A Trauma-Informed, Ethical, and Relational Approach

Working therapeutically with survivors of rape and sexual violence requires more than empathy. It requires steadiness, attunement, ethical clarity, and a deep respect for the complexity of trauma.

Survivors do not arrive as “cases.” They arrive carrying experiences that may have disrupted trust, safety, bodily autonomy, and often their sense of identity. Sexual violence is not only an event that happened; it can become something that reshapes how a person experiences themselves, others, and the world.

Therapy, when conducted thoughtfully and collaboratively, can become a space where safety is rebuilt and power is restored gently and without pressure.

Understanding the Impact of Sexual Trauma

Sexual violence is both a psychological and nervous system injury.

When threat is experienced, the body activates survival responses designed to protect. These responses can remain active long after the event has passed. Survivors may experience:

• Hypervigilance or heightened anxiety
• Dissociation or emotional numbing
• Shame and self-blame
• Difficulty with trust or intimacy
• Somatic symptoms such as chronic tension, fatigue, or pain
• Freeze or fawn responses
• A disrupted or fragmented sense of self

Some survivors minimise their experience or struggle to name it as violence, particularly where coercion, manipulation, or relational abuse were involved. Therapy must avoid reinforcing silence, ambiguity, or doubt.

Responsibility always lies with the perpetrator. Careful, precise language is essential.

Creating Safety Before Exploration

A common mistake in trauma therapy is moving too quickly into recounting what happened. Exploration without stabilisation can replicate overwhelm.

Safety and resourcing come first.

This may involve:

• Establishing clear boundaries and confidentiality
• Collaborative goal setting
• Psychoeducation about trauma and nervous system responses
• Developing awareness of hyperarousal or shutdown states
• Learning grounding and emotional regulation strategies

Stabilisation is not avoidance. It is preparation. Survivors deserve to feel supported and equipped before revisiting traumatic material. Therapy should not recreate loss of control.

The Importance of Pace and Consent

Therapy itself must model consent.

This includes:

• Checking in before discussing sensitive topics
• Allowing the survivor to determine depth and pace
• Respecting silence
• Normalising ambivalence
• Offering choice wherever possible

Control was taken during the traumatic experience. Therapy restores control by consistently offering choice.

Even small decisions, whether to pause, continue, shift focus, or remain silent, can be reparative.

Working With Shame and Self-Blame

Shame is one of the most pervasive consequences of sexual violence. Survivors may hold beliefs such as:

• “I should have stopped it.”
• “It wasn’t serious enough to count.”
• “It was my fault.”
• “My body responded, so I must have wanted it.”

Part of ethical trauma work involves clearly and gently locating responsibility where it belongs.

Physiological responses during assault, including arousal, immobility, compliance, or freezing, are autonomic survival responses. They are not consent.

Therapists must be deliberate in challenging cultural myths and narratives that reinforce blame, including those related to clothing, intoxication, previous relationships, or delayed disclosure.

Understanding Trauma Responses

Many survivors present with anxiety, depression, relationship difficulties, or disordered eating without immediately connecting these difficulties to past sexual trauma.

Common survival responses include:

• Freeze: immobility, shutdown, compliance
• Fawn: appeasing behaviours to maintain safety
• Hyperarousal: panic, irritability, startle responses
• Dissociation: detachment, feeling unreal or disconnected

These are adaptive responses to threat, not character flaws or pathology. Reframing them as survival strategies can reduce shame and support self-compassion.

Cultural Sensitivity and Power Awareness

Sexual violence does not occur in isolation from social context. Gender, race, class, sexuality, disability, and cultural background influence both the experience of violence and the response to disclosure.

Therapists must remain aware of systemic inequalities, unconscious bias, and power dynamics. The therapeutic relationship should not replicate societal imbalances. Intersectionality is central to ethical trauma work.

When Trauma Is Complex

For some survivors, sexual violence occurred in childhood or within attachment relationships. In these cases, trauma may be deeply interwoven with identity development and relational templates.

Therapy may involve:

• Attachment-focused work
• Parts or inner child approaches
• Somatic awareness
• Gradual trauma processing
• Boundary development

Work with complex trauma often unfolds in phases: stabilisation, processing, and integration. Progress is not linear. It is reflected in increased safety, greater self-trust, and expanded choice.

The Role of the Therapist

Supporting survivors requires:

• Emotional regulation and steadiness
• Ongoing supervision
• Clear ethical boundaries
• Awareness of vicarious trauma
• Patience

Therapists must be able to tolerate intensity without rescuing, minimising, or withdrawing. Survivors are not “fixed.” They are accompanied.

Healing Is Possible

Sexual violence can have profound impact, but it does not define a person’s identity.

Therapy can support:

• Reconnection with the body
• Restoration of boundaries
• Reduction in shame
• Reclaiming sexuality on one’s own terms
• Strengthening identity
• Renewed capacity for trust

Healing is not about erasing what happened. It is about reducing its control over the present and restoring choice.

If You Are a Survivor

You deserve to be heard.

You deserve to be believed.

You deserve therapy that respects your pace.

You deserve safety.

If you are considering therapy, seek a practitioner trained in trauma-informed practice and experienced in working with sexual violence. You do not have to navigate this alone.