Surviving the Emotional Effects of Sexual Trauma

by Carrie Collins-Fadell

Every year in the United States, an estimated 470,000 women are sexually assaulted. Sadly, that number is rising and likely even higher as assaults often go unreported and uncounted. While we regularly analyze the statistics, we as a community need to add to the conversation by exploring ways to support the brain health and well-being of survivors.

Carrie Collins-Fadell, a member of the Editorial Board for Brain Health Magazine, discusses options for providing support to sexual assault survivors with two esteemed professionals. Following is her exclusive roundtable with Julie Rake, MSPAS-PAC, an integrative health professional and sexual assault survivor, and Anne Adkinson, the Women’s Brain Health Navigator for Veterans and Military Families.

Carrie: People can be confused how sexual assault  impacts the brain. How does that happen?

Julie:  Being a victim of sexual assault is overwhelmingly traumatic. One way the brain is affected is the limbic center of the brain, our “fire station” that gets the call during threats, becomes hyper-aroused or “hyperactive.” This hyperactivity causes the release of a variety of stress hormones that flood the body and brain.

Another part of the brain, the Amygdala, becomes “hijacked.” As this center of the brain gets lopped into hyperreactivity mode, a person stays “stuck” in fight or flight and experiences a great deal of negative outcomes. Mental and emotional effects of this hyperreactivity include chronic fear, anxiety, depression, irritability, flashbacks, anger, and the tendency to develop negative feelings about the world and ourselves.

Anne: So much negative stigma surrounds sexual assault, as well as post-traumatic stress, depression, anxiety, and all the other NORMAL reactions to such a violation.  Victims cycle through a wide range of emotions and often feel like no one understands.  Friends and family might not know anything happened or expect the victim to work through their trauma quickly and go back to who they were before the assault.  This can lead to further frustration, isolation, guilt, and shame.  Learning why sexual assault victims respond a certain way, and that these normal responses provide a good support system are keys to helping them take their lives back from the trauma.

Julie: When we are in a chronic state of fight or flight, the body shuts down the higher executive brain centers allowing us to make good decisions, plan, and prioritize. When in this state, our bodies and brain should only be prepared to fight or flee from the threat, not operate from the higher intellectual center. The brain changes occurring after experiencing a sexual assault are the root cause of post-traumatic stress disorder.  PTSD is indeed a significant and challenging brain disorder.

Carrie:  We sometimes hear from clients who feel guilty because they have not disclosed to others that they have been assaulted.  Resiliency and advocacy can mean a variety of things and can morph and change over time.

Julie:  Every survivor will walk a different journey, and that’s okay.  While on the way to school as a teenager, I was assaulted by a stranger. It’s something I did not share regularly with my colleagues in medical school. As a practitioner, when I speak openly about it, it gives my colleagues a richer and diverse understanding that many of their clients who are professional women and doing just fine, could also be a sexual assault survivor.  For those whose lives have not been touched by this deeply personal violence, it changes the script on who they see as a “survivor”. I find when I share my experience with other survivors, it empowers them to take charge of their own narrative.

Anne:  I work with female veterans, some of whom survived a sexual assault while serving our country in the military.  Some are not comfortable revealing they were assaulted for a myriad of reasons, including a fear of retribution from the chain of command and embarrassment that it happened to them.  Some must work with or take orders from the person who assaulted them.

I always want my clients to know however you handled it at the time, you did the best you could. Also, advocacy takes many forms.  Sometimes the best thing you can do is be a self-advocate and just take care of yourself.

Carrie:  What role can loved ones play in the recovery of a survivor of assault?

Julie:  It is human nature to want to be loved and understood by those who mean the most to us. Loved ones can always support survivors by encouraging them to be healthy and take care of themselves; it reminds us we matter.  My brother gifted me a book on meditation when I was going through a hard time, and it changed my life.

Anne: Fear of losing the love and support of those closest to them is one reason a survivor could potentially stay silent and not disclose to others or even report their attack.  If you don’t know what to say if someone confides in you that they survived an assault, simply tell them you are so glad they felt they could share that with you. Also, reaffirm that they are brave and it’s not their fault. Then, just be there for them without judgment. It’s really that simple.

Carrie:  There can be a lot of anger and grief after surviving an attack.

Anne:  Anger, which usually comes before grief, can give us a false sense of power and security.  People can easily get stuck in the anger phase and not even get to grief and mourning.  Anger can be used as a protection or to drive people away.  We can feel a need to stay angry because what happened to us was so terrible.  Ultimately, the anger can lead to isolation from those we need around us the most as we move forward.

Julie: Absolutely. You must be kind to yourself, no matter what your pace or process for understanding what happened, and developing your unique plan to get yourself through it.  A range of emotions comes after an attack, including shame, blame, grief, and fear.   Survivors can be angry that this happened and even angry at themselves for “letting” it happen, even though the survivor is NEVER to blame.  There can be a loss of sense of security and the anger can manifest in some self-destructive behaviors, such as misusing substances or being hypervigilant.

Carrie: Many survivors talk about alternating between being fatigued and feeling the need to stay vigilant. How do you explain that?

Anne: This is really where we see survivor fatigue set in.  Your brain really can’t be on high alert all the time without serious consequences for both your brain and the rest of your body.  Even things you may think aren’t connected, like your immune system, will suffer. If you experience symptoms like chronic fatigue, muscle tension, changes in sleep, or involuntary shaking, please reach out and talk to a medical professional equipped to help you work through this trauma

Julie: I can understand the heightened fear after surviving an attack. After I was attacked on my way to school, I felt the need to always be on guard and ready to defend myself.  Ultimately, it led me on a journey to understand more about our brain and how we can get stuck in fight or flight mode.

Carrie: Thanks for sharing all your important insights. Is there anything else you would like all of the amazingly brave and strong survivors to know?

Anne: No matter the circumstances, what happened to you is NOT your fault and you are not alone!  Unfortunately, what you are going through has happened to many others and while it’s normal to feel the way you do, you aren’t stuck there.  I encourage you to reach out and find your tribe, whether that’s with fellow survivors, an organization, or a supportive friend.  Shame can only control us when we let it lead us into the shadows.  When we shine light on our shame, it can’t hold us hostage anymore.

Julie: Yes, indeed. I would like survivors to know they were made to heal. Your body is an amazing, intelligent, organizing system, and your brain is capable of tremendous growth and recuperation. Don’t give up! Stay strong and be courageous. Face the issues confronting you with an experienced therapist and healthcare team.

Millions of individuals have navigated this path, experienced healing, and flourished.  The most difficult experiences in my life propelled me to rebuild myself anew… piece-by-piece. My experience proves that living a life of joy, passion, and purpose is possible after an assault. Good health and healing are possible. Never give up!