Being pushed into a room, thrown onto a bed and groped: Those are the kinds of details that get embedded in a sexual assault survivor's memory.
Peripheral information, like what day it was or what someone wore, may fall away or grow fuzzy, especially with time. But the most distressing moments get "locked in" and remain "very salient," explained Dean Kilpatrick, a clinical psychologist and director of the National Crime Victims Research and Treatment Center at the Medical University of South Carolina.
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Kilpatrick, a senior investigator in the medical school's department of psychiatry and behavioral sciences, has spent more than 40 years working with sexual assault survivors. He knows the subject well.
"Memory is not like a video camera" and can't capture everything, he said. But life's most impactful experiences -- whether they be positive or negative -- stay in focus.
Fears of being killed
All of this is pertinent as Christine Blasey Ford considers testifying and answering questions about accusations she's made against Judge Brett Kavanaugh. Ford says the Supreme Court nominee sexually assaulted her more than three decades ago, when they were both high school students.
Kavanaugh has denied the accusation that he sexually assaulted Ford while drunk at a party in the early '80s.
In a letter to Sen. Dianne Feinstein, Ford shared her memories. She recalled the drunken laughter of Kavanaugh and his friend, the loud music meant to drown out her cries for help, Kavanaugh's hand that covered her mouth.
"I feared he may inadvertently kill me," she wrote.
About half of sexual assault survivors, when asked whether they worried about being seriously injured or killed, say they did, Kilpatrick said.
"If they say 'yes' to that, it predicts more likelihood of long-term mental health problems," he said.
Ford told the Washington Post about her years of feeling "derailed" and how she's struggled with anxiety and symptoms of post-traumatic stress disorder.
Cementing painful memories
Not only are women who've experienced a sexual assault likely to remember their assaults, they tend to have memories that are more vivid than women who've experienced other sorts of traumas, such as car accidents, a new study shows.
"They were more likely to see the trauma in their mind, to see the contextual layout, and to consider it a significant part of their life story," said Tracey Shors, a professor of neuroscience at Rutgers University, who co-authored the study published this month in Frontiers in Psychiatry.
Memories of sexual violence also tended to linger, with victims reporting significantly more "ruminations" of the incident -- recurring thoughts about the past -- than those who remembered other stressful life events. That sort of thinking can cement the painful memories, making it difficult to move past them, the study showed.
"When you bring up a memory from the past," Shors explained, "you actually make another memory in your brain, because you bring it up in the present."
The study also found that those with recurring thoughts of their trauma were more likely to have other symptoms, she said, "like depression, anxiety and what we call post-traumatic cognitions."
Victims of sexual violence reported 44% more depressive symptoms and twice as many symptoms of anxiety than those who had no history with sexual violence, the study showed.
"If you're thinking a lot about the past," Shors said, "you're also probably worried about the future."
And when it comes to sexual violence, those sorts of fears can become debilitating.
'Depends on where you sit'
Kilpatrick can't help but see an irony in the latest headlines about Ford's allegations against Kavanaugh.
More than eight years ago, he appeared before the US Senate Committee on the Judiciary to talk about rape. The title of his prepared testimony: "Rape in the United States: The Chronic Failure to Report and Investigate Rape Cases."
He does not know Kavanaugh's accuser. But based on what he's gathered, he said, he sees something "very consistent with what has happened with a lot of sexual assault victims."
She didn't report the incident to authorities; the vast majority of women don't. Fewer than 20% of rape cases are reported, Kilpatrick said.
She was below the age of 18, which is when half of all sexual assaults of women (or girls) occur, he said.
And she's outlined having the sort of mental health problems that often stick with survivors.
So when someone like Sen. Orrin Hatch decides that Ford must be "mistaken" or "mixed up," Kilpatrick points to the old adage "where you stand depends on where you sit."
Reactions like Hatch's are more political than anything else, he said. And suggesting that Ford's memories can't be trusted, the very memories she feared talking about for so many years, doesn't match what a lifetime of work has taught him.
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