Coming to terms with a sexual assault

There’s been a noticeable increase in media attention around sexual assault and sexual harassment over the last couple of years, and awareness of issues such as the importance of consent has risen. People who’ve experienced a sexual assault may find themselves thinking more about the incident as a result. Others may be revisiting and reframing things that happened to them in the past, perhaps several years ago.

Whatever happened, it’s the impact the incident has had on you that matters. Nobody else gets to judge how ‘serious’ or how ‘minor’ it was: a traumatic event will affect different people in different ways. The important thing is the thoughts and feelings you have about it – and to recognise that these are valid.

People can feel a range of emotions following a sexual assault. Fear, shame, anxiety, anger…they’re all normal. It’s not uncommon for individuals to blame themselves, or question the decisions they made – even years after the event. They might have regrets: Why did I go out that night? How could I have been so naïve? Why didn’t I stop it happening? Why didn’t I report it?

This can turn into overthinking and rumination, when we go over and over something in our minds. Accredited CBT therapist Kate Tilbury explains: “The brain organises itself differently in response to a traumatic event, and doesn’t process the memory as it typically would. Asa result, the body and brain are on high alert; the body believes the danger is still present and struggles to orient itself in the here and now, while the brain might analyse the event to see if there’s anything we could have done differently, and prevent it from happening again. We can become stuck in this loop, however, and end up living in the past.”

Sexual assault can affect how we perceive ourselves, and lead to anxiety, loss of self-esteem and depression. Problems in relationships can also arise – due to difficulties with intimacy or trust, for instance. Some people might repeat unhelpful patterns, such as going from one bad relationship to the next.

Survivors of rape and other types of sexual assault are also at risk of developing PTSD. An estimated 94% of survivors may experience consequences such as nightmares in the first few weeks after the event, which is a normal part of processing it. However, around 50% go on to have long-term symptoms like flashbacks and continuing nightmares.

PTSD involves the internal alarm system we all have within us which maintains our survival, alerting us to danger so we can run or protect ourselves. If we haven’t processed the memory of a trauma properly, this system can become faulty, and be triggered when we’re not at risk.

A trigger could be any number of things; a news report, being in a similar situation, or a smell, piece of music or texture. It could be caused by being physically close to someone, or being touched.

“People with PTSD can be hypervigilant, hypersensitive and jumpy – or they can be numb, not reacting to danger like others would,” says Kate Tilbury. “It’s actually common to oscillate between the two states. This can lead people to worry that they’re losing their minds, or that they can’t trust their body, but it’s atypical response to trauma.”

If a sexual assault is having an impact on your life, it’s worth seeking help. Not everyone goes on to develop PTSD, of course. This can depend on a number of factors, including the level of fear and potential danger the individual experienced at the time of the incident. PTSD could be more likely to occur to someone who’s had previous difficulties or abuse in their life, or – conversely – to someone who’s had their positive beliefs about the world shattered.

If you’re troubled by what you went through, and this is holding you back from feeling happy, confident and safe, you deserve to be able to heal and move on. CBT has proved to be a very effective therapy for treating people who’ve experienced sexual assault.

During CBT you form a strong and safe alliance with your therapist to learn about the impact of trauma on the mind and body. You’ll build your own understanding of what you experienced, and be guided toward the most effective ways to address your specific needs and heal your suffering. This may involve being compassionate with yourself, or challenging unhelpful beliefs that might be keeping you ‘stuck’. By the end of therapy people typically feel they’ve reclaimed the narrative, and have a renewed interest in a life that has meaning and purpose.

“CBT provides a safe way of revisiting and processing what happened, so you can find a sense of self-mastery and agency, and reach a place of wellbeing and strength, ”adds Kate Tilbury. “It helps you piece together the fragments to build a clear picture you can make sense of, and ‘file away’ with other memories. Your therapist will also help you to track what triggers rumination or flashbacks, and equip you with the tools to emotionally regulate.”.  

The NHS Live Well website has some great guidance around finding the right help and support after a rape or sexual assault. You can find out more about how CBT is used to treat PTSD here.