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The Psychological Effects of Sexual Assault

     

A sexual assault experienced by either you or a loved one can evoke a variety of reactions. To avoid confusion about what can be called a sexual assault, the U.S. Justice Department recently defined it as any sexual act you do not consent to, “including when the victim lacks capacity to consent.”

The spectrum of assault covers, for example: being sexually abused as a child by a relative, family friend or a person in authority; being violently raped by a stranger; having your spouse or partner force you to have sex; being subjected to physical violence because you are trans or gay; being taken advantage of sexually while drinking at a party; having a college friend, date or coworker refuse to take “no” for an answer; or being fondled or groped at work. By far, the most likely perpetrators of sexual assault are either family members or close friends.

Tragically, at least 300,000 individuals in the United States are victims of sexual assaults each year, though it is believed that the actual number is much higher because so many assaults are unreported. Excellent studies have been done to assess the psychological effects of a sexual assault, both soon after it occurred and for years afterward. These studies have shown that no matter how serious the assault, or how long it has been since it occurred, treatment can be successful and help you or your family member heal and recover.

Right after an assault, the most common emotions include acute feelings of fear and panic, plus concerns about safety. Another widely recognized reaction is to feel overwhelming guilt and shame that you were the cause of this assault, even though when someone attacks you sexually against your will, you are zero percent at fault. Believing that you are somehow responsible for this horrible act may give you a temporary, but false sense of control over an experience that was extremely frightening and out of your control.

Because of the effect of trauma on brain chemistry after such an assault, you might also feel numb, disoriented, or as if you are in shock. You might have trouble focusing or feel that the situation is not real. You may feel convinced that you are irreversibly damaged. Another common reaction is to deny that anything happened, hoping that you can just ignore the problem or make it go away. Or you might make excuses for the person who assaulted you, such as, “Well, he was drinking,” or “That’s just what men do when they need sex,” or “Doctors know what they’re doing, so what she did must be OK.”

If you have been forced into any type of sexual act, it is important to seek medical attention to ensure that you are not pregnant and that you have not been infected with HIV or another sexually transmitted disease. A rape crisis center or child sexual abuse center at a hospital is a safe place to receive the care you or your family member needs and to ensure that any health and emotional needs are met as soon as possible.

Long-term physical or psychological effects are present in roughly 80 percent of untreated assault victims. Studies have shown that you may experience physical effects, such as sleep disturbances, chronic pain, poor health, and headaches.

The psychological effects include being more prone to develop depression—a clinical state of sadness, hopelessness, and inertia, with symptoms that continue for weeks. These feelings may interfere with your ability to find pleasure in your life or your ability to work or function well as a parent. They may even make you to want to harm yourself. It may be difficult for you to return to seeing sexual activity as a natural and pleasurable experience. After an assault, you are more likely to develop anxiety or a panic disorder that can have a profound impact on your life, causing you to limit your participation in certain activities or avoid certain situations because of fear. For a third or more of assault victims, that sense of fear becomes longstanding in the form of post-traumatic stress disorder (PTSD). Finally, as an untreated assault victim, you are three to 10 times more likely to develop a drug or alcohol problem.

You have been hurt—yet there are people who can help you recover. You just need to find them, whether your assault was relatively small or crippling in scope, and whether it occurred yesterday or many years ago.

Understandably, many people find it extremely difficult to speak to someone about the sexual assault they experienced, probably in a private setting, unwitnessed by others and hard to prove. Bringing your pain into the light by talking to a psychiatrist or other clinician is a way to care for yourself and avoid the psychological consequences that sometimes occur after an assault. Working with a therapist does not mean that you have to report what happened to the police, and your therapist will not report the assault to any authority. Therapy is a confidential, safe, and comforting place where you can relearn trust and undergo a healing process. It is up to you to decide whether or when to seek legal justice for the damage that was done to you.

If you have been the victim of sexual assault and would like to begin the healing process, call the Rape, Abuse & Incest National Network (RAINN) National Sexual Assault Hotline at 800-656-4673 or visit their website. You can also call the Office for Women’s Health at the Department of Health & Human Services (OWH) at 800-994-9662 or visit their website.

For help finding a psychiatrist, please go to the American Psychiatric Association website.

References

  • Sexual assault. US Department of Justice, Office on Violence Against Women (OVW) website. https://www.justice.gov/ovw/sexual-assault.
  • Scope of the problem. Rape, Abuse & Incest National Network (RAINN) website. https://www.rainn.org/statistics/scope-problem.
  • Morgan RE, Grace K. Criminal Victimization, 2016. Washington, DC: US Department of Justice, Office of Justice Programs, Bureau of Justice Statistics; December 2017. full text
  • Thurston RC, Chang Y, Matthews KA, von Känel R, Koenen K. Association of sexual harassment and sexual assault with midlife women’s mental and physical health. JAMA Internal Medicine. October 3, 2018 [epublished ahead of print]. full text
  • Rothbaum BA, Foa EB, Riggs DS., Murdock T, Walsh W. A prospective examination of post-traumatic stress disorder in rape victims. Journal of Traumatic Stress. 1992;5(3):455-475. abstract
  • Davidson JRT, Foa EB, eds. Posttraumatic Stress Disorder: DSM-IV and Beyond. Washington, DC: American Psychiatric Press; 1993: 23-36.
  • Kilpatrick DG, Edmunds CN, Seymour AK. Rape in America: A Report to the Nation. Arlington, VA: National Victim Center and Crime Victims Research; Charleston, SC: Treatment Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina; 1992. full text
  • Langton L, Truman J. Socio-emotional Impact of Violent Crime. Washington, DC: US Department of Justice, Office of Justice Programs, Bureau of Justice Statistics; September 2014. full text

     

 

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