Sexual Harassment & Assault

The widespread prevalence and impact of sexual harassment and assault have recently been brought to the fore, as a result of the #MeToo movement. People of any age, sex, gender identification, or culture can, unfortunately, be subjected to sexual harassment or assault.

Broadly speaking, sexual harassment refers to any kind of unwanted sexual advance, request, or behavior. Definitions of sexual harassment often include sexual assault - which is any kind of unwanted sexual activity. Definitions of these terms vary widely; the legal definitions, in particular, vary from country to country.

Sexual harassment or assault can be a degrading and humiliating experience, and it’s common to experience shock, fear, or anxiety in the time following. Survivors of sexual assault are also vulnerable to experiencing mental health problems including post-traumatic stress disorder (PTSD), as well as anxiety, depression, addictions, or eating disorders.

For individuals who experience psychological symptoms, it’s essential to be aware that it bears no reflection on any personal weakness. It’s really important to seek help, and effective treatments are available to help people heal.

Types of sexual harassment and assault

According to the Department of Justice, types of sexual assault may include the following nonconsensual contact and non-contact acts (1):

Rape
Attempted rape
Sexual assault other than rape or attempted rape
Verbal threat of rape or threat of sexual assault other than rape
Unwanted sexual contact with or without force

In addition, sexual harassment includes unwanted verbal or nonverbal sexual behaviors, such as:

Inappropriate or intrusive comments, questions, jokes, or photos (in-person, or via email or text)
Inappropriate touching
Others exposing themselves
Inappropriate staring

Prevalence of sexual harassment and assault

As it tends to be underreported, it’s difficult to build an accurate picture of just how prevalent sexual harassment, assault, and any associated mental health problems actually are.

However, sexual harassment appears to be a widespread problem. For example, a study in the European Union found that over half (55%) of female survey respondents had experienced sexual harassment since the age of 15, with inappropriate staring (30%) and unwelcome touching, hugging or kissing (29%) being the most frequent types of harassment (2).

In the U.S., The National Crime Victimization Survey suggests that 9.2 out of every 1000 Americans experienced incidents of rape and sexual assault in 2017 alone (1). Furthermore, nearly 1 in 5 women and 1 in 71 men have experienced rape at some point in their lives, and around 22% of women and 5% of men who had reported experiencing symptoms of PTSD, according to the National Intimate Partner and Sexual Violence Survey (3).

Consequences of sexual harassment and assault

People react in complex and often very different ways over the short and long term. Reactions can be influenced by individual factors, the nature of the experience, and the support resources available.

Those who have experienced sexual harassment or assault may:

Feel vulnerable, distressed, anxious, or unsafe
Have lowered self esteem
Alter their behavior to avoid further harassment
Experience relationship difficulties
Have reduced interest in sexual activities, or sexual difficulties
Engage in high-risk sexual behavior

In the weeks following sexual harassment or assault, some people experience symptoms of trauma, such as:

Intrusive recollections, flashbacks or nightmares related to the event
Avoidance of anything that is a reminder of the event
Increased arousal, feeling anxious or easily startled, or having difficulty sleeping
Depressed or anxious mood

As with any type of trauma, those who have experienced sexual assault may be at increased risk of mental health conditions. As such, if any of the above symptoms impact your functioning at work, cause strain in your relationships, or last more than a few weeks, they may be a sign of one of the mental health conditions below, and it’s important to seek treatment.

Ways to heal from sexual harassment and assault

If you’re feeling distressed or experiencing mental health challenges in relation to sexual harassment or assault, also consider one or more of the following options:

Therapy: A therapist who can help you understand and make sense of your experience, build healthy coping strategies, and heal from the trauma you experienced. See more tips below on types of therapy and selecting a therapist.
Check-ups: It’s important to have a check-up with your gynocologist or primary care doctor, especially following an incidence of sexual assault.
Self-care: Pay attention to your diet, try to maintain a regular sleep pattern, and exercise regularly. Find activities that you enjoy, and make time for them in your schedule. Such lifestyle factors can help to regulate our moods (4,5,6).
Social support: Talking to family and friends about your experiences and how you are feeling can be a helpful part of the healing process. It can be hard to do, but the people who are important supports in your life will be better placed to help you, once they understand how you feel.
Hotlines: Contact the above-listed National Sexual Assault Hotline, or if you’re having thoughts of suicide or need immediate support, call the National Suicide Prevention Hotline at 1-800-273-8255.
Online resources: Exploring self-guided resources online or reading about the experiences of others can also be helpful.
Journaling: With guidance from your therapist, a helpful part of the healing process may include writing about your trauma experience (7).

For many people, the experience of sexual harassment or assault is traumatic. The American Psychological Association suggests that there are several things you can do to help improve your wellbeing following a traumatic event, including (8):

Giving yourself time to adjust
Asking for support from people who care about you and who will listen to you
Communicating your experience
Finding a local support group led by appropriately trained and experienced professionals
Engaging in healthy behaviors to enhance your ability to cope with excessive stress
Establishing or re-establishing routines
Avoiding making major life decisions
Calling the National Sexual Assault Hotline at 1-800-656-4673 or visit online.rainn.org to receive support via confidential online chat.

Therapy types to consider

There isn’t a one-size-fits-all approach to therapy, and this is especially true for sexual assault and harassment. This is because people can have very different psychological responses to such experiences, which influences the type of treatment and therapy that is most appropriate. Common types of therapy to consider include:

Trauma-informed therapy: If you are experiencing symptoms of trauma, consider a trauma-informed therapy. A therapist with specialized training in trauma will be able to help you to heal from the impact trauma can have on your thoughts, feelings, and behavior.
Eye Movement Desensitization and Reprocessing Therapy (EMDR): EMDR can be a helpful technique particularly for people who have experienced sexual trauma. EMDR can help people to heal without necessarily having to discuss painful experiences in-depth. In EMDR, side-to-side eye movements helps our brains to reprocess the trauma experience and reduces the associated distress.
Psychodynamic Therapy: Psychodynamic therapy involves the exploration of past experiences and how they influence current patterns of thought, emotion, and behavior. This can help people who want to gain insight into how their experiences have shaped them, as well as how to move forward and heal.
Narrative therapy: Narrative therapy helps people to re-examine their life experiences, reinterpret events, and make meaning from trauma. This helps people to deepen their understanding of themselves and move from feelings of shame to feeling empowered, for example.
Mindfulness Practices: Mindfulness helps us to connect with the present and develop moment-to-moment awareness. Through mindfulness, people are encouraged to tune into sensations, feelings, and current experience rather than getting caught up in and reacting to thoughts.
Cognitive Behavioral Therapy (CBT): CBT is a skills-based treatment that helps us to become aware of and change unhelpful thinking patterns, behaviors, and beliefs. In particular, Trauma-Focused CBT can help people heal from trauma, which may be associated with sexual assault or harassment experiences.

It’s important to consider different therapy types and how they resonate with you before choosing. If you’re unsure, your prospective therapist is a great person to seek advice from.

What to look for in a therapist

There are several factors to keep in mind when selecting a mental health professional, including:

Specialization: Look for a therapist who has specialized training in trauma or sexual trauma, as well as the particular therapy type that resonates with you. Therapists often include this kind of information in their onlne biographies so that it’s easy for you to find.

Qualifications: With so many different provider types available, it can be difficult to decide which type of mental health professional to see. The most important thing is to look for a currently licensed therapist. That said, if you think medication might be needed, make sure you see a psychiatrist. This particular type of mental health professional is able to prescribe.

Personal fit: The trusting relationship between you and your therapist, known as the “therapeutic alliance” can have a huge impact on the efficacy of therapy. This is especially true of treatment for experiences related to sexual harassment or assault, given much of the work relies on you feeling comfortable sharing difficult memories with your therapist. The best way to judge how you might feel about a therapist is to ask for a preliminary phone call. This also enables you to ask about their experience, which therapy type they suggest, and what therapy with them will be like. Try to speak to a few different therapists before deciding on a provider.

Sources and references

(1) Morgan, R.E. & Truman, J.L., 2018, “Criminal Victimization, 2017”, U.S. Department of Justice, Office of Justice Programs, available from the Bureau of Justice Statistics website or PDF
(2) European Union Agency For Fundamental Rights, 2014, "Violence against women: an EU-wide survey. Main results report” available from the website or PDF
(3) National Intimate Partner and Sexual Violence Survey, 2010 Summary Report, available online from the Centers for Disease Control and Prevention website or PDF
(4) Walsh, R., 2011 “Lifestyle and Mental Health”, American Psychologist, 66(7). PDF accessed online December 2019 at https://escholarship.org/content/qt0786x6tw/qt0786x6tw.pdf
(5) Hearing, C.M., et al., 2016, “Physical Exercise for Treatment of Mood Disorders: A Critical Review”, Current Behavioral Neuroscience Reports, 3(4). Accessed online December 2019 at https://link.springer.com/article/10.1007/s40473-016-0089-y
(6) Reid, K.J., et al., 2006, “Sleep: A Marker of Physical and Mental Health in the Elderly”, The American Journal of Geriatric Psychiatry, 14(10). Accessed online December 2019 at https://www.sciencedirect.com/science/article/abs/pii/S1064748112608628
(7) American Psychological Association website, “Open Up! Writing About Trauma Reduces Stress, Aids Immunity”
(8) American Psychological Association website, “Recovering emotionally from disaster”