There is no "typical" reaction to experiencing sexual assault, but some ways of responding are more common than others. The likelihood of developing mental health problems varies from person to person, but a recent study found that 80% of teenage girls who had been sexually assaulted were suffering with anxiety, depression, post-traumatic stress disorder (PTSD) and other conditions months after the event.
Professionals said the findings showed that abuse in childhood can lead to mental health issues that can have a lasting impact into adulthood and even persist for a lifetime. A quarter of women with mental health conditions have been abused as a child, according to research from Agenda, the alliance for women and girls at risk.
"Too many are not able to get the help they need and are left to try to cope on their own," Jessica Southgate, the charity's policy manager, told Refinery29. "Some turn to drugs and alcohol to deal with the trauma, which can be the start of a downward spiral affecting their whole lives." The charity is calling for greater investment in appropriate mental health support, "where women and girls are asked about experiences of abuse and trauma and this is then taken into account in their care."
One woman who has felt the lifelong impact of childhood abuse is 32-year-old Rachel (not her real name), from Oxfordshire, who was abused from the age of 10 by a family member, and as a result has suffered a number of mental health problems into adulthood. Her experiences with mental health support have led her to believe trauma isn’t recognised and properly responded to in mental health services. She told her story to Refinery29 UK.
When the abuse first started I had no idea what was going on, but I guess that’s the nature of grooming; it’s the way a perpetrator prepares their victim for the abuse. He was manipulating me psychologically, so he could get away with what he wanted to do to me. He wore down my confidence, while taking advantage of the fact that I trusted him, looked up to him and wanted his approval. It didn’t take long before he started touching me sexually. He was left to babysit me when my parents went out in the evening, so it would inevitably happen then. I was scared of him, but I was more scared of his threats about what would happen if my parents knew what was going on, so I didn’t put up a fight. Often, the terror response made me unable to move. I’d dissociate, and my body would freeze.
I didn’t even notice that I felt scared and worried all the time. Constant fear was just normal.
That time period is hazy for me, but this happened at least every week for a number of months. The assaults got progressively worse as he gained confidence, and he eventually raped me. When he started to attack me while my parents were home, I tried to resist. He was violent then, and used his bodyweight to hold me down. I was only a little girl – there was no way I could win a physical fight. The abuse stopped when my parents found out. Despite the authorities being involved, the police only gave him a caution. I continued living in fear of him and feeling the huge shame he evoked in me for another eight years. So while the abuse had stopped, the feelings attached to it were very much alive. Being around my abuser meant that the trauma was cycling through me constantly.
I’ve seen many doctors and been given various diagnoses over the years. Major depression, complex PTSD, emotionally unstable personality disorder (also known as BPD), anorexia. None of these really say much about what I’ve been through. They're just labels for collections of symptoms. Anxiety has been a continuous presence in my life since the abuse. It's been so permanent for so many years that until a few years ago, I didn’t even notice that I felt scared and worried all the time. A state of constant fear was just normal. I’ve had bouts of depression since I was a teenager; some worse than others. This presented as very low moods, trouble sleeping, and a general lethargy that made doing anything at all feel impossibly hard.
In 2014 things got a lot worse when the PTSD symptoms fully emerged. I had a lot of nightmares and flashbacks, and experienced huge anxiety and panic. I self-harmed and drank heavily to calm the horrific feelings and distract from the memories. I also starved myself and used food to try and get a sense of control. I was given antidepressants, but they didn’t have much effect other than to numb me a little. My thoughts were extremely dark and I fantasised about suicide constantly. The self-harm became so severe that I was regularly in A&E.
I tried to kill myself multiple times. I took a lot of overdoses.
After an episode of self-harm that led to me needing 40 stitches, I was admitted to a psychiatric hospital. I stayed in the hospital for three months, much of it under constant observation by nurses. While this kept me relatively safe from myself, it didn’t improve my health. After being discharged, I was more dangerously suicidal than I'd been before. The traumatic memories and nightmares felt unbearable, they made it feel like my life was torture. I tried to kill myself multiple times. I took a lot of overdoses, some meant more to harm myself and some with the intent of ending my life. My anorexia was also attached to my desire not to live. It felt like by not eating, I could just gradually fade out of my life.
None of this has completely gone away, even though it's been several years since my breakdown. Random interactions and experiences in daily life still trigger feelings of trauma, shame, anxiety and panic attacks. I still find those feelings unbearable a lot of the time, and they limit me in a big way. I struggle not to self-harm, and I continue to battle my eating disorder. While things have improved, I know I'm still a very long way from being able to say I’m doing okay.
I’m now unable to work full-time, as I need a lot of time for therapy.
This illness killed my career opportunities. I used to work full-time and was gaining skills and progressing steadily. Shortly before I was signed off work, I’d been promoted to a management role. After taking almost a year off when I had my breakdown, I felt like my employer lost faith in me. I’m now unable to work full-time, as I need a lot of time for therapy and to take care of myself. An employer told me there was no chance of me being promoted again while I worked part-time. I'm now self-employed, and while I don’t have as much job security, it's better for my health that I'm able to choose when, where and for how long I work each day.
In terms of my relationships, the impact of my illness has been huge. In particular, it's put a big strain on my marriage. My wife is an incredible, kind, patient woman who has educated herself about trauma and recovery. But still, I’ve seen the toll it's taken on her; being so afraid for me and being with me in my pain. She went from being my equal to being my carer. It’s very difficult for a relationship to survive that kind of shift. On top of that, it’s hard to have any physical closeness when sexual intimacy can trigger flashbacks. It's frustrating and so sad to be unable to have that intimacy with the person you love most in the world. My illness has often come between us in this way. There have been some tough times and we’ve both had to work hard to try and get our relationship back to a healthy place.
While I've lost friendships as a result of my breakdown, strangely I feel as though I've gained better, more authentic ones. In treatment centres and peer support groups, I’ve met people who really understand me and are willing to hear and be open with me. Those friends are an incredible resource that I didn’t have before I was ill. They’re people I can be truly honest with, and that’s a wonderful thing to have in my life.
It’s important to have inquiries into historic abuse, but nothing is being done to address the legacy of that trauma.
I have sought support and had very mixed experiences. The NHS has, on the whole, massively let my wife and I down. I’ve found support in a few different addiction groups, like AA (Alcoholics Anonymous) and CoDA (Codependents Anonymous). While I haven’t ever come across anyone with my own background, I often find common ground with the people I encounter at meetings that helps me feel less alone. I’m also fortunate enough to be able to pay to have psychotherapy privately. I’ve been working with my therapist for almost four years now, and I can say that without her support there are times I just wouldn’t have got through. Therapy is incredibly hard, and intensely painful, but I look forward to seeing my therapist every single week. It’s amazing to have this very safe space with her, in which I can work through the things I really struggle with.
Anyone who has been the victim of such awful crimes should be referred for specialist counselling to process their trauma. It infuriates me that, as far as I've experienced, there's nothing like this in existence. Given how there has been so much public discussion of sexual abuse in recent years, it's beyond my understanding that there's still no proper trauma treatment available for victims – unless they have the means to pay for it. Of course it’s important to have inquiries into historic abuse, but it feels so wrong that nothing is being done to address the legacy of that trauma.
To anyone who may be suffering in silence after sexual assault, I'd say: You are not alone, and you don’t have to suffer in silence. You might feel ashamed, but that shame is not yours. That shame belongs entirely to the person who violated you. You can have a voice, and if you find someone you feel safe with, you can give a voice to that girl inside you who was so painfully wounded. Your truth matters, and there are people who will help you carry it. The road to healing is not an easy one, but you’ve had the strength and courage to survive this far, so you will get through it.
If you have experienced sexual violence of any kind, please visit Rape Crisis or call 0808 802 9999.