Addressing Trauma: Why Exploitation-Specific Curriculum is Key to Healing for Survivors of Sex Trafficking

Trauma exposure occurs in a continuum of complexity, depending on the timing, duration, intensity, and type of trauma involved. For example, a single traumatic incident, such as a car accident, involving an individual that otherwise has stable factors in their life, results in a certain level and type of trauma. In contrast, repeated incidents that involve a significant level of intrusion, interpersonal trauma, stigma or shame, or increased vulnerability result in a much higher level of trauma and of more complex types. Survivors of sex trafficking are most often placed on this end of the continuum.

Due to the nature of sex trafficking, survivors often experience severe and complex trauma while being exploited. The ongoing trauma they endure usually impacts their physical, emotional, and psychological well-being for years after exiting, if not for the remainder of their lives. Sex trafficking is considered one of the most heinous and destructive crimes possible, which is in large part due to the complexity, severity, and comorbidity of the trauma experienced by survivors.

Not every sex trafficking survivor experiences all of the following types of trauma, but most experience more than one and often multiple during exploitation:

• Physical trauma refers to serious injury to the body which can generally be classified as blunt force trauma or penetrating trauma. Blunt force trauma occurs when an object or force strikes the body and often results in concussions, internal bleeding, or broken bones. Penetrating trauma occurs when an object pierces the skin or body and creates an open wound. 

More than 90% of survivors of sex trafficking report experiencing physical violence while being exploited and 70% say they were injured through physical violence, most often to the head or the face. In one study, survivors were asked about the violence or abuse they experienced, listing twelve possible forms including being threatened with a weapon, shot, strangled, burned, kicked, punched, beaten, stabbed, raped, or penetrated with a foreign object. On average, survivors reported experiencing 6.25 forms of violence and abuse. Eight of the twelve forms were reported by more than half of the respondents and many other abuses were described by survivors that were not included in the list. 

Physical violence, abuse, and trauma are nearly universal experiences for survivors of sex trafficking. While some injuries may heal over time, survivors often report dealing with the effects of physical trauma for years after exiting trafficking.

• Emotional & psychological trauma refers to the mental effects resulting from experiencing peril or risk to one’s lifestyle, wellbeing, or health. This type of trauma typically follows highly stressful events or dangerous situations and may lead to strong emotions, recurring memories or flashbacks, and high levels of anxiety. Emotional or psychological trauma can be overwhelming and negatively impact a person’s ability to cope with normal daily activities or events.

Three types of emotional or psychological trauma include:

• Acute trauma, which results from a single, isolated incident.

• Chronic trauma, which results from repeated exposure to dangerous or stressful situations, such as frequent domestic abuse, continued violence, or other prolonged experiences. 

• Complex trauma, which results from prolonged exposure to varied and multiple traumatic events that are often of an invasive, interpersonal nature. Complex trauma has wide-ranging, long-term effects and is often related to other psychological conditions.

Survivors of sex trafficking universally experience severe trauma and often over long periods of time. For the vast majority of survivors, the abuse suffered creates ongoing psychological conditions and often takes advantage of existing mental instability. On average, survivors report experiencing more than 12 separate psychological issues while being trafficked and 10.5 issues even after exiting. The most frequently reported problems included depression, anxiety, nightmares, flashbacks, and intense feelings of shame. Survivors also reported psychological problems such as bipolar, borderline personality, and dissociative identity disorders at much higher rates than the general population. More than half of survivors suffer from PTSD and more than 40% had attempted suicide at least once. 

Unfortunately, even successfully exiting sex trafficking does not mean a survivor’s psychological suffering is over. Rather, survivors continue to report high rates of psychological issues for years to come.

• Sexual trauma refers to the mental and physical effects of a sexual experience involving force, violence, manipulation, coercion, or a lack of consent. Sexual trauma can occur from a singular event or an ongoing experience and does not necessarily involve rape. 

The effects of sexual trauma may include mental health challenges, physical injury, and problems with sexual and reproductive health. For example, more than two-thirds of female survivors in one study had contracted a sexually transmitted disease or infection and over half reported at least one gynecological problem other than STDs/STIs. 71% of female sex trafficking survivors report becoming pregnant at least once from a buyer or trafficker with unusually high rates of miscarriages and forced abortions. Many survivors report being forced to perform sexual acts, often unprotected, and strangled, beaten, or threatened with a weapon while being raped. Overwhelmingly, survivors in the study were the victims of repeated and extreme sexual and physical violence.

For survivors of sex trafficking, sexual trauma is highly likely to be interconnected with the other types of trauma they have experienced. On average, survivors report being sold for sex to thirteen buyers every day, with some reporting typical days of thirty to fifty buyers. The severity, regularity, and variety of the abuse inherent to sex trafficking means it is unsurprising that most survivors continue to struggle with their mental, physical, and emotional health for the remainder of their lives.

While every survivor’s experience in sex trafficking is unique, nearly every survivor faces challenges in each of these three areas of trauma. The complexity, interconnectedness, and severity of a sex trafficking experience means that a survivor’s journey toward healing is likely to require intensive care, therapy, and support.

Because the effects of sex trafficking last a lifetime, the ultimate goal of a survivor’s journey is to understand and accept the factors that made them vulnerable to trafficking and build protective factors, self-worth, and independence to protect them from being exploited in the future. Reaching this goal requires addressing the trauma they have experienced, which is best done through therapy and support from trained industry experts.

Since the trauma of a sex trafficking experience is so severe and complex, survivors need help to successfully address their emotional, psychological, and physical needs. Safe house programs are an integral piece in supporting trafficking survivors as they heal and rebuild their lives, particularly through the specific curriculums and therapy models they offer. These types of therapy and curriculums are generally not available with a trafficking focus outside of safe house programs. Because a sex trafficking experience is usually more severe, complex, interpersonal, and invasive than other kinds of trauma, the types of therapy and curriculums used to address experiences like domestic violence or childhood sexual abuse are often not adequate for trafficking survivors. It is vitally important for every survivor to have access to the trafficking-specific therapy and curriculums they need to successfully heal and build lasting freedom.

Effective trafficking-specific curriculums are materials used by programs to help trafficking survivors understand what they experienced, the methods their trafficker used to control them, and how to rebuild their sense of identity, power, and independence. For many survivors, this process is complex and traumatic experiences may have compounded their vulnerability to other traumas. Survivors who have experienced multiple types of trauma throughout their life may need to spend more time working through curriculum to fully understand it. 

Most trafficking-specific curriculums help survivors walk through a process of rediscovering their identity, reclaiming their agency, finding compassion for themselves, understanding their vulnerability, and building the relationships, boundaries, and self-worth to achieve their goals and establish fulfilled lives. Curriculums often address harmful thought patterns, perspectives, habits, relationships, or ideals. Because so many trafficking experiences involve relationships with traffickers, such as family members, friends, or significant others, it is critical for survivors to form healthy habits and boundaries to protect themselves in the future. Therapy and trafficking-specific curriculums can also help survivors build coping skills to regulate and address the lasting effects of trauma, such as flashbacks, anxiety, and psychological disorders.

Each of these processes takes time and expert guidance, which is why safe homes and survivor- and trauma-informed curriculums are so important. In safe house programs, survivors have the ability to concentrate on their healing and access to the support and guidance they need to heal. If survivors leave a program without fully addressing their trauma or their vulnerabilities, the chances of being exploited again are very high. However, through supportive and trauma-informed therapeutic environments, survivors can and have been successful in moving beyond their trafficking experiences and living fulfilling healthy lives.