4 Stages of Emotions and Treatment After Sexual Trauma

Person with short dark hair sits on bed in robe looking out open windowThere may be many emotions to sort through after experiencing sexual trauma. These emotions are typically painful, so it is natural to want to avoid them. The problem is, these emotions don’t tend to go away—they fester until you allow the time and space to work through them.

A common cycle of emotions after surviving sexual trauma is: (1) guilt and shame, (2) blame and anger, (3) grieving/mourning, and (4) fear and anxiety. This cycle by no means captures everyone’s experience after a trauma but is a general outline of common reactions. Let’s consider them in more depth.

1. Guilt and Shame

There can be a lot of secrecy surrounding sexual trauma. Victims who come forward are often made to feel like they did something wrong. Some are advised to keep their experience quiet. People often blame the victim by outlining things they “should” or “should not” have done.

Survivors of sexual trauma may internalize these messages and feel guilt and shame. They may replay in their minds the things they could have done to prevent or escape the trauma, even if they couldn’t have done anything differently. They may feel guilty for having not stopped the abuse and ashamed for having been a victim of it.

Learning to challenge these messages is one of the first hurdles of trauma treatment. Treatment at this stage focuses on self-compassion, understanding, and most importantly: accepting that sexual trauma is never the victim’s fault.

2. Blame and Anger

Along with guilt and shame come blame and anger. Many times, survivors of sexual trauma will blame themselves for what happened and will direct anger at themselves. They beat themselves up with critical, hurtful, and mean thoughts and comments. Some may even engage in self-harming behaviors such as cutting as a coping strategy.

A goal at this stage of treatment is to separate responsibility from blame. Again, no matter what happened, it is never a person’s intention to get abused! Treatment focuses on challenging the blame; challenging the hurtful, critical thoughts; and learning to look at things from a new perspective and generate healthier, more adaptive thoughts. The blame and anger then shift to the perpetrator, as it should.

Unfortunately, many people become stuck at this stage, fuming in anger and unable to move forward. Anger can make us feel more in control. When we are angry, people listen, do what we say, or leave us alone. There is power in anger that makes it hard to let go of. There can also be a fear that if one lets go of the anger, it means it was okay that the trauma happened (of course, it’s not!).

Over time, chronic anger can lead to isolation, loneliness, and depression. Treatment focuses on validating the anger, understanding why it’s there, recognizing anger as a protective warning sign, and learning to manage it before it escalates into verbal or physical aggression.

3. Grieving/Mourning

Grieving can help a survivor of sexual trauma to get unstuck and begin to move forward. There may be many things to grieve: loss of innocence; loss of childhood; loss of feeling safe; grief over mistrusting others and always feeling like something is “too good to be true”; grief over loss of time (for school, relationships, jobs, or time spent self-medicating and in depression); and grief over “what could have been.” Grief can make us feel helpless, powerless, vulnerable, and weak.

It is natural to want to fast-forward through grief or, better yet, stuff it. Unfortunately, there are no shortcuts through grieving.

It is natural to want to fast-forward through grief or, better yet, stuff it. Unfortunately, there are no shortcuts through grieving. The more you try to avoid it, the more out-of-control your emotions may feel. You may begin to fear crying or “losing it” when something triggers you. A common complaint is “overreacting” to small things. But remember, your body is not just reacting to the most recent “small thing”; it is also reacting to all the stressful events you experienced and stuffed away.

Unpacking, unstuffing, and letting it all out is part of the grieving process. It is especially important that you set up a support system and a regular schedule of self-care activities. Treatment at this stage focuses on helping you establish the space, time, support to grieve and mourn. Treatment also helps you learn how to manage intense emotions so you are the one in control, not the emotions.

4. Fear and Anxiety

After working through the guilt, shame, blame, and anger, and taking time to grieve and mourn, many survivors of sexual trauma are left with a feeling of emptiness. All those emotions that were stuffed away used to take up that space. Now that they are gone, many ask, “Now what?”

This phase of treatment focuses on building a life worth living. It is important to fill that hole with new relationships, activities, goals, and emotions, as staying in that empty place can put you at risk for becoming depressed and isolated. This process may bring a new set of challenges, as people—regardless of whether they have experienced trauma—generally hesitate to step out of their comfort zones to try something new.

Trying to build a new life tends to raise many fears and anxieties. Fears that your efforts won’t work, that others will reject you, that your most critical thoughts were true. Anxiety about going to new places, being out in crowds, starting relationships, and trying unfamiliar things.

Treatment at this stage attempts to help survivors of sexual trauma learn how to face their fears; to set healthy boundaries; to problem-solve and work toward specific and measurable goals; and to manage the natural anxieties that come with trying new approaches.


There is hope after sexual trauma. Recovery is possible. It takes a lot of courage to reach out for support, but it is the first step in learning to trust yourself and the recovery process.

April is Sexual Assault Awareness Month. Whatever the nature and scope of your trauma, this is a time to remind yourself that you are not alone. Many colleges, hospitals, and groups throughout the country are holding walks, fairs, clothesline projects, rallies, and other events. Look one up in your area, discover the community you deserve, and contact a therapist if you want support.

© Copyright 2018 GoodTherapy.org. All rights reserved. Permission to publish granted by Camila Williams, PhD

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • Leave a Comment
  • Pixie

    April 18th, 2018 at 12:03 PM

    Thank you for sharing this for Sexual Assault Prevention Awareness. I went through all of these emotions and I know that I might never fully recover from what happened to me. I don’t know where I would be without therapy.
    May I share this?

  • Camila Williams

    April 18th, 2018 at 1:51 PM

    Hi yes! Although word-for-word reposting is prohibited, you’re encouraged to share my article by clicking any of the social media icons directly below my byline (at the top of the article). Thanks for your support!

  • anne

    April 19th, 2018 at 9:47 AM

    The guilt part is the worst for me that lasted 5+ years didn’t help people in my family blamed me. but i know it wasn’t my falt now.

  • Rosemary

    April 24th, 2018 at 10:25 AM

    You go to therapy to hopefully work through the shame and guilt and anger… the therapist I worked with was not ethical or professional… as she turned out to be a “Rapist ” and I had to fight my way out of her insanity! And the licensing bd. did nothing… Da’s office the same… so not every therapist is ethical and professional!

  • Kris

    October 6th, 2018 at 6:44 AM

    Religion does a disservice to sexual abuse survivors. “Forgive those that trespass against us” is drilled into every Christian child’s head since youth. Since sexual assault is so difficult to prosecute, this prayer is supposed to solve the situation on a spiritual level, placing the burden of forgiveness squarely on the shoulders of the victim, in face of no justice, no atonement or restitution on the part of the perpetrator. To me, that is incomplete, because perpetrators often create many victims. Moreover, the symptoms and struggles that victims cope with are very real, and to those who are not “In the know” about the origins of the symptoms, may dismiss the victim as “crazy”. how is that for crazy making?

  • toni

    July 28th, 2020 at 7:15 AM

    i recently got away from my abuser, after being held prisoner, against my will, in 2 different motel rooms, over a period of 3 months. because he had people lie for him, they cant prove my case, beyond a reasonable doubt, and because he held me captive, i couldnt report the ongoing abuse right away. he has done this, many times before and has an extensive criminal history, and for just one case, he went to prison for years, for attempted murder, and is very proud of that fact. my husband tragically and unexpectantly passed away on Sept. 06, 2019, and this person kept referring to himself as my “boyfriend”, but mainly my “husband” and told the sheriff deputy that we were in a “dating relationship”, and I was “so in love with him, and mad at him, cuz he broke up with me”, which is nothing but a lie!!! Last I knew, you cant “break up” with someone you are not in a relationship with..because he said he “had health issues and couldnt penetrate me”, he didnt physically rape me, but, he did everything else. Makes me wonder, if he HAD raped me, would they be able to prosecute him??? he hurt me, physically, left bruises all over my body, head and neck, he put his hands around my throat, straddling me, while telling me that he could kill me, i was nothing, he “owned me”, “I had no choice”, and etc… he hurt me, mentally, emotionally, physically, spiritually, and etc. he was trying to”break me”, which he almost succeeded at…hes done this many, many times before. i currently am living in a homeless shelter, and since there is no PPO against him, hes allowed to live here, on the same property. The prosecutor said I should file for a PPO against him, but, no guarantee that I wll get it. I filed for a PPO against a stalker, I had in the past, he broke it 4 times, in less than a week,and all he got was 5 more days in jail and a $100 fine. Within 5 minutes, after he got out of jail, he was at the residence that I lived at, looking for me, and did almost $4,000 worth of damage to my landlord”s car, that he just got back the day before, after someone had sideswiped him, in an accident from icy roads. This current person is a Dr Jekyle/Mr Hyde personality and would constantly go off on me, without any provocation from me. So… i have to go on, try to heal from this, and move on, which I will… Im cureently in a room with 3 other women, and cuz they are friends with him, they all call me a liar, and keep saying, that I made everything all up, which is not true… Because he lives here, in the mens wing, I havde to be subject to being around him. I used to turn away, or turn my back on him, but, my son says I shouldnt do that, cuz then, hes keeping my power, and I need to take it back…So, I saw him come through the front door a little while ago, he didnt know that I was here, and I looked him square in the eye, and he looked like he wanted to kill me…the same look I’ve seen in his eyes before, when he was hurting me, in whatever way he could, and wanted to…Im terrified to death of him, and he knew it, before, but, I won’t let him see it, now…He’s a very accomplised liar, having done this, repeatedly, throughout the years, to many other women, before me, and no doubt in my mind, that he will do it, again, till one day, he IS stopped. He told me, behind closed doors (of course) that he “zeroed in on me, the first second he saw me, that he wanted me, and he was going to have me, cuz he always gets what he wants, nobody can stop him”, he knew that I was “scared and vunerable” cuz I had recently lost my husband, which is the only truth he’s ever told… I was told he was “a nice guy”, and presented himself as such, but, behind closed doors, with no one around, it was the exact opposite, when I told him “NO!!!”… I feel so stupid for ever trusting him…my son says I should never trust ANYBODY again, but, I don’t feel that ,that is the right answer. I’ve never been homeless before, living in a shelter, and now, scared out of my mind, every day, because of him, and all that he did to me…he made me feel like I wanted to end my life, so I could get away from him, but, I couldn’t do that, as I’m a woman of God, and God’s law states, ” you do not kill anyone, including yourself, cuz if you do, you will bring the wrath of God, down on you”, and I wouldn”t be able to go to heaven, and be reunited with my husband, again. He kept telling me, that if I managed to get away from im, that he would have people lie for him, nobody would ever believe me, cuz he’s known as such a nice guy, but, he actually HATES people, he hates everybody….I asked him over and over again, “why are you doing this to me?” he said, “because I can, and there’s nothing that you can ever do about it!!!” So….if anybody out there, can tell me how to deal with this, and get past it, i would greatly appreciate the advise…. thank you and God bless***

  • Agapito

    November 10th, 2020 at 1:40 PM

    Trying to get educated to help abuse victims

  • Jim

    January 6th, 2021 at 10:53 AM

    I was trafficked by my excon step father to his paroled acquaintances when I was 10 to 13 years old. I was told that my mom would be ashamed of me, he would kill me or my little brother and no one would care or that my younger brother would be next if I didn’t go with the men who were paying him for me. I was repeatedly raped and sodomized and lived in fear for my and my brothers life. I finally got away when he was arrested, tried and convicted of another murder. It has taken me over 40 years to sort through all the physical and emotional trauma and I don’t feel like I am even close to putting this behind me. Age and time only changes my perspective. Early on I became a substance abuser and became deeply involved in participating in gay pornographic videos. I became so depressed I constantly considered suicide as a way to end the pain and confusion. I have recently started having very realistic graphic dreams about a very specific particularly violent sexual episode I endured. I seem to be regressing and I don’t know why after all these years the bad dreams are coming back. I need some help

  • Laura

    March 15th, 2022 at 5:11 PM

    No-one I have spoken with or associated with or has been a good friend to me has ever suggested that I should or I need to “experience” another human-being seep or bleed or possess my soul with THEIR vulgarity of a satan which lives within them. I do not need to know “it” this evil. I think what the majority of people dismiss is: Terrible, Morbid, crimes last forever, due to denial in their sac-religious depth. Please think with transparency (DOES NOT MEAN BE EMPTY & UNWISE) Actions against humans are wrong. as individuals a “No” is accepted as no do not molest me. Do not get within me. No-remain at a distance. No-I do not want to give you my blood, oxygen. or time or emotion. or my good actions that make life joyous for all around us. And I never agreed to a soul taking my babies and dogs and my cats and my brother and my sister and my mother and my niece from me. No, i dont need you. Just say no.

  • Angela

    July 15th, 2023 at 1:36 AM

    I know they say do therapy, but what about people who are in my boat? I have a doctor for my daughter, but they don’t do therapy that our insurance covers. So, they put her on a waiting list. She was abused by her father, whom we are now separated from. That happened when she was 6 and 7, and she told me about it. Now she is 11 years old, and we are still waiting. You only get therapy when you can afford a million bucks, and also, I have three other kids. Most of the time, they don’t accept my insurance, and they can’t take in four kids

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