Learn / Rehab for Survivors of Sexual Trauma
Sexual trauma is never the survivor’s fault. It doesn’t matter what you wore, who you dated, or whether you fought back. Many people struggle to believe that, which can make it hard to ask for support. But remember: you deserve care. You have the right to heal. And for some clients, rehab for sexual trauma is a helpful place to start.
Assault may take place as an isolated instance, or it may be a prolonged series of events. And survivors of domestic violence situations may face even more barriers to healing. But under any circumstances, these experiences can have a long-term impact on your mental health.
Healing isn’t a linear process, especially for this type of trauma. Some survivors may continue to experience triggers for years to come, or even permanently. But over time, you can develop the tools you need to live with what you’ve been through, and even thrive as a result of your post-traumatic growth. Yes: after sexual assault, it is absolutely possible to heal and grow.
According to the CDC, 43.6% of women and 24.8% of men report having experienced some form of contact sexual violence1 in their lifetimes. In other words, nearly half of women and nearly a quarter of men have been groped, raped, or otherwise touched in a nonconsensual way. A much greater percentage of people have experienced sexual harassment without physical contact. And these numbers only reflect reported instances of these events.
And these are just the documented cases. Based on purely anecdotal data, it’s safe to assume that many, many more people have experienced sexual trauma and chosen not to report it. When the #MeToo movement2 took social media by storm in 2017, the sheer volume of posts and responses suggested that the actual number of people who have been assaulted is much, much greater than that shown by statistics.
This idea is bolstered by the #WhyIDidntReport movement3, in which people shared their reasons for remaining silent about assault. Researchers found that these reasons fall into a number of categories, including (but not limited to) shame, denial, fear, hopelessness, substance misuse, and even the desire to protect their assailant from legal consequences. Data also suggests that male survivors are less likely to report rape4. As a result, we may never know exactly how common this experience is.
Sexual trauma can be extremely harmful, in both clear and unexpected ways. While it’s easy to see how physical violence can cause injury, some of the other effects of assault are far less visible.
Research has found that “the most frequently observed symptoms following rape5 are fear and anxiety.” And 44% of survivors reported moderate or severe symptoms of depression within one month of their assault. These symptoms may last for a short period of time after the event, or they may indicate the onset of a chronic mental health condition.
Post-traumatic stress disorder (PTSD) is perhaps the most likely diagnosis for survivors of sexual trauma. Findings “indicate that PTSD is common and severe following sexual assault.”6 This condition may result in flashbacks, dissociation, anxiety, and even physical symptoms. Most people with PTSD also struggle with triggers. A trigger is an event that reminds you of a traumatic experience, causing you to respond in a way that is disproportionate to current circumstances but would have been appropriate during the initial incident.
If the experience of sexual trauma occurred over a prolonged period of time, or was one aspect of long-term domestic violence, it may result in complex PTSD (C-PTSD).7 This condition is similar to PTSD, with slightly different symptoms. Some rehab programs are specifically designed to help clients with both PTSD and C-PTSD.
Survivors of sexual assault share a tendency to blame themselves for what happened. It can be hard to reconcile the experience of losing agency with the personal responsibility to heal after trauma. According to experts, “Self-blame is a central construct in the sexual assault recovery8 field theorized to be related to the loss of control that occurs during the assault and internalized feelings of responsibility for the assault happening and/or for one’s responses to it.”
Perhaps as a result of this, survivors of rape report “significantly lower self-esteem” than people who have not experienced sexual trauma. This symptom can make them more vulnerable to other adverse experiences, such as abuse, serious mental health conditions, and substance misuse.
Assault is not sex.9 It may be about sex. And by definition, sexual trauma includes sexual acts. But sex requires consent. That being said, this type of trauma can change the way a survivor feels about consensual sex. After rape, consensual sex may feel unsafe, triggering, or even physically painful. It’s quite common for a person’s interest in sex to change drastically after being assaulted.
Although “sexual assaults alter the frequency of [survivors’] sexual interactions,”10 these changes are not always straightforward. Some survivors may become sex-repulsed, and even decide to be celibate for a time. Others may show signs of hypersexuality, in which they seek out as many consensual sexual experiences as possible. In fact, data suggests that hypersexuality may be directly linked to PTSD.11 Because of this, experts have called for research into possible connections between trauma and sex addiction.
Many survivors of sexual trauma go on to develop substance use disorders. This coping mechanism, while unhealthy, can feel like a way of self-medicating. It may also help survivors temporarily regain a sense of agency. However, it is not an effective way to heal. Substance misuse simply provides a brief break from survivors’ most difficult symptoms, and in the long term it may result in even more serious issues.
According to experts, there’s “overwhelming evidence that victims/survivors of sexual violence are much more likely to use alcohol and other drugs12 to cope with the trauma of their victimization. Women with sexual abuse histories were more likely to report more drug-related problems…A vicious cycle may develop in which an already traumatized individual who uses substances to cope is at greater risk of experiencing additional trauma.” These behaviors may also damage the survivors’ relationships, making it difficult for them to get the support they need.
In addition to its emotional impact on the survivor, sexual trauma can have an effect on their wider community. This can be true in the short term, as people react to the news of the event, and in the long term, as the survivor’s needs from those around them change.
Because trauma may cause changes to the survivor’s sexuality, it often has a direct effect on their current and future romantic relationships. And depending on how a partner reacts to hearing about their history, it may result in either deeper or more fragile trust.
This disclosure, to both partners and friends, is an extremely important part of long-term healing. “A growing body of research suggests that the type of social reactions sexual assault survivors receive from others13 can have a profound impact on their health and well-being.”
There are a number of myths about sexual assault,14 including the idea that it’s normally perpetrated by a stranger. When we think of rape, we may imagine a person wearing a ski mask in a dark alley, grabbing an unsuspecting passerby. While this does sometimes happen, the vast majority of assaults are perpetrated by a person the survivor already knows.
According to RAINN (Rape, Abuse & Incest National Network), 80% of rapes are committed by someone in the survivor’s life.15 39% of perpetrators are acquaintances, and 33% are current or former romantic partners. And these events are associated with significantly higher rates of PTSD and depression than those perpetrated by strangers. “It is also likely that the breach of trust and sense of humiliation women may experience after intimate partner sexual violence16 may contribute to poor mental health outcomes.”
When the survivor and perpetrator share a community, they may both face significant social struggles after the trauma occurs. Survivors risk not being believed, losing friends, and losing access to community spaces inhabited by the perpetrator. Because social support is such an important part of healing, this can make it difficult to move forward.
“This stacked deck, known as ‘rape culture,’17 is the set of social attitudes about sexual assault that leads to survivors being treated with skepticism and even hostility, while perpetrators are shown empathy and imbued with credibility not conferred on people accused of other serious crimes, like armed robbery.” And rape culture has a quantifiable impact on the availability of resources for survivors.18
Healing from sexual violence19 is a process that entails ups and downs. You can absolutely heal, but it’s important to be patient with yourself. Over time, you may recover repressed memories, find that triggers have resurfaced, or even be retraumatized by future events. Because of this, it’s important to develop a strong set of tools that will help you navigate life after sexual trauma.20 Certain styles of therapy can be especially helpful for survivors.
Cognitive behavioral therapy (CBT) has been proven to be effective for trauma survivors. Specifically, experts believe that cognitive processing therapy (CPT),21 which is one subset of CBT skills, can help clients heal from sexual trauma.
In CPT, clients examine their own deepest beliefs and emotional responses. It follows a very specific protocol, and is normally delivered over the course of 12 sessions. During this time, the client recounts the traumatic event with the goal of re-experiencing their own emotional reactions to it. Then, they evaluate their feelings, learning to modify their logical response to their own emotional experience.
In this type of therapy, clients recount their most difficult memories, intentionally causing themselves to have a triggered emotional response in a safer context. This work can be extremely difficult, and should always be guided by a skilled practitioner.
Much like CBT and CPT, exposure therapy22 teaches you to navigate your own most painful emotions. As hard as the therapeutic process can be, it imparts valuable skills that help clients navigate future triggers and challenges.
This is an extremely personal process, even more so than some other forms of healing. The important thing is to choose activities that work for you, and not only those that you believe should work. Some clients benefit from a combination of exercise, massage therapy, healthy eating, or mindful meditation on physical sensations.
Simply learning to feel at home in your own body is a powerful coping mechanism. This skill may also help survivors avoid engaging in unhealthy behaviors, like substance misuse.
Sexual trauma often causes survivors to develop unhealthy coping mechanisms, including substance use disorders and eating disorders. It can also result in co-occurring mental health diagnoses, like depression and anxiety.
Fortunately, many rehabs specialize in treating dual diagnoses. As a result, these facilities are equipped to help survivors with more than one concern. Some programs also offer trauma-informed care, which is specifically designed to treat survivors. This may be appropriate for anyone with a history of trauma, whether or not that trauma includes consent violations.
If you choose to attend rehab for sexual trauma, it’s important to manage your own expectations about the healing process. Rehab can’t undo what happened to you. But it can help you develop the tools you need to successfully navigate life in its aftermath.
Healing from sexual violence is a lifelong process. It may result in permanent changes to your sex life, relationships, and sense of self. That being said, not all of these changes need to be negative. Experts have found that “recovery from sexual victimization is possible”—and you may even experience post-traumatic growth.24
Whatever the future holds, though, healing from trauma often begins with being present in the moment. Many clients benefit from simply accepting difficult emotions, instead of trying to ignore or “fix” them. This can be helpful both for clients healing from a recent assault, and for those who had a traumatic experience long ago. No matter what happened to you in the past, understand that you have the right to heal. And you have the right to ask for help.
If you’d like to attend a program that treats survivors, you can browse our list of rehabs for sexual trauma here.
Reviewed by Rajnandini Rathod
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