How CBT can help after a sexual assault

If you’ve experienced a sexual assault in the past, you may have found yourself thinking more about it lately due to recent events in the news. Whatever happened to you, it’s the impact the incident has had – as well as the nature of that incident – that matters. The important thing is how it made you feel, and the thoughts you have now about it.

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Some people are able to manage their feelings and move on with their lives, sometimes because they’ve received the right support. Others will struggle more, and this can be the case even if they’ve had support.

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People can feel a range of emotions following a sexual assault, from fear to shame to anger. It’s not uncommon for survivors to blame themselves. Incidents can lead to anxiety, loss of self-esteem and depression. Problems in relationships can also arise – for instance difficulties with intimacy or trusting someone. If the impact affects other people, such as a partner, this can lead to guilt.

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Survivors of rape and other types of sexual assault are also at risk of developing PTSD. An estimated 94% of survivors may experience consequences such as nightmares in the first few weeks after the event, which is a normal and expected part of processing it. However, around 50% go on to have long-term symptoms like flashbacks and continuing nightmares.

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A trigger could be any number of things; a news report, being in a similar situation, or a smell, piece of music or texture can all bring the incident back to mind. It could be caused by being physically close to someone, or being touched – even as part of a medical test or procedure. Sometimes it’s the day or certain time of year that will trigger unsettling memories, symptoms or intrusive thoughts.

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If you recognise that having experienced sexual assault is having a significant impact on your life, and is limiting your ability to go about the world feeling happy, confident and safe, it’s well worth seeking help.

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Talking to someone you trust about what has happened can make a powerful difference, if this is something you feel able to do.

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Seeking CBT treatment is also an option. The practical techniques and tools this type of therapy is built on helps people to reduce the impact of a traumatic event, manage their feelings about it, and start to move forward towards the life they want.

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Opting for online CBT – where therapists and patients message each other, rather than talking – may make it easier for someone who’s feeling uncomfortable with the situation to open up. It’s also extremely discreet; you don’t need to leave the house or take time off work to attend appointments, and nobody can overhear anything!

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With CBT, you won’t necessarily have to talk in detail about what has happened. The focus is on learning and practicing techniques and strategies to help you manage the impact, rather than discussing the incident itself.

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This will depend on the individual, however. In some cases it will be helpful to explore the event, the factors that led up to it, and how it was processed and interpreted afterwards. This is particularly true for PTSD, where someone’s memory hasn’t had the chance to properly process everything. You will be fully involved in deciding how best to treat your difficulties.

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It’s very important to know that what happened was not your fault. One particular CBT technique – challenging thoughts and misperceptions – can be very effective for someone who blames themselves in any way, or has lots of ‘what ifs’ and ‘if onlys’…for example ‘if only I hadn’t gone out that night’. CBT can also help people learn to be less critical of and more compassionate towards themselves, which plays a crucial part in moving on.

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Another technique which is useful to try if you find your anxiety or flashbacks are triggered by a specific situation or place is ‘noticing the difference’. Focus on all the differences between the current moment and the time when the incident occurred: “I’m safe with friends”, “It was winter then, now it’s summer”, or “This isn’t the same band that was playing”, for example. This will help to ground you in the present.

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The NHS Live Well website has some great guidance around [finding the right help] and support after a rape or sexual assault. For more information about CBT, click here.