The psychology of healing from sexual trauma

A deeper look at what happens in the first 2 years after experiencing sexual trauma.

women holding #metoo sign concept sexual violence sexual assault

You are not alone.

Photo by Mihai Surdu on Shutterstock

Content Warning:
The content in this article may be triggering to some readers. This article contains discussion around the topics of sexual assault, rape, sexual violence, trauma and PTSD. Please read at your own discretion.


  • Between 17-25% of women and 1-3% of men will report an instance of sexual abuse within their lifetime - however, research suggests up to 80% of sexual violence goes unreported, so the number of people who have experienced sexual abuse is much higher than you think.
  • A 2004 study takes a look at the psychological healing process sexual abuse survivors experience within the first 21 months after their assault.
  • Results of this study prove the decrease in behavioral self-blame that survivors reported feeling within the first 21 months after their attack greatly aided in their recovery.


How common is sexual assault and abuse?

woman sitting alone on couch sad concept female sexual assault survivor

17-25% of American women have reported a sexual assault sometime in their life.

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Sexual assault can take many different forms but generally refers to sexual contact that occurs without the explicit consent of the victim. Some forms of sexual assault include attempted rape, fondling or unwanted sexual touching, forcing a victim to perform sexual acts and penetration of the victim's body (also known as rape).

According to the nation's largest anti-sexual violence organization RAINN (Rape, Abuse & Incest National Network), the rate of reported sexual assault and rape has decreased by 63% from 1993 (when there were 4.3 sexual assault reports per 1,000 people) to 2016 (when there were 1.2 sexual assault reports per 1,000 people.)

While some may look at these statistics and think the risk of sexual assault and rape are diminishing, something of note when dealing with sexual assault statistics is that these statistics are only ever representative of reported cases of sexual trauma.

In reality, these kinds of results only account for sexual assaults that have been reported - and according to the U.S Department of Justice (2018), an estimated 80% of sexual assaults go unreported.

RAINN statistics (2016) on sexual violence:

  • Every 73 seconds, an American is sexually assaulted.
  • One out of every six American women has been the victim of an attempted or completed rape in her lifetime.
  • About 3% of American men have experienced an attempted or completed rape in their lifetime.

Other statistics fall closely in line with these numbers, as you can see in this 2017 study, where it was reported that around 17-25% of women and around 1-3% of men will be sexually assaulted in their lifetime.

Surviving sexual abuse: A look at the psychopathology of sexual abuse survivors 21 months after their trauma

sad man sitting on couch concept male sexual assault survivor

3% of American men have reported sexual assault sometime in their life.

Photo by Sam Wordley on Shutterstock

A 2004 study (Mary P. Koss and Aurelio Jose Figueredo) of the healing process of sexual trauma over the first 21 months proves significant improvements in the psychopathology of sexual abuse survivors.

During this study, reported rape survivors (59 participants) were assessed four times over the course of 21 months after their sexual trauma.

Researchers used the "Rape Attribution Questionnaire", which consists of three 7-item subscales that assess the survivor on the following criteria: Behavioral Self-Blame, Characterological Self-Blame, and External Blame.

This questionnaire consists of sentences such as "how often have you thought: I was assaulted because…" with the participants choosing answers that range from 1 (never) to 5 (very often). This questionnaire is used to gauge the psychopathology of the assault survivor based on how they view their traumatic experience.

The results of the Koss and Figueredo study suggest that many things happen within the first 2 years of a person experiencing sexual trauma…

Causal attributions: trying to find the "why"...
First, uncontrollable and traumatic acts (such as rape) stimulate what is known as "causal attributions", which are defined as our attempts at explaining the situation "rationally".

This leads survivors of sexual trauma to ask themselves questions such as "why did this happen to me?" and "what could I have done differently?"

Behavioral Self-Blame increases in the first few months after sexual trauma
In the months after the initial trauma, Behavioral Self-Blame increases. Survivors begin to question if there was anything they could have done to prevent the attack and can even begin to place blame on themselves (a common example for women is thinking about what they were wearing, if it was too provocative, if they encouraged the attacker in any way, etc).

Initially, after an assault, it's common for our body and mind to go into "protective mode", which is often the "numb" feeling many people experience after sexual abuse. The increase in behavioral self-blame increases the level of global distress in the survivor, bringing them out of the "numb" mode and oftentimes making their assault feel "real".

This often causes symptoms of PTSD (post-traumatic stress disorder) such as flashbacks and anxiety.

Characterological Self-Blame increases, which leads to severe spikes in PTSD symptoms
Characterological Self-Blame also increases in the initial stages after the sexual trauma, once we have been brought out of the numb mode by the increase of our global distress levels. Survivors begin to wonder if what happened to them was a result of who they are as a person (example, thinking that "bad things happen to bad people".) They start to question who they are as a person and if they deserve what happened to them.

This increase in characterological self-blame also spikes the global distress of the survivor, leading to more severe PTSD symptoms and can often lead to self-destructive behavior.

Looking outside ourselves for answers often gives a reason to isolate and "shut down"
External blame and maladaptive beliefs form - which can mean the survivor begins to look for blame outside of themselves, often isolating themselves from the society that harmed them. The survivor begins to adapt their beliefs to attempt to understand what happened to them and why.

In this initial aftermath of sexual trauma, sexual assault survivors may seek to understand the reasons for what happened by blaming external forces (such as their attacker or society as a whole), or they can try to seek answers by turning to internal explanations (often taking their own behaviors and actions into judgment).

21 months after sexual trauma: behavioral and characterological self-blame decrease, driving recovery
A 2001 study (Frazier, Berman & Steward) concluded that Behavioral Self-Blame (example: blaming what we did that night to "provoke" the assault) was consistently associated with more distress among victims of rape or sexual assault.

However, Characterological Self-Blame (example: blaming who we are for what happened) leads to an ever higher distressing and harmful effect on the survivor's overall health. These causal attributions and the self-blame that many survivors put onto themselves directly influence the severity of their global distress.

The results of the Koss and Figueredo study prove that while behavioral/characterological self-blame, isolation, and PTSD increase within the initial months after the attack, the decrease in behavioral self-blame that survivors reported feeling within the first 21 months after their attack greatly aided in their recovery.

You are not alone.

Psychiatrist Judith Herman explains why individual and/or group therapy is so helpful to survivors of sexual abuse:

"Trauma isolates: The group re-creates a sense of belonging. Trauma shames and stigmatizes: The group bears witness and affirms. Trauma degrades: The group restores your sense of humanity."

Need help? Call 800-656-4673 (HOPE).

The National Sexual Assault Hotline is 100% safe and confidential - when you place your call, only the first 6 numbers of your phone number are used to route the call to a hotline center in your area.

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