Is it possible to recover from Rape and Sexual abuse? Yes or No
by Dr. Laura K. Kerr PHD
When she was twenty-two years old, philosopher Karyn L. Freedman was viciously raped at knifepoint. She narrowly escaped being murdered and her body disposed, perhaps never to be found. In her memoir, One Hour in Paris, Freedman recounted her efforts to heal from this horrifying ordeal. Nearly 25 years have passed since she was raped, but she has yet fully recovered and doubts she ever will. Even after years of therapy, support group meetings, and educating rape survivors in Africa about the effects of trauma, Freedman claimed:
“The biological truth of my trauma is anchored in me, but it lives there like a parasite. And as I move in and out of recovery I am reminded that however much work I do, healing from a traumatic experience is never complete. This is one of the most significant facts about psychological trauma. It is permanent. The psychological damage that results from the experience of terrorizing life events over which we have no control is profound. It sticks around for life. It is a chronic condition, which makes recovery from traumatic events an ongoing process.”
“People ask me if I’m recovered now, and I reply that it depends on what that means. If they mean, ‘am I back to where I was before the attack’? I have to say, no, and I never will be. I am not the same person who set off, singing, on that sunny Fourth of July in the French countryside. I left her — and her trust, her innocence, her joie de vivre — in a rocky creek bed at the bottom of a ravine. I had to in order to survive. I now have my own understanding of what a friend described to me as a Jewish custom of giving those who have outlived a brush with death new names. The trauma has changed me forever, and if I insist too often that my friends and family acknowledge it, that’s because I’m afraid they don’t know who I am.”
Although I have never been raped as an adult, I was sexually abused as a child. I spent years nostalgically imagining the person I might have been had I not been abused, and went through periods haunted by nightmares and flashbacks that kept me reliving my twisted fate. Still, I consider myself lucky. I have managed to escape sexual revictimization as an adult, which happens with appalling regularity to women with histories like mine.
Yet like Freedman’s and Brison’s rapes, the impact of sexual abuse persists. Sometimes I fail to see the secureness of my present life because of the protracted shadow of fear that is cast by all forms of sexual violence. Something startles me and I am reminded that safety can be eclipsed in a moment. Even now, I am prone to dissociate the felt sense of my body when I am overwhelmed by fear. I learned to escape in my head conditions that were inescapable in my environment. Some habits are near impossible to break.
It has taken me a long time to honor these survival responses and acknowledge that sexual violence is not something I, or anyone else, fully recovers from, although this is not a reason to give up on recovery. Survivors can and do become strong again — sometimes stronger than they ever imagined — and often graced with an awareness of the fragile nature of life that deepens their capacity for compassion.
But the process of healing from sexual violence is slow, painful, and expensive. And because I have worked hard for a peaceful mind and body, I am protective of them. I have a low tolerance of toxic attitudes and behaviors that might upend my recovery. But I am also quick to stand up to injustices that impact others, and I have witnessed this trait in people like myself who are committed to healing their wounds of violence and abuse. Unintentionally, we become warriors of the heart — the would-be Bodhisattvas and protectors of those less fortunate and vulnerable — those we imagine are like we were before we reclaimed our right to dignity and self-preservation, and those we imagine could become victims like we once were.
Not everyone likes the justice-seeking aspect of recovering survivors of sexual violence and other abuses. Anyone who needs to exert power over another, needs someone capable of being a victim. Furthermore, the psychological complexes and interpersonal dynamics that lead to subjugation extend well beyond the predator-prey dynamics of sexual violence.
I once had a supervisor describe my penchant to protect others as a “Joan of Arc” complex. This observation followed after I asked her to stop calling my clients names like “bitch,” “putz,” and “schmuck.” Shortly after my objections, I was removed from my position. Had I avoided the work of recovery, I might have lacked the courage to defend my clients, especially given what I sensed (and heard) about this person’s penchant for bullying. Had I not taken the time to address how sexual violence had led to certain defensive behaviors and beliefs in me, I might have continued my early life habit of silencing my objections to perceived wrongs, since this submissive style of defense had protected me. But it’s no way to live, even if the consequence of standing up to injustice is more injustice. The price of dignity can be great, but the price of submitting to injustice is greater.
In large part, although often unconscious, the commitment to heal is a sustained effort at avoiding becoming a victim again. And the changes we make in our efforts to ensure future safety and integrity also lead to resisting abuses of power in all aspects of our lives.
Knowledge is a powerful way to defend against further subjugation. In One Hour In Paris, Freedman shared an extensive knowledge of PTSD, the history of the DSM, and the treatment of psychological trauma. Obviously, I share her desire to know everything I can about healing. Every textbook I have read on the treatment of trauma has been with double vision: one eye on how to maintain my own recovery, the other eye on how to help others with their’s. Having fallen victim once, some of us arm ourselves with knowledge to fail-safe our recovery, but also to ensure we never fall victim again.
One outcome of this unanticipated expertise is a nuanced understanding of the consequences of unrestrained power that includes knowing how to heal from subjugation and avoid further victimization. This is valuable wisdom, and a largely untapped resource. The wisdom of recovery can enlighten efforts at creating a society centered on safety, respect, and fairness.
Because of the insights gained through recovery, I believe the commitment to heal is a generous act, even though the process means focusing intently on oneself. Individual efforts to heal become the groundwork for equality and respect in relationships, families, communities, work environments, and societies. Healing society really does begin with healing its members.
Granted, as Freedman and Brison shared, even after an extended period of recovery, suffering still happens. No one ever completely gets over being a victim of a sexual predator. Still, with time and effort the reactions can be managed. In the process, the survivor often gains a stronger spirit, greater integrity, and better self-care that together foster a deep caring for others. As Brison also wrote:
“But if recovery means being able to incorporate this awful knowledge into my life and carry on, then, yes, I’m recovered. I don’t wake each day with a start, thinking: ‘this can’t have happened to me!” It happened. I have no guarantee that it won’t happen again, although my self-defense classes have given me the confidence to move about in the world and to go for longer and longer walks—with my two big dogs. Sometimes I even manage to enjoy myself. And I no longer cringe when I see a woman jogging alone on the country road where I live, though I may still have a slight urge to rush out and protect her, to tell her to come inside where she’ll be safe. But I catch myself, like a mother learning to let go, and cheer her on, thinking, may she always be so carefree, so at home in her world. She has every right to be.”
In what follows, I discuss some of the reactions, beliefs, and emotions that interfere with seeking help following sexual violence, and thus getting the process of recovery started. I have found for myself, and for others I have had the honor to support in recovery, that it is difficult to accept the extent of the damage caused by sexual violence. The tendency is to believe that if you can avoid thinking about the rape or abuse, its impact will fade away. Furthermore, shame, no matter how undeserved, keeps women from seeking help. Taking a trauma-informed perspective can help overcome these obstacles to beginning recovery.
Initial steps towards healing
After sexual violence, most women want to forget what happened, and return to the lives they led prior to the assault. The survivor desires to be the person she was before, and avoid perceiving herself as irrevocably damaged by the rape or sexual abuse. Confusion, humiliation, and hurt are common, and contribute to self-doubt and silence.
Consequently, women often choose a course of action that will protect them from the imagined judgment of others, including avoiding seeking help. And who can blame us? Throughout history, women have been held responsible for the sexual violence perpetrated against them. Remaining silent just may be an archetypal defense response to the anticipated judgment and shaming that across the millennia have been the common response to sexually violated women (along with forced prostitution, stoning to death, and abandonment).
Freedman’s literal cry for help led to the police’s immediate involvement, and eventually the successful prosecution and imprisonment of the man who raped her. (Brison’s rapist was also prosecuted and imprisoned.) Freedman’s family was supportive and protective of her following the rape. However, like many women, Freedman initially shied from telling many about the rape, and instead told people she had been mugged. She also sought only limited professional support following her rape:
“outside of a couple of sessions with a psychologist when I first returned home from Paris (attended at the behest of my parents), I had made no serious effort to come to terms with the experience. I believed — wrongly, as it turns out — that the best way to deal with the trauma of that night was to distance myself from it.”
No one can anticipate the impact sexual violence is going to have, although anticipation isn’t usually needed, since reactions to sexual violence appear rather quickly. In his book, The Trauma Model, psychiatrist Colin Ross gave the following composite description of typical reactions to rape:
“She has nightmares of being chased and murdered, which she never had before. She has repeated intrusive recollections of the rape, sometimes including details she could not previously recall. She is tense, keyed up, anxious and fearful much of the time. She scans the environment for detail and has an extreme startle response to stimuli that previously would not have affected her….
“Because of the nightmares, she loses a lot of sleep. As well, she avoids the nightmares by staying up late. The resulting fatigue begins to affect her concentration and performance at work. She will not let her boyfriend, with whom she previously had frequent, mutually satisfying sexual relations, touch her. When he tries to touch her, she experiences fearful hyperarousal and has to take a shower. She takes at least three showers a day in order to get rid of the dirt on her body and she can still feel the rapist’s semen on her. She develops other psychosomatic symptoms including vaginal pain, painful periods, muscle and joint pains, and diarrhea and nausea.
“… exhausted from lack of sleep, and overwhelmed with traumatic anxiety, she begins to drink in the evenings and uses alcohol to go to sleep. She becomes tired, drained of energy, overwhelmed and despondent. She has many negative cognitions about herself, men and life in general.”
When these reactions are ignored, over time they become the ‘new norm’ as the person she was before the rape, and the woman’s prior way of being in her body and the world, begin to recede.
Freedman suffered many of the reactions Ross described. Finding herself living alone six years after the rape — a relationship ended due to problems with intimacy she believed the rape caused — Freedman’s reactions were exacerbated and became unavoidable:
“I had minor convulsions at the slightest unexpected noise, anything from the ringing of a telephone to the slamming shut of a book. My ability to fall and stay asleep, which had been a struggle since the rape, became seriously compromised. I would lie in bed for hours listening to the pounding of my own heart and trying to close off my mind to the unwanted images that flew threw it. These intrusive thoughts are a form of traumatic flashback, although since I wasn’t actually thinking (or writing or talking) about the rape at that time in my life, these images weren’t usually about me or Robert [the rapist] or the knife grazing lines on my breasts. Instead, the intrusive thoughts were centered on my friends and family, and every possible variation that my mind could configure on each one’s violent and imminent demise. In quick, successive flashes, I would imagine one sister or the other trampled by the crush of an uncontrollable mob, or my grandmother’s head ripped off by a bus whizzing past her, or a friend flattened to death by a crashing plane. At the time, alcohol was the only thing that gave me some temporary relief from these tormenting thoughts….”
At one point, almost eight years after the rape, Freedman visited a psychiatrist who put her on clonazepam, a medication used to treat insomnia and panic attacks. Freedman never disclosed to her psychiatrist that she had been raped. It also seems her psychiatrist never asked if she had a history of trauma:
“By the spring of 1998 I had finally had enough. I decided that I needed to get some help. I went to see a psychiatrist, which is how I first ended up on clonazepam. Remarkably, I saw this doctor once a month for about a year, and not once in that time did I mention to her that I had been raped or almost killed. At the time I wasn’t even aware of this omission (I realized it only after I went back to see her following a long hiatus). It wasn’t that I had entirely blocked out any memory of the rape, but by this point I had assumed that it was long behind me, and I simply did not connect my wretched inner life with the aftermath of that traumatic experience. The event of August 1, 1990, had fallen off my radar even though I was living it out every day.”
Because many women avoid support, or get the wrong kind of support, or lack appropriate support and services, it’s vital they are told how sexual violence impacts the body and mind. This information is best received as close as possible to the time of the rape or sexual abuse. Knowing what to expect can decrease self-judgment, especially the belief that I should be over this already, which commonly creeps in, along with thoughts of self-blame. Such beliefs contribute to a self-persecuting spiral that increases the likelihood of substance abuse/dependency, along with debilitating low self-worth. Furthermore, substance abuse and low self-worth increase the likelihood of sexual revictimization.
Awareness of common reactions to a traumatic event can also help create a healthy distance from body sensations, thoughts, and feelings triggered by reminders of the trauma, including overwhelming fear that is much like the fear felt during the assault. Knowing these reactions can help disentangle disorienting and often frightening traumatic reminders from the ‘going on with ordinary life’ part of the self — that ‘old’ self who existed before the rape and who the survivor initially desires to become again — or for those sexually abused when young, who they hope to one day become.
Knowledge of natural reactions to traumatic situations is a resource that helps dampen their impact. Like it or not, sexual violence splits a person’s psyche such that when triggered by reminders of the assault, defense reactions are activated and override efforts to get on with ordinary life — including sleeping, working, meeting goals, playing, enjoying intimacy, and the like. This splitting between defense reactions and ‘ordinary life’ is a natural response to threat and overwhelming fear.
Trauma memories are not like regular memories, and the body and mind react to them differently. When sexual assault happens, the body (including the brain) instinctively organizes for survival, and triggers defense responses, such as fight, flight, freeze, submit, or a cry for help. This instinctual drive for survival overrides critically thinking about what is happening, in part because thinking about a threat while it’s happening can slow down survival responses. Instead, energy is diverted away from the frontal lobes — the area of the brain responsible for higher order cognitive processes, which includes creating coherent narratives of events. Without the frontal lobes fully functioning, there is no way to integrate overwhelming sensory information into a coherent, meaningful account of the trauma. Instead, emotional reactions are split-off from sensory memories, muscle memories, perceptions, and thoughts also registered at the time of the traumatic event. Thus, survival comes at a price: fragmented memories in search of integration haunt trauma survivors long after danger has passed.
Traumatic reminders feel intrusive, whether these reminders are images, emotions, or body sensations. This is the startle response Freedman wrote about, and the panic attacks too. Yet there is also that other part of the self — the one that has relationships, holds a job, sets goals — but the capacity to express this part of the self is continuously overwhelmed by reminders of the attack or abuse. Healing is about regaining the ability to live from that ‘ordinary life’ part of the self — or for the survivor of child sexual abuse, establishing a sense of ‘ordinary life’ that feels safe and life-affirming — without overwhelming defense responses getting activated at inopportune times.
All of us continuously and unconsciously scan for the presence of danger, a process neuroscientist Stephen Porges called neuroception. However, following sexual violence, this natural unconscious process starts to hypervigilantly register potential signs of threat, often to the point of being overwhelmed, going numb, or dissociating. Having experienced the worst, the unconscious mind becomes primed to expect the worst.
The triggered defense responses, such as the desire to fight or flee that weren’t possible at the time of the assault, are once again truncated by overwhelming fear. Thus, the survivor’s own body and mind begin to feel like they are trapped in inescapable horror, regardless that the threat has long passed. Consequently, despite best intentions and well-laid plans, getting on with ordinary life is exceedingly difficult following rape or any form of sexual violence. We aren’t physiologically built to experience something as threatening and overwhelming as rape and sexual abuse and then get on with life as if nothing happened.
Getting back to ‘ordinary life’ begins with being aware of limiting beliefs, overwhelming emotions, and disruptive sensations as defense reactions, and then creating conditions that increase feelings of body safety, emotional safety, and safety in the environment. Some possible reactions to sexual violence include:
- Physical aches and pains
- Suicidal thoughts and feelings
- A heightened startle response
- Irritability, easily angered
- Fear of intimacy
- Feelings of mistrust and betrayal
- Sexual promiscuity or risk-taking behavior
- Feeling numb, shut down, dissociating
- Feelings of low self-worth
- An inability to feel safe alone
- Catastrophic and morbid thinking
- Foreshortened sense of the future
- Self-medicating (e.g, alcohol or other substances) to get to sleep or to control anxiety
- Overwhelming fear and panic attacks
- Feeling alienated from other people or foreign to them
- Living split — a self presented to the world that hides the part of self that feels vulnerable and ashamed
- Self-silencing around the sexual violence because of feelings of shame
Some of these reactions may seem to contradict each other. Contradiction is the nature of Posttraumatic Stress Disorder, which alternatively involves
avoidance of reminders of the traumatic event and preoccupation with them. Reminders may be either real or symbolic, such as Freedman imagining the catastrophic death of family members. The body reacts to both in the same way — as potential threats.
All of these reactions are the body’s and psyche’s natural efforts at self-preservation and protection from further threats. They are signs of suffering and signs of the need for support. They are not symptoms of a disease or evidence of weak character.
When survivors know the body’s natural reactions to traumatic events, they may be less likely to think there is something wrong with them, and more likely to see such changes as having to do with what happened to them. Unfortunately, however, it is highly probably that all survivors of sexual violence will experience at least some of these reactions.
(Visit this blog post for ways to increase a felt sense of safety.)
The power of shame
The hardest part about healing from sexual violence may be overcoming the shame that keeps women and girls silent in their suffering. Shame increases the likelihood that traumatic stress reactions will go unaddressed and instead become the ‘new norm,’ as ‘ordinary life’ becomes increasingly difficult.
For those of us sexually abused as children, silence is typically how we tried to stay safe — or we were led to believe silence would keep us safe. Shame is also a natural reaction to submitting to sexual violence, which initiates a spiral into low self-worth and blaming one’s own body for failing to protect from the abuse or for failing to hide the reactions to abuse (when of course the blame belonged to another). For those of us sexually abused when young, the splitting of self between defense responses and efforts to get on with ordinary life can become complex and entrenched if the abuse was chronic. And unfortunately, after a history of childhood sexual abuse, it typically takes many years to learn how to live peacefully and safely within one’s mind, body, and relationships and without shame.
Adult survivors of sexual violence are also at risk of becoming entrenched in traumatic defense responses that are exacerbated by feelings of shame. Even when a woman knows she is not to blame — and many doubt themselves — she can feel profoundly humiliated by sexual violence.
Most women, if not all, are aware of societal perceptions of women as irrevocably damaged by sexual violence. Even worse, in some Muslim countries such as Pakistan, Somalia, and Afghanistan, the failure to “resist rape” can lead to a woman’s death. In countries where men are prosecuted for rape, there are still age-old distinctions between the madonna and the whore that were initiated by patriarchal religions thousands of year ago, but continue to influence our collective unconscious and how women are perceived and judged. Women who are raped and sexually abused are regularly judged as at least partially at fault for their victimization. No wonder so many of us stay silent about sexual violence.
In her memoir, Freedman writes the following about how societal attitudes keep women in shame and silence:
“Whether to go public with her story is one of the toughest decisions a rape survivor ever faces…the vulnerability, the shame, the embarrassment, and the inescapable feeling that she should have been able to prevent herself from being attacked, and then some—all reinforced by the myth that, so long as you are careful, the world is a safe place. Rape intersects with multiple taboos—sex, violence, and trauma—and its savage intrusion on our sexuality crosses the boundary into that which is most personal and private. For all these reasons, it is simply not socially acceptable for a woman to speak out about her experience as a rape survivor. This taboo is more deeply ingrained in cultural norms in certain parts of the world, like south-central and eastern Asia, Africa, and the Middle East, where the survivor’s shame extends to her entire family, often permanently, and where the consequences for women who publicly identify as rape survivors can be disastrous, even fatal.”
The taboos that silence survivors of sexual violence also interfere with recovery. Although silence may feel as if it protects from further harm or judgment, it erodes the mind, body, and spirit. When the survivor remains silent, the self hidden deep within may eventually become unidentifiable — or unreachable — even by herself.
To know ourselves, and fully recover, we must story our lives, and share our stories with others. Especially when there has been sexual violence, we must pull together the unintegrated bits of memory, and make ourselves and our stories whole again. However, storying trauma doesn’t require retelling every bit of the rape or sexual abuse, or even remembering everything that happened. The need to know everything beyond a fraction of doubt is the mindset of the courtroom, not the healing attitude of recovery. Rather, in recovery, we need the experience of what psychiatrist Daniel Siegel called “feeling felt” by another, sharing what we feel and having our feelings validated. Without this experience of “feeling felt,” we further fall victim to our sense of selves as shameful.
But the taboo surrounding sexual violence is real, and telling others about sexual violence can be compromising, even dangerous for some women. Fortunately, there are anonymous resources such as RAINN, the Rape, Abuse & Incest National Network, and Pandora’s Project. Eventually, though, most women need professional support and the company of other survivors.
Like Freedman, I started my recovery work with a therapist, then took part in a group dedicated to survivors, and finally began helping others with their recoveries. In areas in the West where therapists and mental health services are accessible, this approach to treatment is common and I believe a good one. There are also specific modalities, such as EMDR and Sensorimotor Psychotherapy, that are exceptional at treating traumatic reactions to sexual violence. The eventual goal of therapy is mindful awareness of how defense responses get triggered and learning how not to be overwhelmed by them. Recovery also involves ceasing to be afraid of one’s memories of what happened.
Treatment is most successful when joined with personal efforts at creating safety and peace in daily life. For me, this has included yoga, Buddhism, art classes, self-defense classes, journaling, exercising regularly, and deep connections with people I love and trust (especially my husband). Of course, everyone has unique ways of creating safety and peace, yet all need to make them priorities in their lives.
Recovery also involves feeling part of society without the fear of further violence, or fear of retribution for protecting oneself. Survivors share this aspect of recovery perhaps with all women. None of us really feel safe when rape and sexual abuse occur with regularity and impunity as they do today. Can any women feel safe when nearly 20 percent of women in the US are raped in their lifetimes and 1 in 5 girls in the US are sexual abused before the age of eighteen? In many countries these percentages are much higher.
Sometimes I go weeks without my fear being triggered, which I feel is quite an accomplishment since I live in a densely populated city. I tend to enjoy these periods like an extended vacation. I know eventually I will read or hear that a woman’s been assaulted somewhere near where I live, or I will personally be sexually harassed. The old fear will be rekindled, although it is muted these days. Still, I am holding out for the possibility of full recovery, and I am waiting on society for the safe environment I need and deserve to get there.