“#MeToo!” Since October 2017, these two, simple words have sparked an exponentially expanding movement that has caught worldwide attention. Survivors of sexual assault are breaking the silence that has bound them with shame and are broadcasting the secrets that have protected their perpetrators. What the long-term effects of the “#MeToo” movement will be are yet to be determined. There is a good chance, however, that it may become less stigmatizing for those who have been abused to admit to having been victimized. As a result, Christian counselors may experience an influx of counselees who present with a background of sexual trauma. We need to be prepared.
How is Sexual Trauma Different from Other Trauma?
Our sexuality is integral to who we are as individuals. Therefore, trauma of a sexual nature is violation against a core aspect of the self. While sexual assault by a stranger is horrific, it is more common for the perpetrator to be someone known to the victim. The added sense of betrayal experienced by victims at the hand of someone they thought they could trust adds to the sense of injury. When abuse is chronic, and/or happens in childhood, the sexual trauma has the potential to impact every area of an individual’s life, including difficulty regulating emotion, an inability to develop a fully integrated sense of self, and problems developing healthy, secure attachments to others.
Post-traumatic symptoms, such as flashbacks, nightmares, avoidance of trauma triggers, hyperarousal, and so on, may be experienced by survivors of sexual trauma just as they are by those who have gone through a natural disaster or have witnessed a fatal car accident. However, for the reasons previously mentioned, the consequences of sexual assault are much more pervasive. This places sexual trauma, particularly in cases where there is chronic sexual abuse in childhood, under the broader category of complex trauma.
Judith Herman, in her groundbreaking book, Trauma and Recovery (2015), was the first researcher to discuss differences in treatment approaches between what is now commonly known as complex trauma (or complex PTSD) and PTSD. Her concept of phased treatment has become the standard of care for complex PTSD, including sexual abuse. Its use has been shown to lessen the risk of counselees decompensating emotionally to the detriment of day-to-day functioning by ensuring that adequate coping mechanisms are in place prior to processing the trauma.
Following, I briefly discuss how to approach each phase of treatment, using slightly modified labels for each phase. A more detailed description, with practical suggestions and examples of session transcripts, is given in my book, Restoring the Shattered Self (2013), for readers who want to more fully understand the process.
The time spent in each phase will vary depending on the particular client. A young woman who was healthy emotionally and spiritually prior to a single incidence of date rape may need to spend only a session or two in Phase I before spending several sessions processing her trauma in Phase II, and ending counseling with a couple of sessions in Phase III. On the other hand, a man who was sexually abused several times a week from early childhood into adolescence may require years in both Phases I and II, and another year or two in Phase III for a total of a decade or more.