Belle Knox, the infamous Duke University porn star, is in a documentary where she discusses the realities of her life in porn and her true self, Miriam Weeks, who chose this as her profession to pay her way through college.
It’s a story from last August yet it’s still relevant because the underlying truth of the industry is still the same.
As her alter-ego, Belle Knox, Miriam has spent her first year in the porn industry touting her beliefs that porn is “empowering,” “freeing” and “the way the world should be.” She also portrays her choice in finding a way to fund her tuition and graduate free of debt as something akin to noble in the documentary.
However, the realities of Miriam’s life choice clearly weigh heavy on her.
Weeks did a series of interviews for an upcoming documentary. In them, she paints a much different picture than the freeing, empowering, sex-fueled fantasy world her fans and porn supporters claim she inhabits.
“The sex industry has a way of making you very cynical and very bitter,” a tired-looking Weeks tells an off-camera interviewer, “In a way I’ve started to become kind of a bit bitter and a bit cynical.”
“It teaches you to be street smart and not to trust people…I’m so used to being on the lookout for scammers, people who are going to try pimp me out or traffic me. I think my experiences have aged me. I don’t have the mind of an eighteen-year-old. I have the emotional baggage of someone much, much older than me.”
There is a deeper, darker reason that Miriam entered into the world of porn. She was raped and victims of rape have serious issues with control.
In many interviews, Weeks talks obsessively about how porn gives her control over her own sexual destiny: “In porn, everything is on my terms. I can say no whenever I want to. I am in control.” Later on, we discover why this is so important to her: Weeks reveals that she had been raped. “What porn has done for me,” she says firmly, “is it has given me back my agency.”
Miriam’s thinking is erroneous. She has sold herself into a perverted industry wrought with danger and humiliation for the sake of “control.”
Miriam herself admits that her first scene, shot for a company she refers to as “Facial Abuse,” was “a really, really rough scene. I wasn’t prepared for how rough it was. It was weird having some random photographer watch me have my a** kicked on camera.” She talks about getting literally torn up during porn shoots. She admits that porn shoots in which she was physically beaten up until she sobbed were probably shoots she should have refused. Yet she didn’t.
The truth is the industry controls her. In many cases, if she wants to work, she often must agree to a shoot without knowing the scene and who is in it. Once she agrees she is fined for walking out and the penalty is steep, the risk of not working again.
For one shoot, Miriam recalls almost tearfully, her agent wouldn’t tell her who she had to “work with.” When she arrived at the set, she realized he was fifty years old. She wanted to leave, but then she’d have to pay a 300 dollar “kill fee,” the director would have been furious, and, she says, she could never have worked for that company again. So she did it.
The reality of her choice weighs heavy on her and the consequences are great.
“I felt like crying during the entire scene and afterwards I was really, really upset,” Miriam says tearfully to the camera, looking like nothing more than the hurting 18-year-old girl she is. “I just thought of my mom, who was always there for me and always protected me…I think about my mom a lot when I do porn scenes. Just how sad she would be that her little daughter was doing this.”
Miriam is a lost soul who has been a victim of sexual assault resulting in choices where shame has become her partner leaving scars of self loathing, literally.
One day looking in the mirror, she became so overcome with self-hatred that she smashed the mirror and cut herself, slicing the jagged letters “FAT” into the flesh of her thigh.
While Miriam has her dark moments that hint at unhappiness and regret, she continues down this tragic path.
What is sickening is that there is even a demand in our society that has turned into multi-billion dollar industry that preys on the Miriam’s of the world. As I contemplate Miriam crying wondering what her mom thinks of her doing porn, I wonder what the dad’s of our culture would think of their 18-year-old daughter doing porn.
This is an edited transcript of the first part of Suzzan Blac’s talk at the ‘An evening with Suzzan Blac’ webinar we held in July 2021 and the related discussion with Ygerne Price-Davies. The transcript of the second part of the talk, which was about her research into pornography, is in a separate article. You can watch the recording of the whole talk on YouTube.
I am a survivor of child sexual abuse, sexual assaults, numerous rapes and sex trafficking.
This had been my life. My normal. So normal, that I didn’t even realise that I had been abused and been a victim for the majority of my childhood. I only began to acknowledge and understand this in my mid-twenties. I finally sought counselling when I was thirty-three years old.
Recovery was extremely traumatic and it took me more than twenty years to overcome the worst of it. One of the reasons it took so long to recover, was the victim blaming that many people inflicted upon me. In my experience, victim blaming is as painful and distressing as the abuse itself.
Between 2000 and 2004, in order to try and help myself, I decided to paint my story of abuse to help me process my pain, anger and trauma. I began by drawing subconscious doodles whilst watching TV, as I knew that these drawings had to come from deep inside of me and not my thoughts. I then turned the drawings into realistic paintings that depicted ‘me the victim’ and ‘the perpetrators’.
I was sometimes shocked by what I had painted, but I knew that they were my true feelings. I painted forty images over four years and I hid them away for over a decade, because they were for me alone, and not meant for anyone to see, especially knowing that I would be condemned if I showed them.
In 2011, I decided to put them online. I had other works out there, but I knew that ‘silence impairs the victims and empowers the perpetrators’. So I had to speak out by using my art, and although I had many people make hurtful comments, I had hundreds of survivors thanking me for giving them a voice.
I have also been training police and social workers in child sexual abuse (CSA), child sexual exploitation (CSE) and victim blaming since 2014.
I also paint about sexual objectification, sexual conditioning, pornography, prostitution and misogyny.
I am motivated by my pain, anger, injustice and indignation surrounding violence against women and girls (VAWG) and victim blaming.
I’m now going to show you twenty-four of my works with a very brief description of each one.
1. The trusted uncle
This painting depicts my mother’s brother, who sexually abused me as a baby. I painted it like a ‘Happy family portrait’ to convey the lies and cover-ups of family members who knew that it was happening. It also conveys the horrific fact that babies are sexually abused and raped, especially since the invention of the internet and mobile phone cameras. I was actually told that ‘I was sick’ for painting this image.
2. One of mother’s boyfriends
This painting depicts one of my mother’s boyfriends who sexually abused me from when I six to when I was eight years old. He was also extremely violent, and in this image I watched in horror as he beat my mother to a pulp. No child should ever have to witness such violence.
3. You’re such a good girl
This was the first time that anyone had ever called me a ‘good girl’. He also told me that it was all my fault, because I was so ‘pretty’. Here, I am trying to express what sexual abuse was doing to me internally, whilst I remained frozen and detached throughout the abuse.
4. She likes it
This image depicts the first-time my mother’s boyfriend sexually abused me in front of my mother, whilst she was at her dressing table. She turned around and asked why he was doing that, to which he replied, ‘Because she likes it’.
He laughed and said, ‘What’s the matter love, you jealous? There’s plenty to go around’.
I searched her face for a reaction, but all she did was ‘tut’ and resumed putting on her make-up. I knew then that it was not going to stop, that it was okay and was to become my ‘normal’.
This image depicts my childhood – although at the time, I didn’t feel like a child. I felt like an ‘Entity’ that existed, merely to survive every day, every hour, every minute. He destroyed my childhood and he destroyed my innocence. Still to this day, I get very emotional when I watch small children innocently play, because he took that from me and put me in the darkest of places.
After many years of sexual abuse from others, including those I had trusted, even a teacher, I became a teenager on a path of self-destruction. These next paintings depict the devastating consequences of my years of abuse.
6. Embracing death
By the age of fourteen, I was regularly drinking, taking drugs, partying, being highly promiscuous and self-harming. I was called a slag, slut and a whore, and yes, I was.
One night, as I lay on the piss-flooded floor of a night club toilet, I felt like I was home. I was disgusting, vile and filthy and this is where I belonged. I was so intoxicated, that I thought I was going to die, and I embraced the thought, because I hated my life, I hated humans, and I hated myself.
7. Demonic whispers
This painting depicts the time that I was sex trafficked when I was sixteen years old. This is a portrait of the man who threatened, hurt and (alongside others) repeatedly raped me. I had been taken to London under the pretence of ‘modelling’.
Locked inside a once former Victorian hotel with many other girls and women, we were forced into pornography and prostitution. This was a whole new level of abuse, terror and trauma, one that will always stay with me.
8. Tell me you love it
On the first night that this man abducted me, he led me to a room, told me to take off my clothes and viciously raped me. Whilst raping me, he forced me to repeatedly tell him that ‘I loved it’.
9. I’ve killed bitches before
After raping me, he told me to get dressed, and as I did so – he grabbed me by my throat, shoved me against a wall and as he stuck a large knife underneath my rib-cage, he seethed into my ear, ‘I’ve killed bitches that misbehave before, so you need to think about that.’
My only thoughts were, ‘I’m only 16 and this is how I die’.
While I was still shaking in absolute terror, he withdrew the knife and laughed at me, saying, ‘You should see your face.’
This was pure sadism. I could never speak about how this affected me.
There are no words, and that’s why I had to express myself through my paintings.
10. Pornographic meat
On the second day, along with other girls, I was forced into making pornography in a large room full of men. I had to completely detach; I became a ‘dead actress’, a ‘fleshed robot’ that obeyed their every command in absolute fear.
The other girls and I did not speak or even make eye contact. We were first made to watch films of the worst kind of pornography, including bestiality, sadism and child abuse. One man joked that he was going to get the popcorn.
When they began filming me, one of the men asked for ‘Butcher shots’ and I immediately turned inside out. I cried for me and I cried for the other girls, because we were no longer human beings, we were pieces of meat inside an abattoir.
11. Shut up and take it
This image depicts one of the traffickers taking me back home. In a train toilet, he violently raped me – three times between London and Birmingham. As I whimpered, he shushed me, covered my mouth and told me, ‘This was part of the deal, so shut up and take it’.
He drove me back to my flat, asking many questions about my boyfriend and family. He then told me that I would be seeing him again soon.
12. The end of everything
After I got home, I never told a soul about what had happened to me. I was still traumatised and knew that it was all my fault. I also was being terrorised by one of the traffickers. So I had to internalise all of that pain and fear.
After a while I deteriorated both mentally and physically. I cut all of my hair off, because I didn’t want to be pretty anymore. My weight dropped to six stone, I developed intestinal worms, severe cystitis, boils, chancres and weeping eczema that turned septic.
One night, I sat naked in the shower tray, and poured a bottle of red food colouring all over me. Rocking and crying that ‘I needed to die’.
13. The epitome of sorrow is to die alone
This painting depicts one of my suicide attempts. I had taken all of my clothes off and laid down on my 9th floor balcony, one winters evening, after failing to jump off. I was hoping to die of hypothermia. As my face stuck to the icy concrete floor, hot tears ran down my freezing face as I thought how awfully sad it was to have to die alone.
I woke up at dawn. I slowly walked into my lounge which was like walking into a furnace and saw my reflection in a mirror. It was surreal, I looked like a wax model covered in blue and green veins. I just curled up into my bed, so sad that I wasn’t dead.
14. No one asked me why
This image depicts the time I had my stomach pumped in a hospital after taking an overdose. After hostile staff discharged me, and as I walked away from the hospital, I began to cry – because not one person in there had asked me why I had done this to myself.
It was then I knew that even doctors and nurses never gave a shit about me, they didn’t care if I died, they just did their job.
15. I am a piece of shit
This painting depicts how others made me feel, whenever I disclosed what had happened to me. I was condemned, isolated, abandoned and judged. Not believed, made to feel guilty, ashamed and that much of it was my own fault.
This is how many people make victims and survivors of sexual abuse feel. If someone says that they were robbed, mugged or beat-up, there is sympathy and empathy, but not if you are a victim of sexual abuse, you are literally treated like a piece of shit.
16. I’m fine thank you
I painted this self-portrait to show how it felt, to constantly hide myself by wearing a mask for self-protection and social acceptance. People made me feel like an ‘outcast’. If I spoke out about the crimes committed against me as a child, I would be met with a wall of silence, made to feel uncomfortable, defective and dysfunctional.
No survivor of sexual abuse should have to hide their pain, anxiety and distress, in the fear of being re-victimised. No human being should ever have to feel what I have painted here.
Now I want to show you some of my other works, ones that I painted years after my story of abuse.
17. Your suffering is real
I painted this image of myself to express and convey how severe, continuous sexual traumas impact your mental health, your body and your very soul.
Sexual violence is unlike any other kind of violence. It’s blackness creeps inside your every vein and permeates every organ until you emotionally shut down and are no longer the human being that you once were. Unable to speak of the horrors, you outwardly smile – whilst hiding the truth that you are internally destroyed.
18. The prostitutor
This image represents the men who prey on vulnerable girls and women. They are the pimps and pornographers who target ‘bent but not broken girls’ in order to profit from their bodies. They are men on the streets, men online, sex traffickers, husbands, boyfriends and fathers.
The majority of these girls and women are victims of previous sexual abuse, rape and domestic violence, who have mental health issues and are often alcohol and drug dependant.
19. Let me entertain you
This image depicts the sexual and physical violence now commonplace in mainstream pornography. Women are being humiliated, degraded, hog-tied, raped, punched, kicked, suffocated with plastic bags, strangled, tortured and even hanged.
This isn’t about sex; these are crimes committed against women. These videos are the stuff of serial killer fantasies. In fact, the only thing that they don’t do to women in mainstream pornography is kill them.
20. What women want
Which brings me to this painting, which depicts a young boy watching this kind of sexual violence on his mobile phone.
For the first time in history, boys are viewing this horrific and hateful misogyny and violence against women, which has become so normalised that boys are completely desensitised. Many use pornography on their phones to sexually harass, intimidate and exert power over girls. Pornography alters and influences sexual behaviours and reinforces misogyny in young, malleable minds. This is why the government needs to implement age-verification now.
21. Blue Hair
This painting is one of a set of six images, named Abasement of dolls that depict issues that affect women and girls, such as sexual conditioning, sexual objectification and sexual exploitation.
Right from birth, baby girls are objectified and conditioned with bows, ribbons, lace and frilly nappy pants. Toddlers wear sassy clothes, jewellery, heels and painted nails. Many little girls are only given ‘girly toys’: housework sets, make-up and hairstyle sets, etc. Girls are taught that only being attractive and pretty are valued, and this often stays with them.
Many teenage girls and women resort to extreme diets, Botox and cosmetic surgeries, because they don’t match up to the high standards of beauty.
22. Blonde girls
Again, this is about the sexual objectification of little girls, in the media, film, dance studios and even by their own parents – for example, entering them into horrific ‘beauty pageants’ such as ‘toddlers and tiaras’ or buying Playboy merchandise for them. Incidentally, Playboy merchandise was sold to girls as young as eight in the high street.
23. Black Hair
This painting depicts the young women who enter the porn industry, many because of mental health issues, oppressed religious backgrounds, suitcase pimps and coercive boyfriends. These are eighteen-year-olds – they are still kids! – who enter a world of grown adult men who love ‘fresh meat’.
Many pornographers make them appear even younger and then have them ‘punished’ and ‘destroyed’.
Many of these young women leave after a short period of time after being so traumatised, a trauma that continues, because their videos remain online indefinitely for all to see.
24. The life giver
This painting represents sexism and misogyny. I portray a history of derogatory and sexist terms used to silence, erase, hurt, subordinate, humiliate, degrade, hate and punish women.
My point is that no one is morally or legally allowed to make racist, homophobic or transphobic slurs as they are deemed ‘hate crimes’ but you can call women anything you want, because misogyny is not deemed a hate crime.
Ygerne: I just wanted to say thank you so much to Suzzan for such a powerful and moving talk. I personally find your work really significant. It’s very hard hitting and often can be quite disturbing, but I think that the depiction of such extreme experience and psychological trauma is pivotal because speaking with a lot of women who have experienced sexualized violence and sexism more widely that sharing stories especially in creative ways enables us to overcome misogyny together. So thank you for sharing your story with us.
Suzzan: You’re welcome.
Ygerne: In the past I’ve heard you say that understanding complex PTSD helped your recovery. Would you like to talk a bit more about that and how it’s helped you?
Suzzan: Absolutely. Recovery can take so long and it wasn’t until literally about five years ago that someone explained to me the concept of complex PTSD. I’m now 61 and I wish that someone had told me earlier in my life. That’s why it’s so important to talk about this.
Going through my teenage years and adult life, no matter how many times counsellors and therapists would say to me, it wasn’t your fault… I don’t mean just as a child, I mean as a teenager and a young woman because a couple of years after I was sex trafficked, I actually went back into pornography and prostitution. No matter how many times they said it wasn’t my fault, I still knew it was my fault. So I still had the shame, self-blame, the guilt, everything was still there, it remained.
And you can’t ever recover whilst you have those intense feelings inside of you. Then a few years ago I learned about complex PTSD which is different from ordinary PTSD. Ordinary PTSD occurs after a one-time event, say being held up at gunpoint. That actually happened to a friend of mine in Birmingham. Or like a serious car crash or something like that and afterwards you develop PTSD.
But, with complex PTSD you are traumatised over a long period of time, especially from childhood and the teenage years as in my case, as in many other women’s cases. You are constantly, repeatedly traumatised over years. For me it was every day or every other day for all those years.
Each time that you are traumatised you internalise that trauma and become detached – especially in sexual violence. Each time someone abuses you, you become detached and as in my case, completely detached, all through those years.
And so, you never really feel what’s happening to you, you never really feel that pain. All through my teenage and early adult years I was self-abusing because what you don’t ever want to do is feel that pain. So, you keep abusing yourself, in whatever way, drink, drugs, putting yourself in certain situations, like I did.
I would put myself into dangerous situations because I wanted to keep being abused or abusing myself so I would never have to feel it because it was too enormous. The enormity of it was too much – unlike someone who is suffering from PTSD from a one-time event – they can talk about it. If you were mugged or robbed or attacked physically, you can tell people. But, with sexual violence, you can’t. So that compounds it and you have all these extra symptoms because you cannot talk about it.
Once I understood that, I could understand that it was not my fault. In the end I understood completely why I carried on abusing myself. I wanted to relay that to other people because it took so long for me to understand it.
Ygerne: You mentioned victim blaming and how that made it so much harder for you.
Suzzan: Exactly! You don’t get victim blamed if you are mugged. They don’t say, you shouldn’t have worn that jewellery or you shouldn’t have carried money with you. Nobody says that.
But, if you are raped, especially young girls, around 14 and upwards, it’s what was she wearing? How much was she drinking? And they don’t ask such questions to elderly ladies who are raped.
There’s so much victim blaming of young women and it compounds the recovery. That’s another reason you don’t want to talk about it because people are really cruel. In my book I talk about the many times that I suffered victim blaming. This is something we need to address; we need to address this because it is only young girls and women who are targeted, nobody else.
Ygerne: It’s re-traumatising all over again and it comes from this hatred for women, doesn’t it?
Suzzan: Absolutely. Misogyny plays a large part in all of this.
Ygerne: OK, so we’ve had a question that came through from the audience. She says: are you married to a man and if so, how were you able to trust him or anyone? How were you able to move past the hatred of people?
Suzzan: I never wanted to have a relationship when I was a young woman. I never trusted anybody. How could I? So, I would just go out with someone and you know, whatever. I never wanted to get close to anybody or have anyone close to me.
And I never wanted children, either. I’ve been asked quite a few times by people whether it was because I was worried I would abuse them. And I would say no it wasn’t that. It was because I didn’t want to bring them into this evil world.
But I met my children’s father and I found myself getting close to him and I didn’t want to. I don’t think I’ve ever really trusted him and I had good reason not to. We ended up going through hell.
I even went to the women’s hospital because, like I said before, I thought I was mentally ill. At that time I didn’t know that I had been abused. People find that hard to believe, but I thought I was just a looney. That’s what I thought. That I was a looney who took drugs, drank, and had a good time and hated the world. I thought I was mental. We went through quite a difficult period.
I was on the pill from when I was 13 years old, and I went to the doctor because I had severe migraines. He told me to come off the pill and as soon as I did, I got pregnant, which was a big shock. And that’s a whole other story – of how an abused person feels when they have a child.
We did divorce years later. And I’ve only had one relationship since then. I haven’t had one now since 2017. I’d rather just not.
It not just relationships that I find hard, it’s friendships, it’s work colleagues. Because, being abused affects every aspect of your life. Say something comes up in a work situation – for example, Mother’s Day and you’re asked about your mother. I would often say that she’s dead. She’s not, but I would say she was. I couldn’t talk about her because I stopped seeing her when I was in my early 30’s and I’ve never seen her since and I don’t want to see her.
So, it’s things like that, things that come up all the time. It’s very difficult. So, I would rather be alone, I’d rather just write and go for walks and just be by myself these days, with my cat, I love my cat. And, of course, I’ve got my two beautiful grownup children and a granddaughter. And I’m happy with that, but it’s been very difficult to trust. It’s hard to trust people.
Ygerne: That’s understandable.
Suzzan: It is, because I’ve even been abused by doctors – when I was in my early 20s. I went to a place for help to get into work. One of the lecturers started abusing me there and I went to the on-site doctor and he closed the blinds and started abusing me too. So, all my life, up to a certain point – after having children and counselling, everything changed. But, before I had children, I was constantly, constantly abused.
And as I said, you just detach.
I didn’t know I had an inkling about being abused when I was in my mid to late 20s. Having my daughter was the catalyst to my recovery because I understood at that moment when she was born what it should be… How the protection and love that you have for a child, for a baby, for your baby, was so intense and everything kind of changed from that moment.
Ygerne: That’s a moment of hope.
Suzzan: Oh, absolutely. But it was so hard because even when I had children I had so many difficult times and even when I was in therapy. When I was 33, I’d had my second child, my son and suddenly social workers got involved because they knew I was in therapy for my own abuse and I had a lot of abuse from them. It just went on and on. It was absolutely awful, never ending.
Ygerne: It was the blaming again, wasn’t it?
Suzzan: Instant victim blaming, yeah, absolutely. I mean, I know things have improved, but they’re not good enough, especially when it comes to young women.
Ygerne: There’s definitely a long way to go. We have to keep fighting.
Suzzan: We do, absolutely. And all of us can impart the knowledge and understanding to younger women that I didn’t get, and that’s why I do what I do.
Ygerne: Thank you Suzzan. Thank you so much, it’s been amazing to have you.
Suzzan: You’re welcome. And thank you to everybody who watched. I wouldn’t say it’s been fun, but this stuff needs to be out there and women, especially younger women, need to understand more from us older ones.
If you want to see more of Suzzan’s paintings, you can go onto her art website.
She has also written a book about her life called ‘The Rebirth of Suzzan Blac’ which is available on Amazon.
The second part of Suzzan’s talk, which is about her research into pornography, is available here.
Have you ever wondered what really goes on in the world of extreme abuse porn?
Meet Theodosia, an ex-porn performer who spent years doing bondage, domination, submission and masochism (BDSM) porn. After surviving childhood abuse, the trauma she endured fed into violent and abusive romantic relationships, and eventually to a boyfriend introducing her to the world of violent pornography. She came to learn that the women who could endure a lot of pain on camera were valued in the BDSM porn world, and she was taught that her primary talent was suffering well.
One day, after years of being abused on camera, Theodosia realized she could no longer stomach the world she was thrown into. See how Theodosia got her start in BDSM porn, and why she eventually left the industry on her own terms.
Fight the New Drug is a non-religious and non-legislative organization that exists to provide individuals the opportunity to make an informed decision regarding pornography by raising awareness on its harmful effects using only science, facts, and personal accounts.
To learn more about how pornography impacts individuals, relationships, and society, visit http://ftnd.org/. This video was made possible by Fighter Club. To help us create more content like this, consider joining Fighter Club at http://ftnd.org/fc.
Your records may be allowed as evidence in court Jun 08, 2015 By DomesticShelters.org
Keeping a diary of domestic violence incidents—both physical and non-physical—may seem like the last type of record a survivor would like to collect. The truth is, this type of documentation can be an integral part of your case when it comes time to file charges, file for divorce or file for custody of your children.
According to WomensLaw.org, each state has its own laws about what evidence is permissible in court. It’s best to talk to an attorney or legal advocate prior to your court hearing to learn more about your state’s laws. In the meantime, recording and gathering the following types of documentation can benefit you:
Verbal accounts of the abuse from you and any witnesses. This can include not only physical abuse, but also verbal abuse, stalking, or financial, reproductive or spiritual abuse. Ask these witnesses if they would testify on your behalf in court. You can subpoena a witness, which will force them to appear in court. Visit Womenslaw.org for more information on this process.
Medical reports of injuries from the abuse. Ask your doctor about safe ways they can make notes about this abuse, advises The National Domestic Violence Hotline. For example, some can write “cause of injury” on your medical records, without the report having to go to the police.
Pictures of any injuries from the abuse, documented with the date the photo was taken.
Police reports from when you or any witness called the police.
Objects in your home broken by the abuser.
Photos showing your home in disarray after a violent episode.
Pictures of weapons used by the abuser to harm or threaten you.
Digital evidence. Let your abuser’s or stalker’s threatening calls go to voicemail, and then save those voicemails. Save emails, threatening texts, screenshots of 30 missed calls in a row, etc.
Finally, make sure the place in which you to choose to save these items is a safe one. Don’t keep this evidence in the same home you share with your abuser. Keep it at a friend’s or family member’s house, in a safe deposit box or at your place of employment.
And, advises The Hotline, listen to your gut—if it’s not the right time to compile this evidence because your safety will be at risk, hold off. Know that what’s safe for one person, may not be safe for you.
False allegations of domestic violence are rampant … or are they?
Google “false allegations of domestic violence” and a litany of defense attorneys and men’s rights groups would have you believe that nearly every person who reports domestic violence is lying.
One site even suggests some 70 percent of restraining orders are trivial or false. The article cites a study that concludes 60 percent (not 70 percent as the article proclaimed) of restraining orders are unnecessary or based on false allegations of abuse. But how the “study” got to that number is by discarding any petition for a restraining order that didn’t include actual or threatened physical violence. As any domestic violence advocate or prosecutor will tell you, domestic violence doesn’t only include physical abuse. Other forms of abuse are often predecessors of physical violence, such as stalking, threats or coercive control.
Meanwhile, other sources report the rate of false allegations of domestic violence is low and in line with the rate of false reports of other crimes, such as theft and burglary.
So, why the discrepancy?
Without Physical Proof, Some Survivors Are Labeled Liars
“A lot of it has to do with studies’ biases and methodologies,” says Melissa Hamilton, J.D., Ph.D., visiting criminal law scholar with the University of Houston Law Center. “From a methodological perspective, if you were to count cases that are marked ‘unfounded’ as lies, that’s not sound logic.”
And yet, that’s exactly what some studies on false allegations of domestic violence rely on, according to Hamilton. Just because a case had insufficient evidence to make an arrest or was turned down for prosecution, that doesn’t mean the reporting party made up the abuse.
“A lot of times police are looking for a physical sign of assault, but not all injuries show up right away,” Hamilton says. “So police might close it out as ‘unfounded,’ but it would not be fair to say it’s a false report.”
Police will sometimes mark cases unfounded if they suspect the highly contentious idea of mutual abuse, where its thought that both parties played equal parts in the violence. In reality, self-defense can be incorrectly labeled as mutual abuse when both parties have injuries or both parties admit to using physical violence.
Survivors More Likely to Lie That Abuse Didn’t Occur
According to a 2008 study by law professor Nicholas Bala and three other researchers, in the context of custody disputes, mothers make deliberate false reports less than 2 percent of the time. Fathers are 16 times more likely to make deliberate false reports which contributes to disbelieving true reports made by mothers.
“It is critical to emphasize that the making of false allegations of spousal abuse is much less common than the problem of genuine victims who fail to report abuse,” reads the study.
Deputy district attorney in Los Angeles County District Attorney’s Family Violence Division, Miji J. Vellakkatel, agrees—it’s far more likely for survivors to lie and say they were not abused when, in fact, they were.
“People do sometimes change their statements from the initial report to preliminary hearing or trial,” Vellakkatel says. “But in most cases, it’s minimization. We tend to get victims saying, ‘It was my fault,’ or they no longer wish to participate. When a person decides not to participate in a case, I think people jump to assume that they were lying.”
But Vellakkatel says he doesn’t think that’s the case.
“In my experience, false reports of domestic violence are very rare,” he says, adding he’s only come across one case in his career that was dismissed because the incident was fabricated.
Vellakkatel encourages survivors to report abuse, even when they’re concerned they might not be believed.
“Do not be concerned about being believed or not. Be concerned about your personal safety or your children’s safety,” he says. “If we do not file a case, it’s not because we didn’t believe you. It’s because there’s insufficient evidence to prove a case beyond a reasonable doubt.”
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.
The aftermath of rape and sexual trauma
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 and boys suffer rape and sexual trauma each year.
Regardless of age or gender, 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.
Myths and facts about rape and sexual assault
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 he looks or acts.
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 men target vulnerable people 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, boyfriend, or lover forces sex against your will, it’s rape.
Recovering from rape or sexual trauma step 1: Open up about what happened to you
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.
Step 2: Cope with feelings of guilt and shame
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.
Step 3: Prepare for flashbacks and upsetting memories
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.
Soothe panic with this simple breathing exercise
Sit or stand comfortably with your back straight. Put one hand on your chest and the other on your stomach.
Take a slow breath in through your nose, counting to four. The hand on your stomach should rise. The hand on your chest should move very little.
Hold your breath for a count of seven.
Exhale through your mouth to a count of eight, pushing out as much air as you can while contracting your abdominal muscles. The hand on your stomach should move in as you exhale, but your other hand should move very little.
Inhale again, repeating the cycle until you feel relaxed and centered.
Tips for dealing with flashbacks
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.
Step 4: Reconnect to your body and feelings
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.
To recover after rape, you need to reconnect to your body and feelings
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.
A powerful program for reconnecting to your feelings and physical sensations
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.
Step 5: Stay connected
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.
Step 6: Nurture yourself
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.
How to help someone recover from rape or sexual trauma
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.
Authors: Melinda Smith, M.A. and Jeanne Segal, Ph.D.
Complex PTSD (CPTSD) in Teen Girls after Sexual Assault: Diagnosis and Treatment
Sexual Assault Can Affect Victims for Decades: What Type of Treatment Can Help?
Sexual assault is a crime that affects millions of people in the U.S.
The emotional and psychological consequences of sexual assault can cause severe, lifelong impairment. We’ll discuss these consequences and the details of the impairments below, but it’s important, first, for all members of the general public to understand that sexual assault can affect typical physical, psychological, and emotional development, degrade relationships, reduce cognitive function, and have a negative impact on academic performance, employment, decision-making, self-esteem, social functioning, and overall wellbeing.
We identify the event that leads to this broad host of impairments in the title of this article: sexual assault. The mental health disorder that develops as a result of sexual assault is called post-traumatic stress disorder (PTSD). In cases of sexual assault, many victims develop a variation of PTSD called complex post-traumatic stress disorder (CPTSD), which was defined and added to the International Classification of Diseases, 11th Revision (ICD-11), by the World Health Organization (WHO) in 2019, and came into effect for use by clinicians in January, 2022.
There’s another thing all members of the general public should understand about sexual assault before we offer clinical definitions, prevalence statistics, and additional data:
Adolescent girls have a higher risk of sexual assault than any other demographic group.
That’s why we write articles like this one. We work with adolescents every day of the year, and we see the consequences of sexual assault in adolescent girls with alarming frequency. We accept girls into our programs for depression, anxiety, behavioral issues, alcohol and drug addiction, and other mental health disorders. While every girl we meet does not have a history of sexual assault, the correlation between girls with mental health issues with severe impairment and girls who are victims of sexual assault is shocking: our goal is to inform anyone reading this article about how we – and they – can help girls who experience this crime recover and rebuild their lives in the face of extreme, painful, and recurring emotional consequences.
[NOTE: We understand sexual assault happens to boys and men, too. However, due to the overwhelmingly disproportionate prevalence of sexual assault among women, and teen girls in particular, we’ll use this time to focus on them.]
First, we’ll define sexual assault, share prevalence statistics, outline the devastating effects these conditions have on adolescent girls, then address PTSD and CPTSD in detail. We’ll talk about evidence-based treatments for PTSD and CPTSD in the last section of this article.
What is Sexual Assault?
The Rape, Abuse, and Incest National Network (RAINN) defines sexual assault as “sexual contact or behavior that occurs without explicit consent of the victim.” They identify several types of sexual assault:
Rape, i.e. forcible penetration of the victim’s body
Unwanted fondling or sexual touching
Forcing a victim to engage in sexual acts
Forced sexual acts include:
Being forced to give or receive oral sex
Being forced to penetrate the perpetrator’s body
Now let’s look at the latest statistics on the prevalence of sexual assault in the U.S. We’ll preface this with a figure from a study from 1998, which indicated that at that time, an estimated 17.7 million women had been victims of rape or attempted rape.
Women and Sexual Assault in the U.S.
1 out of every 6 women report sexual assault in their lifetime
66% of victims of sexual assault or rape are 12-17 years old
34% of victims of sexual assault or rape are under age 12
82% of victims of sexual assault under the age of 18 are female
Teen girls age 16-19 are 4 times more likely than the general population to experience rape, attempted rape, or sexual assault
We’ll add another general fact to this series of statistics:
In the U.S., on average, a sexual assault occurs every 68 seconds.
Now let’s look at where sexual assault happens and what victims were doing at the time of the assault.
Sexual Assault: Where Were the Victims and What Were They Doing?
Where they were:
55% were at home or near home
15% were in the open in a public place
12% were at or near a relative’s home
10% were in an enclosed space such as a parking garage
8% were on school property
What they were doing:
48% were sleeping or doing something else at home
29% were out doing errands or going to work or school
12% were working
7% were at school
5% were engaged in unidentified activities
We include these last two bullet lists to drive home a critical point and further dispel an old trope that persist to this day: in almost every case of rape or assault, female victims are not at a nightclub dressed in a miniskirt and tight top. In almost every case of rape or sexual assault, the victim is going about their life, minding their own business, and they become the victim of a crime. In other words, the perpetrator is responsible for the crime, not the victim.
Next, we’ll discuss the consequences of sexual assault.
The Long-Term Emotional Effects of Sexual Assault
As we discuss the long-term consequences of sexual assault and the impact it has on teen girls, let’s not forget the horror of the initial act: while every woman or girl has to deal with the fallout of the experience, it’s important to remember that the incident itself is most often terrifying, violent, and often sends victims into a state of emotional and physical shock.
With that said, let’s consider this next set of facts from tj Rape, Abuse, and Incest National Network (RAINN).
Sexual Assault, Women, and Teen Girls: Long-Term Effects
PTSD, Suicide, and Emotional Distress
94% of female rape victims experience symptoms of post-traumatic stress disorder (PTSD) within two weeks of the rape
30% of female rape victims report symptoms of PTSD persist for at least 9 months after the assault
33% of female rape victims report thinking about suicide.
13% of female rape victims attempt suicide.
70% of rape/sexual assault victims experience moderate to severe distress
Work, School, and Relationships
38% of rape victims report school problems
37% report problems with family and friends
84% of victims of rape by an intimate partner report:
Moderate to severe emotional distress
Increased problem at school
Increased problems at work
79% of victims of rape by a family member, friend, or acquaintance report:
Moderate to severe emotional distress
Increased problem at school
Increased problems at work
67% of victims of rape by a stranger report:
Moderate to severe emotional distress
Increased problem at school
Increased problems at work
Drugs and Alcohol
Victims of rape/sexual assault are more likely to use drugs than people who are not victims of rape/sexual assault. Compared to non-victims, they are:
10 times more likely to use any type of drug
6 times more likely to use cocaine
4 times more likely to use marijuana
When we list the long-term consequences of sexual assault, what we really describe are the symptoms of PTSD and CPTSD. As you’ll see in the next section, the psychological, emotional, and social impairments/consequences associated with rape/sexual assault are virtually synonymous with PTSD/CPTSD symptoms.
“This study aims to determine the frequency and structure of CPTSD, and the relationship of emotion dysregulation with impairment and additional trauma exposure among adolescents who have been sexually assaulted.”
The first thing the study authors do is recognize that sexual assault and rape are severely traumatic events that can disrupt self-organizational capacity and result in the appearance and experience of the core symptoms of PTSD, which include:
Re-experiencing traumatic memories
Cognitive avoidance of traumatic reminders
Behavioral avoidance of traumatic reminders
Persistent sense of threat, in the absence of actual threat
The second thing the study authors do is define the new diagnosis from the ICD-11 – which we discuss above – known as complex post-traumatic stress disorder (CPTSD). When the following three sets of symptoms appear in an individual when no trauma-related cues are present, they meet clinical criteria for CPTSD.
CPTSD: Symptom Profile
Heightened emotional reactivity
Under controlled anger
Beliefs about oneself as diminished
Persistent preoccupation or avoidance of social engagement
Difficulties in sustaining and managing relationships
As we mention above, those symptoms match the post-assault experience of a vast majority of victims or rape or sexual assault. Researchers concluded that CPTSD is a disorder that predominantly applies to victims of rape, but may also appear in victims of torture, prisoners of war, victims of childhood abuse, and/or victims of kidnapping, slavery, or forced prostitution.
It’s clear: CPTSD occurs in response to the most extreme forms of trauma we know about. Now let’s take a look at the results of the study.
Study Results: Prevalence of CPTSD in Teen Female Rape Victims
To measure the prevalence of CPTSD among teen female victims of sexual assault and/or rape, researchers recruited a total of 134 participants. Here’s the make-up of the study group:
All female rape/assault victims
Average age of 15.6 years old
51% had received some type of psychiatric help before the study
32% reported more than on rape/sexual assault
92% of victims reported forced penetration
63% were raped by a person they knew
At two time points – one immediately after the assault and one four months after the assault – researchers gathered data on the following three metrics:
Presence of CPTSD
Further exposure to trauma
Level of impairment
Here’s what they found:
Complex PTSD diagnosis:
59% met criteria for PTSD
40% met criteria for CPTSD
Further exposure to trauma:
After four months:
29% reported additional trauma
9% reported additional sexual trauma
60% reported at least one symptom of self-organization in each of the three domains:
87% emotion dysregulation
75% negative self-concept
75% interpersonal problems
With this data, the study authors confirm their hypothesis: the set of symptoms reported by teen female victims of sexual assault corresponds with both PTSD and CPTSD. In addition, the study authors indicate that:
“Emotion dysregulation was significantly associated with further exposure to general and to sexual trauma above and beyond core PTSD symptoms, negative self-concept and interpersonal problems.”
What that means is that the trauma of rape, particularly when compounded by additional sexual or general trauma, can exacerbate the symptoms of PTSD and meet the threshold for CPTSD. That information is important both for the families of the victims and the therapists who treat them: it can help families find the appropriate treatment team, and enable that treatment team to use therapeutic techniques proven to help people with PTSD and CPTSD.
That brings us to our final topic: what treatments are effective for PTSD and CPTSD?
Evidence-Based Support for Teen Female Rape Victims
In total, they found ten studies that analyzed the effectiveness of a wide range of therapeutic interventions. We’ll pull no punches here: the study authors were neither impressed with the strength of the evidence nor the design of the studies they reviewed. Despite spending significant time discussing the relative weaknesses of the studies, they did identify the following treatment interventions that improved symptoms in female rape victims:
Cognitive behavioral therapy (CBT)
Eye movement desensitization and reprocessing (EMDR)
Cognitive processing therapy (CPT)
Prolonged exposure therapy (PE)
Systematic Desensitization (SD)
Brief psychoeducation (PEI)
Psychological support (PS)
It’s important to note that in the context of this study, all of these interventions occurred in conjunction with CBT. Therefore, the study authors consider them all to CBT-based interventions, and determined they were effective in reducing the following symptoms:
General PTSD symptoms, including:
Avoiding triggers for memories
Constant sense of threat
Fear of subsequent rape/sexual assault
We’ll address that last bullet point, since it’s something we haven’t mentioned. In many cases, victims of rape or sexual assault experience impaired sexual function, which can manifest in various ways. This study indicates that all of the CBT-based interventions listed above can help reduce symptoms related to this phenomenon.
The Bottom Line: Treatment for Complex PTSD Can Help Reduce Symptoms
Adolescent girls who experience rape or sexual assault can develop PTSD or CPTSD, two mental health disorders that can cause severe, lifelong impairment. As we mention above, the symptoms of PTSD and CPTSD can disrupt almost all areas of life, including family, peer, and romantic relationships, academic achievement, work performance, psychological and emotional health, and overall wellbeing. The disruption can be moderate to severe, with severe impairment limiting function in all practical domains. In addition, anxiety, depression, and alcohol/drug use may also accompany the symptoms of rape-related PTSD or CPTSD.
Evidence in the second study we cite above shows that CBT-based interventions are effective in reducing symptom severity. The most effective approaches included:
B-CPT: Brief cognitive processing therapy
Prolonged exposure therapy (PE)
Brief psychoeducation (PEI)
Researchers indicate that multi-session treatments in these modalities that take place over time show the most success in symptom reduction. For families with teenage girls who have experienced rape or sexual assault, that’s valuable information. These girls are at risk of lifelong disruption, but with appropriate treatment and support, they can learn to manage the symptoms related to their experience, and live in the manner of their choosing, rather than a life dictated by the result of one – or several – traumatic experiences during adolescence.