The Impact of Society and Culture on Recovery from Sexual Assault

These days, most people know that sexual assault can be very harmful to mental health. However, the rates of various mental disorders in survivors of sexual assault are still staggering. Rates of PTSD are especially high: estimates suggest that 26 percent of survivors have had PTSD in the past year, as compared to 10 percent of people without a history of sexual assault (Dworkin, 2018). The risk of having a past-year anxiety, depressive, or alcohol-use disorder is more than doubled for survivors of sexual assault (Dworkin, 2018). Even more concerningly, nearly one out of every four survivors of sexual assault has attempted suicide (Dworkin, DeCou, & Fitzpatrick, 2020).

Public attention is increasingly turning to how society can affect survivors’ recovery from sexual assault. In 2018, a set of events collectively referred to as the #MeToo movement—including the trial of Bill Cosby, the Supreme Court nomination process of Brett Kavanaugh, and public acknowledgements of personal experiences of sexual assault from people around the world—demonstrated the high prevalence of sexual assault, the tenacity of outdated and problematic views about sexual assault, and the gaps in justice for survivors of sexual assault. Many survivors publicly shared that they had stayed silent for years out of concern that they would receive the doubt and blame that they say public figures such as Christine Blasey-Ford receive. Others discussed the distress that they felt about repeatedly being reminded of their own trauma because sexual assault had become part of the 24-hour news cycle. In addition, these events highlighted how society can promote recovery for survivors by creating a culture in which survivors are believed and supported.

My colleague Terri Weaver and I have characterized the societal factors that could impact survivors’ recovery. By reviewing the literature in this area, we identified three components of sociocultural settings that could affect mental health following sexual assault in both positive and negative ways: norms, structures, and environmental stressors.

Norms include the typical ideas, beliefs, ideologies, and/or values in a society, culture, or subculture. Norms that could affect sexual assault recovery include problematic norms related to sexual assault (e.g., victim blame) or sex and gender; general cultural values and expectations (e.g., the importance of supporting others through difficult experiences); norms about emotions, trauma, and mental health; and oppressive belief systems like racism, sexism, and heterosexism. These norms may influence how survivors, or the people and systems they turn to for support, think about and respond to sexual assault. In addition, norms like racism and sexism may create additional sources of stress for survivors, while norms like cultural pride may create a source of strength and resilience for survivors.

Structures include things like laws, policies, and media. Structures may affect recovery in that they influence and are influenced by norms, and are thus a vehicle by which norms can affect survivors. For example, in a society that believes problematic norms about sexual assault, laws about sexual assault may be unfriendly to survivors. Structures that could affect sexual assault recovery include laws about what is considered to “count” as sexual assault and the types of evidence that is acceptable to use in sexual assault cases, policies and practices in systems that serve survivors (e.g., how college campuses handle sexual assault allegations), and media representations of sexual assault survivors.

Environmental stressors are things that aren’t directly related to sexual assault, such as mass traumas and environmental conditions. These environmental stressors could increase survivors’ stress, change survivors’ options for coping with the assault, or get in the way of the effectiveness of survivors’ services and supports. They could also make it hard for survivors to get access to services that they need to recover. For example, because of the 2020 COVID-19 pandemic, survivors may lose their jobs and be unable to afford therapy appointments, and those who do not lose their jobs may have difficulty attending therapy appointments due to the quarantine. Other survivors may rely on their friends’ emotional support, but when their friends are also stressed out, this support might be harder to come by.

These societal factors are bigger than any one survivors’ personal experience. Even if a given survivor is not blamed or doubted when she comes forward, living in a society where people blame and doubt survivors could compound survivors’ trauma. Even if a given survivor has their case successfully prosecuted, living in a society where successful prosecution of sexual assault is rare could have effects on survivors. Just like the air we breathe, these societal factors affect all of us, whether or not we have experienced sexual assault. When the air is more polluted, people will be more likely to experience health problems. Similarly, when the societal contexts in which survivors recover include problematic norms, structures, or stressors, survivors may be more likely to develop mental health problems.

We all have a part to play in making our societal contexts more supportive of survivors. This can include being careful to not amplify problematic norms about sexual assault. Calling out myths about sexual assault when we hear them can help to challenge these norms. We can also vote for policies and politicians that will fight against structures that reinforce these problematic norms. Finally, when environmental stressors like COVID-19 are present, it’s important to keep checking in on friends and providing emotional support. Although it can sometimes feel like it’s hard to overcome all of the forces that get in the way of recovery, you can be more helpful than you might realize.

Emily R. Dworkin, Ph.D., is a clinical-community psychologist and Acting Assistant Professor in the Department of Psychiatry & Behavioral Sciences at the University of Washington School of Medicine.