Victim-survivors of sexual assault may experience psychological trauma that affects thoughts, emotions, identity, relationships, and overall health. While trauma responses vary, common reactions include but are not limited to: ^1-4

• Numbness
• Intrusive thoughts and flashbacks
• Night terrors 
• Difficulty opening up to others 
• Shame, guilt, and self-blame
• Depression 
• Anxiety
• Disordered eating 
• Emotional detachment and dissociation
• Hypervigilance
• Suicidal ideation
• Self-harm

Many victim-survivors struggle with these reactions and question whether their experiences are worthy of support. It’s important to recognize that all responses are valid, and all victim-survivors deserve care and support. 

Post-Traumatic Stress Disorder

A commonly reported mental health diagnosis after sexual assault is Post-Traumatic Stress Disorder (PTSD). PTSD can develop after experiencing or witnessing a life-threatening or deeply distressing event (like sexual assault). Not all survivors develop PTSD. Some may experience Acute Stress Disorder (ASD), Adjustment Disorder, and/or trauma-related anxiety and depression. According to the National Center for PTSD, around 94% of sexual assault victim-survivors experience symptoms of PTSD, with an estimated 30–50% going on to develop chronic PTSD.^3-4 

Symptoms of PTSD can include:

• Re-experiencing the trauma through flashbacks, nightmares, or intrusive thoughts.
• Avoidance of reminders, places, people, or situations associated with the trauma.
• Negative changes in thoughts and mood, including hopelessness, detachment, or distorted blame.
• Heightened arousal
• Irritability
• Difficulty concentrating

Complex Post-Traumatic Stress Disorder

For some survivors, including those who may have experienced child sexual assault (CSA), intimate partner violence, and/or repeated traumatic experiences may align with Complex PTSD (C-PTSD). Although C-PTSD is not officially recognized in the DSM-5 it is widely accepted throughout international diagnostic models.⁸ Therapies such as EMDR and trauma-focused CBT are often recommended for victim-survivors with C-PTSD Some symptoms of C-PTSD may overlap with PTSD, but have distinct features of C-PTSD include: 

• Difficulty regulating emotions
• Distorted self perception 
• Trouble with trust and intimacy
• Difficulty forming healthy attachments and problems maintaining healthy boundaries.   
• Chronic feelings of emptiness
• Chronic pain 

Minoritized victim-survivors of sexual assault such as BIPOC, LGBTQIA+ individuals, people with disabilities, immigrants, sex workers, and others often experience compounded trauma from systemic oppression, discrimination, and/or lack of access to culturally competent care and support.⁹ These intersecting barriers can worsen trauma and delay or prevent healing. All healthcare providers, including mental health professionals must acknowledge and affirm victim-survivor’s intersecting identities, past experiences, and cultural contexts. Culturally responsive and anti-oppressive therapy is critical to adequate and affirming support. 

The Body-Mind Connection

The effects of trauma are not just psychological, they live in the body. Survivors often experience somatic symptoms like headaches, fatigue, muscle tension, or stomach problems that have no clear medical explanation but are very real.

The body-mind connection refers to the intricate ways our nervous system, hormones, and immune responses interact with trauma:^{6, 7}

• Hyperarousal of the autonomic nervous system can keep the body in a state of fight-or-flight long after the threat is gone.
• Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis can disrupt sleep, appetite, and stress responses.
• Dissociation is a sense of disconnection from one’s body and emotions.
• Somatic flashbacks are when our body re-experiences physical sensations that occurred during a traumatic event.

Somatic-based therapies like sensorimotor psychotherapy, somatic experiencing, and/or trauma-sensitive yoga can help victim-survivors reconnect with their bodies.^{6, 7}

Long-Term Mental Health Effects¹⁰

Victim-survivors may continue to experience challenges that interfere with daily life functioning and relationships for months or years after the trauma. These can include:

• Depression including symptoms of persistent sadness, loss of interest, feelings of worthlessness
• Anxiety Disorders: including panic attacks, generalized anxiety, social anxiety
• Obsessive Compulsive Disorder (OCD) which can sometimes be triggered by a need for control post-trauma
• Eating Disorders: such as anorexia, bulimia, or binge eating that tends to be linked to body control 
• Self-harm and/or suicidal ideation

Longitudinal studies following sexual assault report that victim-survivors of sexual assault are three times more likely to suffer from major depressive disorder and over six times more likely to attempt suicide than non-survivors.^11-13 However, many survivors are able to heal after trauma. There are many national, local, and virtual resources available to help victim-survivors rebuild and move forward with a fulfilling and joyous life. It’s important to recognize that survivor’s mental health does often suffer after experiencing violence or abuse, but that there is hope beyond those struggles.

Sources

1. Dworkin, E. R., & Weaver, T. L. (2021). The impact of sociocultural contexts on mental health following sexual violence: A conceptual model. Psychology of violence, 11(5), 476. https://dx.doi.org/10.1037/vio0000350 
2. Campbell, R., Dworkin, E., & Cabral, G. (2009). An ecological model of the impact of sexual assault on women’s mental health. Trauma, Violence, & Abuse, 10(3), 225-246. https://doi.org/10.1177/1524838009334456 
3. Dworkin, E. R., Jaffe, A. E., Bedard-Gilligan, M., & Fitzpatrick, S. (2023). PTSD in the year following sexual assault: A meta-analysis of prospective studies. Trauma, Violence, & Abuse, 24(2), 497-514. https://doi.org/10.1177/1524838009334456 
4. Brooker, C., & Tocque, K. (2016). Mental health risk factors in sexual assault: What should Sexual Assault Referral Centre staff be aware of?. Journal of forensic and legal medicine, 40, 28-33. https://doi.org/10.1016/j.jflm.2016.01.028 
5. Kilpatrick, D. G., Resnick, H. S., Milanak, M. E., Miller, M. W., Keyes, K. M., & Friedman, M. J. (2013). National estimates of exposure to traumatic events and PTSD prevalence using DSM‐IV and DSM‐5 criteria. Journal of traumatic stress, 26(5), 537-547. https://doi.org/10.1002/jts.21848 
6. Ulirsch, J. C., Ballina, L. E., Soward, A. C., Rossi, C., Hauda, W., Holbrook, D., & McLean, S. A. (2014). Pain and somatic symptoms are sequelae of sexual assault: results of a prospective longitudinal study. European journal of pain, 18(4), 559-566. https://doi.org/10.1002/j.1532-2149.2013.00395.x 
7. Jacobsen, S. A., Frostholm, L., Buhmann, C. B., Petersen, M. W., Ørnbøl, E., Dantoft, T. M., & Carstensen, T. B. W. (2023). Are sexual assaults related to functional somatic disorders? A cross-sectional study. International journal of environmental research and public health, 20(20), 6947. https://doi.org/10.3390/ijerph20206947 
8. Shatsky, S. M. (2025). Revising and Consolidating the DSM-5 and ICD-11 Post-Traumatic Stress Disorders Into a Dimensional Spectrum-Based Disorder: A Literature Review. https://doi.org/10.15760/honors.1643 
9. Scott, C. V., Singh, A. A., & Harris, J. C. (2023). The intersections of lived oppression and resilience: Sexual violence prevention for women of color on college campuses. In Intersections of identity and sexual violence on campus (pp. 119-139). Routledge. 
10. Turgumbayev, M., Shopabayev, B., Dzhansarayeva, R., Izbassova, A., & Beaver, K. (2023). An examination of associations between sexual assault and health problems, depression or suicidal ideation in a large nationally representative cohort of male and female 20-30-year-olds. Criminal behaviour and mental health : CBMH, 33(3), 196–212. https://doi.org/10.1002/cbm.2280
11. Bentivegna, F., & Patalay, P. (2022). The impact of sexual violence in mid-adolescence on mental health: a UK population-based longitudinal study. The lancet. Psychiatry, 9(11), 874–883. https://doi.org/10.1016/S2215-0366(22)00271-1 
12. Khadr, S., Clarke, V., Wellings, K., Villalta, L., Goddard, A., Welch, J., … & Viner, R. (2018). Mental and sexual health outcomes following sexual assault in adolescents: a prospective cohort study. The Lancet Child & Adolescent Health, 2(9), 654-665. https://doi.org/10.1016/S2352-4642(18)30202-5 
13. Li, J., Jin, Y., Xu, S. et al. Anxiety and Depression Symptoms among Youth Survivors of Childhood Sexual Abuse: A Network Analysis. BMC Psychol 11, 278 (2023). https://doi.org/10.1186/s40359-023-01275-3

The post Acute and Long Term Mental Health Needs After Sexual Assault appeared first on Survivors.org.

Join us virtually on the second Wednesday of every month for meditation, musical healing, discussion/writing prompts, and community. Each month, we explore a new topic. Join in the conversation between the facilitators and other survivors, or just sit and listen. All BIPOC are welcome to join, whether you are a survivor yourself or know someone who is. Learn about what healing can look like and take home some tools and tips. Registering once gains you access to all upcoming BIPOC Healing Circles and our Survivor Support Newsletter, so you will only need to register one time. Before registering, be sure to read our Requirements and Guidelines below. This group is not for therapy purposes. Resources will be provided to participants for emergency support.

Upcoming BIPOC Healing Circles

Requirements

• This group is for adults only 18+.
• This groups is for all adult BIPOC survivors, regardless of sex, sexual orientation, etc.
• This group is NOT therapy. The facilitator is there to guide the conversation, not provide therapy or advice.
• This group is for survivors of all types of sexual violence
• There is no vetting process to join the group, but you must register via Zoom
  • registration details via Zoom will only be available to Survivors.org, and attendees may use pseudonyms during the group.
  • while we do not vet or ask participants about their BIPOC identity, we ask that those who are not members of the BIPOC community to not attend this specific group to maintain it as a safe space for BIPOC survivors
• Sharing stories of sexual assault is not required, and, in fact, Survivors.org encourages attendees to discuss coping and emotions as opposed to detailed stories of assault.
• Survivors.org staff is subject to mandatory reporting, so personally identifiable disclosures of the abuse of children, the elderly, and/or vulnerable adults will be reported to the appropriate state agency.
• All individuals must register. If two people are sharing the same computer, they need to both register.

Guidelines

Joining this group means you agree to these guidelines. Anyone who does not abide by these guidelines will be given a warning, and if the behavior continues, they will be removed from the group at the facilitator’s discretion. If a person commits any acts of violence or harassment against other members, they will be immediately removed and not welcome back into the group. Survivors.org cannot guarantee a safe space in all circumstances, but it strives to create a space that is as safe as possible for all survivors.

The post BIPOC Healing Circles appeared first on Survivors.org.

Upcoming Trauma-Informed Art Workshops

Requirements and Guidelines

By registering for the Trauma-Informed Art Workshop, you agree to abide by the following requirements and guidelines, and understand that violation of the requirements and guidelines may result in a permanent removal from our support spaces.

Requirements

• This group is for adults only 18+.
• All adults are welcome, regardless of identity (race, gender, sex, sexual orientation, religion, etc).
• This group is NOT therapy.
• This group is for survivors of all types of sexual violence (stay tuned for info on groups for loved ones, teachers, parents, etc.).
• There is no vetting process to join the group, but you must register via Zoom
  • registration details via Zoom will only be available to Survivors.org, and attendees may use pseudonyms during the group.
• The only materials you will need to participate are something to draw with, such as a pen, colored pencils, or paint, and something to draw on, like a piece of paper or a tablet.
• Sharing stories of sexual assault is not required, and, in fact, Survivors.org encourages attendees to discuss coping and emotions as opposed to detailed stories of assault.
• Survivors.org staff is subject to mandatory reporting, so personally identifiable disclosures of the abuse of children, the elderly, and/or vulnerable adults will be reported to the appropriate state agency.
• All individuals must register. If two people are sharing the same computer, they need to both register.

Guidelines

Joining this group means you agree to these guidelines. Anyone who does not abide by these guidelines will be given a warning, and if the behavior continues, they will be removed from the group at the facilitator’s discretion. If a person commits any acts of violence or harassment against other members, they will be immediately removed and not welcome back into the group. Survivors.org cannot guarantee a safe space in all circumstances, but it strives to create a space that is as safe as possible for all survivors.

• Cameras are not required to be on during meetings, but they are encouraged.
• Participants do not need to share their art, but are more than welcome to do so.
• Please refrain from speaking when others are speaking.
• Please respect everyone’s experience and healing.
• No judgment.
• For additional guidelines, please view PAVE’s Community Guidelines
• We will not share attendee information with anyone outside of the organization.
• We will adjust these guidelines and requirements as needed.
• If you have any questions or concerns about these guidelines, please contact Ashley Badgley, ashley@pavingtheway.net

What does it mean to be trauma-informed?

We are trauma-informed when we:

• Realize widespread impact of trauma
• Recognize potential signs and symptoms of trauma
• Respond by using our knowledge
• Resist retraumatization

What is trauma-informed art?

Reminders:

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CBT helps victim-survivors identify and challenge negative thought patterns that may contribute to emotional distress.^1-3 For example, many victim-survivors experience self-blame, guilt, or feelings of worthlessness.³ CBT helps by providing skills to recognize negative thoughts and replace them with more realistic perspectives. By shifting how they think about themselves and their experiences, victim-survivors can reduce anxiety, depression, and post-traumatic stress symptoms.^3-6

There are specific techniques used in CBT that may be particularly helpful for victim-survivors like: 

Cognitive Restructuring: This technique involves identifying distorted or irrational thoughts and reframing them in a more positive and realistic light.⁷

Exposure Therapy: A safe, gradual exposure to trauma-related memories or triggers can help desensitize survivors and reduce the intensity of their emotional responses over time.⁷

Behavioral Activation: This method encourages engagement in meaningful activities to counteract feelings of withdrawal and isolation that are common after trauma.⁷

Relaxation Training: Mindfulness and deep breathing exercises are often incorporated to help survivors manage anxiety and regain a sense of calm.⁷

One of the key advantages of CBT is its design to be structured and goal-oriented.⁴ Victim-survivors work alongside their therapist to set goals and track progress, providing a roadmap for healing. CBT also focuses on building practical skills that victim-survivors can use in their day to day to cope with triggers, flashbacks, and overwhelming emotions, and negative thinking patterns. CBT can assist victim-survivors in developing resilience, reduce anxieties, and provide positive coping skills to manage distress.^6-7

It’s important to remember that not every type of therapy works for everyone, and not every therapist is the right fit. If CBT isn’t right for you, there are other options available.

Sources

1. Iverson, K. M., Gradus, J. L., Resick, P. A., Suvak, M. K., Smith, K. F., & Monson, C. M. (2011). Cognitive–behavioral therapy for PTSD and depression symptoms reduces risk for future intimate partner violence among interpersonal trauma survivors. Journal of consulting and clinical psychology, 79(2), 193. 
2. Cohen, J. A., Mannarino, A. P., Kliethermes, M., & Murray, L. A. (2012). Trauma-focused CBT for youth with complex trauma. Child abuse & neglect, 36(6), 528-541. https://doi.org/10.1016/j.chiabu.2012.03.007 
3. Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive therapy and research, 36, 427-440.
4. Beck, J. S. (2011). Cognitive-behavioral therapy. Clinical textbook of addictive disorders, 491, 474-501.
5. Kazantzis, N., Luong, H.K., Usatoff, A.S. et al. The Processes of Cognitive Behavioral Therapy: A Review of Meta-Analyses. Cogn Ther Res 42, 349–357 (2018). https://doi.org/10.1007/s10608-018-9920-y 
6. Olatunji, B. O., Cisler, J. M., & Deacon, B. J. (2010). Efficacy of cognitive behavioral therapy for anxiety disorders: A review of meta-analytic findings. Psychiatric Clinics of North America, 33, 557–577. https://doi.org/10.1016/j.psc.2010.04.002
7. Leichsenring, F., Hiller, W., Weissberg, M., & Leibing, E. (2006). Cognitive-behavioral therapy and psychodynamic psychotherapy: techniques, efficacy, and indications. American journal of psychotherapy, 60(3), 233-259.

The post Cognitive Behavioral Therapy (CBT) for Victim-Survivors of Sexual Assault appeared first on Survivors.org.

EMDR is typically broken down into eight phases that help guide a therapist and their client through the steps needed to reprocess trauma safely. 

What does it mean to “reprocess” something? 

When discussing trauma, the term “process” refers to the integration of a memory into our sense of self and understanding of the world around us in a way that is no longer distressing. However, when we experience trauma, the intensity of that event may be difficult to functionally integrate into our self-narrative, meaning that we haven’t been able to process it fully. EMDR is built on the belief that PTSD symptoms are the result of these unprocessed memories, and to alleviate post-traumatic symptoms, we must work with a therapist to process them again or reprocess.

Phase 1: History-Taking

A relationship is built between the therapist and the client. The therapist learns about why the client is seeking therapy and their history of trauma. The client shares their history and triggers to help guide the process. Then, a treatment plan is discussed by identifying target goals for therapy, and additional resources outside of therapy are assessed to ensure client safety between sessions.

Phase 2: Preparation

Next, the therapist will explain EMDR, how it works, and what to expect. The therapist will help the client build additional coping skills and resources for when they become triggered during or after the reprocessing begins. One common exercise is the “safe space,” where the therapist helps the client build a safe space in their mind that evokes feelings of security and comfort. To ensure client safety, Phases 1 and 2 may sometimes span many sessions.

Phase 3: Assessment

In this phase, a target memory is identified. The therapist assesses how the client currently feels about the memory using the Validity of Cognition (VC) and the Subjective Units of Disturbance Scales (SUD). 

Phase 4: Desensitization

Reprocessing begins by desensitizing the client to the memory. The therapist will ask the client to focus on the target memory and engage in some form of bilateral stimulation, which may take the form of moving one’s eyes side to side, alternating taps, or sound that alternates between ears, any physical activity that alternates between stimulating the right and left hemispheres of the brain.

The therapist will then ask the client to discuss any related thoughts or feelings that come up in association with the target memory and encourage them to follow that train of thought. This will continue until the memory is no longer distressing.

Phase 5: Installation

Next, the client will be asked to focus on a positive thought about themselves in association with the memory. They may also visualize what it will look like to be completely free from the hold of this memory. During this step, positive associations are made between the memory and oneself.

Phase 6: Body Scan

The client will scan their body head to toe and identify any lingering distress or tightness remaining in the body. Bilateral stimulation will be repeated to reprocess any remaining distress.

Phase 7: Closure

Steps are taken at the end of every session to return the client to a calm state, whether or not they have finished reprocessing the target memory. If they have not finished reprocessing, steps will be taken to ensure the memory stays contained and the client is safe between sessions.

Phase 8: Reevaluation

At the beginning of the next session, the therapist will review the VC and SUD scales, and if the client still reports distress, they continue to reprocess this memory. They will move on to another memory if there is no reported distress. 

While every therapist may practice EMDR with slight variation, they will always follow these general phases. Remember, you can always ask a potential therapist to teach you more about EMDR during your consultation to see if their practice is right for you.

Sources

1. Kaufman, S. (2021, August 13). The eight phases of EMDR therapy. EMDR International Association. https://www.emdria.org/blog/the-eight-phases-of-emdr-therapy/
2. American Psychological Association. (2017, July 31). Eye Movement Desensitization and Reprocessing (EMDR) therapy. American Psychological Association. https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing

The post What To Expect During EMDR appeared first on Survivors.org.

Cognitive Behavioral Therapy (CBT)¹

CBT is a structured, evidence-based form of psychotherapy that focuses on identifying and changing negative thought patterns and behaviors. CBT focuses on teaching how our thoughts, feelings, and behaviors are interconnected, meaning that combating negative thinking patterns can lead to healthier behaviors and impact emotional well-being. CBT is commonly used to treat conditions such as anxiety, depression, and PTSD. Sessions typically involve setting attainable goals, self-reflection, reframing negative thought patterns, and exercises to develop coping skills. 

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)²

TF-CBT is a structured, evidence-based therapy designed for individuals, particularly children and adolescents, who have experienced trauma. This approach combines cognitive-behavioral techniques with trauma-sensitive interventions to help survivors address distressing thoughts, manage emotions, and develop healthier coping mechanisms. TF-CBT incorporates psychoeducation, cognitive restructuring, and gradual exposure to traumatic memories to foster resilience and empowerment.

Eye Movement Desensitization and Reprocessing (EMDR)³

EMDR helps victim-survivors process traumatic memories through guided eye movements or other bilateral stimulation. This approach allows victim-survivors to reframe distressing experiences and reduce the emotional intensity associated with the experience. EMDR is particularly beneficial for those with post-traumatic stress disorder (PTSD), as it facilitates the brain’s natural healing process and aids in combating intrusive thoughts and flashbacks.

Somatic Therapy⁴

Sexual violence often manifests in both psychological and physiological symptoms. Somatic therapy focuses on the connection between the mind and body, helping survivors release trauma stored within their nervous system. Techniques such as breathwork, movement therapy, and body awareness exercises enable individuals to regulate their physiological responses and regain a sense of safety within their own bodies.

Dialectical Behavior Therapy (DBT)⁵

DBT is particularly useful for individuals who struggle with emotional dysregulation, self-harm, or dissociation following trauma. It incorporates mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness to help survivors build healthier coping skills. DBT is especially helpful for those who experience intense emotions and difficulty managing relationships after trauma.

Psychodynamic Therapy⁶

Psychodynamic therapy identifies unconscious patterns, past experiences, and emotions that contribute to a victim-survivor’s trauma response. In exploring underlying conflicts and unresolved feelings, individuals can gain insight into unhealthy coping mechanisms and develop new healthy ways to process their experiences. This therapy is often long-term and sessions are more frequent. This may be beneficial for those who seek a deeper understanding of their trauma, however, this therapy may be costly and is time consuming.

Group Therapy & Support Groups⁷

Healing from sexual violence can feel isolating, but group therapy and support groups provide a space for victim-survivors to share their experiences and support eachother. Guided by therapists or peer facilitators, these groups help build community to recognize victim-survivors are not alone, foster a sense of connection and promote collective healing. Being in a group environment of victim-survivors can further enhance self-esteem, reduce shame, and provide practical coping strategies. Group therapies often work well alongside individual therapy. 

Expressive Therapies (Art, Music, and Writing Therapy)⁸

For victim-survivors who struggle with verbalizing their trauma, expressive therapies offer alternative ways to process emotions. Art therapy, music therapy, and writing therapy provide creative outlets for self-expression, helping individuals externalize and explore their feelings in a safe and therapeutic environment. These approaches can be particularly helpful for those who find traditional talk therapy overwhelming. Additionally, expressive therapy works well with children and adolescents and adults who experienced childhood trauma. 

Mindfulness and Meditation-Based Therapies¹⁰

Mindfulness-based approaches, such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT), help survivors cultivate present-moment awareness and reduce trauma-related stress. Meditation, yoga, and breathing exercises promote relaxation and resilience, helping individuals manage triggers and develop a greater sense of self-compassion. Other forms of mindfulness and meditation based therapies include forest bathing, sound healing, and trauma-informed somatic massages. 

The journey of healing from sexual violence is deeply personal, and no single therapy works for everyone. Survivors may benefit from a combination of approaches, tailored to their unique needs and preferences. Seeking professional support from a trauma-informed therapist can provide guidance in navigating the healing process. With the right therapeutic interventions, survivors can reclaim their power, rebuild their lives, and find a path toward recovery and resilience.

Sources

1. Hofmann, S.G., Asnaani, A., Vonk, I.J.J. et al. The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cogn Ther Res 36, 427–440 (2012). https://doi.org/10.1007/s10608-012-9476-1
2. Cohen, J. A., Mannarino, A. P., Kliethermes, M., & Murray, L. A. (2012). Trauma-focused CBT for youth with complex trauma. Child abuse & neglect, 36(6), 528-541. https://doi.org/10.1016/j.chiabu.2012.03.007 
3. Valiente-Gómez, A., Moreno-Alcázar, A., Treen, D., Cedrón, C., Colom, F., Pérez, V., & Amann, B. L. (2017). EMDR beyond PTSD: A systematic literature review. Frontiers in psychology, 8, 1668. https://doi.org/10.3389/fpsyg.2017.01668 
4. Kearney, B. E., & Lanius, R. A. (2022). The brain-body disconnect: A somatic sensory basis for trauma-related disorders. Frontiers in neuroscience, 16, 1015749. https://doi.org/10.3389/fnins.2022.1015749 
5. Brown, M. Z., & Dahlin, K. (2017). Dialectical behavior therapy for treating the effects of trauma. In S. N. Gold (Ed.), APA handbook of trauma psychology: Trauma practice (pp. 275–294). American Psychological Association. https://doi.org/10.1037/0000020-013 
6. Leichsenring, F., Luyten, P., Hilsenroth, M. J., Abbass, A., Barber, J. P., Keefe, J. R., … & Steinert, C. (2015). Psychodynamic therapy meets evidence-based medicine: a systematic review using updated criteria. The Lancet Psychiatry, 2(7), 648-660. https://doi.org/10.1016/S2215-0366(15)00155-8 
7. Heard, E., & Walsh, D. (2023). Group Therapy for Survivors of Adult Sexual Assault: A Scoping Review. Trauma, Violence, & Abuse, 24(2), 886-898. https://doi.org/10.1177/15248380211043828 
8. Dunphy, K., Mullane, S., & Jacobsson, M. (2014). The effectiveness of expressive arts therapies: A review of the literature. Psychotherapy and counselling journal of Australia, 2(1).
9. Fjorback LO, Walach H. Meditation Based Therapies—A Systematic Review and Some Critical Observations. Religions. 2012; 3(1):1-18. https://doi.org/10.3390/rel3010001
10. Marchand, W. R. (2012). Mindfulness-based stress reduction, mindfulness-based cognitive therapy, and Zen meditation for depression, anxiety, pain, and psychological distress. Journal of Psychiatric Practice, 18(4), 233-252. https://doi.org/10.1097/01.pra.0000416014.53215.86

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Upcoming Support Groups

What Can I Expect at a Survivors.org Support Group?

This is a peer support group led by PAVE’s Director of Survivor Support, Ashley Badgley. Ashley has years of experience facilitating support groups. This group is a space for survivors to unite and support each other through sharing stories, expressing emotions, and creating community. Attendees will also discuss coping strategies and healing after trauma.

It can be difficult to find people who understand what it’s like as a survivor of sexual violence, and this group aims to be a space for all survivors to gather. Join once or every month.

This group is not for therapy purposes. Resources will be provided to participants for emergency support.

Requirements and Guidelines

By registering for the Survivors.org Support Group, you agree to abide by the following requirements and guidelines, and understand that violation of the requirements and guidelines may result in a permanent removal from our support spaces.

Requirements

• This group is for adults only 18+.
• All adults are welcome, regardless of identity (race, gender, sex, sexual orientation, religion, etc).
• This group is NOT therapy. The facilitator is there to guide the conversation, not provide therapy or advice.
• This group is for survivors of all types of sexual violence (stay tuned for info on groups for loved ones, teachers, parents, etc.).
• There is no vetting process to join the group, but you must register via Zoom
  • registration details via Zoom will only be available to Survivors.org, and attendees may use pseudonyms during the group.
• Sharing stories of sexual assault is not required, and, in fact, Survivors.org encourages attendees to discuss coping and emotions as opposed to detailed stories of assault.
• Survivors.org staff is subject to mandatory reporting, so personally identifiable disclosures of the abuse of children, the elderly, and/or vulnerable adults will be reported to the appropriate state agency.
• All individuals must register. If two people are sharing the same computer, they need to both register.

Guidelines

Guidelines will be read at the beginning of each meeting and emailed to attendees. Joining this group means you agree to these guidelines. Anyone who does not abide by these guidelines will be given a warning, and if the behavior continues, they will be removed from the group at the facilitator’s discretion. If a person commits any acts of violence or harassment against other members, they will be immediately removed and not welcome back into the group. Survivors.org cannot guarantee a safe space in all circumstances, but it strives to create a space that is as safe as possible for all survivors.

The post Survivors.org Support Group appeared first on Survivors.org.

Learn More About The Guest

Denise Bossarte

“Denise Bossarte is an award-winning author, poet, photographer and artist whose passion is inspiring others. Her self-help book Thriving After Sexual abuse is a multiple award winner with recognition from Publisher’s Weekly and Kirkus Reviews. Denise’s short stories and poems have been published in several anthologies and literary magazines: Journey into Art, the engine(idling, Written Tales Chapbook Volume XI, Muleskinner Journal Glitches. Her daytime job in IT helps to keep the household running. She enjoys writing, exploring new art forms, and teaching contemplative photography workshops. She lives in Texas with her husband and literary cat, Za’ Ji.”

–Denise Bossarte’s Official Bio

The post An Interview with Denise Bossarte appeared first on Survivors.org.

Sheri Johnson

“With over 15 years of clinical experience in the field, I am the Founder and Clinic Director at FreeMind Therapy, and a Senior Psychotherapist. I hold a Master of Social Work from the University of Calgary, and a Bachelor of Social Work from the University of the Fraser Valley. I have completed over 450 hours of Rapid Resolution Therapy training with the Institute for Rapid Resolution Therapy.  I also supervise counsellors in training through Yorkville University and the University of Calgary, while supporting a group practice of skilled, master level therapists. 

I am most passionate about healing trauma, particularly military trauma and sexual trauma. Other passions are healing insomnia, Anxiety, and particularly social anxiety & phobias.  

Over the years I have utilized many approaches to counselling. Due to my role as Clinic Director, my caseload is limited to a smaller number of clients, and therefore my primary offering is currently Rapid Resolution Therapy (RRT). I also offer therapy for Veterans, under Medavie Blue Cross (funded by Veterans Affairs Canada/VAC).”

–Sheri Johnson’s Official Bio

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The Science Behind the Fight, Flight, Freeze, or Fawn Response

The fight, flight, freeze, or fawn response is a survival mechanism deeply embedded in our brain. It is controlled by the autonomic nervous system, specifically the sympathetic nervous system, which prepares the body to react to perceived threats.¹ When faced with danger, the brain’s amygdala signals the hypothalamus to activate the release of stress hormones like adrenaline and cortisol.^{1, 2} These hormones prepare the body to either confront the threat (fight), escape from it (flight), become immobile (freeze), or appease it through compliance (fawn).² Understanding all four responses allows for a more comprehensive view of how individuals react to trauma and highlights the varied ways in which people may seek to protect themselves in dangerous situations. 

The Fight Response

The fight response is the body’s way of preparing to defend itself against a threat. When this response is triggered, the person may attempt to physically or verbally resist the attacker. Symptoms can include increased heart rate, heightened alertness, and a surge of energy.²

The Flight Response

The flight response is the body’s attempt to escape danger. During an assault, a survivor might try to run away or find safety.³ This response also involves a rapid heartbeat, quickened breathing, and a rush of energy directed towards getting away from the threat.

The Freeze Response

The freeze response occurs when the body becomes immobilized. During an assault, a person might find themselves paralyzed, unable to react in any way. The freeze response can be confusing for survivors and those around them because it can be mistaken for inaction or passivity.^{2, 3} The response “why didn’t you fight back” is often associated with the freeze response. A person can also experience tonic immobility, when they perceive life-threatening danger. Tonic immobility is a state of motor inhibition and muscular rigidity when a person perceives they are in imminent danger.⁵

The Fawn Response

The fawn response is characterized by people-pleasing behaviors and an attempt to appease the threat.^2-4 This response often arises from a desire to avoid conflict or further danger by making oneself agreeable to an aggressor. This response is often misunderstood and may be used against a victim-survivor by those who wrongfully equate appeasing with consent. 

Why the Brain Reacts This Way

Our brains are wired to prioritize survival. The fight, flight, or freeze response is an automatic reaction that takes over when the brain perceives extreme danger. These responses occur in milliseconds and are not a conscious choice. The amygdala, the part of the brain responsible for emotional processing, plays a crucial role in triggering these responses.⁶ When it senses a threat, it overrides the prefrontal cortex, which is responsible for rational thinking and decision-making. This means that during an assault, the brain’s priority is immediate survival, not deliberate or reasoned action.^{5, 6}

One of the most important messages for assault survivors to understand is that their reaction—whether it was to fight, flight, or freeze is a natural and automatic response to extreme stress and danger.⁶ These responses are not reflective of personal strength, weakness, or character. They are involuntary and driven by the brain’s innate desire to protect the individual.

It’s Never The Survivor’s Fault

Survivors often struggle with feelings of guilt or shame about how they reacted during the assault and sometimes develop post traumatic stress disorder (PTSD).^1-3 They may question why they didn’t fight back harder or why they couldn’t run away. It’s essential to recognize that these responses are beyond conscious control. The body did what it needed to do to survive in that moment. As a result, to protect themselves in the future survivors may be overly hyper vigilant.^1-3 

For those supporting survivors, it is crucial to provide a non-judgmental and compassionate environment. Validate the survivor’s feelings and reassure them that their response to the assault was a natural reaction to an abnormal situation. Avoid questioning or criticizing how they responded during the trauma. Instead, focus on listening, providing emotional support, and encouraging them to seek professional help.

Sources

1. Chapter 4: How the Brain Copes with Different Types of Trauma. (2024). Understanding PTSD, 27–38. https://doi.org/10.1515/9781501519857-005
2. Trauma, Instinct, and the Brain: The Fight/ Flight/Freeze Response. (2012). The Body Bears the Burden, 34–48. https://doi.org/10.4324/9780203836361-8
3. Leavitt, K. S. (2008). Trauma and the Body: A Sensorimotor Approach to Psychotherapy. Clinical Social Work Journal, 36(2), 221–223. https://doi.org/10.1007/s10615-007-0141-1 
4. Van der Kolk, B. A. (1994). The Body Keeps the Score: Memory and the Evolving Psychobiology of Posttraumatic Stress. Harvard Review of Psychiatry, 1(5), 253–265. https://doi.org/10.3109/10673229409017088 
5. Dokkedahl, S. B., Vang, M. L., & Elklit, A. (2022). Does tonic immobility mediate the effects of psychological violence on PTSD and complex PTSD? European Journal of Trauma & Dissociation, 6(4), 100297. https://doi.org/10.1016/j.ejtd.2022.100297
6. Vanderpool, M. (2021). Body science of survivorship. Practicing Yoga as Resistance, 66–81. https://doi.org/10.4324/9781003033073-8

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How Memory Works

Memory is generally divided into three main stages: encoding, storage, and retrieval.

1. Encoding: This is the first step in creating a memory. Encoding involves taking in information from our senses (sight, sound, touch, etc.) and converting it into a format that can be processed and stored in the brain. This can happen consciously, like when we study for a test, or unconsciously, like when we remember the smell of the cookies our grandmother used to make during childhood as we walk by a bakery. 
2. Storage: Once information is encoded, it is stored in the brain. Memories can be categorized into different types:
   • Short-term Memory: This is temporary storage for information that is not processed deeply, like remembering a phone number for a few seconds.
   • Long-term Memory: This type of memory involves more permanent storage. Long-term memories can last from days to a lifetime and include everything from facts and figures to personal experiences.
3. Retrieval: This is the process of accessing stored memories. Retrieval happens naturally, like remembering a friend’s birthday, or intentionally, when we recall information for a test. Not all memories can be retrieved easily; some may fade or become fragmented over time.

Different Types of Memory 

Explicit Memory

Explicit memory is a conscious, intentional recollection of factual information, previous experiences and concepts. 

• Semantic memory: The memory of general knowledge and facts. 
  • How does trauma affect semantic memory? Trauma can prevent information (like words, images, sounds, etc.) from different parts of the brain from combining to make a semantic memory.
• Episodic memory: Autobiographical memory of an event or experience (the who, what, and where)
  • How does trauma affect episodic memory? Trauma can shut down episodic memory and fragment the sequence of events. For some victim-survivors, recalling a traumatic event can be significantly delayed from when the event took place. For others, they may be able to recall every detail of the event. 

Implicit Memory

Implicit memory is a recollection acquired and used unconsciously that can affect thoughts and behaviors. 

• Procedural memory: The memory of how to perform a common task without actively thinking about it. 
  • How does trauma affect procedural memory? Trauma can change patterns of procedural memory for example, a person might tense up and unconsciously alter their posture, which could lead to pain. 
• Emotional memory: The memory of the emotions you felt during an experience. 
  • How does trauma affect emotional memory? After trauma, a person may get triggered and experience painful emotions, often without context.

The Role of Emotions in Memory

Emotions play a crucial role in how memories are formed and retrieved. Our brains are wired to attach emotional significance to experiences, which can influence how well we remember them. For example, people often have a clearer recall of events that are emotionally charged, whether they are positive or negative. Alternatively, people often can have difficulty remembering emotionally charged events. 

Researchers have found that the amygdala, a part of the brain involved in processing emotions, interacts with the hippocampus, which is critical for forming new memories. This connection helps to explain why traumatic memories can be vivid and persistent; the emotional weight associated with trauma can enhance memory encoding and retrieval, sometimes leading to intrusive thoughts and flashbacks.

Key Terms Related to Memory and Trauma

1. Maladaptive Memory Storage: This refers to how some traumatic memories may become stored in the brain in a way that is not beneficial, leading to problematic emotional responses and behaviors. Instead of being integrated into a coherent narrative, these memories may remain fragmented and unprocessed.
2. Unprocessed Memories: These are memories that have not been adequately integrated into an individual’s broader life narrative. Unprocessed memories often lead to ongoing distress and can manifest as intrusive thoughts or flashbacks, preventing individuals from moving forward from the traumatic experience.
3. Distressing Memories: These memories evoke significant emotional pain or discomfort. Distressing memories can provoke feelings of fear, sadness, guilt, or shame, making them difficult to confront and process.
4. Processing Memories: This term refers to the mental and emotional work involved in integrating experiences into one’s life. Effective processing allows individuals to understand and contextualize their experiences, leading to healing and reduced emotional distress.
5. Memory Reconsolidation: This is the process through which previously stored memories become reactivated and can be modified. When a memory is recalled, it enters a malleable state, allowing for it to be altered. This is particularly relevant in the context of trauma, as therapies that facilitate memory reconsolidation aim to help individuals reprocess traumatic memories, leading to reduced distress associated with those memories.

Memory and Trauma

Trauma can significantly affect memory in several ways:

1. Fragmented Memories: After a traumatic event, individuals may find it difficult to recall details of the experience, leading to fragmented memories. Some aspects may be vividly remembered, while others seem lost or hazy. This can make it challenging for individuals to process their experiences fully.
2. Intrusive Memories: Trauma can lead to persistent, unwanted memories. These can occur suddenly and without warning, causing significant distress. This phenomenon is often associated with post-traumatic stress disorder (PTSD), where an individual relives the trauma as if it were happening again.
3. Avoidance: In an effort to cope with the pain associated with traumatic memories, individuals might try to avoid thinking about the event altogether. This avoidance can make it harder to process the trauma and can lead to increased anxiety and other emotional difficulties.
4. Distorted Memories: Trauma can sometimes alter an individual’s perception of the event. Memory distortions may occur, such as exaggerated feelings of guilt or shame associated with the trauma. This can lead individuals to blame themselves or perceive the event differently from how it truly happened.

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