Breaking silence about sexual trauma is just the start of healing

Reality television is often a quiet pleasure enjoyed in silence.

We curl up with snacks and text with friends to watch while others navigate uncomfortable or dangerous situations—comfortably disconnected from the television avatars on a platform also not known for depth. We’ve seen people compete against each other, live with each other, and some even swap spouses as entertainment.

As anticipation builds for a new season of one such show, “Secret Lives of Mormon Wives,” a moment from last season’s reunion pushed beyond the television façade and remains instructive.

During the reunion, nearly every woman, and one man, detailed a history of sexual violence. A hush fell over the stage (and likely in many living rooms) that felt decidedly heavier than typical reality television fare.

As a clinical psychologist specializing in post-traumatic stress disorder (PTSD) who works with survivors of trauma every day, it was a piercing reminder that sexual violence is far more common than most people realize, and many survivors carry their stories in silence for years even as new disclosures seem to splash across the headlines each day.

While the moment was powerful, it was also fleeting and left unsaid what far too many survivors don’t hear: Speaking to a mental health professional can help.

Many come to treatment feeling nervous, scared, ashamed, and often skeptical.

Survivors of trauma often do not seek treatment for PTSD for an average of 12 to 15 years. The most commonly cited reason why a survivor delays treatment is a desire to avoid thinking of and talking about the trauma. Few people may want to talk about the most horrible thing that ever happened to them.

The vicious paradox with PTSD is that this avoidance, while completely understandable, actually worsens PTSD symptoms, leaving survivors stuck in a cycle of misery. Part of healing from PTSD requires willingness to share the story about the trauma in safe and non-judgmental spaces, which is where evidence-based treatments for PTSD come in.

Of course, the path to healing is more winding than is often portrayed on reality television. Often, survivors also navigate family dynamics, legal dynamics, and other issues. These dynamics help explain why it can be so challenging for survivors to reach out for help. Conversations like the ones started on reality television can open the door to push through the many barriers and consider treatment for the first time.

Many clinics and centers, such as the Center for Treatment and Study of Anxiety at the University of Pennsylvania, help patients to process their trauma.

The first step is to find a safe, non-judgmental space to share the story of the trauma and its ripple effect on the life of the survivor. Trauma-focused cognitive-behavioral treatment (CBT) helps survivors to confront traumatic memories to rebuild a sense of agency and re-engage with the parts of life that trauma often shrinks.

This structured treatment can reveal the powerful way that trauma changes patients’ beliefs about themselves (“I am damaged” or “I am unlovable”), other people (“No one can be trusted”), or the world (“This could happen to me again at any time”).

Through CBT, survivors of trauma can work through these painful beliefs and gain a renewed sense of self-confidence and empowerment as a foundation to repair and rebuild safe social connections.

The connection between trauma and suicide risk

Another critical piece is recognizing and disrupting links between trauma and suicide. In my own research, I found that exposure to abuse and trauma increases risk for suicidal thinking and behavior, and that risk is further exacerbated when someone develops PTSD.

Fortunately, effective treatments for PTSD can reduce suicide risk—this effect has been replicated time and time again. Further, we recently developed a new treatment specifically designed for survivors with PTSD who are at high risk of suicide that, while preliminary, show promise.

This approach involves making plans to anticipate and manage future suicidal crises so that patients with PTSD feel confident in processing trauma safely; we also involve supporting people where possible to build a sense of community around trauma survivors while they embark on a painful journey toward healing.

Where to go from here

The “Secret Lives of Mormon Wives” reunion may have accomplished what its creators set out to do: Gain foothold as a culturally significant story that shocks the public into continuing the conversation. However, it can also be a catalyst for survivors, both those on stage and those who may have watched.

The next phase of that conversation must include pathways to effective, evidence-based treatments that moves the disclosure from piercing a deafening silence to a clear, reassuring message to survivors: We can help.

Lily Brown, PhD, is director of the Center for Treatment and Study of Anxiety at Penn, a treatment and research center dedicated to developing, refining, and testing state-of-the-art therapies for anxiety, obsessive-compulsive, and traumatic stress disorders.