The "Second Injury" of Sexual Assault

WRITTEN BY: DR. KRISTEN ZALESKI, PHD, LCSW // CHIEF CLINICAL OFFICER

WHY BELIEVING SURVIVORS MATTERS

Sexual assault is a life altering experience and enough to cause trauma symptoms for life. However, research shows that the sexual assault itself can be less painful than the “second injury” from trusted loved ones. The term “second injury” refers to the additional trauma inflicted not by the perpetrator, but by the reactions of others: disbelief, blame, minimization, or betrayal by those whom survivors turn to for help.

WHAT IS THE SECOND INJURY?

This term was originally coined by Sándor Ferenczi, who was a colleague of Sigmund Freud’s. He worked with child sexual assault survivors and began to notice how much worse a child’s symptoms would present when the family did not offer support and care in the aftermath.

The first injury is the assault itself: the violence, the violation, the betrayal of bodily and emotional safety. The second injury happens later, when a survivor seeks support or justice and instead encounters disbelief, blame, ridicule, or abandonment.

This can happen through:

Authorities dismissing a report or blaming the survivor
Friends or family members questioning the survivor’s behavior
Institutions protecting perpetrators instead of supporting survivors
Therapists minimizing the impact of the experience

SECONDARY VICTIMIZATION

Research has shown that this kind of secondary victimization can intensify PTSD symptoms, deepen shame, and worsen long-term outcomes for survivors. In some cases, survivors report that the second injury hurt even more than the assault itself because it robbed them of hope, trust, and dignity.

SEXUAL ASSAULT HEALING PROCESS

In trauma therapy, one of the most important things we explore is how survivors found ways to protect themselves and seek safety after the sexual trauma. This process is crucial for healing. But when a survivor moves through a world where their truth is doubted, minimized, or disregarded, it can prolong the feeling of unsafety. Over time, this can cause an acute stress response to harden into chronic PTSD.

This experience of the “second injury” is itself a significant wound. Healing it takes time, compassion, and the right support. Modalities like EMDR, somatic therapies such as Sensorimotor Psychotherapy and Somatic Experiencing, and carefully attuned narrative therapies can offer powerful pathways to work through the trauma of both the assault and the betrayal that followed.

Recovery begins not just with processing what happened, but with restoring the survivor’s ability to feel safe, connected, and fully believed.

DO YOU HAVE A QUESTION?

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