In 1996, Sabag immigrated to Israel in the hopes of finding some kind of closure. She volunteered at a hotline for sexual-assault survivors. “I wanted to let victims have someone who would listen,” she says. “Because I didn’t ask for help, so I wasn’t listened to.” Yet the suicide attempts did not cease until 2006, when a friend suggested that Sabag enroll in a specialized self-defense course offered by El HaLev, an Israeli organization founded in 2003 to offer self-defense training to women who have been traumatized by sexual assault, as well as other vulnerable groups. At first, Sabag was dubious. “I said: ‘Fighting? No way. What do I have to do with fighting?’”

But in fact, a growing body of research indicates that self-defense training can enable women to cope with the threat of sexual violence by providing a sense of mastery and personal control over their own safety. Within this field, some studies have examined a unique and pressing question: Can therapeutic self-defense training be an effective tool for sexual-assault survivors who experience PTSD and other symptoms of trauma? Though the research is preliminary, some therapists and researchers believe the answer is yes.

“While ‘talk-based’ therapies are undoubtedly helpful, there is a need for additional modalities,” says Gianine Rosenblum, a clinical psychologist based in New Jersey who has collaborated with self-defense instructors to develop a curriculum tailored to female trauma survivors.

Researchers who study self-defense for sexual assault note its similarities to exposure therapy, in which individuals in a safe environment are exposed to the things they fear and avoid. In the case of self-defense training, however, participants are not only exposed to simulated assaults, they also learn and practice proactive responses, including—but not limited to—self-defense maneuvers. Over time, these repeated simulations can massively transform old memories of assault into new memories of empowerment, explains Jim Hopper, a psychologist and teaching associate at Harvard Medical School.

Sabag was not familiar with these theories back in 2006; however, she eventually decided to enroll in the self-defense training. Perhaps, she thought, it would help her be less fearful of others.

In a 2006 video she shared with Undark, Sabag can be seen lying on the floor of a gym at El HaLev. She’s surrounded by roughly a dozen women showering her with encouragement. A large man dressed in a padded suit and a helmet—referred to as “the mugger”—approaches with heavy footsteps and lies on top of her. The women continue to cheer, encouraging Sabag to kick her assailant. A female trainer leans in, providing instruction. Sabag sends up a few weak kicks, connecting with the mugger. Then she gets up, swaying, and returns to the line of trainees.

Din Aharoni / El HaLev

In that moment of confrontation, Sabag says she felt disoriented, not sure of where she was. She had been nauseous while waiting her turn, and then when the mugger was finally standing in front of her, she froze. “My body refused to cooperate, and there was a split. My mind left my body and I was looking at my body from the outside, like in a nightmare,” she says. “Without this split, I wouldn’t have found the power to react.”