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After Sexual Assault

Effects of Sexual Assault

The effect of sexual assault is not only psychological or emotional but also impacts a person's being physically, socially, interpersonally and financially.

Rape is not just physical violence, it is also mental violence and not easily forgotten” [1]

Information on this page has been adapted  from The impact of Sexual Assault on Women by Cameron Boyd (2011) with permission. 

By Cameron Boyd


Reactions of Survivors

It is important to understand that each person reacts uniquely to sexual violence, and there is no right or wrong way to cope or feel after the experience. Each person is different and there are many factors that can influence feelings and reactions after the event(s). Some of the factors may be:

  • the victim/survivor's relationship to the perpetrator,
  • extent and severity of any accompanying psychological or physical abuse,
  • severity of the abuse,
  • extent of physical harm,
  • length of time over which the abuse occurred,
  • responses of family and friends of the victim/survivor,
  • the person's experience of the first responders such as hospital, nurse, doctor or police as well as the subsequent system of courts and counselling,
  • the personal history of the victim/survivor. [2]

Many survivors experience these responses after sexual assault or abuse:

  • Diminished self-esteem with frequent feelings of shame, humiliation, guilt, anger, and powerlessness;
  • Negative self/body image and feelings of ugliness associated with shame and embarrassment of body;
  • Physical symptoms of stress – such as headaches, stomach upsets, eating and sleeping problems, lethargy;
  • Increased anxieties or tendency towards depression or depressive behaviour;
  • Feelings of anger, fear, rage, couple with numbness and disconnection from shock;
  • Increased isolation from others, withdrawn or difficulty trusting others;
  • Erratic mood swings from hyper-alert to inconsolable grief to aggressive;
  • Increased usage of alcohol or drugs to numb or cope with feelings and memories;
  • Self-harm such as cutting, burning or scratching as way to numb or cope with feelings;
  • Difficulty in returning to usual behaviours with inter-personal relationships;
  • No or little desire for sexual intimacy OR increase in risky sexual behaviors;
  • Flashbacks of the incident(s) and fear of being alone;
  • Nightmares or other sleep disturbances;
  • Loss of employment or school time due to inability to concentrate

These responses and the coping methods to deal with them can change over time. If you are the survivor, remember that it was not your fault, and talking about it will help.

If you are a friend/family member, be supportive and give the person time and space to heal in the way they need to.

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After the sexual assault

It is extremely important to understand that there is no particular pattern of response and some people respond immediately while other have delayed reactions. Some are affected by the assault for a long time whereas others appear to recover rather quickly.

We all respond differently to traumatic events.

Psychological and emotional impacts

Sense of a foreshortened future was for me the most terrifying symptom of trauma, I was obsessed with the thought that I was going to die ... even though he was gone, my psyche still behaved as if it expected a disaster to happen.” [3]

A range of short-term and long-term psychological and emotional impacts have been associated with sexual assault.

Immediate and short-term impacts

During the attack itself, it is common to experience reactions such as an intense fear of death and dissociation. These are natural physical responses. Being paralyzed by fear does not mean the victim/survivor wanted the assault to happen. Even if the victim/survivor "decides" that it is safest not to physically resist in the situation, this does not mean she wanted it to happen or gave consent.

I said no but he didn't care. He was nearly three times my size so when it became clear he was probably going to do what he was going to do, I quit fighting and probably dissociated through the rest of it.” [4]

Research indicates that fear is a common immediate and short-term psychological impact:

  • Anxiety and intense fear are the primary responses following rape. Some research has found that this peaks at around three weeks after the rape [5]  however, it can last for more than a year for a significant number of survivors.
  • Ongoing fears can be related to reminders of the attack (e.g., legal proceedings or medical examinations, being with another person, or being in a location that reminds the person of the assault).
  • Fear of contracting HIV/STIs and/or becoming pregnant as a result of sexual assault.  [6]
  • Fears of future attacks and other harm can follow sexual assault especially if the victim/survivor had previously experienced the world as basically a safe place, and now this assumption is shattered. The world appear to be inherently untrustworthy and unsafe which can lead to the restriction of social activities, including work and community involvement. This may be particularly profound when the perpetrator is an intimate partner. [7]

For some women, particularly those from marginalized communities, sexual assault can reaffirm assumptions about themselves as devalued persons ("insidious trauma"), and about the world being unsafe and dangerous.[8]

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Medium-to-long-term impacts

Research suggests victim/survivors may experience a range of medium to long-term impacts:

  • Feelings of low self-esteem, self-blame and guilt can endure for months and years after the assault.
  • It is common for survivors to forget or deny aspects of their experience. This can be a defense against overwhelming feelings of confusion, shock and bewilderment. This may be especially powerful in partner rape.

I've done such a good job of blocking it all out. I can't remember very much. I hated all of it.” [9]

  • Suicidal ideation is more common among victim/survivors of sexual assault than the general population. [10]  Younger victim/survivors may be at particular risk of actually attempting suicide following rape. [11]

Trauma and post-traumatic stress disorder (PTSD)

The trauma response model and clinical diagnosis of post-traumatic stress disorder (PTSD) has helped to acknowledge the significance of the harm caused to people who have been sexually assaulted, and the extent of the violation they have experienced. PTSD is a psychiatric label for a collection of psychological symptoms following a traumatic event.  Symptoms of PTSD can include:

  • intrusive thoughts and distressing recollections of the violence,
  • nightmares and other sleep disturbances depression,
  • mood or anxiety disorders,
  • depression, lack of any self-care or self-worth.

Though I am ashamed to admit this, yes, suicide did enter my mind on many occasions and thankfully I was blessed in my life by daughters because they were my reason for surviving and pressing on even when I could barely stand my existence. I am still frequented by many of these emotions and am now just beginning, through therapy and strong support system, to work through them.[12]

Women who have experienced sexual violence may constitute the single largest group of people affected by PTSD. [13]

PTSD "stresses the abnormal nature of the stressor that causes the mental health symptoms, not individual pathology." [14] 

In other words, PTSD symptoms are "normal" or typical responses to sexual assault. [15]

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Physical impacts

To this day I will never know whether my back problem was actually caused by the force of the rape or me trying to push him off me. I have permanent damage to my back.” (Unnamed victim/survivor in Easteal, 1994, p. 75.)

I bled for weeks and future sexual experiences were extremely painful and caused more bleeding.” (Unnamed victim/survivor in Easteal, 1994, p. 99.)

Not all women who are sexually assaulted experience physical injuries or medical problems. However, a range of physical injuries and health consequences can be associated with sexual assault. Injuries can be sustained as a direct result of the assault itself, from later complications, or from its psychological impact.

Physical impacts can include:

  • damage to the urethra, vagina and anus (for some victims of penetrative sexual assault),
  • gastrointestinal, sexual and reproductive health problems; pain syndromes and eating disorders, especially bulimia nervosa,
  • increased risk of contracting sexually transmissible infections, including HIV/AIDS,
  • unwanted pregnancy and decisions regarding abortion,
  • pelvic pain,
  • irritable bowel syndrome,
  • chronic diseases such as diabetes and arthritis,
  • headaches,
  • gynaecologic symptoms; for example, dysmenorrhea (severe pain or cramps in the lower abdomen during menstruation), menorrhagia (abnormally heavy or prolonged bleeding during menstruation) and problems associated with sex,
  • sleeping and eating disturbances.

Continued Trauma for victims of acquaintance sexual assault

If the perpetrator(s) is known to the victim and is/are someone with whom they socialize, victims of acquaintance sexual assault often have to encounter their assailants after the rape. Fear of such encounters can cause increased distress and humiliation for the victims.

[1] Anonymous victim, 1994

[2] Daane, 2005

[3] ."Rachel", in Easteal & McCormond-Plummer, 2006, p. 140

[4] "Jill", in Easteal & McCormond-Plummer, 2006, p.26

[5] Peterson, Olasov & Foa, 1987, cited in Petrak, 2002

[6] Holmes et al., 1996, and Resnick, Acierno, & Kilpatrick, 1997, both cited in Astbury, 2006

[7] Crome & McCabe, 1995

[8] Wasco, 2003

[9] "Kate", in Easteal & McCormond-Plummer, 2006, p. 3

[10] Stepakoff, 1998

[11] Petrak, 2002

[12] “Summer" in Easteal & McCormond-Plummer, 2006, pp. 143-144

[13] Calhoun & Resnick, 1993, cited in Astbury, 2006

[14]  Walker, 1991, p. 22, cited in Bennice, Resick, Mechanic, & Astin, 2003

[15] Valentiner, Foa, Riggs, & Gershuny, 1996


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