The aftermath of sexual assault is different for each individual survivor. Some survivors face a lifetime of long-term effects, while others are able to move past the traumatic effects of the attack in several years. Some survivors find it helpful to talk about their experiences, while others do not. In either case, survivors, as well as friends and family of survivors, should be aware of the long-term psychological and physical effects of sexual assault, and the resources that are available to help cope with these effects.

If you read the following effects of sexual assault and feel that you may be experiencing any of them, consider speaking with someone who is trained to help:

• Call the National Sexual Assault Hotline at 800-656-HOPE (4673)
• Chat online with someone on the RAINN website (Rape, Abuse, and Incest National Network)

Physical Pain, Sexually Transmitted Infections, and Pregnancy

Immediately following the assault, a survivor may experience any of the following physical effects: bruising, bleeding, difficulty walking, soreness, broken or dislocated bones.⁹ Victims of sexual assault often fear that they have been impregnanted or contracted a sexually transmitted infection by the assaulter. In approximately, 5% of cases, rape results in pregnancy.⁹ Although a trip to the emergency room may be emotionally difficult, especially after the trauma of a sexual assault, we highly recommend you make the visit. Evidence can be collected, internal and external injuries like those listed above can be assessed, sexually transmitted infections can be treated, and any possibility of pregnancy can be eliminated.¹ It is important to know that most STIs are asymptomatic, so you may not show any symptoms even if you have contracted one.² Testing is the best way to diagnose STIs, and most infections can be cured with antibiotics you can receive by visiting a healthcare professional.² You can be tested and treated at any time, even years after the assault.²

If you do not want to talk to a counselor at the hospital when you visit the Emergency Room (ER), you do not have to. An ER professional will collect any semen left in the vagina or anus, look for clothing fibers, soil, or grass from the scene of the crime; and take clippings of your fingernails to examine any possible residue from the attacker or the scene.³ The evidence is marked, stored, and accessible to the survivor if he or she chooses.

Phases of Adjustment

There are three main phases of adjustment immediately following a rape or sexual assault:

1. Shock: During this phase, the survivor may suffer from “acute anxiety, fear, and guilt, and observable reactions can vary from hysteria to numbness.”⁴ If you are currently in shock and have been raped or sexually assaulted, consider contacting a friend or loved one for help and support. Click here to for more information on what to do if you have been sexually assaulted.
2. Denial: During this phase, the survivor tries to forget that the attack ever occurred.⁴ He or she will probably avoid talking about the assault and will deny any feelings of sadness, hurt, or anger.⁴ The survivor will likely try to get back into his or her “normal” routine.⁴
3. Integration: At this point, the survivor has realized that the rape or assault cannot be forgotten (like he or she was trying to do in the denial phase). The survivor may begin to experience heavier anxiety, nightmares, and difficulties in their personal relationships. ⁴

In the integration phase, you may start to acknowledge your own feelings of anger, sadness, hurt, or depression. Know that this is normal and it is okay. Many survivors feel guilt during the integration phase, and this can lead the survivor to feel as if the sexual assault was his or her fault. Remember, rape or sexual assault is never the survivor’s fault.

Post-Traumatic Stress Disorder

Post-traumatic stress disorder, also known as PTSD, is an anxiety disorder that can result from a traumatic event such as sexual assault or violence.⁵ Those with PTSD experience extreme feelings of stress, fear, nervousness, and anxiety, and these can cause the survivor to feel as if they are in constant danger.⁵ If the survivor knows his or her assaulter(s) or remembers what the assaulter(s) look like, they may constantly fear encountering them again. These feelings make it extremely hard to function in everyday life. According to the Rape, Abuse, and Incest National Network (RAINN), there are three main symptoms of PTSD:

1. Re-experiencing: feeling like you are re-living your attack through flashbacks, nightmares, or negative thoughts⁵
2. Hyper-Arousal: constantly feeling “on edge,” being easily scared or startled, having difficulty sleeping due to outbursts of fright during the night⁵
3. Avoidance: changing your behavior (intentionally or unintentionally) to avoid scenarios that remind you of the event, losing interest in activities you used to enjoy⁵  

Living with PTSD can be extremely challenging. If you are experiencing PTSD, consider letting a friend or loved one know. If you let them, they might be a wonderful support system. Counseling services can also be helpful in overcoming some of these symptoms.

Self-Harm

Deliberate self-harm, also called self-injury, is “when people inflict physical harm on themselves, usually in private and without suicidal intentions.”⁶ Some survivors of sexual assault or rape may use self-harm as a method of coping with difficult or painful feelings.⁶ Common forms of self-harm include “biting, burning, cutting, hitting the body, pulling out hair, or scratching and picking skin.”⁶ Survivors report feeling a sense of relief and control when they harm themselves; unfortunately, this relief or numbness is often short-lived.⁶

If you are thinking about self-harming, try any of the following suggestions by the Rape, Abuse, and Incest National Network (RAINN):⁶

• If you have an object that you intend to harm yourself with, put it away, or leave the room that the object is in until the urge passes.
• Control your breathing. Take slow, deep breaths and count to five each time you inhale and exhale. Repeat this breathing pattern 5 or 10 times.
• Take a walk. Walk for 10 or 20 minutes in a safe, well-lit outdoor area, and describe everything you see in great detail. Talk out loud to yourself.
• Write it all down. Journal about what you are thinking and feeling. This helps many individuals cope with difficult feelings. If you do not want to write about your own feelings, write a story.
• Send a text message to a friend or call a loved one. Chat with them about anything. Tell them a story, even if it is unimportant. Keep your hands busy—this is key.
• Draw on the body part that you intended to self-harm with a pen or henna tattoo ink instead.
• Take a really hot shower or bath and let the steam fill your lungs, then breathe out deeply. Make sure to remove all razors from the shower or bath before you enter. Stay inside for as long as you need to, or until the urge passes.
• Rub an ice cube across the body part where you typically self-harm, or planned to self-harm.
• Tear up a newspaper or magazine into the smallest pieces you can make.

If you are self-harming or thinking about self-harming, consider calling the S.A.F.E. Alternatives information hotline at 800-DONT-CUT (800-366-8288). You can also learn more about treatment options or safe alternatives to harming yourself at the S.A.F.E. Alternatives website.

Depression

It is normal for survivors of sexual assault to feel sad, unhappy, or hopeless.⁷ However, if these feelings persist for an extended period of time, the survivor may be experiencing depression.⁷ Depression is “a mood disorder that occurs when feelings associated with sadness and hopelessness continue for long periods of time and interrupt regular thought patterns.”⁷ Depression often affects an individual’s behavior and relationship with friends and family. According to the National Institutes of Health (NIH), an estimated 16 million adults experienced a period of depression in 2012.⁷ If you feel you may be battling a period of depression, remember, you are not alone. Some survivors describe it as just “feeling down,” while others say that it interferes with daily life, making each day unbearable.⁷ Depression can also lead to dissociation, or the feeling that a survivor has “checked out” or is not mentally present.⁹ This may cause the survivor to have trouble focusing on school or work related tasks. While it is entirely the survivor’s choice, we recommend an appointment with a counselor or psychiatrist during this phase. A health professional can help guide the recovery process and offer medical diagnoses or treatments if necessary.

Substance Use

Many survivors turn to alcohol and drug use in the aftermath of sexual assault or rape.⁸There are a number of reasons survivors use these substances. Alcohol and drug use can help the victim temporarily to numb their pain, or escape their feelings.⁸ Many survivors lack a supportive network of people in the months and years after an assault or fear that their friends and family will not understand their pain, so they turn to these substances instead.⁸ If you are concerned that you are abusing substances in a way that could be harmful to you or your loved ones, consider calling the Substance Abuse Treatment Referral Helpline at 1-800-662-HELP (4357). Substance abuse can be very addictive and cause survivors to withdraw from family, friends, and resources that are useful in coping with sexual assault.

Flashbacks and Nightmares

A flashback is “when memories of a past trauma feel as though they are taking place in the current moment.”¹⁰ Survivors of sexual assault often report that it feels as though the experience of sexual violence is happening all over again during these episodes and nightmares.¹⁰
These flashbacks and nightmares can feel extremely real; it may even feel as though the perpetrator is in the room.¹⁰ If you are experiencing a flashback, consider the following tips suggested by the Rape, Abuse and Incest National Network, (RAINN):¹⁰

• Tell yourself out loud that you are having a flashback and that it isn’t real.
• Panic often causes quick, shallow breaths, decreasing oxygen to the brain increasing feelings of panic.¹⁰ Take slow, deep breaths with your hands placed on your stomach. Watch your hands move out with every inhale, and watch them fall with every exhale.
• Convince yourself that it is a dream/flashback by returning to the present using your five senses: sight, smell, hearing, taste, and touch. Use your senses to observe what is around you. List the items in the room, smell your pillow or clean clothes. Listen to music, or try eating and drinking something. Focus on the flavor of the food. Finally, touch something cold and focus on what it feels like.

You can prevent flashbacks by identifying triggers or causes.¹⁰ Perhaps certain sounds, smells, locations, words, or people bring you back to the trauma of the assault. Be aware of these triggers and try your best to avoid them.

Suicidal Thoughts

Many survivors of sexual assault or rape experience suicidal thoughts after the attack.¹¹ These individuals may feel that there is no way out of the pain they are experiencing, and they would rather end their life than live with the aftermath of sexual assault. If you feel this way, repeat the following to yourself, as many times as it takes to resist the urge: “It will get better.”

Then, consider doing on of the following:

• For immediate assistance, call 911.
• Consider calling the National Suicide Prevention Lifeline at 800-273-TALK (8255), 24 hours a day, 7 days a week.
• Chat with someone online using the Lifestyle Crisis Chat.
• If you feel comfortable doing so, reach out to a friend or family member for support.

Concluding Remarks

By now, you may have realized that the aftermath of sexual assault involves a long and complicated recovery process. With the help of countless resources, your friends, your family, and a network of survivors you can connect with and help, you will get through this. You have a long and beautiful life ahead of you no matter what has happened in your past.

References

1. “Reporting Rape | RAINN | Rape, Abuse and Incest National Network.” Rape, Abuse and Incest National Network. N.p., n.d. Web. 25
2. “Sexually Transmitted Infections-STIs and STDs.” RAINN Rape, Abuse and Incest National Network. N.p., n.d. Web. 10 May 2015.
3. Larson, Nancy. “After Rape, Getting a Medical Exam Is Essential.” About.com. N.p., n.d. Web. 25 Jan. 2015.
4. “Common Reactions to Rape.” Domestic Violence Services. N.p., n.d. Web. 10 May 2015.
5. “Post-Traumatic Stress Disorder (PTSD) | RAINN | Rape, Abuse and Incest National Network.” RAINN Rape, Abuse and Incest National Network. N.p., n.d. Web. 10 May 2015.
6. “Self-Harm.” RAINN Rape, Abuse and Incest National Network. N.p., n.d. Web. 10 May 2015.
7. “Depression.” RAINN Rape, Abuse and Incest National Network. N.p., n.d. Web. 10 May 2015.
8. “Substance Abuse.” RAINN Rape, Abuse and Incest National Network. N.p., n.d. Web. 11 May 2015.
9. “Effects of Sexual Assault and Rape.” Joyful Heart Foundation. N.p., n.d. Web. 10 May 2015.
10. “Flashbacks.” RAINN Rape, Abuse and Incest National Network. N.p., n.d. Web. 11 May 2015.
11. “Effects of Sexual Assault.” RAINN Rape, Abuse and Incest National Network. N.p., n.d. Web. 10 May 2015.

Last updated 24 May 2015.