Drugs,Sexual Trauma,and the Improvised Labour of Survival

Abstract

This article challenges dominant framings of drug-related sexual violence that position drugs solely as external agents of victimisation, offering instead an analysis of how drugs are entangled with the embodied experience of sexual violence and its traumatic aftermaths. Through case-study analysis of a survivor’s narrative, I trace how her capacities to register, live with, and narrate trauma are constrained by the social, cultural, and institutional systems and structures that determine what kinds of harm are recognisable, whose accounts are credible, and what forms of survival are imaginable. Attending to the body as the site where sexual trauma is lived and reworked, I explore how this survivor attempts to inhabit her sexuality, including through cannabis use as a contingent tool for bodily recuperation. In doing so, the article offers an account of survival as ongoing, improvisational, and negotiated through structural constraint and embodied possibility.

Keywords

drugs drug-facilitated sexual assault incapacitated rape sexual trauma survivor narrative trauma narrative

In UK sexual violence discourse, sexual assault or rape involving victim intoxication is constructed as a distinct category requiring specialised surveillance and risk management and is often referred to as ‘drug-facilitated’ or ‘drug-assisted’ sexual assault or rape (Home Office, 2023; Rape Crisis England & Wales, 2025). Within these constructions, alcohol and other drugs are understood as external agents that act on victims’ bodies to enhance their vulnerability.¹ This reinforces a logic of risk in which intoxicated subjects – particularly women, who remain culturally constructed as archetypal victims – are rendered passive and incapable (Laugerud, 2023). As a result, women and girls who choose to become intoxicated are viewed as complicit in, or even responsible for, their own victimisation (Campbell, 2002; Ettorre, 2007) – a logic that reflects a broader neoliberal rationality that equates safety with self-control and situates risk management as a personal moral obligation (Harrington, 2022).

For sexual violence scholars attentive to the body and embodiment, these constructions obscure crucial dimensions of survivors’ experiences. By reinforcing an already gendered, racialised, classed, and ableist model of credible victimhood (Piepzna-Samarasinha, 2018; Spurgas, 2021) in which drug-related incapacitation becomes yet another measure of ‘real’ victimisation, little space remains to recognise or understand the experiences of intoxicated survivors who were conscious, responsive, or otherwise agentive at the time of being assaulted (Brian, 2018). Consequently, there is limited meaningful engagement with the complexity of survivors’ agency in relation to their drug use, or the ways drugs shape the sensory, temporal, and affective registers through which sexual violence is lived and remembered, both at and beyond the moment(s) of violation. This article engages these dimensions through the concept of drug-altered traumatic formation: the process through which the trauma of sexual violence takes shape via the interplay between the altered registers arising from drug use and the structural and political conditions organising the meanings and consequences of this use.

Alongside this, I develop the concept of the improvised labour of survival to describe the ongoing, embodied work of living with sexual trauma, which sometimes involves continued drug use. The term foregrounds both the creativity and chronic exhaustion involved in enduring within a complex of neoliberal structures and systems that emphasise normative and individualised models of ‘recovery’ and ‘resilience’ (Piepzna-Samarasinha, 2018; Spurgas, 2021). My analysis is informed by survivor-led scholarship exploring the affective, political, and structural dimensions of sexual violence and its traumatic aftermaths (Caputi, 2003; Hodges, 2024; Piepzna-Samarasinha, 2018; Spurgas, 2021) and centres the body as the site through which sexual trauma is registered, lived, and at times reconfigured (Hammers, 2013). I aim to make visible the small, improvised practices undertaken by survivors to feel and live otherwise within conditions that continually work to contain them.

Theorising Drug-Related Sexual Violence

Far from neutral descriptors, categories of ‘drug-facilitated’ or ‘drug-assisted’ sexual assault operate within a broader governance of sexual violence that requires women and girls to anticipate and manage their perceived vulnerability, particularly in nightlife settings. In the United Kingdom, where media reports of women and girls being drugged and subsequently assaulted have circulated since at least the 19th century, the idea of ‘spiking’ functions as a gendered ‘cautionary tale’ (Moore, 2009) that reinforces a neoliberal logic of safety as individual responsibility (Campion-Vincent, 2022; Vale Pires, 2024). This logic materialises in the rise of drug-related ‘anti-rape technologies’ – such as reusable drink covers and drug-detecting nail varnish – marketed primarily to women as personal safeguards (White and McMillan, 2020; Wilson-Barnao et al., 2021).

Yet for many women and girls in the United Kingdom, drug use is a routine part of their social and sexual lives, and of how desire and connection are accessed and felt (Griffin et al., 2012; Moyle et al., 2020). The possibilities of intoxication are, however, always entangled with gendered, racialised, and classed moral scrutiny: women and girls who use drugs in ways perceived as ‘excessive’ are judged as reckless, and those already read through tropes of deviance and sexual availability are viewed as complicit in their own victimisation (Ettorre, 2007; Hill Collins, 2004; Skeggs, 2001).

With the above in mind, this article works to keep drug-related sexual violence situated within the material, social, cultural, and institutional conditions that render some bodies hypervisible as ‘at risk’, others invisible as victims, and many unintelligible altogether. My approach is informed by an interdisciplinary background in sociology and criminology, brought into conversation with sexual violence scholarship across body studies (Hammers, 2013), affect theory (Brennan, 2004; Caputi, 2003; Hodges, 2024), critical disability studies (Piepzna-Samarasinha, 2018; Spurgas, 2021), and psychoanalysis (Saketopoulou, 2023).

The article provides a close analysis of one survivor’s narrative – ‘Sarah’ (a pseudonym). Sarah was a participant in my doctoral research who documented her experiences of drug-related sexual violence and their aftermaths in a diary and follow-up interview. My analysis traces how drugs mediate the perceptual, sensory, and affective fields through which sexual trauma is registered, and how drug use becomes a site of misrecognition that undermines survivors’ credibility and intelligibility. Situating Sarah’s narrative within the contradictory demands surrounding drug use and sexuality in teenage femininity, structures of criminalisation, and neoliberal imperatives of self-management and post-traumatic containment, I illuminate sexual trauma as an ongoing bodily reverberation, lived through the tension between structural constraint and embodied possibility.

Researching Drug-Related Sexual Violence

This article stems from my doctoral research project exploring the ethical dimensions of sex-on-drug experiences (Aldridge, 2023). The study was approved by Royal Holloway, University of London’s Research Ethics Committee in March 2020 and followed standard ethical protocols, including informed consent, prioritising participant autonomy, and privacy protections. My approach was informed by feminist scholarship on trauma-informed care, which emphasises minimising harm, creating conditions of safety, and recognising trauma as embodied and relational (Campbell et al., 2019; Pemberton and Loeb, 2020). I also understand trauma-informed care as a historically and politically situated concept and set of practices that can reproduce neoliberal ideals of self-regulation and resilience (Brown and Tseris, 2024). In this sense, my commitment to trauma-informed practice involves both care for participants and reflexivity towards the institutional conditions that shape what care can mean in social research. Over time, this reflexivity has also come to include attention to my own relationship to trauma and the ways it informs how I interpret and inhabit this work.

In the years since conducting the research, my understanding of sexual trauma and its relationship to drugs has changed significantly, shaped by an unfolding and embodied process of recognising and attempting to narrate my own experience of childhood sexual abuse, which involved drugs. I return to this project from within an evolving relationship to both trauma and drug use. What follows is an attempt to account for how I carried out the research at the time, while also sitting with the discomfort of what I might now do differently. This is offered as part of a commitment to reflexive and accountable research.

Participants and Data Collection

I recruited 25 participants – 16 cis women, eight cis men, and two non-binary people, aged between 20 and 59 – through my social circles and social media. Participants were invited to document their experiences of sex on drugs over 3–6 months in handwritten or digital diaries. I chose diaries for their capacity to support reflective engagement while affording participants greater control over what and how they disclose (Dilkes-Frayne, 2016). Of the 25 participants, 21 took part in follow-up diary interviews, where I asked tailored questions based on their entries. These interviews offered space to elaborate, clarify, and co-construct meaning (Fox and Alldred, 2015). Participants were able to skip questions, pause, or withdraw at any time.

The study did not explicitly seek disclosures of sexual violence, but I anticipated them. When participants disclosed sexual violence in their diaries, I researched local support resources in advance of interviews. In retrospect, I would have been more proactive in offering these to participants, rather than waiting for an explicit cue. This, I now see, could have created more affirming and accessible conditions of care.

Case Selection

This article takes a critical case approach (Flyvbjerg, 2006), selecting one participant’s narrative for in-depth analysis to explicate how it feels to be a survivor of drug-related sexual violence (Hodges, 2024). This approach aligns with feminist methodologies that work with situated, embodied accounts to challenge dominant epistemic frameworks (Renold and Ringrose, 2011). The participant, Sarah, was a white, cis, heterosexual, 25-year-old woman who wrote multiple diary entries relating to the experience and aftermath of rape involving drugs that occurred when she was 17. I selected Sarah’s narrative not because it was representative or exceptional (though elements of both could be argued), but because it held a particular emotional and political charge (Blackman, 2015), raising urgent tensions around sexual trauma, intoxication, credibility, and care – both in institutional responses and in how survivors live through these conditions. Sarah chose her own pseudonym, and other identifying details have been removed. I offered Sarah the opportunity to review an earlier version of the article, and she gave her consent for its submission.

Approach to Intoxicated Memory and Data Interpretation

Survivors who were intoxicated at the time of experiencing sexual violence are routinely treated as unreliable narrators, which is a response that forms part of the structural and political mechanisms through which marginalised and traumatised subjects have their accounts of harm and oppression disqualified (Hill Collins, 1989; Fricker, 2007; Piepzna-Samarasinha, 2018; Spurgas, 2021). Rather than treating intoxication as diminishing narrative authority, I understand Sarah’s account as a situated form of knowledge (Haraway, 1988) shaped by the sensory, temporal, affective, and structural conditions through which drugs alter the experience of violation. These altered conditions are part of what I call drug-altered traumatic formation: a mode of traumatic registration that remains largely undocumented precisely because intoxicated survivors’ accounts are treated as epistemically lesser.

With the above in mind, I understand Sarah’s account as relational and co-constructed (Fox and Alldred, 2015), which helps me to reflect on how my positions as researcher and survivor formed part of the narrative that was produced and continues to shape my interpretations. While I do not claim neutrality, I have taken steps to ensure that my engagement with Sarah’s story is accountable, aiming to honour the complexities of her experience. I acknowledge that my interpretations have been shaped by a personal resonance with some aspects of her experience, and I have sought to be attentive to the ways my history might affect interpretation – particularly regarding her descriptions of sexual violence experienced through drug-altered states, and her ongoing use of drugs in negotiating sexuality in trauma’s aftermath.

Introducing Sarah’s Survivor Narrative

The following sections present my analysis of Sarah’s narrative, drawing mostly on excerpts from her research diary, which are occasionally supplemented by material from our diary interview. Her narrative is reproduced in the order it was written, kept as close to the original as possible to preserve the texture and tone of Sarah’s own meaning-making and to allow her voice to shape the analytic encounter.

Negotiating the Contradictory Pressures of Teen Girls’ Drug-Using and Sexual Cultures

Sarah starts by reflecting on her 17-year-old self’s attempts to manage her reputation in a new peer group at a new college, demonstrating the significance of what Hirsch and Khan (2020: xi–xii) term ‘social ecosystems’ for understanding how individual experiences of sexual violence are produced:

It was a time in my life when I was pretty promiscuous. I wore my promiscuity and chaotic drug-taking as a badge of honour. Having changed colleges a few months before, I felt like I needed to rid myself of my past self and prove myself at my new college and make a name for myself in my new group of friends.

In a cultural context where young women are expected to be desirable yet not ‘too sexual’, and where their experimentation with drugs is both encouraged and condemned (Griffin et al., 2012), Sarah’s embrace of stigmatised identities can be interpreted as a pre-emptive defence against shaming and/or exclusion. For sociologists Emma Renold and Jessica Ringrose (2011), teenage girls’ expressions of pleasure and power in ‘becoming-sexual’ are inseparable from the symbolic and material violences that structure their lives, meaning it is necessary to attend to both what they make possible and what they foreclose. As I go on to explore, Sarah’s ‘badge of honour’ both protects her and limits her capacity to later disclose sexual violence.

Surveillance, Carcerality, and Drug-Using Women

Having framed her drug use and sexual behaviour as deliberate, identity-forming practices, Sarah’s narrative shifts to the regulatory-carceral conditions that structure her experience of sexual violence. While her ‘chaotic’ drug-taking provided a means of negotiating status among her peers (Measham, 2002), it also exposed her to heightened scrutiny and punishment. This becomes apparent when Sarah describes her experience at a nightclub when she is captured on CCTV preparing to take ketamine:

Just as I was raising my hand [with a small amount of ketamine on it] to my nose a security guard’s hand went round my wrist and we were all taken outside. It turned out a security camera was pointing directly at the sofa we were sat on. I remember thinking ‘damn, I was having such a fun time. Oh well, let’s just jump in a taxi home’, but the security guard wouldn’t let me leave. She called the police.

In line with ‘zero-tolerance’ drug policies adopted by many nightlife venues in the United Kingdom (Doherty, 2023), leisure tips into carceral control, and Sarah’s body is subject to punitive and public state intervention:

They pinned me against the wall and did a thorough search, but they didn’t find anything and didn’t notice I was using my sister’s passport as ID.

To the police officers, Sarah’s vulnerability as an underage and intoxicated teenage girl cannot coexist with her drug-related criminality (Malloch, 2004). This is drug-altered traumatic formation in its structural register: carceral logics organising the meaning of Sarah’s drug use in ways that, as the analysis below shows, expose her to further harm and shape how that harm is remembered and misrecognised.

Structural Abandonment and Bystander Intervention

As Sarah is searched by police officers, the nightclub closes, and people begin to leave:

My friend and her boyfriend were long gone. The police said I could go home, but I had to come to the station the next day for an interview otherwise they would come and pick me up from my house. They did not ask if I had any way of getting home. Essentially, the police left a 17-year-old girl, who they knew was on drugs, alone in the centre of town with no means of getting home. I still (in part) blame them for what happened next.

While it is impossible to determine exactly why Sarah’s friends left, research on bystander intervention suggests that dominant narratives around intoxication and responsibility shape how people perceive and respond to situations of vulnerability (Quigg et al., 2024). If Sarah’s visible drug use led her friends to see her as responsible for her situation, they may have felt less obliged to stay. Alternatively, they may have wanted to stay but feared drawing police attention to themselves. Either way, Sarah’s abandonment is structural and political, highlighting the need for bystander intervention strategies that attend to the conditions shaping the possibilities for peer support and solidarity (Hirsch and Khan, 2020).

Alone outside the nightclub, Sarah encounters the man who later rapes her, a ‘friend of a friend [she] had kissed earlier’.² He had witnessed her being searched by police and waited for her out of sight. In our interview, Sarah described the perpetrator as someone with a reputation in her peer group for being sexually ‘forward’. She initially used the word ‘forceful’ but corrected herself, explaining that ‘forward’ better reflected her teenage understanding.

When I found the guy waiting for me, he said he was planning to get the train back to his house and I could go with him but didn’t have enough money to get his own train and pay for my taxi. I knew my parents would be fuming if I didn’t come home so it seemed that the sensible thing to do was both get a taxi back to mine and I could get bus fare for him to get home in the morning from my parents. I remember saying to him that him coming home with me did not mean that I was going to have sex with him. I was obviously pretty traumatised after my interaction with the police and sex was the last thing on my mind. I just wanted to go home.

Sarah’s fear of parental punishment drives her decision to return home, illustrating how family structures can regulate girls’ actions in ways not always conducive to their safety (Sarre, 2010). By accepting the perpetrator’s offer and agreeing for him to spend the night, Sarah knows that she is participating in a heterosexual script in which the exchange of help carries an expectation of sex. Her assertions that she does not want to have sex are also expected and read as further evidence of her participation.

We bumped into two of his female friends on the way to the taxi rank. We sat with them for a few minutes, and they made jokes about how we were going to go home and have sex. I said again that I did not want to do that and that I just wanted to go home. He told them how we had kissed earlier and that I was just pretending. Obviously, with hindsight, I should never have accepted his offer of ‘help’ as all his behaviour so far was full of red flags.

The taxi rank scene shows how the heterosexual script organises what can be seen and what can be done: two young women are present, yet no solidarity or help materialises. Instead, they jokingly participate in the coercion that is underway. Sarah’s retrospective self-blame shows how thoroughly she has internalised victim-blaming logics. It is significant that the only person Sarah blames is herself.

The Embodied Experience of Sexual Violence

We got a taxi back to my house. My parents had a ‘shed’ in the garden – a room with sofas and speakers. He insisted we stay in there as he didn’t want to bump into my parents. I didn’t want to, but I was too exhausted to argue.

Arriving home is widely regarded as a marker of safety for women, as evidenced by initiatives like ‘Home Safe’, a non-profit organisation that funds women’s Uber rides in London (Home Safe, 2021). For Sarah, however, home becomes a site of ongoing social and spatial coercion (Shaw, 2022):

Once inside, he immediately started kissing and touching me. I said again I didn’t want to have sex. He responded with all the classic statements (‘you kissed me earlier’, ‘I know you’re not usually shy’, ‘but I paid for the taxi’, ‘you’ll enjoy it’). I said no, over and over. I thought about going to my parents, but I was scared they would guess I was on drugs and blame me for a bringing a boy home. At some point, I gave in. He fucked me hard and aggressively. I felt I was having an out-of-body experience. I just wanted it to end. The drugs had mostly worn off by that point, but my mind was foggy from the comedown and the traumatic experiences of the night.

In line with the script unfolding through the night, the perpetrator acts on his sense of entitlement to Sarah’s body, positioning sex as a debt she must pay. Sarah verbally resists and even considers seeking help from her parents but fears they will view her as culpable. The last two things Sarah considers before ‘giving in’ are her parents’ perceptions of her drug use and her decision to bring a boy home, illustrating how internalised judgement around drug use and sexuality operate as felt constraints that foreclose help-seeking (Hirsch and Khan, 2020).

Sarah’s ‘out-of-body’ experience during the rape reflects feminist trauma scholarship on dissociation as a survival mechanism (Hammers, 2013; Herman, 1992), but it is the ‘fogginess’ she describes that most precisely illuminates drug-altered traumatic formation. Sarah herself disaggregates it: the pharmacological effects of alcohol, MDMA, and ketamine; the comedown; and the cumulative traumatic weight of the night’s events. The trauma of sexual violence, here, takes shape through the drugs, and through everything that surrounds their use.

Sexual Violence and Fragile Masculinity

The rape finishes once the perpetrator ejaculates, after which he seeks validation from Sarah for his sexual ‘performance’. That he does so reflects what masculinity scholar Michael Kaufman (1987) identifies as the fragility of patriarchal masculinity, which much of men’s sexual violence both expresses and attempts to resolve.

Immediately after he came, he asked me how good he was. I told him he was great, hoping that if he thought he had ‘succeeded’ at fucking me he would leave me alone and not feel the need to ‘prove himself’. I was a shell of myself and did not know what to do next. I found my laptop and put on an album I used to relax (Phaeleh’s Afterglow). It’s very otherworldly and I hoped I could be transported somewhere else so I could fall asleep. But he said it was keeping him awake and made me turn it off. He fell asleep and sometime later so did I.

The way Sarah appeases her perpetrator illustrates the improvised labour of survival in its most immediate form: she protects him from his fear of sexual inadequacy to protect herself from further harm. That Sarah appears to do this instinctively reflects how the patriarchal structures that make women and girls responsible for men’s emotional lives are carried in the body, shaping their responses before they can be consciously reasoned (White, 2024). The cost of Sarah’s survival practice is visible in the resulting asymmetry: the perpetrator’s fear is resolved and he falls asleep; Sarah absorbs it and lies awake. In Jane Caputi (2003) and Teresa Brennan’s (2004) terms, this is how sexual violence burdens survivors affectively: acts of rape construct perpetrators as masculine subjects through the hierarchal transfer of their unwanted emotions (such as inferiority, powerlessness, anger) to feminised others, who serve as ‘containers’ that are depleted of their vital energies (a depletion evident in Sarah’s description of herself as a ‘shell’).

Disconnection and Foreclosed Support

The following morning, Sarah attends an interview at her local police station as instructed, where she is charged with possession of a Class C drug under the Misuse of Drugs Act 1971.³ Her second interaction with the police further illuminates drug-altered traumatic formation, showing how carceral institutions and practices intensify survivors’ disconnection from their experiences and needs:

I cannot really remember the next day until I reached the police station. The policeman said something like ‘Do you remember me? Probably not!’ and laughed. I obviously did not find the situation funny at all. I spent the next hour being interviewed about where I had bought the drugs, who from, etc. They did not ask if I needed support. They did not ask how I got home. They had assumed I was a fuck up and were visibly confused when I told them I was predicted A’s in my maths, chemistry and Latin A levels and had offers to 5 universities. They charged me with possession of a Class C drug (this is before ketamine was reclassified) and told me to stay out of trouble.

The officer’s laughter contrasts sharply with Sarah’s state, conveying interpersonal mockery and institutionalised indifference to her suffering. Despite being 17 years old, Sarah navigates this process alone, reflecting a criminal justice system that systematically denies support to drug-using women and girls (Gelsthorpe and Canton, 2020), and a context of familial and peer relational dynamics in which asking for accompaniment feels impossible. Sarah’s sharing of her academic achievements reveals how social status can reframe perceptions of credibility – but only superficially. As a drug-using teenage girl, Sarah is positioned outside normative scripts of innocence and victimhood, her distress unintelligible and her experience of rape unsayable:

I had just been raped and I could not tell them – partly because I hadn’t yet processed what had happened, but also because they so clearly thought the worst of me. Perhaps worst of all, I couldn’t tell my friends. I felt it would make me vulnerable. It would have shattered my ‘I don’t give a fuck’ attitude. I would have had to face up to him. I would have had to explain myself. I would have been blamed, or told I was lying, or that I’d ‘loved it really’. So instead, I laughed and joked about getting arrested and fucking [perpetrator] (the use of ‘fucking’ here instead of ‘being fucked by’ is purposeful) as it allowed me to control in my mind what had happened. It made me an active participant, not the scared teenage girl that I was inside.

Having constructed an identity centred on ‘promiscuity’ and ‘chaotic drug-taking’, Sarah is unable to talk to her friends about the trauma of her experiences. She fears it would make her ‘vulnerable’: to loss of face, the perpetrator’s response, and victim blaming (Meyer, 2010). Faced with so many constraints on speaking about her experiences, Sarah reframes her agency in the telling and retelling of events, both to regain control and to deny her fear and pain (Hirsch and Khan, 2020).

The Affectivity of Survivorhood

Sarah’s narrative shifts to the years following the rape:

It took me 3 years to tell anyone what happened. My mental health was desperately bad, deteriorating through drug use and detachment from the real world. I lost my sex drive and my boyfriend at the time could not understand why even though he knew what I was trying to process. He would often try and force me to have sex, retraumatising me every time. Eventually, I refused to have sex, or kiss, or even be touched by him as I was in constant fear that if I gave an inch, he would take a mile, which did happen on one occasion (he gave me a half gram line of ket, I went into a k-hole and when I came round I was aware that he had had sex with me. I was disgusted at him and we never had sex again).

Sarah powerfully conveys what survivorhood feels like – a slow, wearing accumulation of shame, fear, and disgust that lodge in the body and restructure Sarah’s relationship to drugs, touch, desire, and self (Hammers, 2013; Hodges, 2024). Sarah’s description of her relationship also points to the cyclical nature of harm (Rogers et al., 2023): she and her boyfriend are engaged in a struggle for control marked by coercion, refusal, and an eventual rape during which Sarah was in a ‘k-hole’ (Muetzelfeldt et al., 2008) from a high dose of ketamine administered by her boyfriend.

Sarah’s description of the rape further captures the process of drug-altered traumatic formation: here, how ketamine’s distortion of time, space, and sensation shaped the violation, folding the rape into an altered perceptual and affective field. Sarah remembers the rape not despite being in an altered state, but through it (‘when I came round I was aware that he had sex with me’): the disorientation of the k-hole becomes part of trauma’s form and endurance.

For Brennan (2004), the recurrence of harm can be understood as a consequence of how violation reshapes the body’s openness to certain affective forces:

[In cases of sexual abuse], it does seem as if the affects of the perpetrator are in some way negatively affixed to the victim [. . .]. As long as trauma is unhealed it keeps the victim open to the same affects (and attracts them from a variety of sources); there is something in trauma that permits such affects a permanent entry. (2004: 48)

While I approach the idea of ‘unhealed’ trauma with caution, I find Brennan’s formulation useful for making sense of Sarah’s stuckness in a relationship where further violence feels inescapable. Importantly, this stuckness is not passive or static. Sarah’s account clearly conveys the labour it entails: enduring persistent fear and disgust; managing these feelings through drug use and dissociation; and slowly disentangling from a coercive relationship embedded within a peer group in which Sarah is read as a promiscuous, chaotic drug taker. Crucially, the labour through which Sarah survives this period both protects and constrains her. Her survival practices emerge in response to the conditions that harm her, even as they keep her tethered to them, illustrating the non-linear and frequently repetitive trajectories of sexual violence survivorhood (Piepzna-Samarasinha, 2018).

At the same time, Sarah turns towards the medicalised and individualised frameworks of ‘healing’ available to her, including talking therapy, prescribed medication, and eventually, homeopathy:

I had been receiving therapy for over a year, been on antidepressants for two. I visited a homeopath as I was desperate for something, anything, that could save me from the misery that my life had become. I told her everything and she used the word ‘rape’. I had never used it to describe this event myself (even to myself, as I’d argued internally that at some point I had consented, even if it was coerced). I was angry and upset and full of every negative emotion. I could not align what had happened to me with my idea of what rape was (the ‘stranger in a dark alley’ stereotype). I cried and cried and cried.

The homeopath offers a moment of relational witnessing that marks a turning point, reflecting trauma scholar Judith Herman’s assertion that experiences of trauma cannot be integrated by individuals in isolation:

[H]oldi[ng] traumatic reality in consciousness requires a social context that affirms and protects the victim and that joins victim and witness in a common alliance. (Herman, 1992: 8)

Experiencing this alliance is vital for Sarah. The homeopath’s recognition and naming of her experience as rape enables a release – what Caputi might describe as an ‘exorcism’ of ‘something evil that remains within’ (2003: 6) – in which Sarah experiences ‘every negative emotion’: anger, grief, and a profound sense of misalignment between what happened to her and the cultural frameworks available to name and hold it. In the final paragraph of her diary entry, Sarah describes bringing this experience into her subsequent therapy sessions:

I decided to tell my therapist and we spent some sessions talking about it but nothing seemed to shift. Eventually we did EMDR, a strange technique that’s supposed to reconfigure the memory of traumatic events and after a few sessions, I could speak about it without crying. I still find it a difficult night to think about and if I saw him again I know I would break down but at least I no longer blame myself for what happened. I am a better person for the experiences that I have had but it has been an extremely long and painful journey to get here.

Without diminishing the meaningful changes Sarah articulates, her account speaks to the complex relationship between trauma and narrative (Serisier, 2018). I interpret the extract above as shaped in part by a broader imperative to make meaning out of experiences of harm through redemptive notions of personal growth, even when these are at odds with the non-linear labour of survival (Hodges, 2024; Piepzna-Samarasinha, 2018; Spurgas, 2021). This can, for example, be seen in Sarah’s statement that she is ‘a better person for the experiences [she has] had’, which offers the reader a sense of purpose and resolution, even as it follows: ‘I still find it a difficult night to think about and if I saw him again I know I would break down’.

The Improvised Labour of Survival

The remainder my analysis is based on a separate diary entry, focused on Sarah’s attempts – in part assisted by cannabis – to ‘take back control’ of her sexuality. As before, the entry reflects the neoliberal imperative for individual management and containment of trauma’s effects, even as it documents Sarah’s ongoing use of illicit drugs in sexual contexts.

This kind of follows on from the last one but is far less depressing. After losing my sex drive and realising I had been raped I knew that I needed to take back control of my sex life and go forward on my own terms. However, it was a bit of a shitty situation as I was still terrified of being touched at all and had never really spent any time thinking about what I liked sexually. I didn’t masturbate and didn’t own a vibrator or anything like that.

I knew I needed to sort it out, as I had had some positive experiences of intimacy early on in the relationship with my previous boyfriend and missed having that. I was so shy of my own body and of my own sexual self. I felt embarrassed and incapable of getting myself off. I didn’t feel like I could talk to anyone about it because it’s kind of odd to be 22 years old and to have never come, especially when you’ve had so many sexual partners. I think sex was always a kind of shameful thing to me, even when I was sleeping around, because my motivations for having it were never for my own pleasure but for someone else’s.

The above captures the affective terrain Sarah feels compelled to master to move forward: terror, embarrassment, shame, and a sense of estrangement from her body and sexuality. Sarah’s sense of being ‘odd’ and somehow behind (22 years, ‘never come’ – yet with ‘so many sexual partners’) reflects the imperative that women cultivate knowledgeable, confident, and agentic sexual selves (Angel, 2021), which is further evident in her ‘methodical’ approach to sexual self-improvement:

I set about changing things in a very methodical way. I read and read and read online about masturbation and orgasms. I signed up to OMGYes and watched so many videos. I looked at vibrators online and read all of the reviews until I found the best one. I bought candles and incense, made playlists. Everything I could to give myself the best chance of enjoying myself. Unfortunately, it just still didn’t work. I’d built it up to be such a massive thing that my mind was always racing whenever I tried.

Sarah’s project resonates with the neoliberal ‘sexual entrepreneur’ who works to produce a flourishing sexual self through investment, optimisation, and self-care (Beecham and Unger, 2019; Favaro and Gill, 2020). The tools and curated environments Sarah assembles demonstrate her willingness to perform this labour – to ‘do recovery’ in the ways culturally demanded of a ‘good survivor’ (Piepzna-Samarasinha, 2018: 229). But that ‘it just still didn’t work’ demonstrates the limits of will when it comes to trauma’s persistence in and through the body, shaping in/capacities for sex and pleasure in ways that cannot straightforwardly be overcome.

As psychoanalyst Avgi Saketopoulou writes, ‘[m]uch as we would want to think otherwise, the impact of traumatic experiences cannot be eliminated or repaired: at best, we live in their aftermath on different terms than when they were inflicted on us’ (2023: 2).⁴ In critiquing a cultural obsession with ‘healing’ trauma, Saketopoulou urges consideration of what subjects do with their trauma – how they find ways to be with, rather than overcome, their traumatic histories. This shift underpins her theorisation of ‘traumatophila’: a generative concept for understanding how trauma survivors may return to the conditions under which harm occurred – in Sarah’s case, drug-altered bodily states – to open possibilities for transformation (Saketopoulou, 2023: 134). The final sections of Sarah’s diary entry turn to her use of cannabis – a Class B drug in the United Kingdom during the early 2010s – as part of her improvised labour of ‘bodily reclamation’ (Hammers, 2013):

[Cannabis] changed everything. When I first masturbated after using cannabis the sensations were so much stronger. I felt so much more part of myself, my body didn’t feel so alien. The most important thing though is how it makes my brain feel. I could relax and focus on pleasure, without intrusive thoughts or a desperation for it to ‘work’ making enjoying myself impossible. It was a complete lightbulb moment. When I first made myself come I felt like a woman again, not the incomplete person I was before. It sounds weird but I was so excited to tell my therapist as she had been so supportive throughout everything.

For Sarah, a cannabis-altered state eased the heightened self-awareness and bodily estrangement that had made masturbation and orgasm feel impossible, allowing her to inhabit her body otherwise. Given her experiences of sexual violence, it is significant that these shifts in bodily possibility occurred while Sarah was in a drug-altered state. While medical discourse often treats post-traumatic drug use – especially when the original traumatic experience(s) involved drugs – as evidence of damage or dysfunction (Rehabs UK, 2025), a traumatophilic reading illuminates Sarah’s cannabis use as creative experimentation with new modes of inhabiting her body in ways ‘conducive to expanded psychic freedoms’ (Saketopoulou, 2023: 132):

Nowadays I don’t need cannabis to masturbate but I think it makes it better, less so for the headspace but for the increase in sensation that it causes. Cannabis allowed me to get through that toughest bit where I was so scared and anxious and has allowed me to be able to have a happy healthy sex life on my own and now with my current boyfriend. I can’t say that I wouldn’t have got to this point without cannabis but it definitely would have taken much more time (and probably much more therapy).

While Sarah ends this diary entry again by offering a sense of resolution, I would like to end on the parts of her narrative that are less resolved, namely her use of drugs. I do this in resistance to normative formulations of gendered sexual trauma that are, in Spurgas’ terms, ‘founded upon a specific vision of an innocent and whole (white) woman, who is then damaged and broken, but who is finally cured and can live normally (normatively) again’ (2024: 10). That Sarah’s narrative contains something of this vision reflects, in part, the limited cultural frameworks available for survivors to talk about their drug use beyond notions of addiction or cure. But as this analysis has shown, Sarah’s relationship to drugs exceeds both. Drugs afforded her status and belonging among her peers; they led to her criminalisation; they were present in two rapes she experienced; she used them in the aftermath to detach from a world that had become unbearable; and she used them to reconnect with her body. It is in this excess that her improvised labour of survival is most visible as the ongoing and partial work of orientating towards feeling and living otherwise within conditions that continually work to contain her.

Conclusion

In sexual violence discourse, discussion of drug-facilitated sexual assault is often framed through questions of ‘impairment’ or ‘incapacity’, such as whether the victim/survivor was conscious, responsive, or able to give their consent (Brian, 2018; Laugerud, 2023). Seldom discussed is how drugs shape the embodied and phenomenological dimensions of sexual violence – how, for survivors like Sarah, trauma takes hold within already-altered sensory, temporal, and affective fields, intensifying disorientation, dissociation, and terror.⁵ These altered conditions do not arise from the effects of drugs alone: they are constituted through the social, structural, and political conditions that shape the meanings and consequences attached to their use. It is this entanglement that I theorise as drug-altered traumatic formation. The survivor narratives it produces – shaped by gaps in memory, distorted temporality, sensory disorientation, and self-blame – are also those most readily dismissed by the institutions survivors are expected to turn to, reflecting structural and political investments in disqualifying survivor knowledge in ways that ultimately sustain gendered sexual violence (Spurgas, 2021).

Against this backdrop, survivors’ ongoing use of drugs in the aftermath of sexual violence demand readings that resist familiar tropes of the ‘damaged’ or ‘addicted’ survivor (Piepzna-Samarasinha, 2018). Survivors like Sarah use drugs, alongside a range of improvised practices, in ways that are (sometimes simultaneously) life-enhancing and life-limiting. That survivors’ drug use is routinely pathologised is itself constitutive of drug-altered traumatic formation and also sits in tension with the growing interest in certain psychedelic and dissociative substances – including ketamine – as ‘treatments’ for trauma (Zaretsky et al., 2024). It is significant that a survivor like Sarah was criminalised for ketamine possession when this same drug is now administered clinically to treat the very conditions this criminalisation helped produce (Sicignano et al., 2024). Rather than situating survivors’ drug use within these emerging therapeutic frameworks, this article has understood drug use in relation to survivors’ social worlds: the peer groups, familial pressures, romantic relationships, structures of criminalisation, and other everyday negotiations within which drugs do their work. This resists the idea of drugs as having inherent curative properties – whether for sexual ‘functioning’ or traumatic healing (Dymock and Dubus, 2025) – and opens space for a more situated and political account of what drugs do in survivors’ lives.

This article intervenes across sexual violence scholarship and trauma studies by offering two related conceptual contributions. Drug-altered traumatic formation provides a framework for understanding how the trauma of sexual violence takes shape and endures through the entanglement of drug-altered states and the social, structural, and political regimes that govern drug use, giving form to a neglected domain of traumatic experience that is necessary for it to register as legible and legitimate. Alongside this, the improvised labour of survival illuminates the situated, embodied practices through which survivors attempt to live through trauma and in its aftermath, always negotiated within uneven distributions of criminalisation and care and in relation to neoliberal demands for self-management and post-traumatic recovery. Together, these concepts offer a phenomenologically attuned and political account of drug-related sexual violence that attends to the socio-material conditions through which it is lived and survived, and to the forms of knowledge that such living and surviving produces.

Footnotes

ORCID iD

Alex Frankovitch

Notes

Alex Frankovitch is a fellow in Interdisciplinary Social Science at the London School of Economics and Political Science. Their research spans two related areas: queer cultures of public sex and the sexual politics of space; and the relationships between drugs, sexual trauma, and memory. Their current work focuses on mixed-gender darkrooms in London’s queer nightlife scene.

This is part of the Body & Societyspecial section on ‘Sex, Drugs and Embodiment’, edited by Maurice Nagington, Alex Dymock, Kiran Pienaar and Joshua Pocius.

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