Sexual abuse is distressingly common, and it can leave emotional scars that feel like they’ll never heal. For some, it complicates their lives even decades later as they struggle with their emotions, relationships and mental health.
These problems may seem insurmountable. But Shweta Kapoor, M.D., Ph.D., a Mayo Clinic psychiatrist with expertise in complex trauma, has walked alongside many people as they deal with sexual trauma. And she knows there’s hope.
“You can live a very successful life,” she says. “You can heal.”
Healing sexual trauma
Talk therapy can be incredibly helpful for those who have experienced sexual trauma, Dr. Kapoor says. It can help people make sense of their histories and current symptoms.
“Often, people reach out saying, ‘I feel depressed, sometimes I feel really angry and sometimes I am completely numb. Am I going crazy? ‘” Dr. Kapoor says. “And there can be a lot of shame inherent in this. You can internalize it like, ‘What is wrong with me? Why am I thinking this way? When will I get over it?’ “
But these people aren’t going crazy — and there are reasons for their feelings. These are trauma reactions. Dr. Kapoor considers one of the biggest parts of her job to be explaining how trauma works and how it can affect people. Psychoeducation can provide validation and normalization of trauma responses, she says.
“Just the awareness of, ‘Okay, I’m not crazy. This is a trauma reaction,’ can be very powerful,” she says.
Medications
Diving into your past can be exhausting, difficult and depressing. Medications — such as antidepressants to help anxiety or depression, or mood stabilizers for those who have trouble regulating their emotions — can help lay the groundwork for therapy or work alongside therapy, Dr. Kapoor says.
Dialectical Behavioral Therapy (DBT)
Dialectical Behavioral Therapy (DBT) is a form of cognitive behavioral therapy. DBT works on emotional regulation and helps people learn to tolerate distress while practicing acceptance. It also helps people learn to engage in healthier relationships and practice mindfulness. It was initially studied in borderline personality disorder and those with repeated thoughts about suicide but has had more recent mental health applications as well.
Trauma-focused therapies
In many trauma therapies, a person recounts and reconstructs the negative events in their lives. In the case of abuse, this helps them make sense of how the abuse has affected their lives. It also can help them develop coping skills and significantly reduce trauma symptoms.
“The therapist has to be very skilled to know when a patient is ready, because this is a very intense treatment,” Dr. Kapoor says. “The aim is ultimately that they better understand their reactions to trauma and their own life story.”
Plenty of healing for sexual trauma and abuse
Sometimes victims of sexual trauma or abuse are told to “let go” of their past or “get over it.”
“I don’t think this is helpful and, in fact, can be countertherapeutic,” Dr. Kapoor says. “It’s your life story.”
“Having lived with abuse for a prolonged period of time, it may seem like your lived trauma experience is woven into your emotional DNA. But with the help of treatment, your relationship with your life story evolves and changes. You can reach a place of belonging, self-love, self-compassion and growth.”
Knowledge about the aftermath of trauma and effective interventions for trauma have grown exponentially, she says, and there’s a lot of help available.
But it’s good to recognize that even if you feel like you’ve dealt with your trauma and have moved on, it may crop up with certain life stressors.
“I always tell my patients that there is no definitive cure for it. But how you process the trauma can be helped by learning coping skills and understanding your story,” she says. “So, when something traumatic happens again, there may be an uptick in trauma reactions, but you’re more ready. It’s a marathon. It’s not a sprint. But it gets easier.”
Dating a survivor of sexual abuse: What to know
If you’re a partner to someone who is struggling with the consequences of prior sexual assault or abuse, you may feel powerless. But there’s a lot you can do to help. Dr. Kapoor suggests trying to:
- Educate yourself. Learning about trauma reactions generally — and your partner’s triggers specifically — can be massively helpful.
- Believe your partner. If a partner tells you they were abused, believe them. If you know the abuser, don’t say, “I just can’t believe he would do something like that.” Or “Are you sure you really remember correctly?” Validate their feelings and experiences.
- Watch your reaction. It’s natural to feel very angry at your partner’s abuser. But be careful about how you present that anger. Your partner might misinterpret and believe the anger is directed at them. Alternatively, if you fall apart in response to their news, they may blame themselves for burdening you and think, “I never should have told them.”
- Get your own support. If you’re in a committed relationship, you need your own support system — which could be your own therapist — as you help your partner work through their trauma.
- Be cautious about consent. When initiating sex or even just physical touch, some partners may need you to liberally ask, “Are you OK with this?” “Is this comfortable?” Communicate as openly as possible before, during and after sex. A couples’ counselor may be able to help you navigate these issues.
- Don’t take their trauma reactions personally. If despite your best efforts, something triggers your partner during sex, recognize it is not about you nor is it a rejection. Alternatively, you may feel guilty or wonder if you should be having sex at all. Again, a couples’ counselor or therapist may be able to help.
There’s lots of hope and help, Dr. Kapoor says.
Related Article:
The lingering effects of sexual trauma
Sexual violence can lead to trouble regulating emotions, a loss of sense of self, dissociation, post-traumatic stress disorder and other mental health conditions.
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