Introduction
Most people who come to see me about trauma do not arrive using the word trauma.
They arrive saying they are tired. That they cannot seem to trust anyone. That they left two years ago and still cannot work out why they are not over it. That they feel like a different person from the one they were before, and they would quite like that person back.
Some are still in the relationship. Some left a decade ago. Some are not sure whether what happened to them counts, because nobody hit them, because it was only words, because other people have had it worse. Let’s deal with that last one immediately, because it’s the single factor that stops more people from getting help than almost anything else. What happened to you does not need to be the worst thing that has ever happened to anyone in order to have hurt you.
This guide is for survivors of abusive, controlling and narcissistic relationships, and for anyone carrying the effects of trauma. It covers how this kind of harm works, why leaving is so much harder than outsiders assume, what recovery actually involves, and where to find help. Read what is useful and leave the rest for another day.
Where to Get Help Right Now
If you are in immediate danger, please stop reading and phone the South African Police Service on 10111. The national Gender-Based Violence Command Centre operates a free 24-hour line on 0800 428 428.
For emotional support, the South African Depression and Anxiety Group offers free telephonic counselling and referrals nationally. Here in the city, Rape Crisis Cape Town Trust provides counselling and court support for survivors of sexual violence.
None of these services will pressure you into a decision you are not ready to make. They exist to help you think, not to take the thinking away from you.
The South African Picture
It matters to know that you are not an unlucky exception. In this country you are, painfully, part of a very large group.
- The first national gender-based violence study, published in 2022, found that roughly one in five ever-partnered women had experienced physical violence from a partner in their lifetime, with around 6% reporting sexual violence.
- That translates to more than three million South African women reporting lifetime physical intimate partner violence.
- South Africa’s rate of intimate femicide is approximately five times the global average.
- Spatial analysis of national survey data identifies the Western Cape as one of three provinces with a notably high proportion of intimate partner violence.
- A pooled analysis of youth mental health across sub-Saharan Africa found post-traumatic stress in around 12.5% of young people, making it one of the most common presentations in the region.
Two things follow from this. The first is that what you experienced is common, which is not the same as saying it is acceptable. The second is that the scale of the problem is precisely why individual support matters so much, because national statistics do not knock on your door and offer to help. Somebody has to sit with you, one person at a time.
How This Kind of Abuse Actually Works
Abusive relationships almost never begin abusively. If they did, nobody would stay for the second date.
They begin with intensity. Attention that feels flattering, a pace that feels romantic, a sense of being understood more quickly and completely than anyone has understood you before. What follows is a gradual shift, usually so slow that no single moment stands out as the one where things changed.
The Pattern
- Idealisation. Intense attention, rapid commitment, a feeling of extraordinary connection.
- Devaluation. Criticism arrives, usually disguised as honesty or concern. Standards start moving.
- Control. Finances, friendships, time and movement narrow, often framed as practicality or love.
- Isolation. The people who might reflect reality back to you become inconvenient, then unwelcome.
- Intermittent reinforcement. Warmth returns unpredictably, which is what makes the pattern so difficult to break.
Gaslighting
Alongside all of this runs the slow, deliberate rewriting of what you are allowed to believe about your own experience. You raise something that hurt you and are told it did not happen, or happened differently, or happened because of you. Do this a few hundred times and a person stops trusting their own memory. That is not a failure of intelligence. It is the intended result of a sustained process, and it works on clever, capable people just as reliably as on anyone else.
A Word About the Word Narcissist
The term is used loosely these days, and I would rather be honest about that than pretend otherwise. Narcissistic personality disorder is a formal diagnosis, made by a clinician, about a person sitting in front of them. I cannot diagnose someone I have never met, and neither can the internet.
What I can say is that the pattern of behaviour described above causes real and lasting harm regardless of what label sits behind it. You do not need a diagnosis for your partner in order to get help for yourself.
Why Leaving Is So Much Harder Than People Think
If I could change one thing about how this is discussed publicly, it would be the question “why did you stay?” It is asked with real bewilderment by people who mean no harm, and it lands on survivors as an accusation.
The honest answer involves several things at once.
The Bond
When affection and harm come from the same person in unpredictable cycles, the attachment that forms is unusually strong. The bond itself is built out of the very unpredictability that makes the relationship harmful. This is not a character weakness. It is a well-documented response to intermittent reinforcement, and it is why people who would give any friend the obvious advice cannot take it themselves.
The Early Learning
For many people, the pattern is familiar before it is romantic. If you learned early that being needed was the safest way to be loved, that lesson does not simply expire when you turn twenty-five. It shows up as an instinct to manage other people’s moods, to apologise pre-emptively, and to treat your own needs as negotiable.
The Practical Reality
And then there is everything else. Shared finances. Children. Housing. Immigration status. A family who adore your partner. A church or a community that will have opinions. Leaving is not a single decision but a process, and it is the point at which risk is highest. Anyone who tells you to simply walk out has not thought about it carefully.
Safety First
If you are still in the relationship, safety planning comes before anything else in this guide. That work is specific to your circumstances and is best done with someone trained to do it, whether that is a counsellor, a social worker, or an organisation such as those listed above.
What I want to say here is only this: you are allowed to prepare without having decided. Thinking about safety is not disloyalty and it is not a commitment. Many people work through the whole process and choose to stay, and that is their decision to make.
What Trauma Actually Does
Trauma is not stored as a tidy memory that can be reasoned with. It is held in the nervous system, which is why survivors so often describe reactions that make no sense to them: the heart rate that spikes at a particular tone of voice, the going-blank in an ordinary disagreement, the exhaustion that no amount of sleep resolves.
When harm is repeated over months or years rather than confined to a single event, the effects settle differently. Alongside the classic symptoms of post-traumatic stress, survivors of prolonged relational harm frequently experience difficulty regulating emotion, a persistently negative sense of self, and real trouble in relationships. This cluster is now formally recognised as complex post-traumatic stress disorder.
Common effects include:
- Hypervigilance, a constant low-level scanning for threat that never quite switches off.
- Difficulty trusting your own perception, particularly after prolonged gaslighting.
- People-pleasing and conflict avoidance that persist long after the danger has gone.
- Emotional numbness, or the opposite, emotions arriving at overwhelming volume.
- Physical symptoms: disrupted sleep, digestive problems, chronic tension, unexplained fatigue.
- Shame, which is often the heaviest and least talked about of all of them.
I want to be clear that none of these are signs that something is wrong with you. Every one of them is a survival adaptation that worked, in an environment where it was needed, and has simply not yet been told that the environment has changed.
After the Relationship Ends
Survivors often expect that walking away will end it, and are blindsided when it does not. Six months out, a year out, sometimes a decade out, the effects are still shaping how safe they feel in the world and how much they trust a new partner who has done nothing wrong.
There is also grief, which surprises people and then shames them. You can be entirely certain you were right to leave and still mourn the person you thought they were, the future you had planned, and the version of yourself who believed in it. That grief is not evidence that you made a mistake. It is evidence that something real was lost, and losses are mourned.
Trauma in Teenagers
Children and teenagers who grow up around this rarely announce it. Teenagers who have lived through trauma often present as difficult rather than distressed, and the behaviour that follows tends to be read as attitude, laziness or defiance rather than as a nervous system doing its best. Schools respond to the behaviour. Very few people ask what is underneath it.
What Recovery Actually Involves
What the Evidence Says
Trauma-focused cognitive behavioural therapy and eye movement desensitisation and reprocessing, usually shortened to EMDR, have the strongest evidence base for post-traumatic stress. Both are recommended as first-line treatments in NICE and international guidelines.
Interestingly, the research on sequencing is less settled than clinical folklore suggests. Randomised trials comparing a stabilisation phase followed by trauma processing against going more directly to trauma-focused work have found both approaches safe and effective, without the clear advantage for stabilisation that many clinicians assume. In practice this means there is more than one legitimate route through, and the right one depends on you rather than on a protocol.
What the Work Looks Like
In my rooms, the early work is almost always about steadiness rather than excavation. Understanding what your nervous system is doing and why. Building a few reliable ways to come back down. Establishing that this hour, at least, is safe.
From there the work usually moves through three overlapping strands: restoring trust in your own perception, which prolonged gaslighting takes apart piece by piece; processing what happened at a pace you set; and rebuilding a sense of who you are that is not organised around someone else’s moods.
Boundaries come into this too, and they are harder than they sound. If saying no has historically been dangerous, then saying no can feel less like an act of self-respect and more like an act of danger, and the body will object even when the mind agrees.
What I Do Not Do
I would rather be upfront than have you find out halfway through. As a registered specialist wellness counsellor I do not diagnose psychiatric conditions and I do not prescribe medication. Where a formal diagnosis or medical treatment is needed, I will say so and refer you to a psychiatrist or clinical psychologist. I am also not a lawyer, and questions about protection orders and custody need proper legal advice.
Trauma Therapy in Cape Town
From my rooms in Claremont, and online across South Africa, I offer:
- Trauma-informed individual counselling for adults recovering from abusive, controlling or narcissistic relationships.
- Support for survivors still in the relationship, including thinking through safety without pressure to decide.
- Counselling for complex trauma and its long-term effects on identity, trust and relationships.
- Work on boundaries, self-worth and codependent patterns.
- Counselling for teenagers affected by trauma or by growing up in an unsafe home.
- Support for survivors of domestic and gender-based violence, alongside referral to specialist legal and shelter services.
- Grief work for the losses that recovery uncovers.
Conclusion
People sometimes ask me whether they will ever feel normal again. It is the wrong question, though I understand entirely why it gets asked.
You will not go back to being the person you were before, because that person did not know what you now know. What happens instead is stranger and better: you become someone who understands exactly what happened, who can spot the pattern early, and who no longer needs anyone else’s permission to trust their own read on a situation.
That is not a consolation prize. In my experience it is the thing survivors end up valuing most, though almost nobody believes me when I say so at the first session.
You do not need to have left. You do not need to be certain. You do not need to be able to explain it well. You only need to be willing to say some of it out loud to someone whose job is to listen carefully.
I see clients in person in Claremont, and online across Cape Town and the rest of South Africa. Online sessions are just as effective as sitting in the room together, and for some survivors they are considerably easier to arrange privately.
About Me
I am Paula Marais, a registered specialist wellness counsellor based in Claremont, Cape Town. I hold an Honours in Psychology (Unisa) and a Master’s in Creative Writing (UCT), and I am registered with the Association for Supportive Counsellors and Holistic Practitioners (ASCHP).
I offer individual and couples counselling, both in person and online. Online sessions are equally as effective as in-person sessions.
You can reach me at info@paulamaraistherapy.com or on WhatsApp at 072 633 7661.
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