How Does PTSD Effect Sexual Assault Survivors?

A guide on sexual assault and the effects it has due to PTSD.

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Sexual assault victims have a 94% chance of experiencing symptoms of post-traumatic stress disorder within just two weeks of their encounter. Up to half will experience negative long-term of from the incident [1].

Due to these factors, people who are confronted by sexual assault have a daily struggle most people don’t take into consideration. PTSD will cause the event to replay over and over again within the victims mind from even the slightest triggers.

For example, watching the news might become a nightmare. For every sexual assault case broadcasted is another reminder of the victim’s own disturbing memories.

In turn, these triggers cause great instability in victim’s life. Often leaving them hopeless and garnering other mental illnesses. However, help is available and hope might just be right around the corner.

In this blog, we review the role of PTSD in sexual assault victims. At the end, we invite you to ask further questions.

Why Do Most Sexual Assault Survivors Experience PTSD?

When someone hears the term “post-traumatic stress disorder,” the first group of people to appear in their minds are veterans. However, statistics reveal that out of all PTSD cases within the United States, half of them include sexual and/or physical assault [2].

This is due to the fact that sexual assault is more than just a violation of the body. It’s a disturbance of personal space and one’s understanding of their safety. This is extremely difficult for someone to just walk away from and has the strong ability of inflicting damaging memories.

So, how does PTSD develop after a sexual assault experience?

According to Akiami McCoy, LCSW, LCSW-C, a psychotherapist, “The brain does not perform well for a victim during a sexual assault.” As she sees it, it’s during the assault itself when the brain natural response is to “flight or flight.” She continues, “Unfortunately, most victims are overpowered and can do neither. They may instead disassociate themselves from the act, and that’s where the mind escapes the body until the assault is over.”

Current research proves McCoy’s words to have validity. In 2015, a study confirms there’s a strong link between PTSD and its victims dissociating themselves from the cause [3].

If a victim of sexual assault is already struggling with a mental illness, such as anxiety or depression, they are at an even higher risk of developing PTSD.

Symptoms of PTSD

Since the symptoms for PTSD are so versatile, they are separated into four different categories:

  • Avoidance
  • Changes in emotional and physical reaction
  • Intrusive memories
  • Negative changes in mood and thought

It’s important to note, most people don’t experience ALL these symptoms. In fact, some people will only experience a certain set of symptoms. Lastly, a person may find specific symptoms more intense than others and at very specific times.

Children ages 6 and under may experience other symptoms. These include:

  • Re-enacting the incident through play
  • Terrifying dreams of the incident

Avoidance

Avoidance symptoms include:

  • Attempting to steer clear of conversations and thoughts about the incident.
  • Avoiding places, people, and/or activities associated with the incident.

Changes in Emotional and Physical Reaction

Sometimes referred to as arousal symptoms, these include:

  • Aggressive behavior or angry outbursts
  • Becoming easily startled or frightened
  • Constantly being on guard for harm
  • Difficulty concentrating
  • Insomnia
  • Irritability
  • Overwhelming guilt or shame
  • Self-destructive behavior

Intrusive Memories

Symptoms for intrusive memories include:

  • Experiencing flashbacks of the incident
  • Intense emotional anguish or physical reaction to something that brings up the memory of the incident
  • Reoccurring and undesired distressing memories of the event
  • Terrifying dreams or nightmares of the incident

Negative Changes in Mood and Thought

These symptoms include:

  • Difficulty experiencing positive emotions
  • Difficulty keeping close relationships
  • Feeling emotionally numb
  • Feeling separated from family and friends
  • Feelings of hopelessness (especially in terms of the future)
  • Lack of interest in activities and people which were once of interest

How Do These Symptoms Play a Role in Daily Life?

Kandee Lewis, the executive director of the Positive Results Corporation, says:

“The way a person thinks, walks, talks, and engages is divided into ‘before assault’ and ‘after assault,’ and they are never the same. There will be a day that that person feels like themselves, the ‘before’ self.”

When considering a sexual assault under these terms, it’s understood that a survivor no longer feels as though simple, everyday things are normal ‘after assault’ [5].

Even the smallest of incidences, such as a scene in a film or a knock at the door, can throw a person back into the experience of their assault. In turn, this completely abstracts them from what’s actually happening.

Still, PTSD from a sexual assault goes even deeper than this.

As McCoy puts it, “During a crisis, the brain is working to encode the violent even in order to store it as a memory. Unfortunately, encoding does not happen the way it would normally after the event is over. The victim may only be able to recall what they set their mind on until the act was over. That may be a picture on the wall, the trash on the floor, the spot on the ceiling…”

Due to the profound punctuality of these memories, even something as simple as a similar picture to that which was seen during the even can cause a reaction.

PTSD is not only a sensitive matter, it’s extremely complicated. Due to this, it’s vital people who suffer from it seek out professional help.

PTSD and Relationships

In the words of Michael J. Salas, owner and founder of Vantage Point Counseling Services in Dallas, “Living with PTSD typically includes recognizing that the traumatic experience has changed you. It is true that you don’t completely lose yourself, but many things will shift as a result… opinions, perspectives, and even personality.”

In turn, these changes all work together when you enter into a relationship. Survivors of sexual assault often have trouble finding a partner they can trust enough. Furthermore, their trauma has strongly influenced their sexuality [6].

Sala teaches victims to recognize the first moment they felt safe following their assault. “Many will say that they never had that realizations,” he says. In turn, survivors who attempt to explore their own sexuality may never feel safe doing so.

“A lot of survivors have difficulty feeling sexual pleasure or describe feeling numb or unable to really be present when they’re with a partner,” Mallonee explains. “Even supportive partners don’t always understand, or may feel hurt that sex with them could be triggering.”

If you are a partner of someone who has survived sexual assault, there are some things you can do in order to make your partner feel more secure:

1. Learn About Trauma and PTSD

Before you try to help a sexual assault survivor, you must understand how PTSD and the trauma itself effects the brain. There are a number of great resources both on this blog and throughout the web.

However, it’s important to note not everyone is affected by trauma in the same way. Learning about PTSD isn’t merely research, it’s having open discussions with your partner in order to better comprehend their position.

2. Don’t Force the Story Out, Let the Survivor Tell It When S/he Feels Comfortable

As you’ll learn in your research, one of the most difficult things for a survivor to do is open up about their experience. Though this is partly a trust issue, it’s namely due to the fact that memories are so vivid, they bring back undesired feelings.

Due to this, survivors will open up and discuss the incident with you (or other problems that surfaced afterwards) on their own time. It’s not up to you to decide when s/he decides to tell you.

A survivor once said, “I don’t give someone all the details at once. I need to see that they can be patient early on, and not because it’s a manipulation, but they are genuinely trying to be understanding of something that is out of both of our control.”

3. Always Communicate

There’s not a single relationship out there that doesn’t survive on communication. When it comes to relationships where PTSD is a factor, it’s necessary for the survivor to be able to process their trauma within the relationship.

Kelly O’Brien, a survivor, notes, “The thing that makes me most comfortable as a survivor is having open communication with my partner at all times, but especially during bad days and during sex. We both make it a habit to check in with each other often and talk about everything too. Whether it is just how we are feeling that day or our past, we are open and make sure we are each up to talking about it at the time.”

4. Make Sure Consent is a Priority

Making sure the survivor is able to consent to anything should be a number one priority. This can be anything from sex to little choices, like what to eat for dinner.

Survivor Alaina Leary points out, “What makes me feel most comfortable is being with a partner who prioritizes consent not just in our sexual and romantic aspects but in every small way, from my ability to make my own choices about my body (how I look, what I wear) and my identity, to what we are each responsible for in our lives.”

When it comes to trauma, survivors must have a sense of control over their bodies. Not only when it comes to sex, but when it comes to every other aspect – from dressing up to what they’re eating.

“I need to feel like I can throw the brakes on something or that I will be heard if I say I’m uncomfortable,” one survivor informs.

Of course, no two partners can expect to agree on everything. Therefore, both sides should always leave room for accommodation.

5. Respect the Needs of Your Partner

In order to handle triggers, survivors have specific needs most people don’t. Sometimes, these needs are little. As survivor and licensed clinical social worker Cynthia Stocker notes, if a survivor “comes home, and wants the curtains to be closed, don’t have an argument about that. Allow [them] to have the curtains closed.”

Often, you’ll find these needs putting a halt to certain actions. Especially, in the bedroom. It’s vital you don’t take these things personally. As Stocker explains:

“If a survivor says, ‘I don’t want to have oral sex. That isn’t something I’m comfortable with.’ Whether it’s giving or receiving, understand that that isn’t about you. It’s not personal.”

6. Go With the Flow of Your Relationship

A survivor must recover at their own pace. Therefore, so should your relationship with them.

“Understand that time for a survivor is going to look very different than it is for you,” Stocker informs. “Understand that their recovery is fluid, and can change from day to day and just accept that. What’s true one day may not be true the next, and has a lot to do with where they’re at in their process.”

As partner, one thing you can do is influence treatment.

7. Don’t Be Afraid to Celebrate Recovery

“If you are recovering from trauma, and you are a survivor, we have to notice the small changes we make every day,” says Stocker. “If you are able to make one small change, celebrate that. And as you celebrate every small change that you make, you will make larger changes. But if you don’t notice the small changes, it’s impossible to make bigger ones.”

Sexual Assault Treatment

When it comes to treating PTSD inflicted by sexual assault, there are two different ways a medical professional will recommend [7]:

  1. Medication
  2. Psychotherapy

Since PTSD effects everyone differently, treating is seldom the same. There is no treatment option where “one size fits all”. If you run into a facility advertising this, turn away at all costs.

If you have suicidal thoughts¬†it’s vital you get help immediately. Help is available in the following resources:

  • Calling the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).
  • Contact your spiritual leader or someone within your faith community.
  • Go to the emergency room or make an appointment with your doctor.
  • Reach out to a loved one or someone you trust.

Medication

Antidepressants are most commonly prescribed to those facing PTSD. Medical professionals have found these medications help survivors better control the following symptoms [8]:

  • Anger
  • Feelings of numbness
  • Sadness
  • Worry

You may be offered other medications to help with specific symptoms. For example, Prazosin has helped many of those with PTSD who face sleep problems, such as insomnia and nightmare [9]. However, it should be noted, Prazosin isn’t currently FDA approved.

WARNING: Some of these medications are addictive and can lead to substance abuse disorder. In turn, this causes survivors further complications that when they were solely facing PTSD. Due to this, it’s in your best interest to look towards the following treatment method.

Psychotherapy

Psychotherapy, also known as “talk therapy,” is a treatment used for a variety of mental illnesses including anxiety and depression. Through this treatment, you’ll see a mental health professional on a regular basis and openly discuss your disorder [10].

The purpose of this therapy is to understand the root of your PTSD, identify all your triggers, and seek out ways to teat these symptoms.

There are a number of different psychotherapies depending on where your problems arise, including:

  • Family therapy
  • Group therapy
  • Individual counseling
  • Job-related therapy

Still, you’ll most likely be placed in the psychotherapy known as cognitive behavioral therapy (CBT). The two most common CBT’s used for PTSD are [11]:

  • Cognitive Restructuring – The purpose of this therapy is to help people understand the memory their trauma stems from. There are sometimes cases where people with PTSD remember the trauma in a worse manner. The goal is for the person struggling with the bad memory to begin looking at it in a more realistic way.
  • Exposure Therapy – through this practice, you’ll be exposed to your fears and then learn how to control the anxiety that follows. This is all done in a safe manner and it can take a lot of time to become adjusted to this exposure. You may be asked to write, imagine, or visit the location where this happened.

National Sexual Assault Hotline

If you’re in need of talking to someone immediately, you can reach out to the 24/7 National Sexual Assault Hotline at 1-800-656-4673 or visit their website for an online chat.

Your Questions

Still have questions surrounding sexual assault and PTSD? Are you a survivor and looking for help?

We’re here to guide you in the right direction.

Feel free to leave any questions or concerns in the comments section below. If you have further advice you’d like to offer to victims, we’d also love to hear from you.

We try to reply to each comment in a prompt and personal manner.

Reference Sources

[1] MJM: Sexual assault and posttraumatic stress disorder: A review of the biological psychological and sociological factors and treatments

[2] Harvard School of Public Health: Helping victims of sexual violence overcome PTSD

[3] Medicine (Baltimore): Traumatic Dissociation as a Predictor of Posttraumatic Stress Disorder in South African Female Rape Survivors

[4] US Department of Veterans Affairs: PTSD: National Center for PTSD

[5] Massachusetts Amherst Police Department: Common Reactions to a Sexual Assault

[6] HHS Public Access: Predictors of PTSD Symptom Severity and Social Reactions in Sexual Assault Victims

[7] Office of Women’s Health: Post-traumatic stress disorder

[8] MedlinePlus: Antidepressants

[9] Therapeutic Advances in Psychopharmacology: High-dose prazosin for the treatment of post-traumatic stress disorder

[10] NIMH: Psychotherapies

[11] NCBI: Cognitive behavioral therapy

Featured Image by Pete Baker (The Auburn Plainsman profile)

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