Price survivors pay: The long-lasting trauma of sexual harassment and assault

Mental health repercussions of sexual harassment can be severe and long-lasting, and few realise the unfair tangible and intangible costs that survivors pay.

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The past week has been extremely troubling for many. Social media is full of heart-wrenching accounts of sexual harassment, abuse and misconduct faced by a number of people at the hands of powerful men. Apart from those who have mustered the courage to tell their stories, there are also those who are extremely disturbed at the extent of misogyny at the most seemingly liberal workplaces now laid bare.

Many people have asked by now, “What about the accused man’s career? His family? His elderly parents? His relationships?” But, despite survivors recounting the months and years of trauma that has affected their mental health, few seem to be thinking of the unfair tangible and intangible costs that survivors pay for years.

How sexual harassment and assault affect survivors

One of the first things people say to survivors is, “Why didn’t you say no?” and its variations. Research has found that freezing is a legitimate reaction to sexual assault (or any kind of trauma), apart from the more commonly known ‘fight or flight’ reactions.

Dr Divya Kannan, a Bengaluru-based clinical psychologist who specialises in trauma, explains that this freezing, which is also known as ‘tonic immobility’, is a temporary involuntary paralysis of the body when it is under attack. Studies say that women who experience extreme tonic immobility are twice as vulnerable to suffer post-traumatic stress disorder (PTSD) and three times more susceptible to severe depression in the months following the assault.

The mental health repercussions of experiencing sexual harassment and/or assault can be severe and long-lasting. “Exposure to traumatic events such as sexual assault/harassment and power-based interpersonal violence can have lasting effects on an individual. They may have difficulty sleeping, in focusing and concentration, have recurrent memories of the event(s), and increased in anxiety or depressed mood, as well as relationship and identity difficulties,” Dr Divya states.

“In addition, many survivors of violence experience intense shame when they encounter sexual abuse. A natural reaction to such an incident is humiliation and a sense of violation of integrity and violation of emotional and physical safety,” she adds.

Gajalakshmi, a Chennai-based clinical psychologist, says, “The abuser, in many cases, is someone who enjoys power over the person. This discourages the survivor from telling their story and confiding in others.” And a person who cannot share their story and hence validate their feelings can experience isolation and loneliness, says Dr Divya. “It may be disempowering to the survivor’s sense of agency,” she adds.

That being said, Dr Divya asserts that survivors have the right to tell their story to whom they choose, and at the time and manner in which they deem appropriate and safe to do so.

Further, there is no ‘ideal’ victim behaviour. If a survivor goes back to work the next day, for example, it does not mean that they have not experienced trauma or are lying. “Shock, denial, confusion and fear can cause survivors to suffer in silence, particularly when retaliation and victim shaming is prominent in society. This gets even more complex when the person is someone whom you trust or have trusted until this point or if the person is in a position of power. It takes courage and incredible resilience to come forward, and the threat of retaliation to those who do come forward cannot be minimised,” Dr Divya says.

The situation is compounded if a person is financially not well off and cannot afford to lose their livelihood by telling their story, Gajalakshmi points out. She adds that people who experience sexual harassment and/or assault can develop depression, anxiety, insomnia and PTSD.

“On a personal level, because they internalise the trauma, a survivor’s sense of self and identity is deeply affected. They undervalue their talent and can close themselves off to others, leading to further isolation. The socio-cultural norms are such that for women survivors, the burden of family name, children’s well-being if they have any, societal stigma and consequential denial of opportunities ends up further silencing them,” Gajalakshmi observes.

The cost of therapy

Due to the severe health repercussions of sexual harassment and/or assault, the financial costs that survivors bear, if they can afford it, are substantial. Dr Divya says that the cost of one session can vary between Rs 750 to Rs 5,000, with rates differing across the country. However, Gajalakshmi points out that therapy has become more accessible recently, with many government hospitals being mandated to have clinical psychologists and counsellors available at affordable rates.

However, survivors have pointed out at several instances in the recent past that many mental health practitioners often suffer from the same patriarchal biases as most of society.

“There are also other costs to victims of violence – think about medical treatment from sexually transmitted infections or other health problems that can develop over time, fees for psychiatrists and/or therapists, leave of absence away from school or work, loss of productivity, etc.,” Dr Divya points out.

And while a recent mandate by the Insurance Regulatory and Development Authority of India has asked insurance companies to include coverage for mental healthcare as well, there are loopholes that could result in certain mental illnesses not being covered and the costs may vary. “Having nationwide mental health coverage would be helpful in terms of affordability,” says Dr Divya.

Self-care and affordable options for mental healthcare

There have been several accounts of people leaving social media in the past week because the accounts of sexual harassment and/or assault have been quite triggering. The White Swan Foundation, in consultation with Dr Divya, listed some measures of self-care, such as taking a break from social media and putting trigger warnings to help people trying to avoid triggers.

Tips from Dr Divya on taking care of your mental health in these times:

1. Distance yourself from the trigger or triggering event (e.g., limit social media for some time, switch to a more soothing activity) — White Swan Foundation (@mentalhealthind) October 9, 2018

2. Journalists and writers can help here by issuing trigger warnings when publishing content on sexual assault

3. Create a buffer between stimulus (trigger) and emotional response (anxiety) by using grounding techniques to feel calm and safe (as guided by a professional) — White Swan Foundation (@mentalhealthind) October 9, 2018

4. Talk to a trusted friend or family member about what you're experiencing, with whom you feel fairly confident that you will be supported in your disclosure — White Swan Foundation (@mentalhealthind) October 9, 2018

5. Write down or journal the thoughts and feelings that are causing distress for a structured amount of time, remind yourself that you are safe in the current moment and not in danger

6. Stay with your normal structure and routine as far as possible — White Swan Foundation (@mentalhealthind) October 9, 2018

Continuing the conversation with Dr Divya what #metoo & mental health:

"The impact of the #metoo movement on those that are allies, supporters, and listeners, for those that are directly impacted by sexual harassment and abuse can also be an emotionally difficult journey." — White Swan Foundation (@mentalhealthind) October 10, 2018

It is be important to understand any sense of personal discomfort that can come up in this role so that you can be mindful of your own emotions, reactions, and limitations. — White Swan Foundation (@mentalhealthind) October 10, 2018

It’s important to practice self-care, as the emotional gravity of the outpouring of messages on social media can be overwhelming for all. — White Swan Foundation (@mentalhealthind) October 10, 2018

Do take “time outs” from social media and gadgets, utilize creative spaces and outlets for yourself. Do take “time outs” from social media and gadgets, utilize creative spaces and outlets for yourself. October 10, 2018

Seek support within your personal and professional networks where feasible. Build in time in your day to slow down, breathe, and relax (try the @headspace or @calm app for a quick mental respite)" — White Swan Foundation (@mentalhealthind) October 10, 2018

Further, people have been compiling lists of mental healthcare practitioners across India willing to provide their services at a nominal fee for those in need. The document below also contains details of lawyers who are willing to give legal aid to survivors and other useful resources.