How a label sparked a new vision for rape recovery

When I was first diagnosed with Female Sexual Dysfunction, it didn't feel like a sense of relief, that 'aha' moment that I thought a diagnosis might help me achieve. It did not, as I had hoped, help me to understand why I had struggled to connect with my body or why desire felt so elusive and unsafe. Throughout my search for answers, I instead received a label. One that reduced something deeply relational, contextual and traumatic into a single term: dysfunctional. 

It said nothing about trauma, about shame, about the way societal messages around gender sex and power shape the way survivors of sexual violence – like me, and too many others – live in their body.  Although it was meant to be a helpful label, it wasn't. But it did do something important – it sparked my curiosity. 

Around me, not within me

I began to search for everything I could that might offer alternative explanations to what the medical system had missed. From sexual educators, feminist critiques of psychiatric labels to polyvagal theory, I was able to develop an understanding that sexuality is something deeply embedded in context, safety (or lack of) and meaning. It cannot be reduced to simply functional/dysfunctional. 

This new knowledge sparked a thought: what if the issue isn't within me, but around me? What if my sexuality isn't dysfunctional – rather, it is responding exactly as it should based on my experiences and the systems around me? 

This thought encapsulates the notion of the ecological model of trauma, a framework that would later become the foundation of my doctoral research.

The ecological model argues that trauma is not just an individual psychological event. It is shaped by and impacts every layer of our existence: our physiology, our relationships, the institutions we interact with, and the wider culture we live in. It was the first model I encountered that made me feel whole rather than fragmented. This wasn't personal dysfunction, it was about poor ecological fit. What is 'wrong' with survivors should therefore be reframed as what is wrong with the systems we expect them to recover within. 

That's a concept which particularly resonates with the values of counselling psychology, and what drew me both to the field and Enough. From there my doctoral research and my work with Enough To End Rape began to grow. 

The real aftermath of rape

My research explored women's experience of sexuality after rape from an ecological perspective. It challenged the notion that healing happens in isolation, or that trauma is simply a psychological injury. It is physiological dysregulation, it's being pathologised by clinicians, it's isolation, shame, silence, failure of police, disbelief by friends. I saw how the women I interviewed were impacted by the people around them, the quality of the services they accessed, the policies that protected or punished them, and the cultural narratives that shaped their self-perception and sexuality. 

This is the real aftermath of rape and unless we address all of it, we're not offering recovery. We are offering survival at best. Recovery, as highlighted by these women, has to meet us at every level of the ecosystem not just in therapy room but in everyday life, in ways that help us feel empowered and understood. 

But even as my research offered new frameworks, I couldn't ignore the practical reality: most survivors don't access to support. Statistics show that only 5 per cent of survivors use Sexual Assault Referral Centres (SARCs), fewer than one in six rapes are reported to the police and around 75 per cent never access therapy. And for those that do access support or reporting platforms, there are too many tales of re-traumatisation and pathologisation. I didn't want my research to gather dust on a shelf. I wanted it to do something. This is where Enough to End Rape recovery was born. 

Creating Enough: A survivor-led systemic solution

Enough is a digital platform that offers trauma-informed psychoeducation, survivor-led storytelling, and practical tools, all accessible for free. We meet survivors where they are: often in the quiet, shame-soaked corners of the internet, in the palm of their hand, late at night, when they feel most alone. We didn't want to replicate what already existed, we wanted to create something that filled in the gaps.

The platform includes bite-sized Instagram and YouTube videos that explain complex theories around trauma, sexuality, and recovery through a compassionate lens: how the nervous system responds to trauma, why sex might feel unsafe or numb after an assault, how shame takes root, and what survivors can do to begin restoring safety in their bodies and relationships.

But we also do something few services have dared to do: we offer an anonymous self-swabbing and reporting tool (see also below). This allows survivors to collect evidence on their own terms, without the pressure of immediate police involvement. It's not a replacement for justice. It's a reclamation of agency.

Every element of is built using the ecological model:

• Individual level: Our content helps survivors understand their trauma responses and regulate their nervous systems.
• Microsystem level: We create digital communities that foster validation and reduce isolation.
• Exosystem level: The self-swabbing tool challenges traditional barriers to justice and therapeutic intervention, giving survivors more control.
• Macrosystem level: Survivor-led narratives challenge cultural myths, stigma, and the medicalisation of recovery.

Enough is not about fixing survivors. It's about fixing the systems around them. It's a first of its kind approach in the UK, and it came directly from listening to what survivors were telling us they needed. 

But it has not come without its challenges. We've encountered resistance from statutory services, and experienced difficulties with collaboration as our approach challenges existing protocols. Others have raised concerns around safeguarding, fearing that a survivor-led, digital-first model might be unsafe or too radical. Our self-swabbing tool has triggered concerns around admissibility and forensic integrity, despite our promotion that this tool is about choice, autonomy and social deterrence rather than being a criminal justice solution.

We've had to fight for legitimacy in spaces that still see digital care as inferior, despite growing evidence that online psychoeducation and community support can rival face-to-face therapy in both accessibility and outcomes. We've also had to carefully design Enough to balance innovation with integrity to offer scalable tools without compromising safety. This includes clear protocols around safeguarding, rigorous clinical oversight, and ongoing evaluation. 

An alternative to inaction

The critiques of what we are doing have been both anxiety provoking and at times frustrating particularly due to a lack of openness to conversation around concerns. Whilst I welcome constructive criticism and understand the concerns around forensic integrity, everything we do has been created with ethical integrity at the fore, as well as ensuring the voices of those with lived experience are heard. Not a single aspect of Enough has been designed without survivor co-creation, right from branding to video content. 

We know that no single tool digital or otherwise can solve the systemic failures that surround rape recovery and justice. But we also know that waiting for permission to build something better isn't working. We are not a replacement for therapy, SARCS, or the police – we are an alternative to inaction and the barriers in being able to access support. We simply provide choice to survivors which is a key principle within trauma-informed care and one that is essential for a regulated nervous system. 

Despite critics and many sleepless nights, we continue to receive positive feedback, we continue to learn and adapt from what survivors tell us they want and need. We have had an overwhelming influx of praise from survivors: 'I watched your video and for the first time, I didn't feel crazy', or simply 'I am so glad this exists'. It's not just survivors. I've heard from parents, nurses, partners, people trying to understand, to support, to unlearn. These conversations give me hope. They show that change is not just possible, but already happening.

What we must do differently

Like, I imagine, many of you reading this article, my path to becoming a psychologist started with lived experience. As one of the too many individuals who have experienced sexual violence, I know how isolating it can be to navigate the aftermath of trauma and the profound sense of shame that often comes with it. So what am I looking for from my own profession?

If psychology is to truly serve survivors, we must move beyond individualised models that locate the problem inside the person. We must challenge diagnostic systems that pathologise protective responses. We must centre survivor voices not just as case studies, but as collaborators, leaders, and experts in their own right. Compassionate psychoeducation should be a frontline intervention. It should be freely available, culturally sensitive, and deeply rooted in lived experience. 

If you are a clinician, educator, or ally, ask yourself: am I treating trauma as a pathology, or as a response to something unjust? Am I offering labels, or am I offering context, compassion, and choice?

And if you are someone who has been handed a label that felt more like a sentence than a solution know that it doesn't define you. It can be the beginning of a different story. For me, that label led to Enough. It led to community, clarity, and a kind of healing I didn't think was possible. It taught me that recovery is not a return to who we were before. It's a movement forward into who we get to become, when we are finally seen, heard, and supported. A message that is prioritised and promoted through Enough. Not clinical detachment, but compassionate knowledge. Not a single path, but multiple doorways into healing.

If you are a survivor, you are not broken. Your body is not malfunctioning. You are not too much or not enough. Your responses make sense.

We need to start creating systems that fit survivors. Enough is one attempt at that. A digital space that offers what I wish I'd had: knowledge, agency, and a sense that you're not alone. If Enough had existed then, I think things might have been different. Not easier… necessarily, healing is never linear… but less lonely. Less shameful. More hopeful.

• Dr Maisie Johnstone is a Counselling Psychologist and Clinical Lead at Enough. Find more about their approach to recovery here.

  More on self-testing kits: Self-testing kits are for people who do not want to report to the police or a SARC. You can use one in the privacy of your home and send it straight to Enough's UKAS accredited laboratory. You can also write a time-stamped testimony, saved on your encrypted account. At the lab, half of the sample is frozen untested and the other half is tested immediately to show the number and gender of DNA profiles in or on your body. The aim is not to identify an individual, but to give validation and confirmation that it did happen, and restore agency - an important step in recovery. If you decide to report to the police at a later point, they will consider all relevant information for your case. This could include DNA from the moment it happened (the frozen untested sample) and your time-stamped testimony. Evidence collected via Enough can be admissible in court (confirmed by a leading KC barrister here), but there has not been a case yet.

• Recovery channel (instagram)
• Recovery channel (longer YouTube episodes)
• Website
• If you'd like to support or work with Enough, please get in touch with Dr Maisie Johnstone via [email protected]