2017 was the year of #MeToo, when victims of sexual harassment—often women, but men as well—shared their experiences and raised awareness of this pervasive problem. It's clear that even when the harassment stops, the mental health effects may linger on.
What exactly is sexual harassment?
“The definition of sexual harassment is wide ranging,” says Amanda Spray, PhD, a clinical psychologist in the Department of Psychiatry at NYU Langone Health and Assistant Director of the Cohen Military Family Clinic. It begins with offensive comments or unfair treatment based on sex and ranges up to sexual assault. According to the U.S. Equal Employment Opportunity Commission (EECO), sexual harassment may include requests for sexual favors, verbal or physical harassment of a sexual nature—even remarks about a person’s sex. Regardless of what form it takes, sexual harassment is unwanted behavior.
How prevalent is it?
Spray says we don’t really know. According to the #MeToo movement, 17.7 million women have reported a sexual assault since 1998. A EEOC Task Force Report issued in June 2016 (notably, before #MeToo) found that of the roughly 90,000 charges of employment discrimination it received in fiscal year 2015 (from private employers or state and local governments), about one-third included an allegation of workplace harassment and 45 percent of them alleged harassment on the basis of sex.
Furthermore, 25 to 85 percent of women reported having experienced sexual harassment in the workplace. The large range is due to differences in the way the questions were asked and who was asked. Finally, the report says, “many individuals do not label certain forms of unwelcome sexually based behaviors—even if they view them as problematic—as ‘sexual harassment,’” which suggests the problem may be even more widespread.
“Sometimes, it’s very clear. It’s cut and dry that [what happened is] sexual harassment,” Spray says. “Other times, folks need validation: No, it’s not okay that happened.”
What is the mental health toll of sexual harassment?
Distress following sexual harassment can manifest in different ways, such as depression and anxiety, Spray says. Symptoms of depression may include loss of interest in activities, lack of motivation, social withdrawal, feeling tearful or sad or having a low mood. Anxiety can manifest as restlessness or an inability to relax, muscle tension, fatigue and persistent worry. In the military (Spray’s area of expertise), sexual trauma is also a risk factor for triggering suicidal thoughts.
Failure to deal with the stress of sexual harassment can lead to self-harming behaviors as a way to forget or escape the memories. “If you experience distressing behavior, you may turn to drugs or alcohol to help you cope because it’s so detrimental to your mental health,” Spray says. In fact, substance abuse is not unusual in people who’ve experienced trauma and can go hand-in-hand with other mental health disorders, including Post Traumatic Stress Disorder (PTSD).
We tend to think of PTSD in terms of military personnel and people who experience war or catastrophe. However, Spray says, some people can develop PTSD following sexual harassment. In fact, sexual assault is the most frequent type of trauma in women diagnosed with PTSD.
Symptoms of PTSD include unwanted memories of the traumatic event that pop into your head—thoughts that are difficult to remove from your mind—and avoidance of people, places or things that remind you of the trauma, Spray says.
Spray says people who develop PTSD following sexual harassment or assault also tend to blame themselves. “They ask, ‘Did I do something to contribute to this happening?’” she says. “It’s a very common thought in one’s mind. In therapy, we help them figure out that it’s not their fault and there’s nothing they could have done.” Victims also tend to have self-doubt, and to not trust their intuition or abilities.
What helps?
The good news is that there are effective mental health treatments. In fact, two in particular, have been extensively validated for use in individuals who experienced sexual assault, Spray says. Prolonged exposure therapy teaches individuals how to gradually approach their trauma-related memories and feelings. Cognitive Processing Therapy helps them learn how to challenge and modify what they believe about the trauma.
“It’s important for people to know that if you’re experiencing symptoms, it doesn’t mean you have to be in therapy forever,” Spray says. Both treatments are time-limited interventions, usually 12 to 15 sessions with a mental health professional.
Final thoughts
Awareness of the problem is important in dealing with it, Spray says. “If we’re not talking about it, we’re ignoring it and potentially colluding with the problem.”
Finally, Spray says, “Often times, sexual harassment can be very triggering for someone who has experienced additional trauma in their past.” She says it’s important to be aware that even hearing about others’ experience of sexual harassment on the news, for example, can be difficult and trigger symptoms of depression, anxiety or PTSD. “Know that this is common and you’re not alone,” Spray says, “and that it’s really important to get treatment and help.”
