Experiencing sexual assault or violence can make your world feel like it’s been turned upside down. It may leave you feeling violated, sad, hypervigilant, anxious, or shameful. Everyone experiences trauma differently, and the effects may last longer for some people than others.
Sexual assault is sadly all too prevalent. The CDC estimates that over 50% of women and nearly one out of three men have been a victim of sexual violence in their life.
For survivors, sexual trauma therapy can be a saving grace to feel better and recover from trauma.
What Is Sexual Trauma?
Sexual trauma is a broad umbrella term that refers to many traumatic events involving non-consensual sexual scenarios, such as rape or sexual abuse.
“Sexual trauma is a form of bullying which involves either psychological manipulation, harassment, or aggression to force someone to engage in unwanted sex, intimacy, closeness, touching, or kissing,” says Britta Neinast, a licensed clinical social worker who specializes in sexual trauma with Grow Therapy.
Any instance of sexual trauma can happen to anybody, regardless of age, gender, or background. The perpetrator of sexual abuse could be a stranger or it could be someone the victim knows. Some examples of people who might carry out sexual abuse include (but are not limited to):
- Parents
- Family members
- Teachers
- Bosses
- Co-workers
- Medical professionals
- Romantic partners
- Ministers, youth leaders, or church members
Sexual abuse and sexual violence take many different forms. Examples of traumatic sexual experiences include:
- Non-consensual sexual intercourse (vaginal or anal)
- Non-consensual oral sex
- Non-consensual insertion of fingers, hands, or other objects
- Non-consensual sexual contact or touching (whether over or under clothing) of the genital region, breasts, buttocks, thighs, etc.
- Non-consensual subjection to sexually explicit situations, such as being exposed to porn or watching someone engaged in sexual acts
- Being verbally harassed, such as by unwanted explicit remarks or the spreading of rumors related to sex
- Being non-consensually filmed or photographed in a sexual way
All of these instances can happen through different means. The sexual acts might occur due to physical force by the perpetrator, or they could happen by way of emotional manipulation, ongoing pressure, or other verbal threats.
Survivors of sexual trauma may experience a wide range of symptoms. It all depends on the individual. Neinast says examples of these symptoms include:
- Flashbacks and/or nightmares
- Depression
- Anxiety
- Heightened startle reflex
- Dissociating
- Guilt, shame, self-blame, and/or anger
- Fear of intimacy while desiring intimacy
- Acting out sexually
What Are the Long-Term Effects of Sexual Trauma?
Sexual trauma can result in a variety of long-term effects, especially if the trauma is not addressed and processed.
Avoidance is one of the key factors in preventing recovery from sexual trauma. The intense emotional pain caused by the memories, flashbacks and/or nightmares becomes intensely overwhelming and victims use avoidance to escape the pain and memories. This is only a temporary solution and can take many forms, which include:
- Aggression
- Self-harm behaviors
- Substance abuse
- Bingeing
- Cognitive avoidance
- Behavioral avoidance
- Dissociation
- Emotional suppression
- Social withdrawal
- Behavioral inhibition
- Somatic complaints
Another apparent long-term complication is post-traumatic stress disorder (PTSD). It’s normal and common to experience some type of trauma response. There may be a variety of emotions or even physical symptoms someone feels after a traumatic event. For many people, this passes on its own and they return to their baseline. However, for some individuals, symptoms continue on, causing distress and difficulties in day-to-day functioning. This may lead to a diagnosis of PTSD. It is estimated that about 30% of PTSD cases are related to sexual violence.
Oftentimes PTSD is chronic, meaning it may last years, especially if those suffering don’t seek treatment. Sexual trauma victims who suffer from PTSD can be impacted in the areas of trust, safety, power and control, intimacy, and esteem. Some examples of PTSD symptoms include:
- Flashbacks that cause you to re-experience the trauma
- Nightmares
- Distressing intrusive thoughts about the traumatic event
- Feeling on edge and getting startled easily
- Getting angry easily and having outbursts
- Struggling to sleep
- Difficulty with memory surrounding the trauma
- Feeling guilty or putting blame on yourself or others who were not directly involved, but not the perpetrator of the sexual trauma
- Thinking negatively about yourself or others
- Losing pleasure or interest in things you used to enjoy
Aside from PTSD, other potential effects that could be short or long-term include:
- Depression
- Dissociation
- Eating disorders
- Panic attacks
- Self-harm
- Sleep disorders
- Substance abuse
- Suicidal ideation
Furthermore, a survivor’s relationship with sex and sexuality could change greatly after being assaulted. Two potential outcomes are hypersexuality and hyposexuality.
“Hypersexuality occurs when someone is excessively acting out, or has a preoccupation with sex. Hyposexuality is the opposite, where someone may suppress their natural sexual desires and are then unable to develop a healthy sexual relationship,” Neinast says. “In both cases, it’s an attempt to compensate for feeling a loss of power and control in their sexuality.”
There aren’t just long-term psychological effects from sexual assault, there may also be physical effects. Trauma can result in a variety of otherwise unexplained physical symptoms or health conditions, even if the trauma happened earlier in life. Sexual trauma in particular may be “stored” in the pelvic region. For example, a study by the American College of Obstetricians and Gynecologists found that the following health conditions were common amongst survivors of childhood sexual abuse:
- Chronic pelvic pain
- Chronic abdominal pain
- Painful sex
- Vaginismus
- Sexual dysfunction (difficulties with arousal or orgasm)
EMDR Therapy For Sexual Trauma
If you are seeking sexual trauma therapy, you might have heard the term “EMDR,” which stands for eye movement desensitization and reprocessing. This is a commonly used and effective treatment for trauma survivors, including survivors of sexual abuse. EMDR is based on the premise that unprocessed memories associated with a traumatic event are linked to the emotional and physical feelings you felt back then — and when you think of these memories, you will experience these distressing feelings.
EMDR uses bilateral stimulation (meaning stimulation that has a left-right component) to help the brain “juggle” these uncomfortable, painful, or triggering memories that are stored in the brain that affect the individual’s current mental health and quality of life, says Karina Hester, a licensed marriage and family therapist who practices EMDR with Grow Therapy. Essentially, EMDR can help you work through these triggering memories, processing them with a more beneficial narrative, thereby reducing future associated symptoms, Hester says.
With EMDR, the bilateral stimulation is in the form of eye movements. For example, your therapist might move their hand left and right and ask you to follow the movement with your eyes, without moving your head, so your eyes are moving left and right. However, Hester says EMDR can also be done with tactile stimulation (touch) or audio. These methods are better suited for people who have eye conditions or sensitivities, and some people may simply just prefer touch or audio instead of eye movements. The most important part is that the bilateral left-right component is present.
A great benefit of EMDR is that it can address not only distressing emotions, but also uncomfortable physical sensations. “Trauma is not only in someone’s mind as part of their stored memory, but can also be stored in the body as physical pains, headaches, or involuntary and painful sensations that almost mimic or bring back a sensation as if the trauma was happening again,” says Hester. For example, in the case of sexual trauma, someone might experience physical pain related to intimacy as the body’s response to stored trauma, she says.
How quickly someone notices results from EMDR varies depending on how someone’s brain stores the distressing memory or set of memories, as well as the trust and comfort that someone feels with their therapist, Hester says. According to the American Psychological Association, EMDR usually occurs over six to 12 therapy sessions, but positive results can appear sooner.
What Other Types of Therapy Can Help Heal Sexual Trauma?
Thankfully, helpful and effective therapy is available for survivors of sexual abuse. On top of EMDR, psychotherapy (also known as talk therapy) is an excellent tool for survivors to unpack their trauma in a safe space with a trained professional, address guilt, shame, and self-esteem, learn coping skills or relaxation techniques, and discover new ways to push forward and thrive.
“Trauma is not something you can think your way through. A traumatic event is experienced through your thoughts, feelings, and energy,” Neinast says. “Since it happened viscerally, it must be released viscerally.” This is best done with a trained mental health professional who specializes in trauma.
Three highly recommended sexual trauma therapy modalities are:
Prolonged Exposure (PE): This is a type of therapy that helps you safely revisit memories of traumatic events. It is very common for survivors of sexual assault or other trauma to avoid memories related to the assault, or to avoid anything that might remind them of their trauma. However, by continuously avoiding the trigger, this actually reinforces in the brain that this is something you should fear. Prolonged exposure therapy counteracts this and can ultimately help desensitize you.
“To heal, the body must relive the emotions while teaching the brain that it is now safe and has power. Prolonged exposure is highly effective, but must be done with a trained professional,” Neinast says. A trauma-informed therapist will help you expose yourself to triggers, such as by recounting memories in detail during a session, as if it is happening in the present, and allowing yourself to feel the emotions that come up — or by “in vivo” exposure where you will expose yourself to something in real life rather than your imagination, such as a certain place you have been avoiding. Regardless, your therapist will give you coping skills, such as breathing exercises, to get you through the emotional and physical discomfort.
Cognitive Behavioral Therapy (CBT): CBT is based on the principle that there is a strong relationship between your feelings, thoughts, and behaviors. With a CBT therapist, you will learn to identify unhelpful and unhealthy ways of thinking that might be affecting your feelings and behaviors. When you work on learning healthier thought patterns, you may notice that you have more positive emotions and more helpful behaviors — all of which can improve your quality of life and functioning.
Cognitive Processing Therapy (CPT): CPT is also very beneficial for trauma. Since many trauma survivors have beliefs that can be unhelpful surrounding their sexual trauma, CPT can help you directly address these beliefs. This will help you conceptualize the trauma in a more helpful way that causes you less distress.
CPT is an evidence-based approach to PTSD consisting of 12 sessions. Each session is organized in a way to help someone explore “stuck points,” which are distorted thoughts holding them in the trauma. Stuck points can include any thought that is not 100% true and lacks evidence to support it.
The first half of the CPT treatment addresses a person’s “stuck points” directly related to the trauma incident. These stuck points will include feelings of guilt, shame, self-blame, anger towards self or others who are not the perpetrator. An example could be: “I shouldn’t have worn that red dress.” The second half of treatment addresses stuck points that are focused on the present and future, in the areas of safety, trust, power and control, esteem and intimacy.
However, CPT treatment is difficult due to the strong emotions that are felt when recalling the trauma. A person must be educated on the process and agree to treatment, and must be able to tolerate emotional distress or learn necessary skills before starting CPT.
Mental health professionals will often blend multiple treatment modalities in sexual trauma therapy to best address your symptoms along the healing process. Furthermore, if there are any co-occurring conditions, such as an anxiety disorder or depression, your therapist can help you with those related symptoms, too. Individual therapy and group therapy are both options.
Seeking Help For Sexual Assault
If you are currently a victim or have been a victim of any type of sexual violence, sexual abuse, or sexual assault, help is available. One great resource is the Rape, Abuse & Incest National Network (RAINN). They have a free and confidential 24/7 hotline that can be reached at 800-656-HOPE. Alternatively, you can use their online chat option. Trained support specialists with RAINN can help you whether you need to vent, need crisis intervention, or need referrals to local providers.
On top of this immediate short-term support, it is crucial for survivors of sexual abuse to seek treatment to process trauma and related symptoms with the help of a therapist. This can help improve your mental health in the present day and future, preventing worsening of symptoms and long-term effects of traumatic events. Even if your trauma happened long in the past, such as childhood sexual abuse, it is never too late to seek treatment and take back control of your mental health.
When seeking professional help, it’s important to pick the right therapist for you. In the case of sexual trauma therapy, you want to make sure your therapist has extensive training and experience working with trauma survivors. You may choose to ask them if they have expertise in sexual trauma and if they are trained in specific modalities such as EMDR or prolonged exposure. With a platform like Grow Therapy, you can search and filter by state, insurance, and specialties to find the therapist who’s best for you.
Sexual trauma can make you feel all sorts of emotions. Remember: you are a survivor — and it is absolutely possible for you to address your trauma, put in the work in therapy, and come out even stronger than you were before.
