative or story) memory, so aggression looks like it comes "out of nowhere." Actions do not make sense.
They look "spaced out, blank, not all there."
They can shut down (freeze) or they fly into a violent rage (fight) or bolt (flee) or become hypersexual (flock or submit) or start pleading with those around them to stop doing something or accuse them of doing something (fight).
Behaviorally the person might be:
on constant alert, unable to relax
feeling fearful
overwhelmed in social situations
learning abilities impaired
delayed developmental milestones
decreased ability to process positive or negative feedback
Supports
If in flock, flee or fight (sympathetic response) ask: "How can I help you feel safe?" This is a curiosity question that helps signal safety, it is not imperative for the person to answer logically with clear verbal language. Ask this question without expectation, keep a calm, supportive and safe face, tone of voice and posture and breathe deeply as you sit in the pause between the question and their verbal or nonverbal response.
When the person is regulated, engage in grounding activities from PSP Workbook PG 11
After you have created safety within the relationship, you can plan for the future by connecting rules to safety and/or using the safety script to set limits. If in a freeze or submit (parasympathetic) response, use grounding. Tell them who you are, that they are safe and where they are. Repeat slowly and calmly.
Mindfulness techniques when in safe social settings or with a safe other.
Anger Volcano activity to understand themselves and for caregivers to understand how to support at different levels of stress.
It will be important for the caregiver (or any person in relationship with the person experiencing challenging behavioral expression) to keep themselves regulated and resist asking “why” questions or demanding the person use their voice. Our behavior is an indicator of how safe we feel in our bodies and in the relationship so if someone is behaving in ways that are unsafe to self and others they need compassion, understanding, patience and for you to ‘connect, before you correct.’ This may mean a few days go by before you address the challenge, you will want to wait until you and the person you are supporting are regulated and feel safe to express themselves.