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This article I wrote first appeared at when I was their Official Guide to Post-Traumatic Stress Disorder.


Did you know that approximately fifty percent of women will experience trauma at some point during their lifetimes? The trauma they endure may or may not lead to the mental disorder known as Post-Traumatic Stress Disorder or PTSD. That said, though, one of the more common forms of trauma that women experience, and one that often does lead to PTSD, is sexual assault. In fact, it’s estimated that one third of women will ultimately experience a sexual assault. However, there is not a consensus regarding what percentage of these women will ultimately develop PTSD. But again, the figure seems to be higher than we see for other forms of trauma.

Before we go further, let’s define sexual assault. After all, it may include things you wouldn’t have considered. It doesn't just involve rape, in other words.

What is Sexual Assault?

Sexual assault is any type of sexual activity occurring between two or more people in which at least one of the people is involved against his or her will. And again, while many of us might instantly think of rape after reading this definition, other sexual activities could be involved—such as unwanted touching, grabbing, oral sex, anal sex, sexual penetration with an object, or it could involve sexual intercourse. Also, you need to realize  that there are a number of ways a woman could become involved in sexual activity against her will. Certainly, sometimes an aggressor will use the type of physical force that we typically associate with rape. However, a woman could also be bribed or manipulated into having sex with someone, for example, who has some form of authority over her—such as her doctor, a professor, or a boss.

A woman might also be taken advantage of sexually while under the influence of alcohol or drugs. While the perpetrator may have given these to the woman, it is also possible he may not have found this to be necessary—not if she already was abusing chemical substances, for instance. Sadly, if the assaulted woman had a history of childhood sexual abuse, she may well have been using alcohol or drugs to manage her emotional wounds stemming from this earlier trauma. But then, her addiction essentially set her up to become an easy target for a male with likely neither scruples nor a conscience.

Did you also know that some women who were sexually abused as children are inclined to engage in high-risk sexual behaviors that increase the likelihood that they will be raped or otherwise sexually assaulted? Are you wondering why this would be so? Well, it's important to to realize that some of these women do not become sexually aroused unless they are engaged in dangerous sexual liaisons or behaviors. This makes sense when you realize the childhood sexual abuse likely occurred under conditions that promoted fear as well as provided pleasurable sensations. As a result, the woman became programmed by her past to respond to sexual experiences encased in fear—not those that the average woman would prefer because they make her feel cared for as well as safe.

The woman who has been programmed by her childhood sexual abuse history in this way is apt to find nice men boring. Well, and she may also have difficulty becoming orgasmic in sexual relationships with nice, safe guys.

The Psychological or Behavioral Aftermath of Sexual Assault

Not all women will respond to sexual assault in exactly the same way. In fact, while some sexual assault victims may experience immediate reactions, others may have delayed reactions instead. Furthermore, while many a woman will report feeling shock, confusion, anxiety, and/or numbness soon after the sexual assault, other women will experience feelings of denial—thereby not fully acknowledging what happened, or downplaying the intensity of the experience.

If the woman knew the individual who assaulted her, which is more frequently the case than not, not only is she apt to downplay the severity of what happened, but she may well blame herself for the sexual assault. For example, she may try to convince herself that she wore clothing that was too provocative, was flirtatious when she hadn’t intended to lead the man on, that she should never have agreed to meet in private with him—or she’ll cling to some other rationalization that essentially clears the attacker of any responsibility for what he did to her.

During the early days following the sexual assault, the woman is apt to experience flashbacks as well as nightmares about the event. She is apt to have difficulty concentrating—to feel jumpy or on edge. These symptoms can sometimes become so severe, in fact, that the sexual assault victim discovers she can’t resume a normal life. Instead, she may describe the world as feeling strange and unreal—as if she's now in a dream.

The sexual assault victim may also come to avoid anything that she believes could possibility remind her of that attack. As a result, she may avoid sexual activity with a spouse or loved one. The thing is, she may do this at a conscious level or, instead, her brain may essentially hijack her more rational mind and cause her to behave this way. As a result, she may refuse to go places, do things, think thoughts, experience feelings, or interact with people she was perfectly comfortable with prior to the sexual assault.

The sexually assaulted woman may experience anxiety or hyper-arousal, too. In other words, it is as if she's in a fight or flight mode and can’t get out of it—that her body will not calm down. Not surprisingly, this can cause her to have difficulty sleeping and concentrating. She may also find herself becoming irritated at things that she’d have previously overlooked—that she sweats even the small stuff, you might say.

Of course, if you know anything about Post-Traumatic Stress Disorder or PTSD, you may realize that we’ve just been talking about re-experiencing, avoidance, and hyper-arousal—all categories of symptoms used to diagnose PTSD. However, they're used to diagnose PTSD only after they've lasted for longer than one month following the traumatic event that gave rise to them.

PTSD Symptoms Should be Treated Sooner versus Later

The sexual assault victim should seek immediate professional help whether or not she fears developing PTSD. But certainly, if she has symptoms indicative of PTSD, she should seek out a qualified mental health professional who can make a proper diagnosis as well as begin treatment of those PTSD symptoms. After all, as it is with any significant physical illness, the sooner the impacted person seeks out diagnosis and treatment, the better the prognosis for successful treatment. (However, some people have been effectively treated for PTSD many years after the traumatic event, so please don't continue to suffer just because you failed to get treatment early on. It's better late than never!)

That all said, remember how we talked earlier about the victim of childhood sexual abuse perhaps going on to engage in substance abuse to try and manage the wounds of that hurtful victimization? Well, the sexually assaulted PTSD sufferer may be inclined to do the same if she does not get treatment for her PTSD symptoms early on. Please realize that unlike the symptoms of low-level depression, PTSD symptoms are not apt to just disappear on their own. Furthermore, unlike the pain of an injury, just trying to endure the pain—emotional pain in this case—won’t work well, either.

Sexual assault is a serious form of trauma to have endured. And indeed, when there are PTSD symptoms present, they should be viewed as essentially shouting at the survivor that things are going on with her mind and body that aren’t healthy. Hence, immediate professional attention is needed. But of course, the sexually assaulted PTSD sufferer should try to find a mental health professional who specializes in PTSD stemming from sexual trauma.

Oh, let me offer some more words of advice. Any victim of sexual assault needs to be upfront with the therapist about what happened—and she should divulge any prior incident of sexual assault (which would include a history of childhood sexual abuse should there have been one). The better history a sexual assault victim can provide the therapist, the better level of help that mental health professional should be able to offer.