As Supreme Court nominee Brett Kavanaugh faced allegations of sexual assault from Christine Blasey Ford, President Donald Trump came to his defense.

"It's a shame," he said, "because this is a great gentleman."

Shame is a word frequently used regarding sexual assault, but not in that "what a pity" way. In a primal way, something fearsome from which we must protect our daughters, as Padma Lakshmi wrote revealing her rape in the New York Times; and a crippling way, "overwhelming" as Andrea Constand put it in her Bill Cosby victim impact statement; in a way inextricable from other awful feelings, as second Kavanaugh accuser Debbie Ramirez told the New Yorker: “I was embarrassed and ashamed and humiliated.”

Shame – the feeling that "I am bad" rather than simply "I did something bad" – is one of the most primitive, universal pieces of our moral system, said June Tangney, a clinical psychology professor at George Mason University. Just as shame is a central feeling, sexuality is a central piece of identity, which may be why sexual assault survivors feel shame so profoundly.

"There’s something about sex that is very much at the core of ourselves," said Tangney, who has studied shame for more than 30 years. "And if it’s not something that’s freely given … it just really hits at the core of who we are."

When someone is physically attacked or experiences other kinds of trauma, they may feel helplessness, terror and other extreme, negative emotions. However, it's likely they will be able to get support from others and unlikely they'll need to keep it a secret. But when the trauma is sexual it violates the most intimate parts of a person's body and psyche. Added to the feeling of helplessness is humiliation with a long and strong cultural history, creating a complex, potent cocktail of shame.

"Whenever we feel that we’re being totally controlled by another person we experience shame because we all want to believe that we have control over our lives, so when we’re faced with the reality that that’s not true it’s very shaming for us – but with sexual assault in particular they feel very invaded and defiled," said Beverly Engel, a psychotherapist who’s worked with sexual assault victims almost 40 years. "The act of sexual assault is a very humiliating experience for the victim. They feel exposed physically and emotionally."

More: Kavanaugh accusers Ford, Ramirez admit memory gaps: Here's what trauma experts say

Shame as a verb – and as a silencer

Sexual assault and shame seem so intertwined not only due to the base nature of sex and violence, but because their coupling is reinforced by people and the culture at large.

Other people pile on the shame when they have any of these three reactions to abuse, therapist David Bedrick says:

Denial: "That didn't really happen, come on." "He wouldn't do that."

Dismissal: "It's not that big a deal." "That was a long time ago." "This happens to lots of other people and they're not behaving this way."

Pathologizing the victim: "You're exaggerating because you're messed up." "You're oversensitive." "You're overdramatic."

Bedrick compared sexual assault to being wounded, and such blaming reactions to wrapping the wound in an infected bandage. It results in the victim thinking not just that something wrong happened but that something is wrong with them. That destroys their sense of self-worth, which in turn silences them, sometimes for decades.

For the question, "why didn't she report it?" to be asked shows "profound ignorance" of the level of pain experienced and the internal and external pressures at play, Bedrick said.

"Why are so many women saying 'I believe [Christine Blasey Ford] 100 percent'?" Bedrick asked. "Because it’s the feeling that 'if one more person doesn’t believe a woman who’s been sexually assaulted, I’m going to die, I can’t handle it anymore.'"

Bedrick said if he were a Republican senator being asked about the Kavanaugh accusations, he would first address the "cultural shame" in any statements.

"I’d say, 'Before I talk about this woman and this man, do you know how many women have been assaulted and shamed and denied and dismissed and killed themselves … I can hardly speak about this one instance given the violence that women have spoken to … and please forgive me for not being sure about this,'" he said.

Engel, author of It Wasn’t Your Fault: Freeing Yourself from the Shame of Childhood Abuse with the Power of Self-Compassion, notes that not reporting an assault is more common than reporting it – and shame is a big reason why.

"People who are full of shame don’t have the self-confidence to report," she said. "They have a very strong belief it was their fault already and then they have a belief they’re going to be blamed."

Many women have witnessed shaming long before an assault takes place.

"There was a part of me that knew, deep in my bones, that he raped me," said Chrissa Hardy of her experience at age 17. But "if I did come forward, I knew nothing would happen to him. ... In high school, word gets around quickly ... whenever a story made a guy look bad at all, [the girl] would be dismissed as crazy or that she was just lying to get attention, and it's like her side of the story was totally erased. It seemed like a losing battle to say anything to anyone, even my closest friends, and that it would be safer for me to stay silent." And so she did for 10 years.

Tangney agrees that reporting, even outside of law enforcement, can seem like "a no-win situation."

"It feels like such a terrible, terrible risk to tell someone, because a lot of bad things could happen. There's the feeling that they will now see you as spoiled or dirty or damaged in some way – and that goes back centuries, particularly about women, everyone wanted a virgin. So how the person you tell is going to see you: Are they going to see me as a different person? Are they going to believe me? Being invalidated in that way is very harmful," Tangney said.

This resonates with Liz Taylor, who was raped her freshman year at the University of Missouri in 1996.

"I was a virgin when it happened so there was a feeling of 'I’m damaged goods now' because that’s what I was told," she said. Like Constand, Taylor also called the feeling of shame "overwhelming."

Taylor felt shame for a number of reasons common to victims, both men and women, that outsiders seize on to place blame: she had been drinking, she felt she should've been able to fight him off, and her feelings of shame were reinforced by other people – in her case, her mother.

The reason people who aren't traumatized are so quick to shame those who are can be explained by "just-world bias."

"[It's] human bias to believe that we live in a just world, to believe that bad things happen to bad people or to think that people are somehow responsible for bad things happening to them," Tangney said. "Because if bad things happen to good people anything could happen to me."

Shame on the brain – and in the body

Once shame manifests, it can be difficult to shake and can impact other areas of a person's life.

"People who are prone to feel shame more often than the average person tend to be more vulnerable to a range of psychological and behavioral problems," Tangney said.

Studies have shown that shame and self-blame are associated with PTSD. A 40-year review of research also found that sexual assault was linked to increased risk for and severity of all disorders assessed (anxiety, depression, bipolar, substance abuse disorders, obsessive-compulsive disorder, disordered eating), with the "most robust" link to PTSD and suicidality.

Trauma and shame can show up physically, too, Bedrick said.

"It could live in [illness or] in other bodily experiences – tiredness, weakness ... stomach acid, certainly weight," he said.

Taylor believes that her trauma is at least partly to blame for the autoimmune issues she has now.

"I know that there’s been a physical toll on my body because of the fight-or-flight responses that are triggered more regularly and more severely in me because of what’s happened," she said.

Her intuition may be right. A study out in June found that PTSD is linked to autoimmune diseases such as rheumatoid arthritis, Crohn's disease, celiac disease and others. Tangney said research shows a "clear" link between shame and pro-inflammatory cytokines, which regulate immune responses. Low doses of such cytokines are associated with arthritis, but a spike in them actually results in a change in body posture, temporarily.

"It makes you move into a submissive posture – which is a good thing for nonverbal animals to do with each other because they’re much less likely to be physically harmed by the alpha," Tangney said. "You bow down a bit."

These animal-like reactions, like "the deer in the headlights," strike interest in the context of "fight, flight or freeze," which experts say more accurately reflects response to a threat than the more commonly known "fight or flight" duality.

"During rape, temporary paralysis is very common; in fact, it occurs in up to 88 percent of rape victims," Engel writes, further supporting the idea that victims should not feel shame for not "fighting off" their attackers.

Stopping shame

For many people who feel shame, understanding the difference between shame and guilt can be an "ah-ha" moment.

Shame is "'I feel small and diminished ... I feel lower than dirt,' as opposed to, 'I did that thing and it was wrong,'" which is guilt, Tangney said. Guilt is "all about confessing, apologizing … behavior that’s in some ways fixable, and it’s more future-oriented and constructive."

The trick is that with sexual assault, the victim didn't do something wrong, Tangney said.

It's not "a situation where they’ve failed or transgressed in some way, so there’s not the option of turning [shame] into guilt and undoing that," Tangney said. Still, she said that talking about it with a cognitive behavioral therapist or "trusted others" could help people move on.

As Brene Brown said in her viral TED Talk: "Empathy's the antidote to shame. If you put shame in a Petri dish, it needs three things to grow exponentially: secrecy, silence and judgment. If you put the same amount in a Petri dish and douse it with empathy, it can't survive. The two most powerful words when we're in struggle: me too."

Confidants have a lot of power and responsibility to help survivors release shame, Bedrick said.

"I think when someone gets shamed by ... gas-lighting, they need the opposite. Someone who doesn’t deny it. 'I believe you' is really important. 'I want to know the details,' that’s really important," Bedrick said. "When someone takes interest in the details not to figure out why you screwed up but because they want to know, [the victim] feels like they see them. And having a feeling response."

Engel says the most important thing someone can do is practice self-compassion.

"Self-compassion is specifically about attending to and acknowledging your own suffering," she said, calling it the anti-dote to the self-criticism that most survivors feel.

Though not for everyone, speaking out about the experience upends the shame for many women.

Chloe Allred, an artist who was sexually assaulted in 2011, now uses her trauma in her work.

"It’s a way of embracing something and sharing it, and it’s a lot harder for shame to exist that way. But that also takes time," Allred said. "It’s not something you can tidily wrap in a linear kind of way."

Though initially she felt her experience was "this disgusting thing," she knows "it wasn’t mine to carry or to own – my rapist did something wrong."

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