Coping with Adversity and Trauma

In October 2017, the New York Times published a story in which several A-list actresses accused a high-profile entertainment executive of sexually harassing or abusing them and others for several decades. Afterward, they claimed the producer offered them money to keep quiet or threatened to damage their careers if they didn’t. The victims alleged that although this individual’s behavior was widely acknowledged within the industry, it was somehow deliberately and blatantly overlooked.

Ten days after the article was published, actress Alyssa Milano suggested in a Twitter post that anyone who had been sexually harassed or abused reply to her tweet with the words “me too” to “show the magnitude of the problem.” Tens of thousands of women — some famous, others not — and many men commented on Milano’s post with comments like these:

“Me too, he was my stepfather.”

“I was 14 and she was 27. I was coerced.”

“53 with PTSD from childhood sexual assault. You never get ‘over it.’ You just learn to live with it.”

“#MeToo but not ready to talk 20+ years later.”

Twelve months after Milano’s tweet, news outlets reflected upon what they deemed “The Year of #MeToo.” The words “me too” and its corresponding hashtag went viral and turned into a movement that spread well beyond the entertainment industry. Politicians, musicians, businessmen, fashion photographers, educators, and even scientists were publicly called out as abusers. Amid this controversy, formerly beloved actor Bill Cosby was convicted of sexual assault and Supreme Court nominee Brett Kavanaugh became the subject of an FBI investigation after being accused of the same.

The aftereffects of #MeToo

The #MeToo movement has led to what one publication calls a “global reckoning on sexual harassment and assault.” The courage demonstrated by those who openly made admissions and accusations of personal traumatic experiences inspired others to come forward, many for the first time. In fact, in the four days following Christine Blasey Ford’s televised allegations against Kavanaugh, a record number of people called the sexual assault hotline run by the Rape, Abuse & Incest National Network (RAINN). The organization reported that hotline traffic increased by 338 percent that weekend, and the day after the hearing, Friday, September 28, was the busiest day in RAINN’s 24-year history. In total, RAINN’s victim services programs responded to 28,509 survivors in September 2018. During this period, the hotline fielded about 950 calls per day, compared to an average daily call volume of 435.

Not only did #MeToo empower women to reach out to report an assault; it also led many to reconsider previous relationships and sexual encounters as potentially inappropriate occurrences. A survey of 3500 men and women, conducted jointly by Women’s Health and Men’s Health magazine in June and July of 2018, revealed that 37 percent of women and seven percent of men now considered a past sexual encounter inappropriate. Eighty-three percent of women expressed that “just thinking about a past experience that crossed the line made them feel anxious, depressed or regretful.”

Sexual abuse and mental health

The responses of these women and men aren’t uncommon in cases of sexual abuse and trauma for a variety of reasons. For one, some people aren’t sure what constitutes abuse or assault. RAINN president Scott Berkowitz told the New York Times that one of the first questions many people get asked when they call the sexual abuse hotline is, “Was I raped?” The situation is often further complicated if the abuser is someone they trusted; it may take years for victims to realize that they were sexually violated. Extensive news coverage like what occurred during the Cosby trial or the Kavanaugh hearings can quickly dredge up trauma-related memories and open up old mental wounds.

In April 2017, several months before the #MeToo movement, psychologist Elyssa Barbash wrote in Psychology Today that people’s reactions to sexual assault are often similar to other traumatic or life-altering negative experiences. In fact, 94 percent of women who have been raped experience symptoms consistent with post-traumatic stress disorder, or PTSD, in the two weeks after the assault, Barbash says. Although PTSD is commonly linked to the symptoms experienced by returning warfighters, this mental health condition can be triggered by any terrifying or shocking event.

In addition to PTSD symptoms, victims of sexual assault may feel depressed, anxious, angry, hypervigilant, irritable, or easily startled. Avoiding what happened by not thinking or talking about it is one of the most common responses to this trauma. Unfortunately, avoidance is a short-term strategy that can prolong and worsen post-trauma mental health symptoms. Barbash writes that likewise, deciding to delay seeking help from a therapist or mental health professional, or not seeking it at all, may make the victim feel “in control” or that they’ve “gotten past” their trauma. In actuality, it causes significant prolonged distress.

Startling statistics

According to Barbash, repressing emotions about sexual trauma and avoiding therapy can escalate into more serious mental health conditions. Research conducted in 2015 by the National Sexual Violence Resource Center (NSVRC) found that women who have experienced a sexual assault are more likely to abuse drugs and alcohol, encounter significant problems at work and school, and have trouble forming trusting relationships with family and friends. Sadly, one-third of women who were raped contemplate suicide, while 13 percent attempt to end their lives.

To put those numbers into context, consider the following startling statistics from RAINN. According to the organization’s website, an American is sexually assaulted every 92 seconds. They also report that one out of every six women in the United States has been the victim of an attempted or completed rape. However, sexual violence is not limited to women. RAINN estimates that about 1 in 33 American men, or three percent of the male population, have been victims of an attempted or completed rape. The majority of sexual assault victims are under age 30, with the highest-risk years for rape and sexual assault being ages 12 to 34.

Sexual trauma in childhood

RAINN estimates that “child protective services substantiates, or finds evidence for, a claim of child sexual abuse every nine minutes, with females accounting for 82 percent of victims under age 18. One in four girls and one in six boys will be sexually abused before their 18th birthday, according to NSVRC.

Just like adults who suffer sexual assault, many children who have been abused experience a wide range of mental health-related reactions. They may withdraw from friends and family members, suffer from nightmares or have trouble sleeping, regress into thumb-sucking and bedwetting, explode into angry outbursts or tantrums, or share age-inappropriate sexual knowledge, language, or behaviors, says the National Child Traumatic Stress Network (NCTSN). Children may also develop anxiety and depression.

Psychotherapy can help children who have been victims of sexual violence. The Mayo Clinic recommends ongoing treatment to prevent future abuse and reduce the long-term psychological consequences of abuse. A mental health professional can help a child learn to trust again, teach them about appropriate behavior and relationships, and boost their self-esteem. Counseling can also help the parents of abused children to cope with their frustrations and learn healthy parenting strategies.

Adult repercussions of childhood abuse

As these children advance into adolescence and teen years, their behaviors can evolve into those with more severe consequences if there has been no psychological intervention. Similar to adults dealing with sexual trauma, teens with this history might be more likely to abuse drugs or alcohol and engage in self-destructive behavior, such as self-harm, suicidal tendencies, or even prostitution.

Many victims of childhood sexual abuse also suffer long-term effects of the trauma well into adulthood. According to RAINN, adult survivors of childhood abuse will experience a range of short- and long-term emotions, including guilt, shame, and blame. Looking back on the incident, adults may replay the abuse and try to re-evaluate their role in what happened. They may feel that it was their fault, or that they must have done something wrong to deserve the abuse.

The National Center for Victims of Crime reports that the psychological consequences of sexual violence can lead to a dysfunctional and distorted view of sexuality, crippling an adult’s ability to establish healthy sexual relationships. Attempts at intimacy can inevitably and unconsciously lead to flashbacks during the act, unearthing painful memories, even in a consensual situation. Shockingly, victims of child sexual abuse are also much more likely to be revictimized. A study by the Center found that children who had a rape or attempted rape experience were 13.7 times more likely to experience the same in their first year of college.

Bringing it into the open

In 2017, Emily R. Dworkin, a senior fellow at the University of Washington School of Medicine, published a paper in the journal Clinical Psychology Review that explored 200 relevant studies on the relationship between sexual assault and mental health. Dworkin shared her findings in an interview with National Public Radio (NPR), reinforcing previous conclusions that “sexual assault is associated with a higher risk for a lot of different mental health problems, including PTSD [and depression, anxiety, substance abuse, and suicidality]…especially PTSD.”

When asked how sexual assault compares with other forms of trauma in terms of effects on mental health, Dworkin replied, “We never want to have the Olympics of trauma.” However, Dworkin added, “[C]ompared to other types of life-threatening trauma, survivors of sexual assault do seem more likely to get PTSD.” She later cites sexual assault as a “unique form of trauma” that is highly stigmatized, especially by law enforcement.

“When people go to seek help for it,” Dworkin says, “unlike in a car accident — well, the police are not going to ask you if you’ve really been in a car accident.”

The fear of not being taken seriously or not being believed is just one reason crimes of sexual violence go unreported. It’s quite common for victims to keep their trauma to themselves. An estimate by the Department of Justice shows that only 310 out of every 1,000 sexual assaults of any kind are ever reported to the police. The NSVRC found that rape is the most under-reported crime and that more than 90 percent of sexual assault victims on college campuses do not report the crime to the authorities.

When President Donald Trump posted a tweet during the Kavanaugh hearings in September 2018 questioning why Kavanaugh’s alleged assault victim Christine Ford didn’t “immediately” file a report with local law enforcement, he was met with a backlash of more than 75,000 comments. Victims replied with their reasons for not reporting their own experiences of sexual assault, and the hashtag #WhyIDidntReport went viral.

Stories included:

• Because he was a cop.
• I was told he would kill my family if I told.
• Because no one does. It just happens too much.
• Shame, fear, guilt, sadness, grief to name a few.
• I blamed myself & was sure no one would believe me.

Dr. Kim S. Menard, a Penn State Professor and author of a book about reporting sexual assaults, told Vice that sadly women are now discouraging other women from going to the police because of the lack of support they’re expected to receive. This sort of reaction, Menard says, ultimately enables perpetrators of sexual violence. “It serves to silence the victims and allow the perpetrators to continue their abuses over and over again because people don’t report because they’re not supported in their report,” Menard said. Although only two to 10 percent of all reported assaults are false, baseless, or unsubstantiated, there is still a pervasive feeling among victims that authorities will not believe them.

Menard cited other reasons for not reporting crimes of sexual assault. “In addition to being blamed,” she said, “there are a number of other reasons why victims don’t report, including victims not wanting to get the perpetrator in trouble, or the fact that they are too traumatized.”

Seeking help

Dworkin shares, “One of the evidence-based treatments for PTSD is overcoming the trauma by sharing the story” with someone who can help, such as a professional counselor or psychotherapist. “That’s a very different thing than being forced to tell it in public,” she adds.

Repressing and avoiding memories of abuse — even that which happened decades ago in childhood —  can be detrimental. Still, Therapy Group of DC wants victims to know that there is no “statute of limitations” on seeking help for trauma. Working with a licensed professional therapist can have multiple benefits for victims of sexual assault and abuse and help victims move forward toward a healthier psychological state.

Evidence-Based Therapy, in which all of our therapists actively engage, is a highly effective form of treatment for abuse victims and those who have abuse-triggered PTSD. Because trauma impacts so many people, most of our therapists have completed a year-long training in working with people who are dealing with the aftereffects of it. Some of our therapists have completed multiple years of training on it. Treatment is designed to help provide new ways of thinking, acting, and feeling about what happened and how to deal with it going forward.

Following the Kavanaugh hearings, therapist Sherry Amatenstein received a text from a patient who had been the victim of date rape. The text read, “I don’t know how much longer I can go on. I’m in so much pain.” In an article for Vox, Sherry recounted that she texted back, “I’ll be home in under an hour. Can we talk then?” Her patient replied, “You can’t change my past.” Sherry responded, “No, but you can share your feelings with someone you know cares.”

Although nothing can change the childhood or adult abuse victims of sexual violence experienced, psychotherapy can help to shape a healthier future. A therapist specially trained in helping those who have suffered trauma and abuse can help to reduce symptoms like emotions of guilt, shame, blame and treat disorders like anxiety and depression with therapy and medication. Talking about what happened can help victims work through and re-evaluate the experience to understand that the victim is not at fault, no matter what he or she was told by the abuser.

In her piece for Psychology Today, Barbash lists the following as potential benefits of trauma-focused therapy:

• Increased awareness of inner strength and outside resources
• Calming and soothing effects
• Help processing specific memories
• Challenge of trauma-based thinking
• Ability to make meaning of what happened
• Reduced symptoms of depression and anxiety
• Increased personal confidence
• Reduction or complete elimination of trauma-reaction symptoms

The Therapy Group of DC offers therapy that thinks beyond normal. We believe that by working together, we can overcome your biggest challenges, and instead of getting you “back to normal,” we’ll help you get to your best. If you’ve been a victim of trauma or sexual violence as an adult, teen, or child, we encourage you to seek support and help.