A number of sexual assault survivors report enormous benefits from specialized classes, but not all therapists are on board.

In 1978, at the age of 18, Celine Sabag took a trip to Israel. There, she met a 25-year-old bus driver and spent three weeks touring Jerusalem with him. “He was nice and polite,” she recalls. When the man invited her to his parents’ empty apartment, she accepted the invitation. The pair had been sitting together and laughing for about an hour when the door opened. “I turned to look,” says Sabag, “and my gut told me: ‘Something awful is about to happen.’” Four young men were standing in the doorway. They entered the living room, the fourth locking the door behind him. “I believe they had done it before,” she says.

Sabag returned that night to her hotel, and then fled back to her home in France. She felt guilt and shame, and did not tell anyone that five men had raped her that night in the apartment. Shortly after her homecoming, she tried to commit suicide, the first of many attempts. Desperate for help, Sabag entered therapy. She saw psychiatrists and psychologists and started taking psychiatric medication. She also tried alternative approaches like movement therapy. Though some of the treatments helped, they didn’t eliminate the relentless flashbacks of the rape, her overwhelming fear of unknown men in corridors and on elevators and stairways, and other symptoms of post-traumatic stress disorder (PTSD).

In 1996, Sabag, who is Jewish, immigrated to Israel in the hopes of finding some kind of closure. She volunteered at a hotline for sexual assault survivors. “I wanted to let victims have someone who would listen,” she says. “Because I didn’t ask for help, so I wasn’t listened to.” Yet the suicide attempts did not cease until 2006, when a friend suggested that Sabag enroll in a specialized self-defense course offered by El HaLev, an Israeli organization founded in 2003 to offer self-defense training to women who have been traumatized by sexual assault, as well as other vulnerable groups. At first, Sabag was dubious. “I said: ‘Fighting? No way. What do I have to do with fighting?’”

But in fact, a growing body of research indicates that self-defense training can enable women to cope with the threat of sexual violence by providing a sense of mastery and personal control over their own safety. Within this field, some studies have examined a unique and pressing question: Can therapeutic self-defense training be an effective tool for sexual assault survivors who experience PTSD and other symptoms of trauma? Though the research is preliminary, some therapists and researchers believe the answer is yes.

“While ‘talk-based’ therapies are undoubtedly helpful, there is a need for additional modalities,” says Gianine Rosenblum, a clinical psychologist based in New Jersey who has collaborated with self-defense instructors to develop a curriculum tailored to female trauma survivors.

Researchers who study self-defense for sexual assault note its similarities to exposure therapy, in which individuals in a safe environment are exposed to the things they fear and avoid. In the case of self-defense training, however, participants are not only exposed to simulated assaults, they also learn and practice proactive responses, including — but not limited to — self-defense maneuvers. Over time, these repeated simulations can massively transform old memories of assault into new memories of empowerment, explains Jim Hopper, a psychologist and teaching associate at Harvard Medical School.

Sabag was not familiar with these theories back in 2006; however, she eventually decided to enroll in the self-defense training. Perhaps, she thought, it would help her be less fearful of others.

In a 2006 video she shared with Undark, Sabag can be seen lying on the floor of a gym at El HaLev. She’s surrounded by roughly a dozen women showering her with encouragement. A large man dressed in a padded suit and a helmet — referred to as “the mugger” — approaches with heavy footsteps and lies on top of her. The women continue to cheer, encouraging Sabag to kick her assailant. A female trainer leans in, providing instruction. Sabag sends up a few weak kicks, connecting with the mugger. Then she gets up, swaying, and returns to the line of trainees.

In that moment of confrontation, Sabag says she felt disoriented, not sure of where she was. She had been nauseous while waiting her turn, and then when the mugger was finally standing in front of her, she froze. “My body refused to cooperate, and there was a split. My mind left my body and I was looking at my body from the outside, like in a nightmare,” she says. “Without this split, I wouldn’t have found the power to react.”

This dissociation is a coping response that can allow some people to function under stress, says Rosenblum. But, she adds, “it is preferable for any therapeutic or learning environment to facilitate non-dissociative coping.” In a 2014 paper describing the curriculum they developed, Rosenblum and her co-author, clinical psychologist Lynn Taska, emphasize that care must be taken to ensure students remain within their so-called window of tolerance: the range of emotional arousal that an individual can effectively process. “If external stimuli are too arousing or too much internal material is elicited at once,” they write, “the window of tolerance is exceeded.” In these cases, they suggest, therapeutic benefit is lost and individuals may be re-traumatized.

Sabag often struggled to fall asleep on nights after training sessions, but she stuck with the course and even enrolled a second time. Knowing what to expect made a difference, she says. Though she still experienced flashbacks and disassociation, the nausea and shivers subsided in the second course, and she felt increasingly present in her body. Sabag explains that these changes allowed her to concentrate and hone her actions: “The kicks were precise, the punches were correct," she says. "In the sharing circles, I wouldn’t stop talking."

Sabag went on to become an instructor for Impact, an organization with independent chapters around the world, including El HaLev in Israel. Impact offers classes in what is sometimes referred to as women’s empowerment self-defense, which was initially developed in the 1960s and ’70s, although its roots go back even further. Traditional forms of self-defense, such as martial arts, were developed by and for men. Though they can be effective for women, they require years of training and don’t address the dynamics of sexual violence. Most sexual assaults are committed by someone the victim knows, for example, but traditional self-defense classes don’t offer the special knowledge and skills needed to fend off an assailant who is known, possibly even loved, by the victim.

In 1971, the empowerment self-defense course called Model Mugging was the first to use simulated muggings, with the goal of helping women overcome the fear of being raped. With roots in Model Mugging, Impact courses were developed with input from psychologists, martial artists, and law enforcement personnel.

Today, empowerment self-defense courses are offered by a variety of organizations. Though the trainings vary depending on who is offering them, they share some commonalities, including the use of a female instructor who teaches the self-defense techniques, and a male instructor who dons a padded suit and simulates attack scenarios. In some of the scenarios, the male instructor plays a stranger. In others, he plays a person known to the victim. A therapist also provides guidance in helping participants set appropriate interpersonal boundaries.

Over time, specialized empowerment self-defense courses were developed for sexual assault survivors, as well as for men, transgender people, persons with disabilities, and others. Crucially, the therapeutic classes for survivors of sexual assault require collaboration with mental health professionals. In some cases, psychotherapists provide support during the trainings. In other cases, they may recommend that their clients take a course and then provide support during psychotherapy appointments.

“Participants in this kind of course have to be in treatment,” says Jill Shames, a clinical social worker in Israel who has spent more than 30 years teaching self-defense courses to sexual assault survivors. In Shames’ courses, participants sign an agreement allowing her to communicate with their therapists. “The therapist has to agree to be involved in the process,” she says.

In the early 1990s, researchers began to study the psychological effects of empowerment self-defense classes, with multiple studies finding that women who participate experience increased confidence in their ability to defend themselves if assaulted. This sense of self-efficacy, in turn, has been linked to a range of positive outcomes.

In a paper published in 1990 in the Journal of Personality and Social Psychology, Stanford researchers Elizabeth M. Ozer and Albert Bandura described the results of a study in which 43 women participated in a program based on Model Mugging. The trainings occurred over a period of five weeks. Among the participants, 27 percent had been raped. Before the program, the women who had been raped reported a lower sense of self-efficacy regarding their ability to cope with interpersonal threats, such as coercive encounters at work. These women also felt more vulnerable to assault and exhibited more avoidant behavior. They experienced greater difficulty distinguishing between safe and risky situations, and reported being less able to turn off intrusive thinking about sexual assault.

During the self-defense program, participants learned how to convey confidence, how to deal assertively with unwanted personal encroachments, and how to yell to frighten off an attacker. “Should the efforts fail,” the authors wrote, the participants were “equipped to protect themselves physically.” In the trainings, the women learned how to disable an unarmed assailant “when ambushed frontally, from the back, when pinned down, and in the dark.” Because women are thrown to the ground in most sexual assaults, the authors wrote, “considerable attention was devoted to mastering safe ways of falling and striking assailants while pinned on the ground.”

Each woman was surveyed before, during, and six months after the program’s completion. To identify non-treatment effects, roughly half the subjects participated in a “control phase” in which they took the survey, waited five weeks without the intervention, and then took the survey again just before the program commenced. (Researchers found no significant changes in the survey results during the control phase.)

For program participants, sense of self-efficacy increased in several realms, including their ability to defend themselves and control interpersonal threats. Perhaps most notably, in the months after the training, the women who had been raped no longer differed on any measures from the women who had not been raped.

More than a decade and a half later, in 2006, researchers from the University of Washington in Seattle and the Veterans Affairs Puget Sound Health Care System, which provides medical services to veterans and their families throughout the Pacific Northwest, conducted a study that looked specifically at female veterans with PTSD from military sexual trauma. Because all of the participants had been trained in physical and military fighting techniques, the study could test the idea that specialized self-defense courses foster a better sense of safety and security than military or martial arts training.

The study participants attended a 12-week pilot program that consisted of education about the psychological impacts of sexual assault, self-defense training, and regular debriefings. By the end of the study, participants reported improvements on a number of measures, including the ability to identify risky situations and to set interpersonal boundaries. They also experienced decreased depression and PTSD symptoms.

Because the VA study was small, self-selected, and lacked a control group, its authors noted that further study is necessary to determine whether wide-scale adoption within the VA is warranted. This echoes the views of self-defense proponents who say the field is promising, but in need of more research. For now, Hopper explains that the healing reported by participants of these classes may be due, in part, to a process known as extinction learning. In therapeutic self-defense classes, extinction learning occurs when the mugger provides a reminder of the assault memory. But this time, the scenario occurs in a new context, so that one’s typical responses “are over-ridden by new, nontraumatic responses.”

Whatever its potential merits, the use of self-defense training as therapy is far from universally accepted, and not all mental health providers are on board. “My therapist colleagues are wary of self-defense,” says Rosenblum. “They often are anxious about the class re-traumatizing clients.” Several years ago, she attempted to run a therapist-only self-defense class, but had trouble filling it. For this reason, Rosenblum believes it is important to emphasize that specialized classes do not push students outside their window of tolerance, and that students are, in fact, encouraged to set boundaries.

But a lack of standardization can be problematic. “Self-defense started as a grassroots movement, but it’s becoming an industry,” says Melissa Soalt, a former therapist and pioneer in the women’s self-defense movement. “Today I hear about instructor-training courses that take as little as a week, with instructors who have no clinical experience or knowledge,” she says. “Also, self-defense is not easy and it doesn’t always work. If someone is telling you otherwise, they’re not telling the truth.”

Soalt herself served as an expert witness in a trial where a young woman sued a self-defense instructor and won. According to her, the instructor was not properly trained, and he caused the woman to become re-traumatizated. “Safety is number one here," says Soalt, who stresses that this was an extreme case. Nonetheless, she adds: "When choosing a self-defense course, it’s essential to check out the instructors.”

Indeed, when self-defense is taught with or by professionals with a background in trauma treatment, “the few studies that exist consistently demonstrate its potential," said Shames, the clinical social worker in Israel, though she acknowledges that self-defense as a therapeutic modality remains a tough sell.  

To encourage further standardization, Rosenblum and Taska’s paper describes the features of an Impact self-defense class. “The next step for research would be to obtain a grant [to] create a formal therapeutic class protocol and have that same protocol used in a number of locations by staff who had all underwent the same training,” says Rosenblum.

The now-defunct National Coalition Against Sexual Assault (NCASA) developed guidelines for choosing a self-defense course. While originally written for women, they were later updated by a member of the original NCASA committee to include men as well. These guidelines stress that “people do not ask for, cause, invite, or deserve to be assaulted.” Therefore, self-defense classes should not cast judgement on survivors. Further, during an assault, victims deploy a range of responses. Many even experience a state of involuntary paralysis. According to the guidelines, none of these responses should be used to cast blame on the victim. Instead, “a person’s decision to survive the best way they can must be respected.”

Ideally, a course will cover assertiveness, communication, and critical thinking, in addition to physical technique, the guidelines state. And while some women may benefit from a female instructor, “the most important aspect is that the instructor, male or female, conducts the training for the students geared to their individual strengths and abilities."

Self-defense courses and instructors that say they aim to meet these or similar criteria are currently available through Impact, and through the U.S.-based National Women’s Martial Arts Federation and the U.K.-based empowerment self-defense nonprofit Action Breaks Silence.

Sabag recently turned 60. She currently works as a fitness coach for older persons, and she assists students who immigrate to Israel. She is a devout yoga practitioner and has developed an interest in Eastern philosophy. Over time, she says, she has gradually managed to reconnect with her body.

Sabag estimates that she trained considerably more than 100 women and teenage girls in empowerment self-defense. “In the future, or in my dreams, I would like to go back to teaching girls how to set boundaries and show self-confidence,” she says. “I believe that this is where everything starts.”

About The Author

Gitit Ginat is an Israeli journalist who for many years contributed to the weekend magazine of Haaretz. She is currently working on a documentary that recounts the story of the women’s self-defense movement.

This article was originally published on Undark. Read the original article.

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