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WARNING

The following describes accounts of child sexual and physical abuse, which the Innocent Lives Foundation works to prevent. This blog contains content that some individuals may find disturbing or distressing in nature. Please be emotionally prepared before proceeding.

Names, locations, and other identifying information have been changed for the safety of the victims and the Innocent Lives Foundation team. Any similarity to actual names, living or dead, is purely coincidental.

Authors: Dr. Abbie Maroño
Published: July 17, 2023

Imagine waking up in the body of a stranger. Imagine waking up in the body you know is yours, but it feels entirely unfamiliar to you. Imagine waking up feeling physically dirty, but no amount of cleaning could wash those feelings away. This is a devastating reality for many victims of sexual assault. 

Crimes of a sexual nature are the most personal of crimes, in every sense of the word, and can leave victims to feel as if one’s own body has been weaponized against them. Consequently, victims may feel as though their bodies are ‘dirty’ or contaminated and engage in behavioral coping strategies, such as increased washing. In fact, sexual assault victims may develop obsessive-compulsive disorder (OCD) manifesting as compulsive washing behavior, this includes washing oneself and even the washing of possessions present at the time of the assault. These behaviors may be puzzling and frustrating to observers who are unaware of the victim’s feelings of contamination. This is why a better understanding of the victim’s inner experience is vital for recognizing signs of sexual assault and supporting victim recovery. 

Feelings of Contamination

Previous research has consistently found that sexual assault is associated with persistent feelings of dirtiness, contamination, and subsequent compulsive washing. This phenomenon is referred to as mental contamination (MC), which specifically denotes “the feeling of internal dirtiness that arises without physical contact with contaminants”. Unlike contact contamination which can be located at a specific point of contact, the feelings of mental contamination, following sexual trauma, are difficult to locate and exist “inside their bodies” or “under their skin”. 

When I was working as a university lecturer, one of my roles was to be a personal tutor and an academic advisor to a selection of students. Within the year I worked in this role, the sheer number of students I had referred to, or referred with, the mental health and counseling team for sexual-related trauma was devastating. One conversation I had with a young woman will stick with me for a lifetime and exemplifies the mental contamination that can result following such trauma; she told me that it felt as if she had been “tainted” and couldn’t “wash away the feeling of his hands on my skin”. 

 It is thus somewhat unsurprising that these feelings are typically accompanied by self-directed emotions of disgust, shame, and revulsion. Indeed, across peer-reviewed studies, in-depth interviews with victims have demonstrated that feelings of internal dirtiness can be overwhelming and immune to external cleaning.

 “Even after I showered, I felt that my friends could tell”.

 “Dirt can be washed away, but not this”.

“It is like a dirty film on my skin and cannot be removed”.

“I am stuck with this forever”.

These quotes highlight a harsh reality; sexual assault, as opposed to other types of assault, has a devastating ability to leave victims feeling unsafe in their own skin. 

Recognizing Underlying Factors 

When looking to provide effective support or treatment for mental contamination, we must first understand why such symptoms arise and address the underlying cause. Although conclusive research in this area is surprisingly limited, there is evidence to suggest that self-focused disgust may be a specific mechanism through which mental contamination arises. In simple terms, this means that following sexual trauma, victims feel disgust towards themselves and their bodies, and it is this feeling of disgust that results in subsequent feelings of dirtiness and contamination, rather than the feelings of contamination leading to disgust. Another important finding from clinical research is that the disgust felt is self-directed, rather than directed towards the perpetrator. This suggests that viewing oneself as disgusting following sexual assault is more predictive of later developing mental contamination than feelings of disgust toward the perpetrator. This is important because it allows for more targeted therapeutic interventions.

Additionally, one of the most widely used clinical interventions for individuals suffering from feelings of mental contamination is cognitive and behavioral therapies (CBT) (e.g., prolonged exposure therapy and cognitive processing therapy). However, it is becoming increasingly apparent in the empirical literature that self-disgust-related cognitions are largely unresponsive to these kinds of therapeutic interventions. As such, focusing treatment on altering victims’ feelings towards themselves prior to addressing their feelings towards the traumatic experience is crucial.

Recognizing the Signs

Despite the experience of abuse being devastating for their well-being, children often do not fully understand the traumatic impact of what they have endured. Additionally, feeling unsafe in one’s own skin can be debilitating for a developing child, particularly as the experience of such feelings can feel impossible to describe, and thus ask for help. However, there are behavioral indicators of mental contamination that, if observed, should be taken seriously 

  • Increased washing or asking to wash
  • Complaints of feeling dirty
  • Sudden change in comfort with physical contact
  • Not wanting to be touched
  • Sudden discomfort with physical proximity
  • The onset of compulsive behaviors (particularly compulsive washing of hands)
  • Sudden isolation or withdrawal 

In sum, as a parent, it is important to remember that children cannot always articulate how they feel inside, and the existence of behaviors such as the ones described above may indicate feelings of self-disgust and feelings of mental contamination. If you recognize any of the abovementioned signs, you should initiate an open dialogue with your child and seek the help of a licensed professional if needed. 

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References
Adams, T. G., Badour, C. L., Cisler, J. M., & Feldner, M. T. (2014). Contamination aversion and posttraumatic stress symptom severity following sexual trauma. Cognitive therapy and research38, 449-457.
Badour, C. L., Ojserkis, R., McKay, D., & Feldner, M. T. (2014). Disgust as a unique affective predictor of mental contamination following sexual trauma. Journal of anxiety disorders28(7), 704-711.
de Silva, P., & Marks, M. (1999). The role of traumatic experiences in the genesis of obsessive–compulsive disorder. Behaviour Research and Therapy37(10), 941-951.
Fairbrother, N., & Rachman, S. (2004). Feelings of mental pollution subsequent to sexual assault. Behaviour research and therapy42(2), 173-189.
Fairbrother, N., Newth, S. J., & Rachman, S. (2005). Mental pollution: Feelings of dirtiness without physical contact. Behaviour Research and Therapy43(1), 121-130.
Ojserkis, R., McKay, D., & Lebeaut, A. (2018). Associations between mental contamination, disgust, and obsessive-compulsive symptoms in the context of trauma. Journal of Obsessive-Compulsive and Related Disorders17, 23-30.
Olatunji, B. O., Elwood, L. S., Williams, N. L., & Lohr, J. M. (2008). Mental pollution and PTSD symptoms in victims of sexual assault: A preliminary examination of the mediating role of trauma-related cognitions. Journal of Cognitive Psychotherapy22(1), 37.