Arousal/Orgasm in Sexual Assault: IAmA Psychotherapist, Founder/Director of Sexual Assault Awareness, (and local mod), Back to Talk Taboo, #MeToo & Answer Your Q's on SA!

Good day, AP.

I've discussed this with a number of male victims of rape or sexual assault, of my acquaintance. Quite a few have said that their perpetrators (either sex) deliberately tried to provoke a physical reaction from them, for various reasons. In other words, the victim's arousal or orgasm wasn't an incidental aspect of the assault, but one of its main purposes.

Have you seen much evidence of this in the course of your professional work?

I see this more with child survivors than adults, but a yes to both. With children, male or female, part of the grooming process is to make them feel involved and complicit, a partner in their own abuse. One tool abusers use is to elicit sexual responses; erections/ejaculation in males, lubrication/orgasm in females.

It's a terrible and cruel act as it leaves many victims believing they seduced, wanted, partnered in their abuse, which simply isn't true.

And to be clear, despite my Reddit handle, the majority of my work is with adolescent through adult females, though I have worked with children as well.

It's a terrible and cruel act as it leaves many victims believing they seduced, wanted, partnered in their abuse...

Indeed. And sadly, that's what the general public seem to believe too. I wonder how the message can best be conveyed to them that this is in fact an especially nasty and damaging kind of assault, whose perpetrators if anything deserve a particularly severe sentence.

I should have mentioned thrf is one of our intrepid mods over at /rape, a Reddit survivor support sub.

I think the answer always lies in education. Some public schools in some areas of the U.S. are starting to talk more explicitly about sexualized violence and recognize things such as ACES (adverse childhood experience survey) data to support openly addressing how violence and oppression in childhood leads to a wide range of maladies in adults. And not only mental health ones, but physical expression of emotional trauma. We know so much more know than we did even 10 years ago. Now it's a matter of telling everyone!

Complex traumatization early on also leaves kids open for other forms of abuse and makes for very confusing situations.

When I was sexually abused as a child, I knew it was utterly wrong and disgusting, but at the same time, life at home was so much worse that it was in a very twisted way "nice" to be wanted for once. I wasn't physically hurt (in hindsight probably more to not leave evidence than out of any actual care for me) and in a gross way cherished. That had its own appeal. So much that I was jealous when a classmate told me that he abused her too.

Which was the most difficult part to heal. If I in any way wanted/enjoyed the sexual abuse, maybe that meant I was so bad that I deserved everything else that happened, too.

It's something that's still not emphasized enough in trauma healing. There can be enjoyable physical, emotional, mental reactions during horrible events. The current narrative claims there's only ever one or the other. Enjoy one bit and it wasn't a bad experience at all. Both the public and the victims need help accepting that both can and commonly does happen at the same time and that does NOT absolve the perpetrators ONE BIT.

The "good" parts can be a lot harder to come to terms with than the horrors.

Beautifully stated and absolutely true!

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It's hard to answer these types of personal questions in an AMA format as there are many questions and areas I'd explore with you before being able to answer this. As someone else mentioned, talking with a trained trauma specialist would really be the best thing to recommend.

Dealing with an abuser is specific to each person. For some, if you had the support to live on your own, I would explore cutting ties. Others realistically couldn't afford to do that. Confrontation is a whole other thing. I'd want to explore your safety and protection before doing anything like that. Could they escalate or harm you? Could they affect your life in ways you may not anticipate?

I'm sorry I can't provide recommendations beyond seeking professional support as well as some reading to help you. One book I always recommend is "Courage to Heal." It's a classic in the field and does discuss handling confrontation of abuse. Again, though, this really needs to be done in partnership with your therapist. If you need more support, please feel free to PM me.

I have another question if I may:

Whenever someone comes forward about assault or abuse, I find it very hard to navigate between "it's entirely up to you if you want to report it to police or not and don't let anyone pressure you into it" And my default emotional response which is to urge them to do it. But I don't want to push too hard because of how delicate a subject it is.

How do you deal with this?

The sooner it's reported the better, but it's difficult trying to convey that to someone who is scared or isn't sure if they even want to go to the police.

This is such an important and difficult question to answer. We WANT victims to report so that 1) their voice is heard and the horrible silence of sexual assault is broken, 2) for justice to attempt to be served. But we know how scary it is to talk to anyone about it, much less being scared to tell an officer who might not be sympathetic. Which is why officer training is important and a big part of what I do!

What I try to do is help the person look at what's keeping them from reporting versus their desire to report. Often women WANT to report, but don't for...reasons. Those reasons are important and may be different for different people. Helping them examine them can break down the barrier to report. Unfortunately, this isn't a simple "Hey, try this..." kind of answer. It takes time to help someone examine their fears. And many times it's things like I talk about here that stop them. "Well, I came during my rape, so they won't believe me." or worse, "It wasn't really rape because I had this response during it."

There are two kinds of barriers: internal (fear of disclosure) and external (fear of not being heard/believed). Our justice system sucks and is a large reason for the externalized fears.

Taking time to help someone name and examine those fears will often break them down and help them see a path to reporting.

I'm sorry I don't have simple answers for this. Reporting has so many layers and parts to it.

Do you liaison at all with local sex abuse detectives?

I can't speak for the norm, but at my department the detectives in that unit will meet with the victim privately and stream line the reporting process as much as possible. Unfortunately, most victims don't really know to contact them directly, so they'll just call for a police officer. That's fine, but it requires the victim to have to go through a lengthier process and deal with more people. Bypassing this also limits the likelihood of dealing with a random officer that may have a temperament that makes the victim less comfortable.

I've spoken with law enforcement officers around the country(U.S.) and while there are some advanced departments that fully understand and incorporate our latest findings in neuroscience, interview techniques, and use of empathy in creating improved victim reports, the vast majority of this country and most others, lag far behind.

Officer bias and education is the main factor here. This is why I do the trainings I do. I've spoken to many SVU officers who will say that IF the report makes it to them, they can move it forward, but that line officers who are usually the ones taking initial reports have bias that will discourage the victim from reporting or moving the report forward.

One solution to this is that every sexual assault report be moved up to the trained officer, but this isn't policy in most jurisdictions.

Hello!

I'm a male sexual assault survivor. I understand that generally speaking our minds try to block out traumatic events. I'm 34 years old and only until a year and a half ago didn't understand that I was assaulted twice in my life - once when I was very young (I believe around 3 or 4) and once again when I was around 10. I didn't "remember" this assault until the person that committed one of them (I say one because I don't remember clearly when I was very young) tried to add me on Facebook and sent me a message.

My question is this: Why or how would someone's mind make them forget that something like that happened, not once but at least twice? What causes gaps in the memory to remain even when you acknowledge an event occurred - like what's the mechanics of it? I don't want to remember by any means, but I can clearly feel the edges of the memory and where that memory goes black if that makes sense? That's just my experience and I wonder if it's the same way others would describe that gap in memory?

I go into this in-depth when I train, but the short answer is we have several parts to our brain. The oldest part, our "primal" brain is where our defense response, sexual response, and emotional memory storage are. When we are sexually abused, those memories are often recorded emotionally rather than in images or thoughts. This makes retrieval into our higher or executive brain difficult unless you know what you're doing. The difference between these two structures is a couple of million years worth of evolution.

One of the amazing things about emotional interviewing, which I'll be talking about with Russell Strand at a conference later this year, is how much information we actually store, but are just now learning the tools to retrieve.

This is where fake ideas like "false memory syndrome" come from. Because we just don't store trauma memory the same way we process and store other memory, it feels vague and disconnected. But it's there!

Wait, are you implying that false memory isn't a thing? Because there is quite a lot of research out there coming out of Cognitive programs that revolves around that phenomenon. It's not a mere "idea".

There's a researcher out of England who has been able to create false memories in people, but it's akin to the kind of memory formed during cult indoctrination or "brainwashing."

The idea that someone would have self-created memories (outside of a psychotic disorder), and develop PTSD or trauma symptoms from those false memories doesn't happen.

The difference is in installation of false memory versus having actual buried trauma memory being seen as false. I hope that distinction is helpful.

I've experienced arousal whilst I was sexually assaulted, but I guess the most troubling thing was in that moment, I wasn't able to tell him to stop or to push him away. He then asked, "you like it don't you? Don't lie", to which I didn't respond.

I guess my question is - is it absolutely not possible that I wanted it?

These are such difficult questions to answer and why therapy really is so important to recovery. I hate to sound like some ancient philosopher, but my answer truly doesn't matter. Only yours does.

Is it possible for someone to have genuinely enjoyed their abuse, reflecting on it afterwards? Sure. I've absolutely worked with women for whom that was true. As we say, there really is no right response to sexual assault.

In your case though, it sounds like you experienced a very normal freeze reaction, that most people don't know is normal. Your body is geared towards survival. For women, one element of survival in pre-history was lubricating and orgasming in response to sexual attack, so that you wouldn't die from injuries. Because we largely associate orgasm with pleasure, we get very confused afterwards about what that response meant. It meant your body was saving itself.

A qualified sexual trauma specialist could help you really answer your question though.

For women, one element of survival in pre-history was lubricating and orgasming in response to sexual attack, so that you wouldn't die from injuries.

I do not mean to sound rude but do you have any evidence to support this assertion?

Not rude at all. It's important to acknowledge what we've studied versus what we know from a great deal of experience. There actually isn't a whole lot of research (which is part of the work I'm trying to do), but there have been some studies on this concept, in addition to being well-known in the study of human sexuality.

Here's one: Suschinsky, K., and Lalumiere, M. (2010). Prepared for Anything?: An Investigation of Female Genital Arousal in Response to Rape Cues. It was published in the journal of Psychological Science in 2011. You may be able to find it online.

Hello, I am a woman who was assaulted/raped as a child, teenager, and adult. My question is... Is it normal for me to feel physical arousal when discussing/reading about topics such as sexual assault and rape? I feel the physical sensation, but emotionally I am so far from aroused. It makes me feel disgusted with myself and I don't understand why it happens. Could you shed any light on this?

I can. One of the key differences between male and female sexual response is that women are capable of physically/sexually responding to a far wider range of sexual "cues" than men do. For example, listening to the sounds of animals mating can stimulate a woman's sexual response even though the intellectual idea of it holds no interest for them.

There's another piece for you though, I think. And that is for many survivors, they find themselves sexually responding to elements of what they went through. It's another part that isn't discussed much and survivors are made to feel bad about. If you think of it as a connection that was forced upon you; the emotional intensity of what happened paired with the physical experience, it makes sense that your brain would now associate those things. This goes to the heart of the work I do in what I call "Unlinking." Helping my clients to separate out emotional/sexual association from the events that happened.

Ha! Just goes to show you shouldn't have preconceived ideas. I expected you to be a woman.

Thanks for this AMA, and for what you do on reddit <3

So I need a question:

While discussing this delicate topic, what was the most rage-inducing reaction you've gotten?

Are there stories that have stuck with you more than others?

What do you do in your free time to not become submerged with the sad stories you hear everyday ?

Thank YOU so much and for your support of the /rapecounseling community!

I have a recent example of rage-inducing. In the study we're doing which will show the FIRST real-world numbers of arousal ever, we were told to run it by "industry professionals." Many of my more well-known colleagues who do the work I do said the study wasn't relevant as they didn't believe women had orgasmic responses to sexual assault. RAGE! These are my respected colleagues, many of whom have written "the" books on sexual assault and incest, yet still ascribe to these views. It's very frustrating!

Stories: my current clients are always with me as I focus on where they are and how best to help them move to a happier/healthier place. One that sticks out though is a sex worker who was sexually abused starting at 3 yrs old and continued throughout her life. She wrestled with the idea that she was "meant" for sex and being used by men. Working through that was a profound experience, yet so typical for many women I work with.

Not to sound geeky, but I genuinely enjoy crafting presentations and developing interesting talks on what I do for an audience. It's a skill I have that I like to indulge. When asked to speak, I will often tailor it specifically to the audience. I am watching Daredevil now though. Started with Jessica Jones, which is a really good portrayal of struggle with PTSD from sexual abuse.

Thanks for your response :)

I also struggled with believing sex was all I was good for when I was a young teenager.

Thank you for all that you do and your commitment to your work and mission <3

And I didn't mean to glide past your discovery I was a man! I actually assume most of the regulars on /rc and /rape know by now. But I take the confusion as a compliment. One of the things I hear from my clients is that I don't "talk like" or "treat them like a man" which is strong praise of my work.

Oh my god it so was. I knew a girl who had never had any kind of sexual assault or major harassments in her life (such a rarity in modern society), and seeing her react to the first episode was bizarre in how different it was from my reactions (ex sex worker and rape and child molestation victim). She was sitting there going “wait like what’s wrong with her? Why is she struggling so much?” And to see someone who just didn’t even have a frame of reference to understand that portrayal was a. A huge relief, b. Extremely envy-inducing, and c. Just plain weird.

I'm planning to use clips from JJ in my presentations. I've discussed many elements, like the use of grounding (the street signs), her physical trauma reactions, use of alcohol to cope, and her explosive repetitive confrontation of Killgrave (which I loved).

Good morning!

You mention in the original thread that anywhere from 5% to 50% of victims experience this during rape, and that considering the variation it's obvious it needs more research.

Has your research allowed you to reach a more accurate number for the ratio of victims experiencing this issue?

To an extent. I've been running informal online surveys for several years now. Those numbers run much closer to 50%, but these are women responding from survivor sites where there tends to be a little more insight and knowledge about survivor responses.

I believe the real-world number is around 30% which is FAR higher than most people in my field believe. I'm very interested in seeing the findings of our current study with a San Diego university that specializes in trauma research. That's going to be awhile though as we are still in survey development phase.

Hello! I would like to know what you think a therapist dealing with this very sensitive subject could do to make the victim feel more comfortable talking about this? I have been to several therapists who wished to discuss this with me and I have never been comfortable enough to fully heal from my past. I felt that the therapists were badgering me for information, and I was curious about your approach.

I'm glad you've actually had therapists who have raised this! So many don't which I believe makes it far more difficult for people to feel that it's safe to even approach.

I do a combination of psycho-education, meaning I talk about the existence of the subject without connecting it to the clients experience. I often will talk about a lot of different possible experiences, including arousal, to let the person know that there are many kinds of responses to sexual assault.

From there, I essentially "let them come to me" by continuing the work on what they are able to talk about and trusting they will disclose when they are ready.

What can be done to make this information available during sex ed?

First we need to make it routinely available within the mental health and trauma profession. It's so sad to me to meet established trauma therapists who have never considered arousal and so fail to bring it into the treatment room.

From there, it will take the will of the community to go to their schools demanding full discussions of difficult topics. I think this is true in a lot of educational areas, not only sexuality. The more we talk about this, the more people know and the more they will want their children to know.

Is there an understanding as to why people often feel arousal during these traumatic experiences? I understand that arousal and orgasm is a physiological response, but arousal particularly for women is very deeply tied to their mental state, which causes many women to have problems achieving orgasm. I was just wondering if these insights helped to understand human arousal and orgasm outside of sexual assault.

There is a clear understanding, yes! It has to do with the difference between the older "primal" part of our brain where our arousal process exists. By arousal I don't only mean sexual, but physical/emotional. It's all part of our defense response system. The difficulties women have in achieving orgasm, when there isn't a medical reason, is due to our higher brain where thoughts and ideas and associations can interfere with our ability to connect to that primal sexual part of ourselves.

One of the confusing parts for survivors is accepting that rape essentially bypasses our "smart" brain and connects directly to primal sexuality, fear, and arousal. This makes physiological arousal easier.

This is really the crux of understanding this and where a lot of people get uncomfortable. But if we can accept that our brains and bodies are wired first and foremost for survival, then it's much easier to understand the why of our responses in a given situation.

One of the more difficult situations I face is with women who haven't orgasmed in consensual relationships, but find their body responding powerfully during a sexual assault. It's confusing and painful, but completely understandable when you learn the science behind it. Even harder when I'm working with couples and he is trying to be supportive, but feels resentment.

Hello! Thanks for doing this AMA. As a therapist working with survivors of sexual assault and rape, much of the work centers so much on how the trauma affected the client’s relationship with pleasure and with their body as it becomes aroused. Whats your approach to helping clients begin the process of reconnecting with their bodies as sources of intimacy, pleasure and connection? I can certainly see this being worse for survivors who experienced sexual arousal and/or orgasm during an assault.

Thank you for your work and insights on behalf of survivors!

And you're right, the process of re-learning healthy pleasure is much harder when there has been orgasm. What I've found is that when the trauma can be resolved, the desire to reconnect emerges which is a huge step towards that work. Once desire is present, then we can do stimulating work, such as self-pleasure techniques, learning to connect with the body through masturbation, then regulated partner play, proceeding to more uninhibited play as the person connects. I've had clients start from simply enjoying soothing baths and gentle self-touch before moving to sexualized touch. Always a process...

Hi, credit to your deft skills of handling the minefield of this topic - I noticed in another response you mentioned a body's response to sexual assault was to save itself via lubrication etc, and also that culturally we have left out the primary response to dangerous situations of freeze, where fight or flight are actually less used. (an aside, half of learning to be a martial artist or a soldier is training to overcome the freeze, but we don't acknowledge that commonly).

Question - when you educate people on biological reasons, is there resistance to the idea of being 'programmed' by evolution? Or is it a comfort?

Also, had you seen research on pregnancy rates from sexual assault versus long term partner - another related taboo subject.

Great questions and ones I often field at trainings. I've found most people respond well when provided with education and understanding. When you walk people through the brain/body connection and response, this all makes a lot of sense. Comfort would be my answer. I've gotten more flak from people who think my even talking about arousal means I'm suggesting women enjoy rape. Even then, once they get the neurology, I see their understanding shift.

I'm very familiar with the higher rates of pregnancy stemming from sexual assault than partnered pregnancy. It's another area that's confusing and challenging for people to understand, but makes sense when viewed from an evolutionary perspective.

Hi. I'm a survivor of childhood sexual abuse by two male family members, which occasionally did induce orgasms from me. I believe I was 7 or 8 when I experienced my first orgasm. My entire adult life, I have only been able to make myself orgasm by masturbating to rape fantasy. I'm currently 28 and just in the last couple of years have realized I'm really into BDSM (don't know why that didn't occur to me sooner given the chronic rape fantasy). My question is, are my kinks a result of my abuse? And is it healthy for me to engage in them? And if I ever do finally make it through trauma therapy and recover (I'm seeing someone it's just been super slow moving), will I still have those kinks?

This is an excellent question and one more survivors face than I think we know!

If we understand that our sexual desires are rooted in our early life associations, then it makes complete sense that when we are stimulated in a particular direction we are going to develop sexually in that direction.

I generally have two types of clients who fall into your experience. The ones who enjoy their kink and are afraid they will lose the excitement of them if they process their trauma. And those who are so overwhelmed with disgust in having them that their focus in treatment is to rid themselves of those feelings.

One of the key components of BDSM play is consent. So if you are consenting to engage in non-consensual play and no harm is coming to you or your partner, there is nothing wrong with it. There's actually a name for this in BDSM, though it isn't widely known and not fully accepted in some BDSM communities. It's called CNC or consensual non-consent.

The answer to whether you will still find your kink to be enjoyable when you've worked through your trauma is largely up to you. I find some women lose interest and the idea of "losing their kink" doesn't bother them anymore. For others, they are able to see their trauma as simply a bad memory that may have started their kink, but doesn't carry any harmful association now.

Every person is different. And what you enjoy is okay!

Hi. Me again, survivor of childhood SA. Would you say that trauma therapy is the absolute only way to recover and live a happy normal life? Especially in regards to overcoming self-worth and trust issues. I desire very much to get better but desire very little to work through stage 2 of trauma recovery, since it sounds like it involves sharing a large degree of detail specific to my abuse. To be clear, the only reason I can casually mention my history of abuse here is because I am cloaked in the anonymity of the internet. In an actual face to face conversation this sort of discussion feels insurmountable. I think I am very worried that my abuse was not "bad" enough for me to be as fucked up as I am about it, and this fear is strong enough to keep my silent on the details of my abuse until I die. In other words, will I never be able to recover if I can't get over that hang up and actually open up to my therapist about the specifics of what occurred?

You have written really well on the fears that most survivors face. Talking about the abuse/rape is the hardest part. My job and any good therapists job is to make that process as easy as possible. Feeling safe to talk about it is a key part of what I build in sessions.

However, I will never say that therapy is the one-and-only way to heal! There are many paths and finding one that works for you may be your journey. Some people respond well to physical healing methods like yoga and graduated massage, others to creating and accomplishing relationship goals which may require using other "psychological muscles." Some find intense commitment to physical activity and hobbies to be incredibly healing. Whatever you do, you need to be ready for the emotional connection and release that will occur if you're on the right path.

Something else you may wish to look into is EMDR. I am not yet trained in this and, to be fair, I have my criticisms of it, but I do not argue with its success rate. If done by an accomplished practitioner, you will not need to go into details of your abuse. Read up on it and see what you think.

the emotional connection and release that will occur if you're on the right path.

Could you elaborate on this please?

I was raped in my early twenties, and it spent quite a number of years in repressed memory before my brain imploded and I began dealing with what happened. I haven't been to therapy specific for this (I've been to deal with unrelated issues and tried to bring it up, but it was outside the focus of that therapy and the therapist suggested rape crisis counselling and moved on). I've been pretty terrified to do since and so am practicing self healing (sort of, sometimes...)

Sorry for jumping in late here. I'm curious what emotional connection and release should feel like? Just reading the words, I don't think I've attained that.

What I'm talking about is the experience of fully connecting emotionally with what happened, and allowing yourself the time and space to grieve. While "aha!" moments do happen in therapy, it's not the norm. More typical is a gradual connection of your feelings to the memory of what you went through. More like mini-ahas!

These moments can be overwhelming if you aren't prepared for them with soothing or grounding skills.

The good thing about therapy is that your therapist will anticipate and guide you through what you need for the stage of grief and healing that you're in. There can be a lot of nuance needed that other methods won't provide. I believe other methods can be helpful, but you have to do a lot more of the work on your own, which many people don't know how to do.

What's making you terrified to speak with another therapist, trained in sexual assault healing?

Hi, thanks so much for doing this. When I was around 8 years old, I had an experience with an older cousin which I've never been able to identify as assault or not.

Essentially, he held me in his lap and jabbed my sides repeatedly to keep me flinching and unable to move, while he rubbed himself against me and called it a massage; I could feel that he was aroused. Eventually I had the voice to yell stop and he did instantly, before giving me an actual massage. Does this count as assault in your professional opinion?

Yes.

how did you get started with this? what was your inspiration to go down this path v. something else?

This question always gets me thinking about different parts of my life. It's such an "it depends" because talking about how I saw a documentary on sex work at 15 yrs old would just mean I was one of millions of people who saw it if I didn't have my very first client as an intern be a lesbian struggling to come out of the closet and disclosed her sexual abuse to me for the first time. From there, I realized I seem to have a natural skill at this which inspired me to keep learning.

Understanding and working with arousal wasn't something I thought about. I thought all sexual assault therapists knew about it until a talk with a colleague made me realize that wasn't true. I went back to all the books I had read and saw that almost none of them even touched on this.

But the national attention I've gotten, I really do have to credit Reddit. I was because of how big the last AMA got that I was invited to begin speaking about my work.

Is it possible to get rid of the link from past sexual assault to current consentual sex?

I was sexually assaulted as a child and basically sex triggers memories and makes it hard to stay present. Or if orgasm actually happens that is then also a trigger. And finally thoughts of the the past abuse can also cause arousal. All the above bring a good amount of shame, I don't really see how one moves past it.

Yes, it's very possible. This is part of sexual assault and trauma treatment. To help you in the present to relieve yourself of how that past trauma affects you. Shame work is a key component of trauma work and one most SA therapists are familiar with, even if they don't work in arousal response.

Coffee sized duck, or a duck sized coffee?

I should have known. This is Reddit, after all.

Hmmm, I'll go duck-sized coffee right now. Need the caffeine to keep up with all of you.

Have you ever had patients/victims who started out as abusers, but out of regret or remorse allowed themselves to be harassed/abused? How would you go about shaping their mindset, in that people might find them being hypocritical for supporting causes that they have violated?

I haven't worked with abusers, at least not in that "order" so to speak. I've worked with girls who were abused and then became bullies or abusers out of that. It's important to state though that the idea that people who were abused will become abusers is a false one. It's a fairly low percentage.

I think anyone who genuinely comes to understand the process and cycle of any type of hurting, even when they did the hurting themselves, can add to and be part of healing.

I'm not certain I fully understand your question though.

1. Are you in fact Jesus Christ?

2. How does it feel being older than time?

3. Is it your fault that O.N Improv suddenly disbanded?

And this is my friend come to troll me. I'll give this a shot though:

1. Despite my dedication and passion for the work I do, the JC association is in appearance only when I grow my hair out.

2. Pretty darn good!

3. Yes and no. It wasn't sudden since I announced my departure (to attend speaking engagements & trainings on sexual assault, I should mention) a year before leaving. I think the group didn't have the will to continue. I wish it had!

Also I love you Andrew, and I am really happy you're doing this.

Thank you! Back atcha.

Hi, thanks for doing this and addressing something that I find very difficult to talk to anyone about.

The information about it being evolutionary to stop serious damage in these circumstances is something that never even occurred to me but is so good to know.

How do you recommend people discuss this in an open forum without being judged/dismissed? I have spoken to my partner about it but not at length and I can’t see how to have this conversation without causing damage.

Thank you! And thank you for saying you hadn't known about this before. THIS is why I value talks like this so much. My hope is that the more we can talk in open forums like this, then the more acceptance these ideas will have.

I think first, educating yourself on how the system works will give you confidence to explain it to others. One analogy I use is that our bodies bleed when cut in order to protect us. We don't bleed for no reason and when we understand why we bleed, we realize it's not a deadly process, but a safety one. Blood cleanses a wound, covers it, then dries to protect the body. Most people get this and there isn't shame around it.

But because lubrication and orgasm has such strong sexual connotations, we see it differently. It really isn't.

I use a lot of analogy to help people understand this process. It is not under your control so how could it be a woman's "fault" if she cums during sexual assault? It can't. No more so than laughing during forced tickling or having a euphoric response to being forcibly injected with heroin.

Thank you for answering. This is very useful.

I have just re-subbed to r/rape, I had come off of a few months back as I was finding it hard to read a lot of the stories without remembering a lot of what happened. Knowing there are people involved with the sub that are educated and forward thinking about this makes me feel much more comfortable. (Sorry to sound so egotistical)

Please continue your work, you (might) have no idea how much something as simple as you acknowledging that bodily arousal during a rape can and does happen, and isn’t a matter of shame /doesn’t change that it was rape, will help people. Thank you.

Thank you for that. Sadly, I know all too well, which is why this specific subject is so important to me. I encounter far too many colleagues who are as surprised as my clients to learn this.

And glad you are rejoining the sub. You will definitely find that the mods understand this along with survivors who have experienced it. Not everyone will though, just so you're prepared.

I have a question, I'm a gay man who was sexually assaulted by an old man (I was 18 he was 55) and we were friends up to that point and had sex before, but when he wanted to one time I said no and he didn't take that for an answer. I didn't enjoy it but I ejectioned as well, now he is serving 50 years in state jail for what he did to me a several others and I feel conflicted and confused. I didn't want to have sex but he was also a friend, I know he would have done something like this to more people but he was very convincing that I enjoyed it and being further away from that moment it feels harder to figure it out. Is guilt in this situation normal? Should I feel guilty or rest assured that I did the right thing?

Thanks for you time

Such a hard question to answer because these are your feelings. They deserve the time for you to process and understand them. It's easy for me to say with certainty that you did the right thing in standing up for yourself and protecting others from a known perpetrator. But does my certainty result in yours?

Well, I'm happy to chip in here with a firm opinion. u/chad313 most definitely did the right thing. The perpetrator in question, however charming and persuasive, is a serial rapist. There is no such thing as an "innocuous" rape, nor can either the rapist or the victim predict the amount of damage -- short or long-term -- that any such act is going to cause. I, for one, am greatly relieved that so reckless and selfish an individual is no longer on the streets, and am exceedingly grateful to u/chad313 for the part he played in bringing that about.

I agree completely. My focus was on whether our certitude would help chad in his acceptance of that.

Hello, this account is a throwaway.

I'm a child sexual abuse survivor, and I am involved with writing and reading "dark" erotic fiction/fanfiction - erotic horror, rape fantasy, etc. Right now there is a lot of controversy about this in fan communities online. People who are anti this kind of work claim that it "romanticizes abuse", sometimes to the point of thinking people who produce or consume this kind of content should be socially shunned or even legally prosecuted. On the other hand, defenders point to free speech, creativity expression, lack of harm to real persons, and coping mechanisms.

For me, I don't deny that my early grooming and sexual abuse had profound and lasting effects on my sexual tastes, but what I think antis don't understand is that when I read a story about a fantasy rape, which is written to appeal to it as a fetish, first, I'm imagining myself in the role of the victim, second, there's a built-in "safeword" for the scenario, which is closing the browser window. And when I write these kind of scenarios, I'm ultimately in 100% control of the entire scenario. And what it comes down to is that even after years of therapy there is a part of me that is ashamed to feel sexual pleasure that isn't forced on me, so these fantasy scenarios allow me to imagine that I'm being forced so that I am free to experience orgasm.

Anyway, this topic seems tangentially related to your research. Do you have any thoughts on survivors creating and consuming abuse and rape-related erotic content? Do you think it's harmful, harmless, something in between?

There is controversy in my field about repeated exposure to elements of your abuse. However, I tend to fall more into your camp. I think if we eliminate versus explore this attraction, we risk sending people further underground and further into their shame, if they even are shamed.

Many of my clients get off to depictions of what they went through or versions of it. It's not unusual at all. Many clients play with power dynamic themes in their sex lives. It's not unusual at all.

What I do think is important is to develop awareness and understanding of why those themes are so powerful and if they push the person towards self-harm.

Let's remember that rape fantasy is THE most popular fantasy for most women, aside from any history of abuse. There are numerous studies to support this. And I think the reasons are fairly clear if you understand historical oppression and marginalization of women, along with the need to empower oneself to neutralize the power by taking control of it.

I worry about this when people immerse themselves in it without exploring the root of their interest. I guess my short answer is: somewhere in-between.

First of all, thanks a lot for the kind of work that you do. I believe this deserves a lot more exposure, and I'm glad that there is people out there informing about this subject that it seems very taboo until recently. I'm sure a lot of women out there would be thanking you for this!.
What are your thoughts on Complex PTSD, specially within the perspective that many women are being SA by their SO, or are in long term abusive relationships that they can't break free from?
I heard that being sexually active with a partner builds an unique bond with them. Would a similar behavior be formed with your abuser over a long term period?

If you're asking me if it exists, yes absolutely! You're describing one aspect of a classic domestic violence relationship. Forced sex is often part of it and an area we don't talk enough about. We focus on the physical abuse and don't look at the fact that many women in DV relationships are forced to have sex, forced to carry their abusers children, forced to serve them sexually, etc.

That intense, ongoing type of trauma can rise to the level of Stockholm Syndrome and cult indoctrination. It fits perfectly to the definition of complex trauma.

Hello, first off I would just thank you for making time to answer these questions. Even for people who may be embarrassed to hesitant to ask about their own experiences, hearing an answer to an issue that may be similar could be hugely beneficial to them. I think it’s great that you give your time for something like this.

My question:

As a very young child I have small fragments and bits and pieces of very disturbing memories that may have resulted from abuse I experienced but do not remember. I am reluctant to write these off as fantasies or dreams because what happens in them do not seem to be fantasies a child of that age would engage in.

Being as vague as possible...I have fragments of memories of a grown female family member allowing me (a male) to explore and touch her naked body asking me repeatedly “do you like that?” And there are also bits and pieces of more then one male family member exposing themselves to me.

My question is there a way to recover these possibly repressed memories? My fear is these memories were the most benign part of these experiences and things far worse were done to me that I have no recollection of. Even worse then that...I am afraid these may just be a result of an overactive imagination and these people are completely innocent and I have carried these strange “memories” since childhood for no reason.

There is a history of at least one of the people mentioned above being arrested and jailed for child molestation. It is very likely I was a victim too.

My confusion with these memories is that in them, I don’t feel frightened or upset. That’s why I feel I may have blurred a line into fantasy...because in these small foggy recollections, I don’t feel taken advantage of almost like I was okay with what was going on.

Is there a way to tell these memories apart from actual events or something concocted in my imagination?

Yes, there is a way, but it isn't something I can type an easy answer to. It would be you working together with someone like myself to help you review what you do recall and slowly help you rebuild the memory of what happened. I am not talking about leading someone to recall things that didn't happen, before anyone goes down that road. I am talking about a process where you would lead and the therapist would support you with techniques in recall.

Short answer: it's possible, and takes time.

I was sexually abused by my ex. I've dealt with depression and suicidal thoughts. I want help, but I don't have much disposable income or insurance. I live in the state of GA. Are there any resources you can recommend so I can get the help I need?

There are SOME online resources nowadays, such as RAINN and www.pandys.org which will provide some basic support. RAINN can help connect you with lcoal resources in your area, but depending on where you are, those may be in a major city far from you.

Most states have a "CASA," coaliton to end sexual assault with many resources. The CASA for GA is: http://www.gnesa.org/page/rape-crisis-centers-georgia

Check them out and see what they have.

One of the benefits of the internet age is that there are therapists, like myself, who now provide tele-therapy aka video-therapy. I do this with clients who request my services, but live in other areas.

Real Question Though. You once stated on Facebook that the #metoo movement was a "trendy hashtag" in the larger conversation of Sexual Assault. Is this something you still feel?

It's always difficult to hold nuanced discussion when there are strong movements and passion behind those movements.

What I was reflecting in that post was that many voices, those of my clients, women in the sex industry, and women in online spaces, felt marginalized by #metoo. Not that the movement itself was trendy, but that we must center ALL women and survivors. Historically, women had to present a certain way to be a "good victim." Usually white, pure, Christian, upper-middle class, etc.

Women of color, the poor, women in sex work were always seen as "unrapeable" because of who they are. Acknowledging them was my intent with the post. And apologies if that came across poorly.

How do you feel regarding the spreading Incel/misogyny movements in popular culture?

Do you think sexual assault awareness is still progressing in the general population despite these movements?

Do you see forensic science, the law, and therapy changing adequately to adapt to the shift in defense strategies from "proof of sexual act" to "proof of consent"? Or is there still a ways to go?

Sorry these are so general. Thank you for peering into this dark corner of SA. We need professionals to take these leaps in order to better support future laws/ support systems for victims.

I hope you have a great day!

These are great questions and some are beyond my pay grade and knowledge base. I'm not certain what you mean by the incel movement, though I'm very familiar with patriarchy and the effect that male-dominance has on the subject of sexualized violence.

One of my main forensic developments in the past couple of years has been using neurology and victim response to better prove lack of consent, which is a complete turnaround from where the forensic field is and has been. We are just barely rounding the corner from arousal=consent to arousal=irrelevant, but I believe there is another huge step forward once people understand primal trauma and how arousal works. I don't know anyone else in the field who is proposing what I am though I have been assured by many colleagues that I'm on the right path.

So yes, a long way to go, and the field moves slowly.

You might not be able to answer this, but if we abandon the notion that arousal=consent how can you prove beyond a reasonable doubt that a rape occurred? It seems that if we go all the way down that path, the act of rape becomes (on an empirical level) indistinguishable from the act of consensual sex. Which i think is problematic from a legal standpoint.

It's difficult to take a multi-hour presentation into a quick answer, but when we understand that arousal is not a decision process, but a biological instinctive reaction that can only occur in the absence of decision in the case of rape, then it's clearer to see. Decision can only occur in our higher brain and arousal/orgasm only occurs in our primal brain. Going further will take us into a neurological discussion beyond my ability here, but I hope this gives you a framework.

proof of sexual assault to proof of consent

This is literally innocent till proven guilty to guilty till proving innocent. It’s a complicated issue, and it’s not something any advocates want to hear, but women need to be encouraged to be proactive if they want to see their abuser behind bars. Ultimately it’s up to them whether or not they want to legally challenge their abuser, but if they choose that approach it needs to follow a procedure.

It’s about the integrity of our justice system, not incels.

I wouldn't want to recind anyone's assumption of innocence. That wasn't the intent of my question. Nor was myline of questioning solely about incels. I just wondered about professionals take/awareness on their existence.

Currently part of the system puts burden of proof on the victim. A situation that is easy to abuse when a jury of peers is not aware of many facets of victim response. And a victim is easily triggered.

I (tired to) ask(ed) if he knows if science etc. is improving and can help victims be better self advocates and better evidence providers. Or how he interprets if there are improvements in these fields.

Ex: when a jury of your peers is not aware of SA neuroscience and victim responses that are normal - such as delaying reporting, they may just assume its a case of regret, case closed. Thats not fair for the victim in this case / from my POV. But it is due process.

There is still a heavy bias towards non logical stories equating to lies for most people. I'm just wondering if he see's the efforts of himself and other professionals making a difference and if its in all levels.

Wendy Murphy, the well-known sexual assault attorney, and I were discussing this exact idea. We differ somewhat, but one of her ideas is spot-on. In jury selection, we weed out those who have been victimized as biased, but we do nothing to remove anyone with a history of abuse/perpetraton. So we end up with biased juries against the victim. This one aspect of jury screening and selection would address a major injustice in our system.

Currently part of the system puts burden of proof on the victim.

Honestly the system often puts a great deal of the burden of proof on a victim. This is true for many crimes, but obviously in the case of an abuse victim it presents unique problems.

A situation that is easy to abuse when a jury of peers is not aware of many facets of victim response. And a victim is easily triggered.

Ex: when a jury of your peers is not aware of SA neuroscience and victim responses that are normal - such as delaying reporting, they may just assume its a case of regret, case closed. Thats not fair for the victim in this case / from my POV. But it is due process.

In cases where this may come up, it may be wise for the prosecution to employ an expert witness to explain these concepts to the jury.

There is still a heavy bias towards non logical stories equating to lies for most people.

This is actually what made me want to comment. I definitely can't speak for the general populace, but prosecuters and detectives don't necessarily think that non-logical stories are lies. They're just saddled with needing to reach an extremely high burden of proof, and that can be very challenging in many of these cases. The inability to do so can make a victim feeling no one believes them.

One reason I do expert testimony in this area. To educate the jury (and judges and attorneys) on what victim response really looks like, not the myths people buy into.

Just wanted to jump in and say thank you for engaging in open and honest dialogue on this topic. What advice would you give to family members wanting to provide support for a loved one that has experienced sexual abuse?

There's a great guide for male loved ones which I'll try to link...HERE!

It has a lot of great information and supportive advice for any secondary survivor (people supporting a survivor), including women.

My main advice is always:

1. Listen without judgement.
2. Provide suggestions/ideas, not directives. For example, going to therapy, reporting to police. Of course those are good ideas, but not everyone will be ready now or ever to do that.
3. Take care of yourself! You cannot be supportive if you feel drained by their trauma.

There's more, but I'd recommend checking out /r/secondary_survivors. It's a great sub for family and friends of survivors.

You mentioned a university in San Diego that specializes in trauma research.

Which university is that?

Do they have CPTSD therapist specialists?

It's Alliant University and I don't believe they do practical work, meaning having a psychotherapy unit.

For specialists, I'd recommend checking the r/cptsd forum and seeing what they recommend or checking the regular online referral sources: Psychology Today, helppro.com, goodtherapy.org.

I'm apologize if this may be outside your scope of practice, but what are the exciting psychotherapies (I believe 3rd wave was one name, maybe their called or 4th now?) that are currently in research and academia that are showing success rates among fear disorders such as PTSD, OCD, GAD, etc.

One of my favorites is inhibitory control theory, is it explains the habituation model more clearly (example: fears and memories seem to come back even after fear extinction is said to occur - the idea is new learning is taking place to better strengthen a behavioral response for coping). Inhibitory learning theory also seems in line with neuroscience for example plastic changes such as demyelinated neurons and such by explaining the weaken memories to strengthening new connection (example: synaptogenesis, neurogenesis, etc) to an improved (practice) behavior patterns to better cope with the psychological response.

I ask because I assume you fool with a lot of PTSD. I'm always looking forward to improved therapies.

It's also worth nothing the failure of success rate with drugs yet the low success rate with pharmacology (at least SSRIs and such but apparently NDMA and other inflammation (immunological) pathways are gaining steam example would be ketamine. I believe this goes both ways, I feel like medications like D-cycloserine used in exposure therapy without clinical guidance may not be the best options as it could potentially strengthen fears. It would be wise to include a therapist to ensure that a patient sticks with the exposure. I would really love to see CBT followed with TMS or tDSC for improved learning

I often hypothesis why CBT seems to work better than medication according to studies (including studies showing publication bias) and I hypothesis that it may be due the a more natural response (body's way of maintaining homeostatic mechanisms) to deal with environmental stressors influencing homeostasis maintenance. Your thoughts? What are the leading ideas on the development or cause of mental disorders and related pathologies? I figure like all cells, neurons have only so much tolerance for stressors before they become a pathological state which is trying to keep the organism alive even with such malfunctions occuring.

Thanks

I'm familiar with most of the major trauma treatment theories and am a trained trainer in a couple. The combination of CBT style work with meds to support anxiety or depression is well-known in the field. Less known is the growing neuroscience which most psychotherapists don't deal in, though it's extremely useful in supporting clients understanding of their experience as well as for developing techniques to enhance recall and my process of Unlinking.

I struggle with a repressed memory of someone in my church abusing me by touching my genitals while holding me after taking me into different rooms to be alone, though I think sometime he would even do so through my tights while in a crowded room. I was 3-5 years old, and it was a habitual repeated abuse. I can't remember ever being more afraid of anyone than him, a well documented fear (others remember me running from him in terror). In fact I knew my whole life I was terrified of him but only 5 years ago when I was drunk and the memories started to come back up did I slowly, over the course of two years, figure out the connection between the previously inexplicable terror (I was a highly outgoing and friendly child) and the abuse.

But, I can't remember specifics... except for the ones im terrified I made up. I doubted myself for years until my parents mentioned how creepy he was towards me, how they'd set up a "watch group" of other adults to keep an eye on me when he was holding me, etc. It confirmed my fears.

My questions: 1) does what he did qualify as abuse? 2) he was a somewhat mentally delayed teenager. I don't know how to factor that into my perception and reaction. It seems like he had no malicious intent but just curiousity. Does it make any kind of difference at all? 3) It's much easier to remember things when I'm drunk. Does that mean I can't rely on those memories though? Does that invalidate them? Is this common? 4) I despise that my parents didn't protect me better and opted for just "keeping an eye" on it , and not even very well. Is confrontation of them necessary in my healing process? They know it happened but didn't address it very much or give me much support/validation. Rather they wanted all the (gross) details, which I was unable and unwilling to give. My lack of providing them seemed to lessen my credibility. I dont knoe if thet believe me. I don't want to hurt our otherwise good relationship by blaming them or shaming them. I just want to move on.

Sorry for all this, but you are the first person (even after 5 therapists) to whom this felt acceptable to say. Any help, any advice, would be met by a very grateful heart.

Thank you!

I am so sorry you've been through all this! And more sorry that you've gone through so many therapists without being able to really talk about this.

My answer to your first two questions is: your experience is what matters, not the abusers intent. This question comes up in legal circles all the time and it makes me so angry. Whether or not someone meant to harm you does not mean that harm didn't occur. And you are 100% entitled to your feelings about that harm!

If you read any of the replies I gave talking about the primal brain, then my answer on recalling while drinking will make a lot of sense to you. Since alcohol (and other drugs) cause us to disconnect from our executive functioning, we are better able to access primal memory. I am not recommending this as a good idea! Just saying it works that way. It makes sense to me that you are able to tap into that part of your brain while drunk. The work then is to make sense of them, which I do recommend doing with a therapist.

You don't have to confront anyone in your healing process. Healing from sexual trauma is about your acceptance of what happened and being able to shift from connecting it to shameful feelings to being able to be "feeling-free." For many people, facing their abuser is part of that process. For many, it isn't. And it won't affect your ability to heal either way.

I wish you strength and love on your path to healing!

This question comes up in legal circles all the time and it makes me so angry.

The question of intent is pretty critical in gauging a crime:

Intentionally planning to kill your hated boss? Murder 1.

Striking your hated boss with a moving car when he leapt in front of it? Involuntary manslaughter.

So, it makes a lot of sense from the legal perspective -- while being entirely irrelevant from the victim's perspective: the hated boss is deceased either way.

I agree with you. I was more focused on the victim experience, not how the law views it.

Hello, thank you for doing this AMA. I am a survivor of child sex trafficking, and I had a question about suppressed memories. My therapist wants me to work to recover and remember these memories, but whenever I start to remember, my mental health always takes a turn for the worse. I get more panic attacks, have suicidal thoughts, find it harder to manage my eating disorder, and dissociate more than usual. Why does it help to remember? Is it worth it, if remembering affects me like this in the short term?

This is a really good question as it goes to the heart of why many people never seek treatment, even though it hurts and affects them in their daily life.

Let's start with why it's important to do this work. Working through the memories and emotions/thoughts that we've attached to them allows us to decrease the hold they have over us now and let them go. The goal is for the horrible pain of SA to become simply bad memories, without affecting us in the here and now.

However, you are right that doing this work is asking us to put those horrible experiences right in front of us which then pushes all of those painful thoughts and feelings, leading to things like panic attacks and self-harming behavior.

The solution is balance. When I work through SA or abuse with someone, it's always by first putting tools and ideas in place to decrease anxiety and depression. There are specific skills I teach and reinforce before we ever get into the details of what happened. Then, as we move into those memories, there is a constant "checking-in" to ensure we aren't moving too fast or triggering self-harm thoughts. If it gets too intense, we pull back, use our calming tools, and then step forward again.

It might be that your therapist either isn't aware of these tools to prevent you from going into panic mode or just hasn't spoken with you about them yet. They are an integral piece of your treatment. You are absolutely right that trying to move into those memories without being mindful of your triggers won't work for you.

Is it worth it? I can't tell you how much it will free you from your past. Yes, it's worth it. But you are worth taking the time to do it in a way you can tolerate. I won't tell you it's easy. It's not. It can't be. But it is worth your life and your future to not be haunted by what someone else caused in your life.

I hope this helps you to understand a little better how this process can really work.

All my best!

What is a good definition of sexual assault?

I mean, if the victim would give off signals of consent, while they don’t feel that way, and the perpetrator has no intent of going against one’s will, can it still be classified as sexual assault? And why? (Hypothetical situation of course, mainly related to the skepticism around victims speaking out)

Perhaps not a psychological question, more about law, but I’m interested in your view on it none the less, since you are quite involved in the subject of SA. Thank you for the AMA :)

You raise an excellent question of how we support victims in the real world versus the legal justice world. They are very different things and sometimes mutually exclusive. As you raised, it is possible and often happens that a case lacks the elements, under our biased system, to move a case forward, while still being sexual violence that the person needs support and recovery for.

This is really more often the case, and it's important for everyone to understand that just because a rape/sexual assault doesn't get moved to trial for any of a hundred reasons (including whether the DA thinks it's a "winnable" case), the assault still happened.

I think that minority of people who want to equate lack of a conviction with false report refuse to see the reality. You can still be a person who was punched in the face and never see the person who punched you held accountable. Happens all the time.

I'm over halfway through my first year in an MSW program.

There's a good chance I may be working with adolescents who are both victims and perpetrators of sexual violence in my advanced field placement next year.

Could you name a book(s) and/or a research paper(s) that I should be reading? (Obviously I will read many, but I trust your judgment based on your body of work.)

I'm looking not just for more insight, but also direct practice skills.

Also, as you are a LCSW in the field doing all kinds of work that I look up to, any advice you'd have for me in general? I'd appreciate it. Thanks for the work that you do.

Congratulations on your Social Work pursuit! Always great to welcome another to the profession.

So many books and I don't want to overwhelm you. Here's a few:

Courage to Heal & the Courage to Heal Workbook by Laura Davis/Ellen Bass. Written for adult survivors of child sexual abuse, but excellent in understanding many elements of sexual assault and helping all survivors. The books are written for survivors, so have a lot of good exercises and ideas for positive change.

A newer one I like is The Sexual Trauma Workbook for Teen Girls by Raychelle Lohmann & Sheela Raja.

A more general one about rape, though very good is: The Rape Recovery Handbook by Aphrodite Matsakis. She writes in a wonderfully supportive and compassionate style.

There is a training I'd recommend: Traumatic Focus-CBT. For certification, you'd have to get the full training, but there is an excellent 10-hr overview provided by the Medical University of So. Carolina at: https://tfcbt2.musc.edu/ They've just updated it for 2018, so there's even newer info.

As far as research goes, there's so much and it's best to direct you to the National Child Traumatic Stress Network's sexual abuse section: http://www.nctsn.org/trauma-types/sexual-abuse. The entire website has great information on working with teen trauma and all supported by research. If you want to do your own research, I highly recommend: Research Gate https://www.researchgate.net You can create a profile and use search terms to see what's being published and what's cutting edge. Look for me and you'll find occasional updates on my project.

My final thought is to educate yourself a little on CSECY, commercial sexual exploitation. Often female victims of sexual abuse are highly vulnerable to being exploited by traffickers and pimps. Having some knowledge in this area will arm you both to recognize yellow flags and provide preventive education for the girls, but also for you to better intervene.

Keep my info handy and don't be afraid to reach out if you need other suggestions along the way. I believe supporting new professionals keeps the professional strong.

I'm a survivor. Female. I know the orgasm is a reflex etc and so is freezing, but I can't accept the facts on an emotional level, where they need to be accepted the most.
Do you have any insight on this?

Hi ProfaneExpanse,

I'm sorry you struggle with this so deeply. Know that you are not alone, even though you may feel you are in silence. Most survivors won't and can't acknowledge to themselves, much less others, that they had such a strong physical response to their assault.

We are able to "accept" things and experience emotional shift when our understanding changes. The emotion will follow the idea. A simple example is waiting on a friend for dinner, feeling angry they stood you up, until you find out they were in an accident. Then anger shifts to understanding and concern. New information gives you new perspective and the feeling that goes with it.

The key difference here is that sexual assault bypasses our ability to "understand" because it taps directly into our emotional, primal brain. We skip the part of our brain that reasons, until after the event is over. The experience is often so intense that it's difficult for us to change the idea that the orgasm wasn't a wanted, sexual response because of what we've been taught all our lives about what orgasm means.

Simply being told it's something other than what you've always thought isn't enough. This is why therapy is such a powerful tool to change. You have the opportunity not only to hear the information multiple times, but to examine together all of your doubts and work through them.

I wish it was as simple as "Oh, it isn't what you thought, it's this other thing." For some people, that works. For others, it's like being told that gravity is actually caused by a machine inside the planet. Until you have the time and focus to work it out for yourself, just knowing may not be enough.

I'm sorry I don't have an answer that can give you the emotional shift you deserve. But there is a path through and I hope that gives you hope.

As a victim myself I find myself blaming myself. Even when I'm told it's not my fault. I was old enough to say something or try to stop it but I just laid there like an idiot. Sometimes it didn't hurt so I feel guilty about that too. I didn't know what sex was. It sucks I had to lose my virginity to rape. Now as an adult I don't think I can ever have sex with a man. It's actually really hard for me to think or talk about ejaculation or sex. It feels gross to me. How do I deal with This? Do victims ever stop thinking about it? What advice do you give clients for telling someone the first time? Any techniques you'd suggest? I think most guys think I'm damaged goods.

It's so difficult when you are swimming in the middle of all those horrible feelings to imagine not feeling this way and thinking terrible things about yourself. My first answer is, yes!, you can definitely stop thinking badly about yourself. But it will take effort and time, with the guidance of a trained professional. It is really doable though and very worth the work.

I believe telling people "it's not your fault" has good and bad parts to it. I believe it's true, but very often just because I believe it to be true, it means very little to the person I'm working with. It's far better to help them explore, with compassion and trust, why they think it was their fault. By going into those beliefs, we have the chance to really talk about them and correct them.

I wasn't sure if you are asking how to tell a therapist for the first time, or someone you are dating? If you meant dating, then there's a few things to think about that will help that decision. How long you've been dating, whether it's gotten physical at all or when you want it to become physical, looking for signs of trustworthiness in your new relationship, and having supports in your life.

I can give general ideas online, but can't really do the personal level of discussion needed for you to know just how to handle this, but hopefully that gives you a starting place.

I understand why you see yourself as damaged, but what someone did to you has nothing to do with who you are!

All my best!

THANKS for answering. I want to know how to tell a boyfriend about my past and how would we engage in a sexual realtionship. I think most guys don't want a girl who's been violated like that. The thought of having sex scares me because to me it's similar to being abused. There's no difference between rapeand sex for me. So I don't know how to tell a future boyfriend and actually engage in sex.

I'm scared a therapist will yell at me or treat me differently when they find out. I had one really bad therapist who fell asleep on me in a session. It's really hard to talk about. I really don't want to talk about it or remember it. So therapy is hard. Thanks for answering my questions.

I can give you some ideas, but I really encourage you to see either a trauma specialist or sex therapist. Some do both, like me, as healing sexually after a sexual trauma is a large part of treatment for some.

The two concepts to keep in mind when talking with someone about your abuse or rape are timing and communication. This isn't first date talk, nor is it something you want to wait on until things are already getting physical.

If you are seeing a man you like and you decide you want to move the relationship forward, that's the time to sit down and see how he feels/thinks of you and begin talking about more serious things. Do this when you aren't being romantic and can leave if you need to.

As far as the how, be straightforward. It's hard to think of that, I know, but practicing ahead of time will help. Keep it simple and tell him that something bad happened to you in the past and it's made you very nervous about having sex. Most men will figure out where you're going with this. If he responds in a compassionate way, continue. If you get the sense that he's pulling back or being dismissive, that's the time to stop. I hope this is giving you enough to start with. You can't really write a script out, but you can plan for the different ways it might go.

I was confused as to why you think a therapist would yell at you for having been raped. Anyone who deals in sexual assault or trauma will know how to work with you in a safe, compassionate way. I'm very sorry you had that experience with the therapist falling asleep. It doesn't mean it was about you though. You may not know what was going on for her.

And it is hard to talk about, I understand that. That's why we build very slowly so you can trust your therapist to treat you with respect as you tell you story.

Let me know if I can help you more. I think working with a therapist would be really good for you.

I am entering into a relationship with someone who has confided in me that she has been in 2 abusive relationships, and that she was raped. Is there anything I can do to help her healing process, or avoid accidentally doing further damage myself?

Absolutely! And thank you for being someone who cares about her health and wants to support her in healing. It's not always the case that a partner is willing to really provide the support needed.

There's a brief called the Men's Guide to Helping a Woman Who's Been Raped. It covers the basics and provides resources for you to support her in recovery. For deeper reading, a book I recommend is "Allies in Healing" by Laura Davis. Though it's focus is more on child sexual abuse, there is a lot of information on how to support anyone through a traumatic event.

Thank you for being that ally!

Good day, sir. What's the worst case you've dealt with?

I remember getting this question last time and I think the answer is the same. Young woman about 17 yrs old who had been essentially a sex slave to her father and older brothers from 11 yrs old. Finally removed from her home and entered treatment. It's been years but last time I saw her she was doing very well.

One case I discuss at seminars is a woman who compulsively repeated her trauma by deliberately putting herself in situations to be raped. Sadly she was successful at this many many times before entering treatment. She is also doing well now.

Would you say she would put in situations to be "raped" but in her mental state, she put herself in situations of harms, to gain control of her life. I'm not sure if I'm saying this right, but she cannot be raped if she chooses to be in this situation?
I think I'm explaining hypersexuality?
Also, what would it be the treatment for someone in this case?

You are. Hypersexuality and compulsion were two elements of what she and I worked on. In this case, she had completely disconnected her current behavior from her history. Once we were able to make that emotional connection for her, she began to shift away from feeling compelled to repeat aspects of her trauma.

How has the gun violence recently influenced your work if any at all? I'm curious about the possible related dynamics one may not consider in your line of work where you would be in a position to answer due to your exprience.

Not really at all. My clients are aware of it, it's come up in discussion about general lack of safety in the world, perception of safety, that sort of thing. It certainly has an impact. For some clients who were forced at gunpoint or where guns where involved in their abuse, there has been some reaction. I wouldn't say to a large level though.

As a professional concerned with interpersonal violence in general, I am extremely bothered and concerned about this. One organization I'm involved with is an international thinktank dedicated to eliminating global violence. It's the National Partnership to End Interpersonal Violence. You don't have to be a threat professional to join, if you're interested.

Hello, I've been through therapy before. However, I'm currently wanting to find a therapist that specializes in childhood trauma such as rape/incest. Are there any websites or methods you know of that will help me locate somebody specialized who could see me?

Outside of RAINN, I don't know what organizations specifically maintain referral databases for this. I typically recommend RAINN, then standard referral sites such as Psychology Today, www.goodtherapy.org and www.helppro.com.

If you're having difficulty, please PM me and I'll see what I can do.

Rightly so, the focus of your work is very much on victims that find it difficult to process and report a sexual assault against them. Under reporting of these crimes leads to a major injustice, obviously, but my question relates to the other side of this coin. The horrific nature of sexual abuse obviously creates immense obstacles in the life of the victim. Even though I assume it is much more rare, the same is also the case for people that have been falsely accused of a sexual assault related crime. Just by pure statistics, you have likely dealt with clients that you have either strong feelings, or perhaps even hard evidence that they made a false accusation. Why does this happen? How would you treat a client that has gone down this path? Is it even possible for you as a care provider to process the potential of a false claim for fear of undermining their trust?

If these crimes are under reported because victims don't feel like they will be believed, surely this makes false claims seemingly impossible to distinguish. Have you ever dealt with client to help them process a false accusation of sexual assault? In the case of a genuinely innocent person, how would you go about counselling them to cope with this scenario?

I think it helps to know first that false reports comprise perhaps 2% of all sexual assault reports and there are clear reasons attached when they do happen.
The far higher percentage is of unreported assaults.

There's an excellent book out right now called: A False Report: A True Story of Rape in America by T. Christian Miller &‎ Ken Armstrong that addresses the subject of false reporting through a recent case where a number of women were accused of lying about their rape. Due to...some...good police work, it eventually came out that a serial rapist was responsible. They go into the concept of false reporting in great depth. I've seen and spoke with Miller at conferences and was admiring of his journalistic pursuit of this.

To answer the rest of your question, I've never dealt with a client who I thought was making a false accusation. If you think about it, it makes sense that someone who was never really raped wouldn't have trauma and need treatment.

I know this might be off topic, but how many sexual assault cases do you think are false?

I wrote about this in a response yesterday. There are actually very good statistics on this from the U.S. and other countries showing a false report rate of about 2%, including official reports from the FBI. There are other numbers referenced, such as the Lisak study which showed about 6% with a very small sample size.

Your question is phrased oddly as all sexual assault cases are real. I think you meant to ask how many false reportings are there, which is what I responded to.

It's always important to state when this comes up the vast number of sexual assaults that go unreported. This "false report" myth is often raised without those people acknowledging how minuscule that is when we look at the actual numbers in sexual violence. Not only rape, but child sexual abuse, assaults, coercion, intimidation, military rape, campus sexual assault, etc, etc.

Are you Hispanic? You look like the Argentinian dude who came into my Spanish class a few weeks ago.

Off-topic, but I encompass a variety of different ethnicities in my heritage. I've often said there is family history from every continent.

so youire not a trained psychologist or psychiatrist?

Not sure what you're asking. I am a trained sexual assault specialist with my degree in psychotherapy stemming from the field of Social Work. Many people confuse clinical social work with the kind they hear about who work in CPS, so maybe that's what you're thinking?

I don't have a medical or doctoral degree, though I've trained many.