Post-Traumatic Stress Disorder (PTSD)
Symptoms, treatment, and self-help for PTSD
Recovering from sexual assault takes time, and the healing process can be painful. But you can regain your sense of control, rebuild your self-worth, and learn to heal.
Sexual violence is shockingly common in our society. According to the Centers for Disease Control and Prevention (CDC), nearly 1 in 5 women in the U.S. are raped or sexually assaulted at some point in their lives, often by someone they know and trust. In some Asian, African, and Middle Eastern countries, that figure is even higher. And sexual assault isn't limited to women; many men, boys, and transgender people suffer rape and sexual trauma each year.
Regardless of age, gender, or orientation, the impact of sexual violence goes far beyond any physical injuries. The trauma of being raped or sexually assaulted can be shattering, leaving you feeling scared, ashamed, and alone or plagued by nightmares, flashbacks, and other unpleasant memories. The world doesn’t feel like a safe place anymore. You no longer trust others. You don’t even trust yourself. You may question your judgment, your self-worth, and even your sanity. You may blame yourself for what happened or believe that you’re “dirty” or “damaged goods.” Relationships feel dangerous, intimacy impossible. And on top of that, like many rape survivors, you may struggle with PTSD, anxiety, and depression.
It’s important to remember that what you’re experiencing is a normal reaction to trauma. Your feelings of helplessness, shame, defectiveness, and self-blame are symptoms, not reality. No matter how difficult it may seem, with these tips and techniques, you can come to terms with what happened, regain your sense of safety and trust, and learn to heal and move on with your life.
Dispelling the toxic, victim-blaming myths about sexual violence can help you start the healing process.
Myths and facts about rape and sexual assault |
Myth: You can spot a rapist by the way they look or act.
Fact: There's no surefire way to identify a rapist. Many appear completely normal, friendly, charming, and non-threatening. |
Myth: If you didn't fight back, you must not have thought it was that bad.
Fact: During a sexual assault, it's extremely common to freeze. Your brain and body shuts down in shock, making it difficult to move, speak, or think. |
Myth: People who are raped “ask for it” by the way they dress or act.
Fact: Rape is a crime of opportunity. Studies show that rapists choose victims based on their vulnerability, not on how sexy they appear or how flirtatious they are. |
Myth: Date rape is often a misunderstanding.
Fact: Date rapists often defend themselves by claiming the assault was a drunken mistake or miscommunication. But research shows that the vast majority of date rapists are repeat offenders. These people target those who are vulnerable and often ply them with alcohol in order to rape them. |
Myth: It's not rape if you've had sex with the person before.
Fact: Just because you've previously consented to sex with someone doesn't give them perpetual rights to your body. If your spouse, partner, or lover forces sex against your will, it's rape. |
It can be extraordinarily difficult to admit that you were raped or sexually assaulted. There's a stigma attached. It can make you feel dirty and weak. You may also be afraid of how others will react. Will they judge you? Look at you differently? It seems easier to downplay what happened or keep it a secret. But when you stay silent, you deny yourself help and reinforce your victimhood.
Reach out to someone you trust. It's common to think that if you don't talk about your rape, it didn't really happen. But you can't heal when you're avoiding the truth. And hiding only adds to feelings of shame. As scary as it is to open up, it will set you free. However, it's important to be selective about who you tell, especially at first. Your best bet is someone who will be supportive, empathetic, and calm. If you don't have someone you trust, talk to a therapist or call a rape crisis hotline.
Challenge your sense of helplessness and isolation. Trauma leaves you feeling powerless and vulnerable. It's important to remind yourself that you have strengths and coping skills that can get you through tough times. One of the best ways to reclaim your sense of power is by helping others: volunteer your time, give blood, reach out to a friend in need, or donate to your favorite charity.
Consider joining a support group for other rape or sexual abuse survivors. Support groups can help you feel less isolated and alone. They also provide invaluable information on how to cope with symptoms and work towards recovery. If you can't find a support group in your area, look for an online group.
If you’re in a domestic partnership with the person who raped or sexually assaulted you, making the decision to leave is rarely straightforward. You may feel conflicted, uncertain, and confused, or still hold out hope that your partner will change.
But whether or not you're ready to leave your abuser, there are important steps you can take to protect yourself.
Even if you intellectually understand that you're not to blame for the rape or sexual attack, you may still struggle with a sense of guilt or shame. These feelings can surface immediately following the assault or arise years after the attack. But as you acknowledge the truth of what happened, it will be easier to fully accept that you are not responsible. You did not bring the assault on yourself and you have nothing to be ashamed about.
Feelings of guilt and shame often stem from misconceptions such as:
You didn't stop the assault from happening. After the fact, it's easy to second guess what you did or didn't do. But when you're in the midst of an assault, your brain and body are in shock. You can't think clearly. Many people say they feel “frozen.” Don't judge yourself for this natural reaction to trauma. You did the best you could under extreme circumstances. If you could have stopped the assault, you would have.
You trusted someone you “shouldn't” have. One of the most difficult things to deal with following an assault by someone you know is the violation of trust. It's natural to start questioning yourself and wondering if you missed warning signs. Just remember that your attacker is the only one to blame. Don't beat yourself up for assuming that your attacker was a decent human being. Your attacker is the one who should feel guilty and ashamed, not you.
You were drunk or not cautious enough. Regardless of the circumstances, the only one who is responsible for the assault is the perpetrator. You did not ask for it or deserve what happened to you. Assign responsibility where it belongs: on the rapist.
When you go through something stressful, your body temporarily goes into “fight-or-flight” mode. When the threat has passed, your body calms down. But traumatic experiences such as rape can cause your nervous system to become stuck in a state of high alert. You're hypersensitive to the smallest of stimuli. This is the case for many rape survivors.
Flashbacks, nightmares, and intrusive memories are extremely common, especially in the first few months following the assault. If your nervous system remains “stuck” in the long-term and you develop post-traumatic stress disorder (PTSD), they can last much longer.
To reduce the stress of flashbacks and upsetting memories:
Try to anticipate and prepare for triggers. Common triggers include anniversary dates; people or places associated with the rape; and certain sights, sounds, or smells. If you are aware of what triggers may cause an upsetting reaction, you'll be in a better position to understand what's happening and take steps to calm down.
Pay attention to your body's danger signals. Your body and emotions give you clues when you're starting to feel stressed and unsafe. These clues include feeling tense, holding your breath, racing thoughts, shortness of breath, hot flashes, dizziness, and nausea.
Take immediate steps to self-soothe. When you notice any of the above symptoms, it's important to quickly act to calm yourself down before they spiral out of control. One of the quickest and most effective ways to calm anxiety and panic is to slow down your breathing.
It's not always possible to prevent flashbacks. But if you find yourself losing touch with the present and feeling like the sexual assault is happening all over again, there are actions you can take.
Accept and reassure yourself that this is a flashback, not reality. The traumatic event is over and you survived. Here's a simple script that can help: “I am feeling [panicked, frightened, overwhelmed, etc.] because I am remembering the rape/sexual assault, but as I look around I can see that the assault isn't happening right now and I'm not actually in danger.”
Ground yourself in the present. Grounding techniques can help you direct your attention away from the flashback and back to your present environment. For example, try tapping or touching your arms or describing your actual environment and what you see when you look around—name the place where you are, the current date, and three things you see when you look around.
Since your nervous system is in a hypersensitive state following a rape or assault, you may start trying to numb yourself or avoid any associations with the trauma. But you can't selectively numb your feelings. When you shut down the unpleasant sensations, you also shut down your self-awareness and capacity for joy. You end up disconnected both emotionally and physically—existing, but not fully living.
Signs that you're avoiding and numbing in unhelpful ways:
Feeling physically shut down. You don't feel bodily sensations like you used to (you might even have trouble differentiating between pleasure and pain).
Feeling separate from your body or surroundings (you may feel like you're watching yourself or the situation you're in, rather than participating in it).
Having trouble concentrating and remembering things.
Using stimulants, risky activities, or physical pain to feel alive and counteract the empty feeling inside of you.
Compulsively using drugs or alcohol.
Escaping through fantasies, daydreams, or excessive TV, video games, etc.
Feeling detached from the world, the people in your life, and the activities you used to enjoy.
It's frightening to get back in touch with your body and feelings following a sexual trauma. In many ways, rape makes your body the enemy, something that's been violated and contaminated—something you may hate or want to ignore. It's also scary to face the intense feelings associated with the assault. But while the process of reconnecting may feel threatening, it's not actually dangerous. Feelings, while powerful, are not reality. They won't hurt you or drive you insane. The true danger to your physical and mental health comes from avoiding them.
Once you're back in touch with your body and feelings, you will feel more safe, confident, and powerful. You can achieve this through the following techniques:
Rhythmic movement. Rhythm can be very healing. It helps us relax and regain a sense of control over our bodies. Anything that combines rhythm and movement will work: dancing, drumming, marching. You can even incorporate it into your walking or running routine by concentrating on the back and forth movements of your arms and legs.
Mindfulness meditation. You can practice mindfulness meditation anywhere, even while you are walking or eating. Simply focus on what you're feeling in the present movement—including any bodily sensations and emotions. The goal is to observe without judgement.
Yoga, Tai Chi, and Qigong. These activities combine body awareness with relaxing, focused movement and can help relieve symptoms of PTSD and trauma.
Massage. After rape, you may feel uncomfortable with human touch. But touching and being touched is an important way we give and receive affection and comfort. You can begin to reopen yourself to human contact through massage therapy.
HelpGuide's free Emotional Intelligence Toolkit can help you recover after rape by reconnecting you to uncomfortable or frightening emotions without becoming overwhelmed. You can use the toolkit in conjunction with therapy, or on its own. Over time, it can make a huge difference in your ability to manage stress, balance your moods and emotions, and take back control of your life.
It's common to feel isolated and disconnected from others following a sexual assault. You may feel tempted to withdraw from social activities and your loved ones. But it's important to stay connected to life and the people who care about you. Support from other people is vital to your recovery. But remember that support doesn't mean that you always have to talk about or dwell on what happened. Having fun and laughing with people who care about you can be equally healing.
Participate in social activities, even if you don't feel like it. Do “normal” things with other people, things that have nothing to do with the sexual trauma.
Reconnect with old friends. If you've retreated from relationships that were once important to you, make the effort to reconnect.
Make new friends. If you live alone or far from family and friends, try to reach out and make new friends. Take a class or join a club to meet people with similar interests, connect to an alumni association, or reach out to neighbors or work colleagues.
Healing from sexual trauma is a gradual, ongoing process. It doesn't happen overnight, nor do the memories of the trauma ever disappear completely. This can make life seem difficult at times. But there are many steps you can take to cope with the residual symptoms and reduce your anxiety and fear.
Take time to rest and restore your body's balance. That means taking a break when you're tired and avoiding the temptation to lose yourself by throwing yourself into activities. Avoid doing anything compulsively, including working. If you're having trouble relaxing and letting down your guard, you may benefit from relaxation techniques such as meditation and yoga.
Be smart about media consumption. Avoid watching any program that could trigger bad memories or flashbacks. This includes obvious things such as news reports about sexual violence and sexually explicit TV shows and movies. But you may also want to temporarily avoid anything that's over-stimulating, including social media.
Take care of yourself physically. It's always important to eat right, exercise regularly, and get plenty of sleep—but even more so when you're healing from trauma. Exercise in particular can soothe your traumatized nervous system, relieve stress, and help you feel more powerful and in control of your body.
Avoid alcohol and drugs. Avoid the temptation to self-medicate with alcohol or drugs. Substance use worsens many symptoms of trauma, including emotional numbing, social isolation, anger, and depression. It also interferes with treatment and can contribute to problems at home and in your relationships.
When a spouse, partner, sibling, or other loved one has been raped or sexually assaulted, it can generate painful emotions and take a heavy toll on your relationship. You may feel angry and frustrated, be desperate for your relationship to return to how it was before the assault, or even want to retaliate against your loved one’s attacker. But it’s your patience, understanding, and support that your loved one needs now, not more displays of aggression or violence.
Let your loved one know that you still love them and reassure them that the assault was not their fault. Nothing they did or didn’t do could make them culpable in any way.
Allow your loved one to open up at their own pace. Some victims of sexual assault find it very difficult to talk about what happened, others may need to talk about the assault over and over again. This can make you feel alternately frustrated or uncomfortable. But don’t try to force your loved one to open up or urge them to stop rehashing the past. Instead, let them know that you’re there to listen whenever they want to talk. If hearing about your loved one’s assault brings you discomfort, talking to another person can help put things in perspective.
Encourage your loved one to seek help, but don’t pressurize. Following the trauma of a rape or sexual assault, many people feel totally disempowered. You can help your loved one to regain a sense of control by not pushing or cajoling. Encourage them to reach out for help, but let them make the final decision. Take cues from your loved one as to how you can best provide support.
Show empathy and caution about physical intimacy. It’s common for someone who’s been sexually assaulted to shy away from physical touch, but at the same time it’s important they don’t feel those closest to them are emotionally withdrawing or that they’ve somehow been “tarnished” by the attack. As well as expressing affection verbally, seek permission to hold or touch your loved one. In the case of a spouse or sexual partner, understand that your loved one will likely need time to regain a sense of control over their life and body before desiring sexual intimacy.
Take care of yourself. The more calm, relaxed, and focused you are, the better you’ll be able to help your loved one. Manage your own stress and reach out to others for support.
Be patient. Healing from the trauma of rape or sexual assault takes time. Flashbacks, nightmares, debilitating fear, and other symptom of PTSD can persist long after any physical injuries have healed. To learn more, read Helping Someone with PTSD.
National Sexual Assault Hotline – A confidential, free 24/7 hotline for one-on-one crisis support. Call 1-800-656-HOPE or chat online. (RAINN)
Find Your Nearest Rape Crisis Services – In England and Wales, call the rape crisis helpline at 0808-802-9999 or find your nearest facility (Rape Crisis)
Services and Support – Call the national helpline at 1800-737-732 or find services near you. (1800RESPECT)
Canadian Assault Centres and Services – Find a hotline or crisis centre near you. (Chatelaine)
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