WOMEN’S EXPERIENCES OF HEALING AFTER SEX TRAFFICKING IN CANADA by AMY KOBELT Bachelor of Arts in Psychology with Distinction, Trinity Western University 2015 Thesis Submitted in Partial Fulfillment of the Requirements for the Degree of MASTER OF ARTS IN COUNSELLING PSYCHOLOGY in the FACULTY OF GRADUATE STUDIES TRINITY WESTERN UNIVERSITY October 2019 © Amy Kobelt, 2019 HEALING AFTER SEX TRAFFICKING ii ABSTRACT Sex trafficking is one of the fastest growing crimes in the world and is often inaccurately perceived to only occur in developing countries. In Canada, sex trafficking is a hidden crime that impacts women of every race and socioeconomic status, though Indigenous women are disproportionately represented as victims. Victims of sex trafficking experience oppression and silencing as a result of this crime, and this study was designed to counteract those experiences by providing a platform to listen to survivors. This study aimed to hear from survivors of sex trafficking in Canada and listen to their experiences of healing, strength, and resiliency after they have been freed from exploitation. Seven women who were victims of sex trafficking in Canada were selected for inclusion based on their experiences of victimization and their ability to speak to the healing journey that they have been on. In order to provide victim-informed research driven by participant’s narratives, the qualitative feminist method of the listening guide was utilized. Two categories of voices emerged in participants’ narratives: voices of resistance and voices of healing. The voices of resistance (oppression, dismissal, avoidance, confusion, and disconnection), spoke about obstacles and barriers in healing, while voices of healing (connection, knowing, compassion, resilience, advocacy, agency, and purpose), captured women’s stories of healing, strength and resilience. Survivors were found to experience healing through connection with themselves and others, mastery of new skills, regaining their autonomy, finding purpose, and sharing their stories. Key words: sex trafficking; sexual exploitation; listening guide; healing; resilience HEALING AFTER SEX TRAFFICKING iii TABLE OF CONTENTS ABSTRACT......................................................................................................................... i TABLE OF CONTENTS .................................................................................................... ii LIST OF TABLES ............................................................................................................. ix LIST OF FIGURES ............................................................................................................ x ACKNOWLEDGEMENTS ............................................................................................... xi CHAPTER 1: INTRODUCTION ....................................................................................... 1 CHAPTER 2: REVIEW OF THE LITERATURE ............................................................. 4 Sex Trafficking in Canada ...................................................................................... 5 Prevalence. .................................................................................................. 5 Recruitment. ................................................................................................ 6 Indigenous women as victims. .................................................................... 6 Indigenous history of exploitation. ................................................. 7 Systemic contributions to sex trafficking in Canada. ................................. 8 Impacts of Sex Trafficking ..................................................................................... 8 Psychological consequences. ...................................................................... 9 Intrapersonal consequences. ......................................................... 10 Physical consequences. ............................................................................. 11 Substance use. ............................................................................... 12 Relational consequences. .......................................................................... 13 Systemic consequences. ............................................................................ 13 Resiliency in the Exiting Process .......................................................................... 14 Healing .................................................................................................................. 15 HEALING AFTER SEX TRAFFICKING iv Western framework for healing. ............................................................... 15 Indigenous framework for healing. ........................................................... 17 Rationale for healing framework. ............................................................. 18 Healing for Survivors of Sex Trafficking ............................................................. 19 Healing process in psychotherapy ............................................................ 21 Additional healing factors ......................................................................... 23 Experiences of healing for Indigenous survivors.......................... 24 Rationale, Purpose, and Research Question of the Present Study ........................ 25 CHAPTER 3: Method ....................................................................................................... 27 Research Paradigm and Design ............................................................................ 27 Feminist framework .................................................................................. 28 Application of constructivist and feminist lenses ..................................... 30 Researcher position ................................................................................... 33 Methodology: The Listening Guide ...................................................................... 34 Applying the listening guide ..................................................................... 35 Step one: Listening to the plot ...................................................... 36 Step two: Composing ‘I-poems’ ................................................... 36 Step three: Listening for contrapuntal voices ............................... 37 Step four: Composing an analysis................................................. 38 Data Collection ......................................................................................... 38 Participant recruitment .................................................................. 38 Exclusion criteria .......................................................................... 41 Process of data collection.............................................................. 41 HEALING AFTER SEX TRAFFICKING v Data analysis ................................................................................. 42 Rigour and Quality .................................................................................... 45 CHAPTER 4: Results ....................................................................................................... 48 Participants’ Stories .............................................................................................. 49 Lindsay ...................................................................................................... 51 Camara ...................................................................................................... 60 Emily ......................................................................................................... 70 Tracy ......................................................................................................... 79 Cory........................................................................................................... 91 Charlotte.................................................................................................. 107 Marie ....................................................................................................... 117 Description of the Voices.................................................................................... 124 Voices of Resistance ........................................................................................... 128 Voice of oppression ................................................................................ 128 Voice of disconnection ........................................................................... 131 Disconnection from body ............................................................ 132 Disconnection from child-self..................................................... 133 Disconnection from others .......................................................... 134 Voice of confusion .................................................................................. 135 Voice of shame ....................................................................................... 136 Voice of avoidance ................................................................................. 137 Voice of dismissal ................................................................................... 139 Voices of Healing ............................................................................................... 140 HEALING AFTER SEX TRAFFICKING vi Voice of connection ................................................................................ 141 Connection to other survivors ..................................................... 142 Connection to spirituality............................................................ 142 Connection to purpose ................................................................ 143 Connection to body ..................................................................... 144 Connection to child-self .............................................................. 145 Voice of agency ...................................................................................... 145 Agency in relationships............................................................... 147 Voice of advocacy................................................................................... 148 Voice of injustice ........................................................................ 150 Voice of knowing .................................................................................... 151 Voice of resilience .................................................................................. 154 Voice of compassion ............................................................................... 154 Voice of purpose ..................................................................................... 156 CHAPTER 5: Discussion................................................................................................ 158 Personal Comments on Researcher Reflexivity .................................................. 158 Contribution to the Literature ............................................................................. 163 Resistance to healing............................................................................... 164 Experiences of healing ............................................................................ 166 Turning towards .......................................................................... 167 Relationship with self ................................................................. 168 Connection .................................................................................. 168 Advocacy .................................................................................... 170 HEALING AFTER SEX TRAFFICKING vii Definition of healing ............................................................................... 171 Terminology in literature ........................................................................ 172 Clinical Implication ............................................................................................ 174 Strengths and Limitations ................................................................................... 181 Conclusion .......................................................................................................... 185 REFERENCES ............................................................................................................... 188 APPENDIX A: Key Terms and Definitions .................................................................. 198 Human trafficking ............................................................................................... 198 Sex trafficking ..................................................................................................... 198 Sexual exploitation.............................................................................................. 198 Prostitution .......................................................................................................... 198 Exiting ................................................................................................................. 199 Indigenous ........................................................................................................... 199 Childhood sexual abuse ...................................................................................... 199 Grooming ............................................................................................................ 199 Re-trafficking ...................................................................................................... 199 Sex work ............................................................................................................. 200 Trafficker ............................................................................................................ 200 John ..................................................................................................................... 200 Victims and survivors ......................................................................................... 200 APPENDIX B: The Grooming Process ......................................................................... 201 APPENDIX C: The Circle of Courage .......................................................................... 202 APPENDIX D: Three Stages of Trauma Recovery in Psychotherapy .......................... 203 HEALING AFTER SEX TRAFFICKING viii APPENDIX E: Recruitment Poster ............................................................................... 205 APPENDIX F: Phone Interview Script.......................................................................... 206 APPENDIX G: Informed Consent ................................................................................. 209 APPENDIX H Demographic Questionnaire .................................................................. 213 APPENDIX I: Interview Guide ..................................................................................... 214 APPENDIX J: Debrief Script ........................................................................................ 216 APPENDIX K: List of Services for Participants ........................................................... 217 APPENDIX L: Research Member Confidentiality Agreement ..................................... 219 APPENDIX M: Participant Feedback Handout ............................................................. 221 HEALING AFTER SEX TRAFFICKING ix LIST OF TABLES Table 1. Demographics of Participants ............................................................... 40 Table 2. Voices of Resistance ........................................................................... 126 Table 3. Voices of Healing. .............................................................................. 127 HEALING AFTER SEX TRAFFICKING x LIST OF FIGURES Figure 1. Healing Poem, Lindsay. Artwork by Megan Snopek. ......................... 51 Figure 2. Healing Image, Lindsay......................................................................... 59 Figure 3. Healing Poem, Camara. Artwork by Megan Snopek. .......................... 60 Figure 4. Healing image, prayer box, Camara. ..................................................... 69 Figure 5. Healing Poem, Emily. Artwork by Megan Snopek. ............................. 70 Figure 6. Healing Poem, Tracy. Artwork by Megan Snopek. ............................. 79 Figure 7. Healing Mantra Painting, Tracy. ........................................................... 81 Figure 8. Healing image: Fire Goddess, Tracy. .................................................... 82 Figure 9. Healing Poem, Cory. Artwork by Megan Snopek. ............................... 91 Figure 10. Healing Image – Forgiveness, Cory. ................................................... 98 Figure 11. Healing Image, Cory. ........................................................................ 104 Figure 12. Healing Image, Cory. ........................................................................ 104 Figure 13. Healing Image – Journal, Cory. ......................................................... 105 Figure 14. Healing Poem, Charlotte. Artwork by Megan Snopek. .................... 107 Figure 15. Healing image, Charlotte. .................................................................. 116 Figure 16. Healing Poem, Marie. Artwork by Megan Snopek. ......................... 117 HEALING AFTER SEX TRAFFICKING xi ACKNOWLEDGEMENTS To Janelle: thank you for walking alongside this with me and for believing in me from the very beginning, you have shaped who I am as a researcher, clinician, and woman. Thank you for caring about me and encouraging me in my own healing journey and self-discovery that happened along the way. Thank you for allowing me to be human in this process `and for teaching me what it means to truly listen and be changed by what I hear. I am so grateful for all you have done for me. To Jennifer: thank you for encouraging me in this project and for teaching me about your culture and what it means to honour the Indigenous peoples in Canada. Your passion, intelligence, and heart have inspired me and shaped this project. Thank you for believing in me and for all the time and wisdom that you have devoted to this project. To my research team and lab: thank you for walking through this project with me from the very beginning and for all the time you put into this project with me, I could not have done it without you. Each one of you is special to and I have learned so much from you. This project would not be the same without you. Thank you for lending your voices, experiences, and heart to this project. To Katrina: thank you for your consistent support, lending your scholarly intelligence and editing skills, and for dialoguing and dreaming with me during this project. Thank you for being a life long friend, travel partner, and fellow learner. I am so appreciative for how you challenge me to see new perspectives and question my assumptions. I am so honoured to have grown with you for so long and am forever grateful for your support in all parts of this project. HEALING AFTER SEX TRAFFICKING xii To my dad: you have supported all my dreams for as long as I can remember, including this one. Thank you for your continual encouragement and for being gentle, kind, and loving and being an example of a good man. Thank you for the sacrifices that you have made for my education and our family, for encouraging me to see the world, and for giving me life changing advice; I owe you so much and I am proud to be your daughter. To my mom: thank you for the endless cups of tea, prayers, and hugs through this process; you were a safe haven amidst the storm of the last few years. You have shown me what it means to fight for our family, be an amazing mother, and pursue your dreams all at the same time. Thank you for never giving up on me, making me laugh, and loving me so well. I am inspired by the woman that you are. To my support system: thank you for investing in my dreams, my passions, and me in the last few years. Thank you for caffeinating me, listening to me, praying for me, giving me grace, and for reminding me who I was when I felt lost. Thank you for all the adventures and study breaks, for celebrating with me and struggling with me, and for being a bright spot in my day. I am grateful for each of you and could not have done this without your support. To the women in this study: I consider it the highest honour to have met you, learned from you, and to have been entrusted to share this part of your story. You have truly touched me with your bravery, vulnerability, and resilience and this project belongs to us. To the women before this study (J, D, A, and S): I cherish the time we spent together. I am forever grateful that you allowed me to be part of your healing journey so HEALING AFTER SEX TRAFFICKING xiii I could witness the incredible strength and resilience that you each possess. At the beginning of our relationship I thought I would be the one helping and teaching you, and I am thankful that I quickly learned the error of my thinking. You were the ones who taught me invaluable lessons of relationship, life, and healing. You taught me that healing comes in through quiet moments of doing life together: in changing diapers, cooking, dancing, and laughing together. From you I learned the beauty of the hard work in relationships, persevering through miscommunications and challenging moments, and how relationship can transcend countries, cultures, and languages. I am truly honoured to have witnessed your growth and resilience in the time we had together. Your stories inspired this project and have forever shaped me. HEALING AFTER SEX TRAFFICKING 1 CHAPTER 1: INTRODUCTION “I want to tell other survivors that they can all join in the fight against human trafficking if they don’t stay silent…We all deserve a life of dignity and respect. We are not merchandise, or anyone’s property. To everyone hearing my voice, I survived, and you will survive. The world is waiting for us to explore and make a difference.” –Luidel*, program participant at Deborah’s Gate (2018) Sex trafficking is a gross human rights violation that targets women and children and uses their bodies to satisfy the predominantly male demand for paid sex (ILO, 2014; O’Connor & Healy, 2006). While some Canadians believe sex trafficking is a distant, international problem, 600-800 women are trafficked within Canada for sexual exploitation every year (RCMP, 2014). Young females who are poor, have experienced abuse, or have tumultuous home environments, are especially susceptible to be recruited for sex trafficking in Canada (Bingham, Leo, Zhang, Montaner, & Shannon, 2014). Within Canada this is a growing issue that impacts Indigenous (i.e. First Nations, Métis, Inuit and Non-status Indians in Canada) women in particular, as they make up approximately 2% of Canadian population (Native Women’s Association of Canada, 2014), and yet represent approximately half of women who are trafficked for sex in Canada (Farley & Lynne, 2008). This high representation is largely due to this population being more likely to have the aforementioned risk factors as a result of the impacts of colonization on Indigenous peoples(The Native Women's Association of Canada, 2014). Survivors of sex trafficking are left with severe psychological, physical, and relational scars due to the nature and duration of trauma they have faced, complicating their journey to healing (Hossain, Zimmerman, Abas, Light & Watts, 2010 Zimmerman, Hossain & Watts, 2011; Conteras et al., 2017). Survivors often face challenging mental health problems. For example, HEALING AFTER SEX TRAFFICKING 2 one study conducted with female survivors of sex trafficking (N = 204) found that 77% of women met criteria for PTSD, 55% met criteria for high levels of depression, and 48% met criteria for anxiety (Hossain et al., 2010). Survivors are also left dealing with substance addictions, physical injuries and poverty (Canadian Women’s Foundation, 2014; RCMP, 2014). The psychological consequences are often the most challenging to overcome (Zimmerman, et al., 2011), as survivors are left feeling disempowered and disconnected from themselves and others (Herman, 1992; Van der Kolk, 2014). Previous research on sex trafficking has largely focused on survivors in other countries other than Canada, factors that have helped survivors exit, and on recovery from mental health diagnoses (Hickle, 2017; Hossain et al., 2010; Sari & Khairunnisa, 2014). Past research investigating women’s experiences after exiting sex trafficking have predominantly focused on symptom reduction and coping abilities as indicators of their psychological or physical process, but these do not adequately address what these women are experiencing on an emotional, spiritual, or relational level (Egnew, 2005; Conteras et al., 2017). In this study, the term healing will be used as a holistic framework for understanding the process of becoming whole in order to embrace the “intensely personal, [and] subjective experience” that each survivor has experienced in her journey to healing (Egnew, 2005, p. 255). In order to acknowledge the Indigenous voices represented in this population and Canada’s colonial history, the framework adopted in this study has been informed by Indigenous approaches to healing, which value subjective and diverse perspectives and experiences of individuals, and conceptualize healing as a holistic process (Levine, 1997; Stanley, 2016). This study aimed to bring the oppressed voices of sexually exploited women to the forefront of counselling psychology research and contribute perspective on their experiences of HEALING AFTER SEX TRAFFICKING 3 healing after sex trafficking in Canada. This study operated out of a constructivist paradigm (Morrow, 2005) and used a feminist theoretical framework with a relational focus through the method of listening guide (Brown & Gilligan, 1992) in order to contribute victim-informed research, driven by participants’ narratives of their internalized experiences of healing. As the listening guide encourages the researcher bringing her subjective experiences and person to the research I will be using “I” throughout this thesis to show specifically how I have been touched by the research or interpretations that I have brought. I will use the pronoun “we” when I am referring to the collective conclusions and interpretations that the research team came to together. The research team and I encountered seven women who survived sex trafficking in Canada and sought to answer the following question: What are the stories of strength, healing, and resilience of women who have been sex trafficked, and what voices are present in their stories? The emphasis of this study was to hear from survivor’s themselves after they have been left voiceless and powerless for far too long. We immersed ourselves in their stories and allowed their narratives of both oppression and healing to touch us deeply and extract themes and voices from each woman’s story. We wrestled alongside the participants as they shared their confusion, doubt, shame, and desire to shut out the world after what they had experienced. We were deeply touched by each woman’s resilience as she fought to survive through unimaginable trauma. Not only did each woman in this story survive through indescribable evils but also, they are on a path of healing where they are fighting to live a life beyond mere survival, and we are privileged to meet them in their journeys. HEALING AFTER SEX TRAFFICKING 4 CHAPTER 2: REVIEW OF THE LITERATURE The purpose of this study is hearing the experiences of healing from female survivors of sex trafficking in Canada. Within the literature on the sex-trade there are a number of variations between terms, and sexual exploitation, sex trafficking, and prostitution are sometimes used interchangeably (Gerassi, 2015). Sex trafficking is defined as “forcing, deceiving, or coercing a person to perform a commercial sex act” (A21, 2018), and is distinguished from sexual exploitation in that sexual exploitation only refers to victims being under 18 years of age (Criminal Code, 2017). This can often take the appearance of prostitution, which is the act of exchanging sexual acts for payment (RCMP, 2014). There is sometimes difficulty in determining who is a victim of sex-trafficking and exploitation, and women who are working in the sex trade either by free-will, or out of desperation and lack of options (Canadian Women’s Foundation, 2014). Not all people who engage in prostitution are victims of human trafficking; however, all people who are trafficked for sex are considered forced into prostitution (RCMP, 2014). For additional key terms and definitions see Appendix A. This chapter further expands on literature surrounding the consequences of sex trafficking for survivors. This section also provides an overview of literature on healing, provides a working definition for healing, and explains a rationale for the framework of healing that guides this study. A critique on the relevant literature related to healing after sexual abuse, exploitation and trafficking, particularly related to recovery, resilience, and growth will conclude this chapter. Throughout this thesis, special consideration is given to the Indigenous women who are disproportionately represented as victims of sex trafficking in Canada. HEALING AFTER SEX TRAFFICKING 5 Sex Trafficking in Canada Human trafficking is one of the most profitable industries in the world, and currently there are an estimated 21 million people currently enslaved through trafficking (ILO, 2014), many of who are forced to work in prostitution. Human trafficking is the “fastest growing criminal trade” with estimates of generating over $150 billion American dollars annually (A21, 2018). Sex trafficking is one of the main forms of human trafficking globally and is the most prevalent form of human trafficking in Canada (RCMP, 2014). Sex trafficking is often presented as an international issue, however Canadians are not unaffected by this crime: 94% of sextrafficking cases from Canada occur exclusively within Canadian borders, with no international cross-border movements (RCMP, 2014; Grant, 2016). Contrary to popular belief, the defining feature of sex trafficking is not travel and migration of victims, but the control and coercion that victims are subject to (Canadian Women’s Foundation, 2014). Prevalence. It is difficult to estimate the prevalence of human trafficking for the purposes of sexual exploitation as many victims do not come forward with their experiences to the police, and many remain enslaved and unable to escape. Globally, 98% of victims of sex trafficking are female and thus far all identified victims in Canada have been female (Canadian Women’s Foundation, 2014). The RCMP estimates that 600-800 women are trafficked for sexual purposes in Canada a year, though in 2014 only 206 human trafficking cases were actually reported (A New Day Youth and Adult, 2017). Identified victims in Canadian domestic sex trafficking cases have an average age range between 14 and 22 years of age, with victims as young as 13 having been identified (RCMP, 2014). Victims being improperly identified and the challenges that they face in reporting their victimization can explain the discrepancy between the estimates. These challenges include a lengthy, and at times re-traumatizing process of reporting, HEALING AFTER SEX TRAFFICKING 6 the fear of being disbelieved and being associated with criminal behaviour, as well as the stigma associated with sexual exploitation and prostitution (Hossain et al., 2010; Tomura, 2009) Recruitment. Traffickers will target vulnerable girls who often share similar risk factors, including being a female, young age, poverty, lack of education, being socially or culturally excluded, desire for a better life, family dysfunction and migration (Native Women’s Association in Canada, 2014). Additional risk factors include being in the foster care system and previous abuse (Bingham, et al., 2014). Girls who do not have strong support systems, secure financial situations, or high self-efficacy are seen as having levels of controllability and are more likely to end up being recruited by traffickers (Litam, 2017). Common stories of women trafficked across Canada include being lured by false promises or jobs, or being offered a safe home (Canadian Women’s Foundation, 2014). Other experiences of recruitment happened through a process commonly referred to as grooming where girls thought their trafficker was their boyfriend and were showered in gifts and affection (See Appendix B for further explanation). Traffickers gradually create dependence in victims through tactics of inveigling, isolation, manipulation, and disempowerment (Herman, 1992; O’Connor & Healy, 2006). While these are the prevalent reported experiences of recruitment Canada, they are not all encompassing or prescriptive of all women’s experiences of sex trafficking in Canada. Indigenous women as victims. Indigenous women represent approximately 2% of the Canadian population, yet studies have found that more than half the women who are victims of sex trafficking in Canada are Indigenous (Farley & Lynne, 2008; Native Women’s Association of Canada, 2014). Farley and Lynne (2008) found that 70% of the women working in the sex trade on Vancouver’s Downtown Eastside were Indigenous. HEALING AFTER SEX TRAFFICKING 7 Indigenous history of exploitation. Indigenous peoples have a long history of suffering racism and abuse as a result of Canada’s colonial history, and the impacts of this trauma has carried forward into the current Indigenous population, which helps explain the overrepresentation of Indigenous women as victims today (Native Women’s Foundation, 2014). Between 1874 and 1996 Indigenous children were forcefully removed from their parents’ homes and communities, and put into residential school systems where they were punished, often to the point of physical abuse, in order to exterminate all Indigenous cultural practices, language, religion and values (Haig-Brown, 1988). Additionally, many Indigenous children were sexually exploited by residential school staff and clergy (First Nations and Indigenous Studies, 2009). Children suffered the loss of positive parental role models from their communities, which were replaced by the parenting models within the residential school system, who were often authoritative and abusive (McEvoy & Daniluk, 1995). Survivors from the residential schools were severely impacted by the abuse that occurred, and their experiences influenced how they viewed abuse, community, and culture, contributing to the breakdown of the extended family, and a high prevalence of childhood sexual abuse (McEvoy & Daniluk, 1995). As children were moved back into their communities and stories of abuse surfaced, the government began to place them into the foster care system with non-Indigenous families, commonly referred to as the “Sixties Scoop”. Due to the fear of apprehension, suspected sexual abuse was not always reported, keeping the abuse shrouded in secrecy, and carrying the cycle of abuse into future generations (Bopp & Bopp, 1997; McEvoy & Daniluk, 1995). It is due to these experiences that Indigenous women are more likely than non-Indigenous women to have experienced previous abuse or been taken into the foster care system, which are major risk factors for recruitment (Bingham et al., 2014; Grant, 2016). This brief history of Indigenous exploitation also helps HEALING AFTER SEX TRAFFICKING 8 explain the high proportion of Indigenous women that are represented in the sex trade in Canada, as they are also vulnerable to the other aforementioned risk factors of trafficking. Systemic contributions to sex trafficking in Canada. Male demand for sex and a supply of women and children is said to be the root cause of prostitution and trafficking (O’Connor & Healy, 2006). Gender inequality, racism, poverty, migration and lack of economic stability for women are also said to be additional factors that drive women into the sex industry (O’Connor & Healy, 2006). One survivor of sex trafficking shared how “the system keeps women just treading above water”, and that prostitution is a solution to poverty (Canadian Women’s Foundation, 2014, p. 94). Even after women are no longer forced into prostitution, they often have few job skills or connections to work that will allow them to exit. The lack of support for women trying to exit also keeps them in prostitution, which is a systemic problem related to government structures, and mental health facilities (Canadian Women’s Foundation, 2014). Criminalization laws on prostitution can also contribute to sexual exploitation, however, go beyond the scope of this paper. Impacts of Sex Trafficking Victims of sex trafficking often experience intentional abuse, violence and torture, and are traumatized on extreme physical, mental and emotional levels (Native Women’s Association, 2014). Many survivors will battle their various symptoms to the point of struggling to reintegrate back into the community, leaving them to be at risk for re-trafficking (IOM, 2010; Hossain et al., 2010). Based on the prevalent experiences of survivors, it is assumed that based on the commonly used definition of trauma as “exposure to actual or threatened death, serious injury, or sexual violation” (American Psychiatric Association, 2013, p. 271) that victims have experienced trauma as a result of being trafficked. This section critiques literature on the HEALING AFTER SEX TRAFFICKING 9 consequences that survivors of sex trafficking experience on the psychological, physical, relational, and systemic levels. Psychological consequences. The psychological consequences are some of the more challenging difficulties that survivors face after exiting (Zimmerman et al., 2011). Mental health issues such as posttraumatic stress disorder (PTSD), depression, and anxiety have been linked to female survivors of sex trafficking (Farley, 2004; Hossain et al., 2010; Zimmerman et al., 2011). Farley (2004) conducted a study on trafficking and prostitution in nine countries and found that female survivors of sex trafficking had a 68% (n = 562) rate of PTSD. Another quantitative study surveyed sex trafficking survivors across a number of countries (N = 204) and found that 77% of women met criteria for PTSD, 55% met criteria for high levels of depression, and 48% met criteria for anxiety (Hossain et al., 2010). A significant relationship between survivors reporting injuries from trafficking and PTSD, anxiety and depression has been found (Hossain et al., 2010). Time spent in the trafficking situation was also connected to more sustained feelings of hopelessness, humiliation and entrapment, which have been linked to a higher rate of mental health disorders (Hossain et al., 2010). The studies conducted by Hossain et al. (2010) and Zimmerman et al. (2011) provide crucial information about mental health symptoms for survivors of sex trafficking, however like many studies in this area, did not include non-clinical outcomes such as relational or spiritual well-being. Research that focuses on non-clinical outcomes would challenge the traditional value that research has placed on studying medically measurable symptoms and would be more congruent with feminist principles in conducting research on marginalized populations (HesseBiber, 2012). As these studies did not examine services, resources, or relationships that may have helped survivors overcome the psychological consequences that the other survivors still HEALING AFTER SEX TRAFFICKING 10 endured, it is still unknown how some women either avoided or overcame the psychological consequences that others suffered. Further research with survivors is needed to provide understanding on what experiences helped facilitate their healing from the psychological consequences of trafficking. Additionally, one of the less visible draw backs to using exclusively clinical outcome variables with this population is that prolonged exposure to relational and sexual trauma at developmentally vulnerable times, many survivors may experience complex stress disorders such as complex post traumatic stress disorder (PTSD) (Courtois & Ford, 2009; Herman, 1992). However, complex PTSD is not a formally recognized diagnosis in the Diagnostic Statistical Manual of Disorders (DSM-5), so some survivors may experience more complex mental health diagnoses than are present in the DSM-5, and research with only DSM-informed clinical measures may not sufficiently capture the complexity of the psychological impacts survivors endure (Van der Kolk, 2014). Intrapersonal consequences. Survivors often encounter intrapersonal issues such as self-blame, low self-worth and shame as a result of their experiences being trafficked (Conteras et al., 2017). Shame is a common reaction to rape and other sexual trauma, and a reaction to the helplessness that was felt by the violation that survivors have experienced (Herman, 1992). Shame is also linked to sex-work due to the stigma that is associated with it being internalized by sex workers (Tomura, 2009). Survivors are also faced with the stigma associated with sharing what has happened to them with their families and communities (Hossain et al., 2010). The feelings of helplessness that victims experience have been connected to guilt, self-criticism and self-blame in survivors of sexual trauma as a way to gain a sense of control of the situation and move forward (Herman, 1992; Kaye-Tzadok & Davidson-Arad, 2016; Van der Kolk, 2014). HEALING AFTER SEX TRAFFICKING 11 Some survivors of sex trafficking may experience so much chronic trauma that their personality may be changed irrevocably (Herman, 1992). Survivors of sex trafficking have been through so much psychological trauma that they may “lose the sense that she has any self at all” and be unable to connect to their identity and who they were before the trauma (Herman, 1992, p. 86). The trauma survivors of sex trafficking endure can also be damaging to their identity formation and development (Van der Kolk, 2014). There is limited research where survivors of sex trafficking speak of the impacts of sex trafficking on their identity and relationship with their self, therefore, more work needs to be done in understanding these experiences for survivors. Physical consequences. Survivors of chronic trauma such as sex trafficking may feel as if their bodies have turned against them as they experience highly intrusive symptoms even after they are no longer in danger including nightmares, hypervigilance, and a number of somatic symptoms and ailments (Herman, 1992). Dissociation, or disconnecting from one’s emotional reality is a survival strategy for women who are forced into prostitution (O’Connor & Healy, 2006), however, survivors may still feel unable to connect to their bodies even after they are no longer being exploited (Herman, 1992; Van der Kolk, 2014). While being exploited access to health care is rare, and only in the event of serious injury or illness preventing victims from providing services; when victims gain access to health care it may be at the hands of poorly qualified or untrained individuals (Zimmerman et al., 2011). Over half of victims reported sustaining physical injuries due to their trafficking experiences, and over two-thirds reported sexual assault (Williamson, Dutch & Clawson 2008; Zimmerman et al., 2011). Chronic headaches, stomach pain, back pain, loss of appetite, and tooth pain were found among many survivors, with the intensity and duration of headaches correlating to the length of time spent exploited (Oram, Stöckl, Busza, Howard, & Zimmerman, 2012). The impact of sex trafficking HEALING AFTER SEX TRAFFICKING 12 on survivors’ bodies is extreme, and the consequences can impact survivors for their entire lives, including sexually transmitted diseases, sexual disorders, and permanent injuries (RCMP, 2014). One study reported that tuberculosis is highly prevalent among sex trafficking victims and 88% of those with tuberculosis were co-infected with HIV (Simkhada et al., 2018). HIV prevalence was found to be relatively high in women who had been sexually exploited, where in one study 45.8% of women were HIV positive (Dharmadhikari, Gupta, Decker, Raj, & Silverman, 2009), and other studies reported 65.5% of sex trafficking victims reported symptoms of a sexually transmitted infection (Decker, McCauley, Phuengsamran, Janyam, & Silverman, 2011). Other physical health problems included pelvic pain, gynecological infections, lesions or warts, unwanted pregnancies and abortions (Simkhada et al., 2018). The physical consequences of sex trafficking to the body are also so intense that trafficked women die younger and have a higher prevalence of autoimmune diseases and chronic illnesses (Canadian Women’s Foundation, 2014). While there has yet to be a study specifically on sex trafficking survivors and chronic illnesses and disabilities, other research has affirmed a positive relationship between childhood maltreatment or sexual violence and physical disabilities (O’Sullivan, Watts, & Shenk, 2018; Subica, 2013). Substance use. There are a number of ways in which survivors of sex trafficking become addicted to substances: women may use substances in order to survive and numb the pain of sex work (O’Connor & Healy, 2006; Gerassi, 2015), or substances may be used as a method of control and intimidation (Gerassi, 2015). Even after they are no longer being exploited, some are left with substance addictions (O’Connor & Healy, 2006). One survey of women who were victims of sex trafficking found that 100% of the women who did not use substances before HEALING AFTER SEX TRAFFICKING 13 being trafficked ended up abusing substances while they were being trafficked (Native Women’s Association of Canada, 2013). Relational consequences. Chronically traumatized people, as in the case of sex trafficking victims may suffer a sense of alienation and abandonment from others (Herman, 1992). Traumatic events such as forced sexual encounters can leave survivors feeling doubt about themselves and others, and others’ intentions in being in relationship with them, and destroy the idea that one can be separate in relation to others (Herman, 1992; Van Der Kolk, 2014). Survivors report difficulties in their relationships and high amounts of mistrust and face the dilemma of both needing relationships and being terrified of them (Conteras et al., 2017; Van der Kolk, 2014). This is especially important to work through, as lack of social support is connected to symptom severity for survivors of sex trafficking (Hossain et al., 2010). One survivor shared her experiences: “most people don’t know how hard I judge them because I don’t say anything. All I do is cross them off the list. Forever. These men had their chance to help me and they didn’t respond” (Herman, 1992, p. 92-93). Given the relationship between social support, symptom severity, and the mistrust that survivors feel in relationships, more needs to be known in how survivors can work through these experiences. Systemic consequences. Survivors of sex trafficking face a number of barriers in their journey towards healing such as the stress of being involved in criminal proceedings, asylum seeking, and immigration procedures (Hossain et al., 2010). For those who testify against their perpetrators, the criminal justice system is a lengthy process, and can be re-traumatizing for victims. Survivors need economic stability and a steady income in order to begin to rebuild their lives, yet may lack life skills, education, and job skills training, as they may have never had a legal job before or have finished high school (Canadian Women’s Foundation, 2014). Women HEALING AFTER SEX TRAFFICKING 14 who exit due to pregnancy or motherhood also face the additional challenges of raising children while struggling with all the consequences of their trauma. Lack of services for women including counselling, lack of space in substance treatments, and stable housing are huge barriers for women as they exit, creating a higher risk for re-entry into the sex trade (Canadian Women’s Foundation, 2014). Resiliency in the Exiting Process Previous studies have focused on the resiliency of women who have successfully exited the sex trade after being forced into prostitution, and how they were able to exit despite the barriers that were presented to them (Cecchet & Thoburn, 2014; Hickle, 2017; Sari & Khairunnisa, 2014). Cecchet and Thoburn (2014) used narrative interviewing with six women who had been trafficked for sex in the USA and assessed factors that influenced them as survivors and how they were able to reintegrate back into their communities. They found that pregnancy and mental health issues were the main motivations for women to exit, and that processing their trauma through the mental health system was especially helpful in their ability to reintegrate into society after exiting (Cecchet & Thoburn, 2014). A positive mindset, a naturally resilient personality, and a desire to live were also found to influence the women’s resiliency in exiting (Cecchet & Thoburn, 2014). This study has given a foundation of understanding the factors associated with successful exiting and reintegration process after being trafficked in North America. This research addressed reintegration on a macro level; therefore, further research is needed in understanding the experiences of survivors of sex trafficking healing beyond reintegration, focused on intrapersonal and psychological healing. In Canada, near death experiences have also been found to give women the strength and motivation to exit (Native Women’s Association of Canada, 2014). Hickle (2017) conducted a HEALING AFTER SEX TRAFFICKING 15 qualitative study with 19 women who were formerly involved in the sex trade and found that three main factors facilitated the participants’ resiliency in exiting: connections, resources, and personal growth. The women’s ability to exit were largely based on having support services and resources available to them, and then their ability to utilize those resources, which led to them feeling empowered and resilient (Hickle, 2017). It is suggested in the research reviewed that the accessibility of services is important for women trying to exit, however, it is unknown if the resiliency that the women possessed that motivated their exit also contributed to their journey of healing after the exiting process, thus, further research is needed about women’s experiences following the time after exiting to understand what impacts women’s journey to healing. Sari and Khairunnisa (2014) conducted research in Indonesia on the resiliency of women ages 16-18 after exiting sex trafficking and found that external support was the most important factor in their resiliency long-term. This study emphasizes the importance of external support for survivors’ success after exiting, however, these findings may not be reflective of longer term healing that survivors experience as it was conducted within one year of participant’s exiting. It also may not be reflective of the healing experiences of sex trafficking survivors in Canada. Healing This section will explore literature related to Western and Indigenous frameworks for healing and provide a rationale for the framework of healing used to guide the present study. Western framework for healing. The term healing is used in a number of disciplines and in reference to a variety of subjects, including physical, emotional, or relational wounds. Heal means to make whole, which stems from the root haelan, which is the condition or state of being hal, or whole (Egnew, 2005). Hal is also the root for holy, or spiritual purity (Egnew, 2005). Western ideologies of healing tend to focus on the use of counselling and medicine and HEALING AFTER SEX TRAFFICKING 16 on curing diseases and alleviating symptoms, and conceptualize healing as needing to occur in either the mind or the body (Egnew, 2005; Moodley, Sutherland, & Oulanova, 2008). The term healing is perhaps more straightforwardly operationalized in the physical realm of bodily wounds or symptoms, however, its meaning is less clear when applied to emotional, psychological, relational or sexual trauma. In the process of reviewing the literature on healing, it was found that recovery is often used in conjunction and synonymously with healing. Recovery has often been used in reference to substance addictions or physical wounds and is defined as “the act of combatting a disorder (e.g. alcoholism) or a real or perceived problem” (Recovery, n.d.). Healing is “an intensely personal, subjective experience” (Egnew, 2005, p. 255) and so by reducing healing to a remission of symptoms the felt meaning of the word to the individual is neglected. Feminist perspective would also critique this way of conceptualizing healing and challenge this restrictive framework to understand marginalized women’s experiences (Hesse-Biber, 2012). Women have needed to suppress their emotions at times in order to conform to societal expectations and be in relationship with the world (Gilligan, 2015), however, this study values the subjective and emotion-laden experiences of women, and aims to provide a platform for these to be seen and understood. The consequences of sex trafficking are not limited to the mind or body, therefore a framework that acknowledges the complexity and breadth of impact on survivors is necessary to also capture their journey of healing. While recovery and healing are not mutually exclusive, the term healing has been chosen in an attempt to move beyond conceptualizing healing by medical outcomes, and to focus on the process of personal wholeness that is central to this study (Egnew, 2005; Kwee, 2011). HEALING AFTER SEX TRAFFICKING 17 Indigenous framework for healing. Ideologies of healing which encompass the whole person are inherent to most traditional Indigenous frameworks. Indigenous frameworks for healing value subjective experiences of the individuals, the development of knowledge through the community, shared lived experiences, and value diverse perspectives rather than conformity (Levine, 1997; Stanley, 2016). The Medicine Wheel is an Indigenous model of wellness that is used across a variety of nations, which identifies the importance of wellness, connection and equality between the spiritual, mental, emotional, and physical parts of the self for a person to experience healing (Malone, 2007). Within the Indigenous framework, healing has been understood to happen through restoring the emotional balance within the individual and between the individual and her environment (Moodley et al., 2008). Historically, healing came through traditional ceremonies that had a relational and spiritual context, such as circular group dances, creating a community monument, or singing songs of healing as these practices emphasized the interconnectedness between the individual, the community and the world (McWhirter & Robbins, 2014). Community members who spoke of healing from abuse discussed the importance of having healthy positive relationships with their self, their Indigenous identity, spirituality, culture, and community (McWhirter & Robbins, 2014). The Circle of Courage is a model of Indigenous values of wellness, resilience, and strength that emphasizes how belonging, mastery, independence, and generosity are vital needs for cultivating courageous children and youths in the Indigenous community (see Appendix C) (Brendtro, Brokenleg, & Van Bockern, 2005). The first value of belonging, not only in the nuclear family, but also in the tribe and community promotes cultural wellness and health for the individual. Secondly, the value of mastery is developed through listening and learning and is based on the belief that humans innately desire HEALING AFTER SEX TRAFFICKING 18 to succeed and solve problems. Thirdly, the value of independence is cultivated in children through adults giving them free will and opportunities to exercise their agency. Lastly, the value of generosity is understood as learning to contribute to the world and having purpose (Brendtro et al., 2005). The Circle emphasizes a strengths based view of enhancing children’s development, which counters western approaches and encourages a shift towards a more holistic and positive mindset when working with troubled children and individuals (Brendtro et al., 2005). Rationale for healing framework. In addition to the incomplete conceptualizations of healing in Western ideology outlined above, this project has used an Indigenous understanding of healing as a holistic process in order to provide a culturally relevant framework for understanding Indigenous participants from their cultural perspective. I found this framework an appropriate fit for the population of the study as due to the holistic nature of the framework, it is still able to capture participants’ experiences who do not identify with an Indigenous framework of healing and who may conceptualize their healing in a more Western framework. One survivor’s experiences also informed this decision as she explained, “it’s hard to have a healthy sexual relationship…I am trying to learn how to be whole again - to connect my body with my brain and my soul” (Canadian Women’s Foundation, 2014). This survivor’s experience speaks to the fragmentation between body, brain, and soul that is mentioned as consequences of sex trafficking (Van der Kolk, 2014). This woman’s experiences provide further indication that healing for this population needs to be understood as a process of wholeness, and reintegrating all the aspects of the self back together. Additionally, the circle of courage is used as a model for raising courageous and healthy children, however, given that the target age of victims is during childhood, and largely robs victims of belonging, mastery, independence, and generosity, this HEALING AFTER SEX TRAFFICKING 19 model was deemed an appropriate tool to create a foundation for understanding healing in this project. This study will be adopting a feminist framework which aims to challenge traditional knowledge claims (Hesse-Biber, 2012), and therefore, a framework for healing that has space for a wide variety of experiences that lead to an individual’s process of wholeness is appropriate. Terms such as growth and posttraumatic growth are also used to describe experiences akin to healing or recovery. While it is reasonable to expect many women do experience growth and change after enduring the impacts of being trafficked for exploitation, this study did not want to put the expectation on survivors of trafficking to have experienced the positive psychological change that Tedeschi & Calhoun define as posttraumatic growth (1995). Additionally, I decided against researching resilience in survivors of trafficking, as is defined by the American Psychiatric Association as the “process of adapting well in the face of adversity, trauma, tragedy, threats, or even significant source of threat …‘bouncing back’ from difficult experiences” (2013). I believe that all women who have survived the experience of being trafficked for sexual exploitation are resilient, however, it is the researcher’s belief that this definition aligns closer to coping. Consequently, the term healing will be used in this study to better capture the experiences of women and avoid reducing the diversity of their experiences. This study recognizes that survivors’ processes of healing may be encompassing of other terminology mentioned, and therefore cautiously provides this framework as a foundation to capture, and not restrict, understanding of participants’ experiences of healing after sex trafficking. Healing for Survivors of Sex Trafficking There is limited research on specific interventions and treatments for survivors of sex trafficking, and clinicians often borrow from the literature on PTSD and survivors of slavery, captivity and other chronic sexual abuse in order to treat survivors (Litam, 2017; Williamson, HEALING AFTER SEX TRAFFICKING 20 Dutch, & Clawson, 2010). Macy and Johns (2011) reviewed literature related to aftercare treatment and models for survivors of trafficking, and noted that current literature is limited by either only addressing the needs of survivors, or focusing specifically on one aspect of aftercare, creating a gap in providing a more holistic picture of survivors’ needs and implementation of services. At the outset, survivors need practical resources that meet their basic needs before they are able to work through the devastating long term consequences of trafficking (Johnson, 2012; Williamson, et al., 2010), and require trauma specific services over long periods of time to experience healing (Hossain et al., 2010; Johnson, 2012; Williamson et al., 2010). Further, in order to prevent the high level of revictimization that occurs in survivors of sex trafficking, it is important that they have access to trauma services specific that target holistic healing on top of trauma informed services that meet their practical needs (Williamson et al., 2010; Johnson, 2012). Trauma informed practice is meant to build capacity in clients and address their primary problems, while acknowledging and understanding how their trauma is impacting their current experiences and situations (Williamson et al., 2008). Trauma informed care for survivors of trafficking includes making safety a priority, addressing co-occurring problems, using an empowerment and strengths based framework to highlight survivors’ resiliency; maximizing survivors’ autonomy and choices in their recovery process; minimizing chance of retraumatization, and focusing on trust and rapport building between survivors and service providers (Macy & Johns, 2011). When providing trauma-informed care, it is important to ask survivors their preference in receiving mental and physical health services, and provide culturally relevant options as typical western counselling may not be preferred by other cultures (Macy & Johns, 2011). HEALING AFTER SEX TRAFFICKING 21 Hom and Woods (2013) conducted qualitative interviews with front-line service providers for survivors of sex trafficking on the aftermath and recovery process of survivors. Participants spoke of survivors’ struggles with PTSD, depression, and dissociation as the most prevalent mental health concerns. Participants shared their experiences of witnessing survivors’ struggles with self-worth and identity, and their ability to trust people since exiting. The initial outreach to women still entrenched in the sex industry was a paramount step in their recovery journey, as this began a long-term relationship with women where trust and care was established. Service providers emphasized that the recovery process should be individually tailored, strengths focused, culturally appropriate, and not time limited. All of the service providers interviewed emphasized the importance of utilizing a holistic approach to meet survivors’ spiritual, psychological, physical, mental, and vocational needs. While this research is informative and provides helpful perspectives from service providers who work directly with survivors of sex trafficking, hearing from the survivors themselves would add more depth and accuracy to the results, and add more voice centred research to the field from the unique perspectives of survivors who have already been silenced in so many ways. Healing process in psychotherapy. Trauma specific services involve longer-term treatment for the consequences of sex trafficking, especially the psychological and interpersonal consequences. Psychotherapy for survivors of sex trafficking can be a place where survivors rebuild a basic sense of trust in others, and work through the shame surrounding the experiences related to trafficking (Conteras et al., 2017). Suggested treatment models have included cognitive behavioural therapy, exposure therapy, eye movement desensitization and reprocessing therapies (Williamson et al., 2010). However, these treatments have not been empirically validated with survivors of sex trafficking, but have been suggested due to the amount of HEALING AFTER SEX TRAFFICKING 22 empirical evidence of the efficacy in treating PTSD with other populations. Conteras and colleagues (2017) argue that therapists should place an emphasis on the relational and trust issues that survivors have, rather than taking a behavioural, symptom reduction approach suggested by Clawson and Dutch (2008). More relationship based psychotherapy with survivors of sex trafficking can help survivors develop a more textured narrative, where they can understand the impacts of sex trafficking on their self and develop more self-compassion (Conteras et al., 2017). Kwee (2011), also describes how healing in psychotherapy is not about curing and symptom reduction, but about caring, where the “survivor’s wound is seen, heard, believed, and cared for” (p. 290). Herman (1992) provides a framework for trauma-specific psychotherapy that could be used to work through some of the relational and trust issues that survivors may experience, that can be found in Appendix D. Other treatment approaches have been developed for complex trauma such as using group therapy for affect regulation, resiliency building and interpersonal connections, and have found that the use of peer support groups has been helpful in building healthy relationships and establish social support (Cook et al., 2005). Having peer support, counselling, or other services provided by another survivor further along in their healing has been found to be beneficial for survivors of sex trafficking in combatting shame and providing hope for healing (Clawson & Dutch, 2008; The Native Women’s Association, 2014). The research reviewed is focused on organized formal healing through services facilitated by professionals, and consequentially leaves the reader questioning how healing occurs outside of the conventional systems for survivors of sex trafficking. Feminist perspectives hold that that social reality is overly focused on the “public sphere” of society, rather than the informal, supportive, and local structures that women engage in more frequently (Hesse-Biber, 2012), therefore research that is able to capture HEALING AFTER SEX TRAFFICKING 23 and explore experiences of healing outside of the public sphere is crucial to understanding survivors’ journey to healing. Additional healing factors. Within the literature of sexual abuse, exploitation, and trafficking, terms such as resilience, growth, and recovery are used alongside healing to research the process of survivors moving beyond their trauma. Despite the numerous consequences sex trafficking victims endure, research has shown that it is possible for those who have experienced sexual and relational trauma to experience healing and even growth from their experiences through a variety of means (Tedeschi, 1999). Survivors of sex trafficking experience deep traumas on physical, relational, and psychological levels, similar to those who have survived childhood sexual abuse, relational violence, or sexual assault (Herman, 1992). Within these populations, researchers have found that survivors were able to experience growth from their traumas by sharing their stories in order to create and promote justice (Tedeschi, 1999) and to connect with one another (McEvoy & Daniluk, 1995). Through finding meaning in their suffering, survivors were able to move forward from their past (Hall et al., 2009). One study on survivors of childhood sexual abuse found that survivors experienced growth by creating meaning out of their victimization by viewing it as a protective factor for others, such as being abused in the place of their younger siblings as part of their healing (Kaye-Tzadok & Davidson-Arad, 2016). The use of cognitive strategies was also linked to growth after trauma, where survivors focused on factors they could control to ensure their safety in the future (Kaye-Tzadok & Davidson-Arad, 2016). This study demonstrates the importance of empowering survivors to create meaning out of their experiences and help them focus on what they control to facilitate healing and growth. As this is a quantitative study, the results were limited to factors that were provided by the researchers in the HEALING AFTER SEX TRAFFICKING 24 questionnaires, leaving a gap in understanding the healing journey from participant’s perspectives. Further research is needed that creates a space for participants to share their unique experiences of healing and growth, and gives a platform for these typically silenced voices to heard in the research. Experiences of healing for Indigenous survivors. Researchers have found that Indigenous survivors of maltreatment were more likely to identify with metaphors of resilience as a journey and a long-term process rather than a single moment of “bouncing back” (Isaak, Stewart, & Mota, 2015). Indigenous peoples who experienced healing after various abuse and maltreatment found three major themes to be important in their healing journeys: making a conscious decision to set themselves on a new path (e.g. through seeking treatment), reconnecting with their culture and traditional teachings, and forgiving their abusers and acknowledging their emotional pain (Isaak et al., 2015). One study on Indigenous women survivors of childhood sexual abuse found six major themes within participants’ stories including “a sense of shame and guilt; sense of acute vulnerability; sense of internal fragmentation; sense of invalidation and cultural shame; need to make sense of the abuse, and an experience of reintegration” (McEvoy & Daniluk, 1995, p. 225). Another important factor for participants was participating in groups with other Indigenous women who had also experienced childhood sexual abuse, as they had a shared sense of understanding and belonging (McEvoy & Daniluk, 1995). This study guides understanding of Indigenous women’s unique experiences of childhood sexual abuse, however, the experience of sex trafficking is distinct in many important ways from childhood sexual abuse and research is needed to understand how women survivors of sex trafficking make sense of their abuse and reintegrate into their communities. HEALING AFTER SEX TRAFFICKING 25 Rationale, Purpose, and Research Question of the Present Study Sex trafficking exploits and oppresses women, leaving them with long-term consequences based on their victimization. Little is known about these women’s experiences after their initial exit from sex trafficking and how they experience healing in the time after they have exited. Previous research and treatment models for survivors of sex trafficking have appropriately adopted trauma-informed and substance addictions approaches, but Indigenous and feminist perspectives would argue these approaches do not adequately address the complexity of issues that impact this population required for healing (Conteras et al., 2017). The majority of existing research about survivors’ healing process is focused on organized and formal services, and so more research is needed on the impact of unconventional and informal experiences that also contribute to women’s healing journeys. Counselling psychology views research and practice as mutually informative (Canadian Psychological Association [CPA], 2009), and so it is important for survivors’ voices to be heard in the research in understanding their experience so that they are the ones who are informing effective practice in their own population. The aim of this study is to contribute an emic perspective on the healing process for women who have exited sex trafficking informed by feminist and constructivist lenses. Through the use of the feminist method the listening guide, this research purposes to provide a platform for the voices of a historically oppressed population and empower participants by sharing their stories of healing (Brown & Gilligan, 1992; Herman, 1992). It is my hope that the proposed research will be a stepping-stone for understanding culturally relevant healing for all women who have been trafficked, but especially Indigenous women who are overrepresented as victims of sex trafficking in Canada. The following research question will guide this study: What are the HEALING AFTER SEX TRAFFICKING 26 stories of strength, healing, and resilience of women who have been sex trafficked in Canada, and what voices are present in their stories? HEALING AFTER SEX TRAFFICKING 27 CHAPTER 3: Method The purpose of this study is hearing the experiences of healing within women’s stories that have survived sex trafficking in Canada. Given the population being studied has experienced silencing, oppression, and stigmatization, it was of great importance to select a method which can honour these unique perspectives and provides space for their voices. This chapter describes the research design and method, participants recruitment strategies, including inclusion and exclusion criteria, and the processes for data collection and analysis. Research Paradigm and Design This study is situated in a constructivist paradigm with a feminist lens. Constructivist’s ontological position is relativism, where multiple, socially constructed realities are presumed to exist and be influenced by the context of the individual (Mertens, 2015; Morrows, 2005). This ontological stance is congruent with this study’s understanding that healing is a deeply unique and subjective experience and the meaning of healing should not be imposed on participants, but constructed by them (Egnew, 2005). This ontological position also guides the epistemology of this research, in that knowledge is co-created through relationships, and can emerge through interactions between the researcher and participant (Mertens, 2015; Ponterotto, 2005); meaning that it is important to not only look at who the participants are, but also who the researcher is (Taylor, Gilligan, & Sullivan, 1995). The goal of constructivist research is to gain understanding of specific phenomena, however, as knowledge is grounded by the specific historical social reality of participants, their experiences also must be understood within this context (Ponterotto, 2005). Under the constructivist paradigm, the researcher herself becomes an important tool, and lends her subjective understanding and relationship with the participants to the research (Mertens, 2015). HEALING AFTER SEX TRAFFICKING 28 The axiological position of constructivism is such that the researcher’s values cannot be divorced from the research, and therefore they influence the co-construction of knowledge alongside the participants (Mertens, 2015; Ponterotto, 2005). Researcher’s values and biases should be acknowledged and are crucial in creating knowledge and understanding the meaning of phenomena due to the prolonged and close relationship formed with participants (Ponterotto, 2005). The use of qualitative methods is well suited to conducting research under the constructivist paradigm with marginalized populations, as their aims are both emic and idiographic (Morrows, 2005; Ponterotto, 2005). The proposed qualitative method, the listening guide, will be expanded on further in this thesis. Feminist framework. Feminist research is focused on fostering empowerment and emancipation for women and other marginalized groups and adopts the ontological stance that their voices have been silenced and disempowered due to the negative effects of male-dominated social structures (Brooks & Hesse-Biber, 2007; Prochaska & Norcross, 2014). According to feminist theory, female personhood is culturally defined by “the domination and subordination of women” (Prochaska & Norcross, 2014, p. 355), leading to a gap between what is socially constructed and held as truth in society and women’s unspoken realities (Taylor, et al., 1995). Brown and Gilligan found that privileged men spoke as if they were autonomous and not living in relation to others, while women spoke of themselves as living in connection with others (1992). In order to live connected to others, and be a “good woman”, women needed to live silenced and disconnected from their voice (Brown & Gilligan, 1992, p. 2). The focus on disempowerment and silencing due to patriarchal societies is predominant across feminist theories (Hesse-Biber, 2012), and while these perspectives inform the current research, this research adopts a more specific feminist-relational lens, viewing the psychological HEALING AFTER SEX TRAFFICKING 29 problems that women face as consequences of a lack of voice and genuine relationship with self and others (Taylor et al., 1995). This focus is due to known experiences of how sex trafficking impacts women’s relationships to themselves, others, and the world (Conteras, et al., 2017; Hossain et al., 2010; O'Connor & Healy, 2006), and the research is particularly focused on how these relationships impact participants’ healing journey. Taylor and colleagues explain that “you cannot have voice without relationship, [and] you cannot have relationship without voice” (1995, p. 210). The starting point of feminist epistemology is the researcher listening to these silenced voices and discovering and creating knowledge in relationship with the participant (Hesse-Biber, 2012). Feminist research pays attention to the silences and gaps in women’s speech as a way of uncovering meaning beyond what is explicitly stated, and what cannot be safely explicitly stated due to cultural or societal norms (Hesse-Biber, 2012). Feminist research is focused on asking new questions, and challenging traditional knowledge claims by those who occupy privileged positions (Hesse-Biber, 2012). This epistemological stance also requires reflexivity from the researcher being mindful of power dynamics that exist within the relationship with participants, and paying attention to how the researcher as the “knower” is positioned in society and the impact of this on the research process (Hesse-Biber, 2012). Unlike positivist frameworks, the feminist axiological stance gives value to the subjectivity and emotions from both the researcher and participants in knowledge building, rather than seeing them as detracting from the quality of the research (Hesse-Biber, 2012). In terms of this study, where the women participants are likely to hold multiple intersecting marginalized identities, it is important to note that feminist research has broadened from its origins of exclusively researching women’s experiences of silencing to highlighting the oppression that minority groups experience. This includes exploring the interconnections HEALING AFTER SEX TRAFFICKING 30 between components such as class, race, and gender, and how they shape an individual’s experience (Hesse-Biber & Leavy, 2007). In this study focus was placed on how these components influence participants’ relationships with their self and with others. Application of constructivist and feminist lenses. As outlined above, constructivist and feminist lenses have numerous joint values and applications relevant to counselling psychology research and to this study, but they also differ in key ways. This study utilizes the listening guide, a feminist relational method that has congruent elements with constructivism’s ontology of relativism and giving voice to those who have been under-recognized by traditional research. The ontological assumptions of constructivism and feminist theory both understand the influence of context on an individual’s subjective experiences (Hesse-Biber, 2012; Morrow, 2005). This study is rooted in this ontological assumption, which also guides the constructivist epistemologies of knowledge being grounded in specific social-historical-cultural contexts (Morrow, 2005). Feminist theory departs from constructivism by arguing that discernable realities of oppression exist and are visible in women’s experiences of silencing (Mertens, 2015; Hesse-Biber & Leavy, 2007). Feminist theory is intentional and explicit about the reality of power structures and discourses and how they contribute to the silencing and disempowerment of marginalized peoples. If this were not the case, then women would not need to dissociate from their own thoughts and feelings in order to be in the world (Gilligan, 2015). Constructivist theory misses this integral and empirical reality of power politics, which when unacknowledged can contribute to further silencing of oppressed people groups (Locher & Prügl, 2001). Locher and Prügl (2001) argue that because constructivism leaves the social construction of power undertheorized constructivism lacks the ability to answer why and how certain constructs are more influential than others. Therefore, feminist theory’s acknowledgement of power and social HEALING AFTER SEX TRAFFICKING 31 structures adds necessary grounding to the present study and a footing to examine the impact of certain structures on women’s experiences of healing. Due to this study’s participants’ history of exploitation, I found it appropriate to depart from the subjective constructivist assumptions which neglect the influence of power structures, and align with the feminist standpoint that oppressive structures exist and have influenced the women’s experiences in order to act as an ally with the participants in this study. In the pursuit of understanding sex trafficking survivor’s experiences of healing, there first must be an understanding that the historical oppression of women, and specifically Indigenous women in Canada, has contributed to their experiences of silencing and oppression. Given the high representation of Indigenous women in the sex trade in Canada, it is important that the research considers the nuances of cultural diversity and how culture impacts power, privilege, and access to resources (Ponterotto, 2005). Contradictory to the dominant postpositivist paradigm, but consistent with constructivist paradigms, feminist research incorporates the subjective experiences of the researcher and participants as a tool for building understanding and knowledge together (Hesse-Biber & Leavy, 2007). The focus on power structures from feminist theory emphasizes that in order to avoid creating further experiences of disempowerment and reinforcing hegemonic social ideals (e.g., colonialism), the researcher must be aware of the power differentials even between herself and the participants (Smith, 2013). The researcher explored her own positionality and was reflexive throughout the research process in order to deepen her own understanding of her influence in the research process and in knowledge building. Both constructivist and feminist theories value sharing power with the participants, and therefore the researcher will take careful consideration to rectify power imbalances through the HEALING AFTER SEX TRAFFICKING 32 use of the listening guide, which is a relational method by nature and encourages participants to speak into the research process (Gilligan, 2015; Morrow, 2005; Mertens, 2015). Constructivism values research that is emic and idiographic (Morrow, 2005; Ponterotto, 2005), which also lends to the feminist agenda of empowering participants and understanding their lived experiences from their perspective (Hesse-Biber, 2012). Feminist and constructivist axiology’s value the subjective experiences of both the researcher and the participant in the research process. Feminist theory asks the important question of “how do we come to know narratives?” (Doucet & Mauthner, 2008, p. 404), and points to the willingness of the researcher to immerse herself in the participant’s narrative to know and experience the participant to the fullest extent possible, while bringing herself into the process as well. The honest stance of the researcher becomes one of the most important values in feminist research, and in congruence with the axiological assumptions of both constructivism and feminist theories, the researcher will bring her whole person into the research process in order to discover trust with participants (Gilligan, 2015). In doing so, the researcher is able to meet the ethical challenge of relationship in research, by staying in connection to both oneself and with participants (Gilligan, 2015). As part of the reflexivity required of the researcher in this process, the researcher has spent considerable amount of time immersed in understanding how best to represent Indigenous perspectives in her research. Though there are Indigenous paradigms that are appropriate for conducting research with Indigenous participants and may situate their experiences in more specific historical and cultural contexts of oppression and colonization, the researcher decided against electing a specifically Indigenous paradigm because this study is open to a sample of participants from all walks of life, therefore, the feminist lens inherent to listening guide was maintained. HEALING AFTER SEX TRAFFICKING 33 Researcher position. In research conducted from a constructivist paradigm, the researcher herself is an essential “instrument” for inquiry and analysis within the research (Mertens, 2015). As attempts or efforts to eliminate researcher subjectivity are inconsistent with the paradigm and proposed method (see below), and are an important ethical consideration of constructivist research, I will explicitly bring my experiences into this research study. I am a Canadian born, Caucasian woman, who is currently a counselling psychology graduate student at Trinity Western University. My passion for this topic has been fuelled by my experiences working with survivors of sex trafficking in Canada and Thailand. My first experiences working at an anti-trafficking organization in Thailand were shocking. As a result of the overt nature of the sex tourism industry in Thailand, I was confronted by the heartbreaking experiences of women who were currently entrapped in the sex industry; witnessing predominantly Caucasian males haggling with women openly in the streets over the price of their bodies, and choosing them off the stage by a number attached to their bikinis. While I saw only the surface of their experiences, it helped me better understand the nature of the exploitation the survivors I was working experienced and how their value has been linked exclusively to their bodies. Though I have not experienced sexual exploitation myself, as a woman in Western society I empathize deeply with the messages that survivors have internalized about the purpose of their bodies. From a young age I was surrounded by both explicit and implicit messages that my body’s primary function was to achieve aesthetic ideals in order to attract and please men. These messages were enforced through the words of actions of others, in the form of comments about my body and through experiences of sexual harassment and assault. My experiences of HEALING AFTER SEX TRAFFICKING 34 shame and silencing related to these experiences are part of the lens that I bring to this research study. In my work with survivors I have felt an overwhelming sense of helplessness as I watched their struggles with the aftermath of the exploitation they experienced. Other times I watched, amazed, as I witnessed women rebuild their lives and become hopeful about their futures again. I listened as women spoke about themselves in a way that reflected hope, purpose, and worthiness, which inspires my current research. Each woman has a different story, and a different journey towards healing. I have been deeply honoured by the women who have let me be part of their healing journey. Their stories have inspired me to conduct this research in the hopes that it will shed light on the bravery, strength, and resilience of women who are survivors of sex trafficking. Methodology: The Listening Guide In an effort to centre oppressed voices and to decolonize, I chose to employ the listening guide (Gilligan, 2015) to conduct the present research. The listening guide is a feminist and relational approach to data creation and analysis that gives representation to voices of internal experience which have traditionally been silenced (Brown & Gilligan, 1992). This method was developed as a way to listen and attend to the voices, and interactions of voices, from a person’s inner and outer worlds, and specifically emerged out of a need to hear women’s voices in research (Gilligan, 2015; Petrovic, Lordly, Brigham, & Delaney, 2015). The listening guide is designed to understand the influences of culture, context, and relationships on the self, and to use voice as “a way of communicating experience [and] bringing the inner world out into the open” (Gilligan, 2015, p. 69), making it a suitable method to capture participants’ voices and experiences of healing in this study. HEALING AFTER SEX TRAFFICKING 35 The listening guide focuses intentionally on the subjective experiences of participants, which is congruent with a constructivist and feminist ontology (Hesse-Biber, 2012; Mertens, 2015). The listening guide is designed to bring women’s voices clearly into the forefront of research as first-person narrators so their voices shape and inform research about them (Taylor et al., 1995). The feminist philosophy that informs the listening guide is concerned with men’s power in history and how that impacts women’s as “speakers and listeners and knowers and actors in the world” (Brown & Gilligan, 1992, p. 14). Brown and Gilligan (1992) developed the listening guide to not only listen to what is being said, but to listen to voices that are silenced by cultural norms and self-silencing. The listening guide is designed to be “a way of undoing of dissociation” (2015, p. 69) for women who have needed to dissociate from themselves and their desires due to culture and oppression they have experienced, much like the women represented in this study. In this way, it is acknowledged that analyses of the data in this study, which include a focus on unequal power dynamics embedded in culture, is a departure from the constructivist meta-theory that guides this project. While this focus on power dynamics and structures is a shift from constructivist theory, this method is still an appropriate choice under the constructivist paradigm due to the listening guide’s transactional and subjectivist stance on knowledge building between the researcher and participant that is in alignment with constructivist epistemological, ontological, and axiological assumptions (Morrows, 2005; Mertens, 2015). The listening guide was designed to capture voices of cultural and patriarchal oppression and silencing as well as resistance and strength in narratives making it an apt method for understanding the complexity of the healing journey of the survivors of sex trafficking. Applying the listening guide. Using the listening guide to analyze interviews involved four main steps and repeated listenings of the story (Brown & Gilligan, 1992). Embedded in HEALING AFTER SEX TRAFFICKING 36 each step are the researcher and the research team’s subjective interpretations of the transcript (Petrovic et al., 2015). Adding the researcher’s own voice through her interpretations is another way that the listening guide facilitates bringing internal experience to the forefront of research and validates the subjective experience of the researcher (Petrovic et al., 2015). The four steps of the listening guide are outlined below. Step one: Listening to the plot. In this first step the researchers listened for the plot and oriented themselves to knowing the story of the woman, and the “psychological landscape” and context within the details of her story (Brown & Gilligan, 1992, p. 15). The researchers also analyzed what was omitted from the narrative and any themes that they noticed in the story (Brown & Gilligan, 1992). Each researcher engaged in reflexive writing at this stage and provided a summary of their own experiences and history while engaging with the narrative they read. This included noticing emotional and mental reactions and reflecting on the privilege of hearing another’s story (Brown & Gilligan, 1992; Petrovic et al., 2015). Reflexive writing also served to act against researchers objectifying and distancing themselves from the participant in this step (Gilligan, Spencer, Weinberg, & Bertsch, 2003). Step two: Composing ‘I-poems’. I-poems are a unique feature of the listening guide compared to other narrative methods, where the researcher extracted all first person singular “I” pronouns in the transcript followed by subsequent words in order provide a context to understand how the participant speaks of herself (Gilligan et al., 2003). The I-poem was constructed by putting each I statement on a separate line of the poem in the same order they occur in the transcript (Gilligan et al., 2003). As the research was interested in the relationships between the participant and others, as well as the participant and her body I also included pronouns of “we”, “us”, “they”, “he”, “she”, and “my body” in the I-poems in order to understand the complexity of HEALING AFTER SEX TRAFFICKING 37 the relationships each woman has as a result of her experiences of exploitation and healing. We paid special attention towards any discrimination, cultural biases, or oppression that the participant included whether purposeful or unconsciously in her narrative (Brown & Gilligan, 1992). This step allowed us to focus on how the participant spoke about herself and removed the researchers’ bias from the process (Petrovic et al., 2015). The poem captured meaning that is not directly stated (Gilligan et al., 2003). This also added to the rigour required of qualitative methodology by leaving a trail of evidence of the researchers’ process (Gilligan et al., 2003). Step three: Listening for contrapuntal voices. Contrapuntal voices are voices that interact and coexist either in “harmony” or in conflict with one another (Gilligan et al., 2003). In this step, researchers were guided by the research question and listened through each interview at least two times, paying attention to specific aspects of the story one listening at a time. Each listening was focused on one voice at a time in order to capture the complexities of voices present in each participant’s stories and how they interact with one another (Gilligan et al., 2003). The researchers specified what kinds of voices they were looking for and defined features of these voices so they could recognize them when they were present (Gilligan et al., 2003). As a feminist methodology, the listening guide takes into account that women often speak ambiguously due to the history of power dynamics between women, men, and society. The listening guide focuses on uncovering both inner and outer voices in conflict with a woman’s narrative and speech about herself (Brown & Gilligan, 1992). Therefore, in listening for voices that are in conflict with one another, the researchers listened for the relationship between the voices, rather than choosing one voice to characterize the participant (Gilligan et al., 2003). After completing a number of listenings for voices and underlining them in different colours, the HEALING AFTER SEX TRAFFICKING 38 researchers were able to see how the voices moved with one another, if they were in opposition, and if they took turns at different points (Gilligan et al., 2003). Step four: Composing an analysis. In this final step, the data from the previous steps were synthesized and analyzed in entirety (Petrovic et al., 2015). This included the summaries and reflections that the researchers wrote, any notes they took, I-poems, and the underlined contrapuntal voices (Gilligan et al., 2003). The researcher team examined these pieces and considered how these findings related to the research question and reintegrated them into the broad context of the participants’ experiences. In the process of composing an analysis, researchers were guided by asking themselves these questions: “What have you learned about this question through this process and how have you come to know this? What is the evidence on which you are basing your interpretations?” (Gilligan, et al., 2003, p. 168). Data collection. Participant recruitment. Given constructivist research is emic in nature, its approach to sampling was purposeful (Patton, 2014). Purposeful sampling ensured that those who have firsthand, lived experience of the phenomenon being investigated were the ones contributing to the data and informing the knowledge claims. Mertens (2015) does not provide a set sample size for the number of participants required in qualitative research, however due to this being a Master’s level thesis, and the typical sample size from other studies that have utilized the listening guide, I aimed to conduct interviews with 6 to 8 female survivors of sex trafficking in Canada. I recruited participants through local organizations who assist victims of trafficking and sexual exploitation residing in Vancouver, British Columbia, through social media posts online, and through the newspaper. After gaining approval from the overseeing research ethics board, a recruitment poster was distributed through email to each organization that had the potential to be HEALING AFTER SEX TRAFFICKING 39 in contact with survivors that could fit the criteria for the study (see Appendix E). Potential participants were instructed to contact the primary investigator via email. The principal researcher conducted a phone-screening interview with interested participants in order to determine eligibility for participating in the study (see Appendix F). If the study was a fit for the women, an in-person interview was scheduled with the primary researcher at a time and location convenient for the participant. Women who were ineligible were thanked for their time and offered a list of counselling services if they desired. In total there were seven women who met criteria for the study and completed interviews. Locations of the interview included participants’ homes, a room at Trinity Western University’s counselling facilities, my private office, one of the local organizations women were recruited through and a coffee shop that the participant chose. Table 1 gives an overview of the participants who were part of this study. HEALING AFTER SEX TRAFFICKING 40 Table 1. Demographics of Participants Name Age of exploitation Length of time exploited Years since exiting Self-identified Ethnic & Cultural Background Lindsay 13 2 11 Caucasian Camara 16 11 1.5 Caucasian: Russian, Irish, Scottish Emily 15 2 5 Caucasian Tracy 8-9; 19-21 3 18 Caucasian Cory 14 3 31 Canadian, Metis Charlotte 0 16 32 Jewish & WASP Marie 28 25 6 Metis Note: WASP = White-Anglo Saxon Protestant Inclusion criteria. Participants must have been trafficked for sexual exploitation within Canada and meet the criteria for being a victim of sex trafficking according to the Canadian Criminal Code to be included in the study (2017). Participants who were trafficked in Canada as well as another country were still considered to meet inclusion criteria. However, if they were trafficked from Canada and moved to another country where they were exploited this did not meet criteria, as this study was interested in women’s experiences of healing from trafficking specifically within Canada. Participants were also required to identify as a woman and be 19 years of age or older in order to participate. To be a fit for the study, participants also needed to self-identify as having experienced healing, however they define it, and be willing to share about these experiences with the researcher in an in-person interview in the Vancouver area. While the researcher provided a framework for understanding healing as the process of becoming whole, HEALING AFTER SEX TRAFFICKING 41 participants did not need to identify with that definition, and were invited to contribute their own understandings of what healing means to them to the study. Exclusion criteria. Potential participants were excluded from participating in the research if they were below 19 years of age or were trafficked outside of Canada. Participants who contacted the researcher about participating but were unable to make an in-person interview in the Vancouver area were also excluded from the study. Participants who were unable to speak about their experiences without jeopardizing their mental health or safety were also excluded from participating in the study. In order to increase the likelihood that the women will have had an opportunity to begin their healing journey, women were excluded from participating in the study if it had been less than one year since they had been sexually exploited. This exclusion criteria was also in part a safeguard to increase the likelihood that the women had found safety and support in their lives since exiting; having supports in place was considered to be beneficial for the women in the event the interview brought up painful memories. Finally, it followed that if women did not view themselves as having undertaken in a healing journey, they would be a poor fit for the study, and were excluded. Process of data collection. Data was collected via one in-person interview with eligible and voluntary participants; interviews lasted from 60 to 150 minutes. I began by welcoming the participant to the study and ensuring their physical comfort in the interview space. Next, I reviewed confidentiality and informed consent with the participants (see Appendix G), and answered any questions they had about the research, and had them fill out a demographic questionnaire. Participants were given an option of using a pseudonym or their real name in the study. Some women considered it healing to own their stories and use their real name where others chose against this for various reasons, such as safety. Participants were informed that HEALING AFTER SEX TRAFFICKING 42 their data would still be anonymized in the process regardless of their choice. The participant filled out a brief demographic questionnaire (see Appendix H) and then the I used an interview guide to conduct in person interviews (see Appendix I). Participants were invited to bring a visual representation of their healing journey, (e.g. a photograph, a picture they have created, or other art form), to the interview and shared how they defined healing. I shared the framework guiding the study and asked questions pertaining to healing in the quadrants of the medicine wheel. After completing the interview participants were debriefed and thanked for their time (see Appendix J). Participants were given a list of free or low-cost counselling services and the information of local organizations that support survivors of sex trafficking (see Appendix K) as well as a $100 visa gift card and a self-care package made up of donations from local businesses for the women. Interviews were audio-recorded using digital recording devices and stored on an encrypted external hard drive for storage. I transcribed the interviews, and paper copies were stored in locked offices when not in use. Participants were informed that only the principal researcher would listen to the audio recordings and that only the transcriptions of the interviews would be used in the dissemination of the results in order to ensure protection of their confidentiality. Following the completion of this study and upon meeting all the requirements for the completion of a thesis through the Masters of Arts Program at Trinity Western University, the paper and electronic files will be destroyed in accordance to the guidelines set by the Research Ethics Board at Trinity Western University. Data analysis. I completed the transcription of the interviews in order to familiarize myself with the data and fully immerse herself in the listening process. Following the completion of the transcription, I followed the steps outlined above and completed the analysis alongside at least one other member of the research team. The research team was made up of HEALING AFTER SEX TRAFFICKING 43 other graduate students in the TWU Masters of Counselling Program who were familiar with and trained in the listening guide, and the researcher’s faculty supervisor (see Appendix L) Each member of the research team coded for voices throughout the listenings using different colour pens for different voices in order to differentiate them for analysis. After all this information was synthesized, I determined themes and voices that are heard most often and that were apparent throughout the interviews that were relevant to the research question. The research question served as an anchor in the synthesis and analysis process. Following the final analysis, I brought the results to my research team for further discussion. Once the research team was in agreement with the final analysis brought by myself, I contacted participants and set up an in-person group meeting in order to complete member checks and inquire if the findings are congruent of the participants’ experiences, as well as give members an opportunity to share their experiences with other participants. After determining a date and a central location between all the participants 5 of the 7 participants agreed that they were available and would like to meet for the group feedback session. The two participants who were unable to make the group feedback time were given the option of meeting with the researcher individually to receive the results of the study and to review the findings on their individual interview. Participants who attended in-person feedback sessions were also given an additional honorarium of $100 in the form of a visa gift card. On the day of the group interview three participants cancelled for various reasons, however the two participants who were present expressed gratitude at being able to meet one another and hear the results of the other participants as well. My research assistant and myself facilitated the feedback session together first by starting with introductions and a mindfulness exercise. Following this, I presented for approximately twenty minutes on the themes that were elicited from the data and included quotes HEALING AFTER SEX TRAFFICKING 44 from each of the voices found in the results (see Appendix M). After the presentation the researchers and participants engaged in a dialogue about the participants’ experiences in hearing the results. Following this discussion, each participant received a copy of individual feedback specific to her interview in the form of a letter as well as a framed and illustrated I-poem that I felt captured the woman’s theme of healing best. The letters are not attached here due to their personal nature. Myself, the principal researcher, created the poems and a local artist was commissioned to add personalized illustrations to each of the poems. The participants were invited to reflect on their individualized feedback and ask questions to the about the findings and engaged in a dialogue with the researchers. Following further discussion, I thanked the participants for their time and contribution and ended the time with a cedar brushing ceremony. The participants were invited to join the researchers in returning the cedar to the river as a closing part of the time together and both participants joined the researchers in doing so. This was to add to the quality and rigour of the research and allowed participants to give feedback to the researcher about the findings, as well as to gain an understanding for their contribution to the research process and hear the findings from other survivors. The participants who were unable to attend the scheduled group feedback meeting received their feedback individually either by phone or by person. I shared the themes and results found from survivors collectively as well as the participant’s individual feedback. I provided space to dialogue with the participants and hear their experiences of other survivor’s stories as well as invited them to share their feedback on their own results. This added ontological and catalytic authenticity to the project as participants shared their experiences of participating in the research project and hearing the results of the study. HEALING AFTER SEX TRAFFICKING 45 Rigour and Quality. Determining rigour in qualitative research is dependent on the paradigm that the research is situated in; for this study, which represents a combination of constructivism with feminist theory, criteria for rigour were built upon concepts of fairness, coconstruction, verstehen, and ontological and catalytic authenticity (Morrow, 2005). Fairness is demonstrated when different experiences are honoured in the research (Morrow, 2005). Fairness was achieved through reflexivity, triangulation, and the use of multiple members of the research team participating in the listenings. Having multiple members of the research team complete listenings alongside the principal researcher ensured that multiple perspectives of each participant’s story were brought forth for analysis. The researchers engaged in reflexivity by writing their own perspectives and reactions of the listening before continuing onto the next steps in order to understand where their own unique experiences influenced their analysis of the data. Additionally, the principal researcher kept a journal throughout the process in order to be transparent about her subjective experiences of the research (Patton, 2014). In alignment with the feminist and constructivist principles of shared power and cocreation of knowledge, interviews utilizing the listening guide were analyzed in a team of researchers, and participants were invited to speak into the results and the analysis process (Mertens, 2015; Morrows, 2005). Engaging the research team in the analysis also allowed the principal researcher’s biases and assumptions to be challenged, and alternate experiences and interpretations of the data to be honoured, beyond the principal researcher’s interpretations. Reflexivity is congruent with feminist research principles, where the researcher kept track of how she came to interpretations and made explicit any power dynamics between her and participants in the research process (Gergan, 2010). Triangulation, which Patton describes as “capturing and respecting multiple perspectives” through multiple investigators and sources HEALING AFTER SEX TRAFFICKING 46 (2002, p. 546) also adds to fairness in the research. Although the source of data in this study will be singular (i.e., the research interview), no fewer than two members of the research team present will analyze data in order to uphold these criteria for rigour. Embedded in the listening guide is the feminist aim of creating a platform for silenced and marginalized populations (Mertens, 2015). Gaining understanding of participants’ subjective experiences aligns with the criterion of verstehen, which was achieved through the principal researcher being immersed in the data through conducting the interviews, transcription, data analysis, and dialoguing with the participants. Member checks were conducted with the participants in order to ensure that the research team has fully captured the participants’ experiences and voice. This allowed for a co-construction of meaning between the researcher and the participant, and helped rectify power imbalances, as is in line with a constructivist paradigm and feminist principles (Morrow, 2005). Ontological authenticity is when “participants’ individual constructions are improved, matured, expanded, and elaborated,” and catalytic authenticity is “the extent to which action is stimulated” (Morrow, 2005, p. 252-253). The guided reflection process of qualitative inquiry impacts participants and often leaves them more aware of things they did not know about themselves before the interview (Patton, 2014). Herman (1992) found that when victims of sexual abuse tell their stories they experience empowerment as they re-define their stories into narratives of survivors, rather than victims. While the proposed study did not satisfy ontological or catalytic authenticity criteria in an obvious way at the outset, I hoped that as participants engaged in the research project and shared their narratives of healing they were empowered and reminded of their strength and resilience in their healing journey. I hope that this could become HEALING AFTER SEX TRAFFICKING 47 part of a move toward action and would continue beyond the time of the study. This is discussed further in chapter 5 of this thesis. Morrow (2005) states the importance of researchers deliberately preparing themselves before entering the research arena where they are “outsiders” to either the culture or issues they are researching. I intentionally sought out Indigenous leaders in the community in order to broaden her perspectives and educate herself on Indigenous perspectives and issues before engaging in the proposed research with Indigenous women as participants, and consulted with leaders throughout the project. As well, I relied heavily on my personal cross-cultural experiences of working with sex trafficking survivors in Thailand, and other cross-cultural experiences working and volunteering internationally. I also prepared for this work by speaking and consulting with other experts in the field and attending a seminar on sex trafficking in Canada. HEALING AFTER SEX TRAFFICKING 48 CHAPTER 4: Results The purpose of this study is to understand how women who have survived sex trafficking in Canada experience healing. The research question guiding this study was “what are the stories of strength, healing and resilience of women who have been trafficked, and what voices are present in their stories?” and the analysis of the interviews was approached with an openness to hear what emerged from the participants themselves, allowing their experiences to guide and shape the results. This approach is consistent with the method of the listening guide and feminist-constructivist research where we honoured the participant’s own experiences and allowed ourselves as researchers to be impacted and shaped by them. After conducting interviews with seven unique participants and immersing ourselves in the analysis we extracted 41 voices in total among the participants. Some participants’ voices were labelled the same, whereas others had voices that were unique only to them. The voices that emerged were categorized into two broad categories: voices of resistance and voices of healing. The voices of resistance include voices of oppression, dismissal, disconnection, confusion, avoidance, and shame. The voices of healing include voices of connection, agency, advocacy, compassion, knowing, resilience, and purpose. The following chapter gives an overview of each participant’s story and the way these voices are uniquely present in her narrative of healing, as well as speak to how these voices are present collectively in the participants’ narratives. While the present thesis is focused on the experiences of healing, the researcher and supervisory committee felt it was important to demonstrate the voices of resistance as well as they speak to realities of the consequences that women face each day and throughout their journey of healing after sexual exploitation. These voices also answer the second part of the HEALING AFTER SEX TRAFFICKING 49 research question: “what voices are present in their stories?” The voices of resistance were categorized as such using the following definitions from Lexico dictionary: “The use of force or violence to oppose someone or something” and “the ability not to be affected by something, especially adversely” (2019). The voices of resistance represent both external and internal forces that prevented women from healing or created obstacles in their journey; however, the second definition is especially important in understanding the internal voices of resistance in the women’s narratives. Voices of resistance also represented a woman’s resilience in preventing herself from being overtaken by the trauma of her experiences. These voices are important to acknowledge, as by naming them and acknowledging the harm that they have caused to women we are able to then create a bridge to healing. This will be expanded on further as each voice is broken down, however it is an important lens to use while reading each woman’s story. Participants’ Stories Fundamental to the listening guide approach is understanding of each voice individually as it lives in each woman’s story (Brown & Gilligan, 1992). While many women have the same voice, it is captured uniquely in their own story, as well as interacts uniquely with other voices in her story. This section will outline each woman’s story and expand on the voices present in each of their unique stories and experiences of sexual exploitation and their healing journey. There are seven women presented in the following section between the ages of 22 and 59. Women in the study were sexually exploited for varying amounts of time, between 1.5 and 16 years; for some this was continuous, and for others this exploitation was disjointed; given the nature of sexual exploitation it makes it difficult to determine where the exploitation started and stopped and so the total time from entry to final exit was used for this number. The time that each woman has been freed of exploitation also varied between 1.5 and 32 years among participants at HEALING AFTER SEX TRAFFICKING 50 the time of the interviews. In the following section you will meet each participant in the way that I did, as the principal researcher. This will be followed by the analysis of their interview by the research team. Each woman had between five and seven voices that emerged, and the analysis includes how the research team came to identify each voice, as well as how these voices interact with each other and answer the research question. Included at the beginning of each story is an illustrated I-poem that I chose that I felt best captured the woman’s changed relationship with herself and healing journey. HEALING AFTER SEX TRAFFICKING 51 Lindsay. Figure 1. Healing Poem, Lindsay. Artwork by Megan Snopek. Lindsay is a young woman in her 20’s and met me in my office in Fort Langley. She is Caucasian, educated with a bachelor’s degree, and her smile was infectious. As we began our interview Lindsay recounted her story of being gang raped at 13 years old and how her life HEALING AFTER SEX TRAFFICKING 52 shifted significantly after that. She shared how she coped with her pain and confusion with substances and felt like she should give out her body before someone else would take it from her again. This led her to being set up on “appointments” by her drug dealer in exchange for drugs where she would have sex with older men in order to fund her drug use. This continued for approximately two years. It was only because her parents moved across the country that she was able to escape the situation that she was in and begin her journey of healing. Through receiving counselling and education she became aware that she was sexually trafficked as a young teenager and this information has brought her clarity and understanding in her journey towards healing. As Lindsay told her story and shared how she entered the world of sex trafficking, we can hear the voice of confusion for the first time. The voice of confusion is recognized in Lindsay’s story by tones of uncertainty and question asking about both what happened to Lindsay and also about how that impacts her now as a person. This voice is full of doubts and misunderstandings and is present as Lindsay shares how it is hard for her to accept and understand what happened to her now, even as an adult. As Lindsay reflected back on what her experience is, we can hear the voice of confusion. The details feel really confusing…I think piecing together what really happened what was what I thought was exaggerated, it actually wasn’t...That’s a huge fear of mine, of like, is what my body and my mind telling me actually true? Did I make all of this up? Did this really happen? The voice of confusion is not only present as Lindsay shares her experiences of sexual exploitation, but is also heard as she shares about her life after being exploited. Lindsay shares how after exiting she viewed human interactions, especially with men, through the lens of sexual HEALING AFTER SEX TRAFFICKING 53 encounters, manipulation, and power differentials. As Lindsay transitioned into adulthood and started university the voice of confusion weaves its way in her healing journey. I’ve had a guy who had liked me at university and I remember respecting him a lot and him respecting me, but he started out by saying, ‘Hey, I like you, I just think you’re so beautiful’ and all these things. And those words to me always come with a lot of ‘argh’ what does that mean? That’s so confusing. Following the voice of confusion in Lindsay’s narrative is the voice of oppression. This voice can be heard when Lindsay shares about her exploitation, feeling stuck, and feeling manipulated into sex work. The voice of oppression also represents a lack of choice or options in Lindsay’s experiences. One guy that I had been involved with he was the one who would set me up with his friends or people he knew…. I would get a text and then go… that’s when it started to feel…. I think looking back like “I think I’m in a business” or something…. I remember feeling like I’m not really choosing; I’m not meaning to hurt the family. One of the protective factors in her exiting was Lindsay’s family, who left the province they were living in at the time to get Lindsay away from drugs and prostitution. Lindsay speaks highly of her dad being a loving and supportive man in her life and being a major part in her healing. While Lindsay is talking about her dad, we hear the voice of connection when she describes him as an anchor of compassion and understanding towards her. Every time I would come back he would just pull me in and like, not ask any questions, just hug me. I remember coming down from being on specific drugs and he held my hair back and just scratched my back and he was like ‘one day I’ll understand, you don’t have to feel any shame right now’. HEALING AFTER SEX TRAFFICKING 54 The voice of connection is also present when Lindsay speaks about her husband. Despite being abused and exploited by men Lindsay also attributes part of her healing journey to her relationship with husband. For Lindsay, her husband connected with her beyond just a physical appreciation of her beauty, but also loved and valued her for her mind and heart. She describes him and her dad as incredibly healing relationships in her life. He and I got to know each other all through university, and then he told me that he liked me and said like, ‘I just learn from you every time we're together, like I just want to be more like you and like I learn from you, and that's why I would want to date someone like you, just because I learn from you’. And it was just this moment; a guy telling me he wants to learn from me?? The voice of connection also presents itself in Lindsay’s narrative when she speaks about the journey of healing and reconnecting to her own experiences and who she was before sexual exploitation and her rape. I watched myself evolve when we moved like, such growing pains of getting to know who I am. I remember having like our first Christmas in [the new place] and I remember like laughing so hard at something and being like, ‘oh, I haven't laughed in like 3 years’ like pure joy. [I] have this moment that stands out to me, of that: I'm funny and I'm full of life. I remember having that thought of, actually this feels good this feels like me again. The voice of connection continued to weave its way through her story and become stronger as Lindsay has engaged in counselling, shared her story, and embraced her experiences. The voice of disconnection presents itself contrapuntally to the voice of connection and represents disconnection in her relationship with herself and her experiences, as well as in HEALING AFTER SEX TRAFFICKING 55 relationships she has with others. Lindsay describes invisible barriers to connection with others like privilege, misunderstanding, and the assumption that she has lived a “normal life” as her trauma has not left any external marks. This is especially true in her faith community and at university, where no one knew her past and she shared that it was assumed that she grew up in a privileged life. This experience of disconnection has presented a barrier in her ability to experience healing in community and led her to feel disconnected and unknown. The quote below is an example of the voice of disconnection in her narrative. Coming to university, people have phenomenal lives and have had, I don’t know, had it so good for them, that I feel like I come in and I’m like, I was a disaster, just not feeling totally understood… Feeling like I don’t fit? Especially in my Christian communities, feeling like I don’t know, just kind of misunderstood maybe? Or people assume different things and I’m like oh actually like has been really hard. The voice of disconnection can also be heard as Lindsay describes being dissociated and disconnected from her own experiences and from who she was before the rape and subsequent sexual exploitation. One of the biggest obstacles that Lindsay experienced in her healing is the feeling of numbness and disconnection from her reality. She coped with her feelings through drugs and alcohol in the past, however when substances were no longer her coping tool she mentally distanced herself from her reality. This voice is present as Lindsay shares the complexities of accepting what happened and distancing herself from her past: I think it felt so numb, or it felt so far away from me and the more that I heal and it feels so distant, I’m like oh my goodness, I can’t believe that was actually what happened to me. So, I guess just that disconnection. HEALING AFTER SEX TRAFFICKING 56 The fifth voice that stood out to us in Lindsay’s narrative was the voice of clarity. Statements of confidence, knowing, and certainty helped us recognize this voice as Lindsay made statements of both knowing reality and accepting it. This voice is often heard in contrast to the voice of confusion and is recognized as Lindsay states her new beliefs and realizations since being exploited. This voice is present as she talked about a new belief system since starting her healing journey, which includes her ability to make choices, and a new understanding of how life is. The voice of confusion is still present in Lindsay’s life as she continues her healing journey, however, as Lindsay described her journey it was clear that she has gained significant clarity about what has happened to her and this has been part of what has allowed her to heal. The voice of clarity was first heard through other people’s voices such as her counsellor when she was a teenager. After speaking with her Lindsay stated, “I started to realize like okay, this isn’t normal…. it’s just illegal, like what I’m doing, what they’re doing, it’s just not good”. Following this, the voice of clarity is present as Lindsay describes the process of telling others about what happened to her once she was an adult. Lindsay described her experiences to her roommate and a counsellor and both people in her life labelled her experiences as sex trafficking. This experience was a turning point for Lindsay where she was able to recognize what actually happened to her and had it externally validated and labelled as not her fault. Her voice of clarity is present in this quote: It was a really big moment. I remember yeah, sharing my story and them saying that and then again my counsellor saying the same thing…. And labelling it as trafficking, and I remember feeling like so relieved because I was like oh! This makes a lot of sense. As her experiences began to make more sense to her Lindsay’s voice of clarity also became more present in her narrative. Lindsay spoke from a place of knowing and certainty as HEALING AFTER SEX TRAFFICKING 57 she reflected on her experiences. She talked about taking responsibility for some of her choices but not all of them, and understanding that what happened was not her fault but due to many circumstances that she did not choose to be in. She spoke with understanding of herself and the way that the world works, and confusion no longer rules that narrative. Choice is a privilege and when you’re hurt it’s not easy to make rationale decisions, or like good decisions for yourself. And if you feel like a piece of crap it’s not easy to selflove and say, ‘okay this is harming myself’. The final voice in Lindsay’s story was difficult for our research team to find an appropriate label for as it surfaced with when Lindsay was speaking about hope, choice, and freedom. However, we agreed that it was best categorized as a voice of empowerment. This voice was recognized when Lindsay would speak about feeling free, having hope for her future, and when she recognized her ability to exercise choice and autonomy in her life. Lindsay experienced empowerment by other people in her life when they gave her opportunities to change and grow as a leader in her school and to share her story as a survivor. When Lindsay speaks about the concept of “embracing” what happened to her, the voice of empowerment is forefront in her narrative. When Lindsay speaks in this voice there is an inner strength behind her words as she expresses knowing that she can move forward and the belief that she is able to do it. We hear the voice of empowerment as Lindsay speaks about how her faith in God has helped her move forward. This voice is heard as Lindsay shares how her relationship with God impacted her healing: “You can change and evolve and I’ll accept you, and I won’t look at all the strings attached, like there is none. You can just move on. You can be different, and you can change”. HEALING AFTER SEX TRAFFICKING 58 It is clear when Lindsay speaks about healing that her voice of empowerment is present. She speaks with grace for herself and a confidence that she can continue on despite obstacles and challenges that come up along the way. I feel like I’m constantly changing and growing, reassessing and reconstructing and that is just I think a really beautiful process, so it is necessary for me and that’s a gift that comes from all of my trauma…. Learning to love myself again and letting myself have room to grow and change from even who I thought I was even at university or all of that. An important theme that emerged from Lindsay’s interview was the theme of embracing and accepting what happened to her in order to move forward. Lindsay shared how in the beginning she was not accepting what happened to her, and then later she speaks about healing. Healing is embracing it’s going to come with highs and lows, but there’s not steps forward or backwards, but healing is embracing where you’re at right now. Saying like, I'm really hurt, and I'm going to fight for life…. Healing is embracing what you're going through in that moment and finding ways to love yourself in it. We can learn so much about the research question from Lindsay and how she has experienced healing after surviving sex trafficking in Canada. For Lindsay, there were moments where she turned towards what happened to her and made decisions to both embrace reality of what happened to her and decide to learn and grow from it. This was done with the support of her family, many caring counsellors, her husband, and through her relationship with God. Lindsay teaches us that healing can happen through acknowledging the hard realities and using them to teach others and speak out about injustices. Lindsay also teaches us the importance of allowing survivors to experience their inner child again. Lindsay has described how her childhood was taken from her when she was raped and because of this she experiences a divide HEALING AFTER SEX TRAFFICKING 59 in her life from before and after her rape. Now as an adult, embracing her inner child has allowed her to continue healing the wounds that happened when she was 13. Lindsay brought in a picture of a laughing child to represent healing for her because it is so important for her to connect with that part of herself both on an individual level but also as she shared that she is working towards being a teacher in order to protect others from what happened to her (see Figure 2). Lindsay teaches us the beauty of reconnecting to oneself after trauma and how the core elements of survivors are still present years after being sexually exploited, and healing is a journey about reconnecting to them. She has been able to embrace those parts of her through the love and support of people in her life, and her optimism for her future is a beautiful gift that she gives to herself, us, and other survivors. Figure 2. Healing Image, Lindsay. HEALING AFTER SEX TRAFFICKING 60 I met with Lindsay individually for our follow up interview and she affirmed the results that emerged from her narrative. When Lindsay heard the general results of the survivors, she also shared that she identified with the dismissal and judgment from medical professionals that was shared. Lindsay described gaining a fresh understanding and appreciation for her feelings of disconnection from her body and how her body was protecting her from the trauma since our initial interview. Lindsay shared with me her desire to be a mother and how hearing other women’s experiences of this was inspiring for her as she hopes to be a mother one day as well. Lindsay expressed that that she was grateful to get to tell her story and to hear from other survivors and was thankful she is at a place where she has been able to share her story of healing. Camara. Figure 3. Healing Poem, Camara. Artwork by Megan Snopek. HEALING AFTER SEX TRAFFICKING 61 Camara shared her story with me as we were surrounded by sewing machines, jewellery, and fabric in the working room of the program that Camara had been a participant in for the past 8 months. The program provides shelter, food, day care, education, life skills, and emotional support to women as they seek healing. Before we sat down Camara gave me a tour of the program and its facilities and took me to the day care centre where she introduced me to her son. At the time of our interview Camara had only been free from sexual exploitation for a year and half after being exploited for 11 years. Camara and I both held our coffees and she looked past me as she began to tell her story of being trapped in the sex trade by her former boyfriend, Brad. As Camara began to share about how she became a victim of sex trafficking we first heard the voice of oppression. It is distinguished as a voice of force, manipulation, and violence against Camara. The I-poem below represents the voice of oppression in her story: I met a guy 10 years older than me wanting to be with me date with me I did Him, convincing me He put a needle in me Got me wired to heroin Moved me with him He started pimping me out He started forcing me I didn’t HEALING AFTER SEX TRAFFICKING 62 He would beat me Hold me He eventually broke me I couldn’t even talk I wasn’t allowed He treated me basically like a dog As Camara spoke about her healing journey she focused on her healing from Brad specifically. The oppression, manipulation, and exploitation from him were so intense that she felt he completely stripped away her identity. She shared that his actions aimed to remove her agency and control her, not allowing her to make eye contact, have a cell phone, or regular customers. He stripped away her ability to choose what she wore, how she spoke or what she thought. The voice of oppression is heard as Camara explains her experiences saying, Not being able to think for yourself, doing anything for yourself is really traumatic when you’re ripped from all your dignity and choice, and you know? You’re stupid and belittled. It’s very damaging to a person. The grooming process that Camara experienced was intended to disconnect her from both other people as well as herself. As Camara reflected on this we heard the voice of disconnection when Camara shared how Brad exploited her; he cut her off from any type of relationship and connection to other people. “I wasn’t allowed regulars or anything…. I had to look at the ground all the time, I had to wear his boy’s clothes”. Brad stripped Camara of any access to human connection with others, even customers. Substances became a large part of Camara’s survival and allowed her to survive despite the abuse she was experiencing. The voice of disconnection is heard as she explained, “[drugs] were just something to help kill the pain of HEALING AFTER SEX TRAFFICKING 63 everything I had to wake up and endure every day”. While drugs helped her survive, we can also see how they contributed to Camara’s feelings of disconnection. As Camara told her story we became aware that the voice of disconnection not only applies to disconnection from others but also from herself. This voice highlighted how the consequences of sex trafficking go much deeper than the physical, but they also deeply wounded Camara’s relationship with herself and with others. This disconnection is heard as Camara explained what her life was like when she was being exploited. The following I-poem captures the voice of disconnection and shows how Camara detaches herself from those traumatic experiences by using the pronoun “you”: You know You’re just broken and sad You just don’t want to be there You could literally be crying They don’t care They’ll do what they want to do with you Drop you off and leave You’re getting over powered You don’t get a choice It really robs you We recognized that the voice of disconnection represents protection for Camara as she was able to numb from her and kept her from remembering the child she was before she was abused and exploited. HEALING AFTER SEX TRAFFICKING 64 You go into a hollow shell that you’re just a shell of a person cause it’s so much easier to be that than deal with everything that’s going on inside you. Once you’ve detached yourself from who you are for so many years it’s very hard to find yourself again. Lots of people don’t. Many, many girls don’t. As Camara continued sharing her story the voice of disconnection moved to the background rather than acting as the central melody of Camara’s story. She admitted that trusting people, even in the program, is still hard for her because she said, “I’m used to people abandoning me”. Despite oppression having been the central voice in Camara’s story for over 11 years, it was not long after we heard the voice of oppression that we heard the voice of agency countering the voice of oppression in Camara’s narrative. When Camara would run away she described how Brad would do anything in his power to find her again and remove her from people as she would begin to feel like herself again saying, “Many times I would take off from him and go into hiding and stuff but he would always find me”. The voices of agency and oppression dance in opposition during Camara’s narrative until Brad was murdered and Camara shared how she was able to finally get away from him, and “slowly started thinking… [and then] was able to start making choices for myself”. The voice of agency is demonstrated in the I-poem below as Camara began to choose herself and was able to escape prostitution and other exploitive situations. I just got up I left I just left I just like ran HEALING AFTER SEX TRAFFICKING 65 I decided Camara had made a promise to herself when she was a young girl that if she were to bring a child into this world she would have to be able to take care of it. Getting pregnant and then remembering this promise was the catalyst for her to begin to make choices for herself in order to care for her baby. Having her baby and honouring the promise that she made to herself to be a good mom is a beautiful illustration of how Camara is choosing herself and that promise she made so many years before. The voice of agency is heard in the quote below as Camara shares how she began to make decisions to work on herself and begin the heal: It was like a wake up call…. I can’t be selfish anymore. I can’t party or drink or numb my pain, I really have to sit down and deal with all my childhood trauma…. I don’t have that choice anymore. I have my son as well, so I need to work on myself and it’s been the best thing. This decision led her to the program that she is in now, where she said that she has learned to think, speak, and make decisions for herself and for her son. As Camara spoke about how her relationships have changed in her healing journey she sounded certain and confident making her decisions saying, “I’m not ready to make relationships with anybody, right now I just need to focus on myself…. I pick and choose who to let in”. While her son has been the catalyst to this healing journey, Camara is also learning what it means to make choices for herself, because she says, “I’m worth it.” We heard Camara’s voices of connection and agency together when she spoke about wanting to go back to who she was before she met Brad and connect to herself as a young girl. We can see that the decision to become a mom after she realized that she was pregnant was a huge milestone in her healing and this decision has given her purpose to continue in her healing journey. These voices counter the voices of oppression and HEALING AFTER SEX TRAFFICKING 66 disconnection as we hear them as she connected back to a promise she made when she was young, allowing herself to come out of the numb, “hollow shell” that she was forced to be because of Brad. A fourth voice sprung forward in Camara’s story that we broadly defined as the voice of compassion. At times this voice speaks through others, including the staff at the recovery program that Camara is currently part of. The voice of compassion is heard when Camara shares how the staff cared for her despite relapsing while in the program. This was a turning point in Camara’s healing journey: When they didn’t kick me out, they let me come back and stuff that was a real big milestone for me…they didn’t abandon me here, that’s all I ever wanted to know that ‘hey people make mistakes. You’re going to make mistakes it’s when you learn from your mistakes that matters’…. They gave me a lot of faith in myself…to give myself a chance too, ‘cause they are. I’m learning to love myself. It was after she was extended this compassion by the staff from the program that she was able to internalize this compassion towards herself saying, “to know that it’s not my fault…. to have a bit of validation, like I did go through this stuff and it was scary, and you know, it’s okay to feel the way I feel”. Camara’s voice of compassion speaks clearly as she extends compassion towards herself by saying, If I have to put something off for a bit until I can be mentally capable of it, you know, without being overwhelmed and panicky and freaking out then I do that now, which is great! Because I never did that before. As Camara internalized the compassion from others to herself this voice also changed to include tones of acceptance and reconnection to her experiences. Now that Camara is free from HEALING AFTER SEX TRAFFICKING 67 prostitution and Brad is gone forever she spoke about returning to herself before Brad was in her life and before she experienced sexual abuse from her step-father, she said, “I feel more like myself, I feel like I’m picking up again where I left off when I was 12”. The last voice that was extracted from Camara’s narrative was the voice of clarity. The voice of clarity is heard countering the voice of disconnection in Camara’s narrative. Statements of knowing, conviction, and certainty distinguish Camara’s voice of clarity when she speaks. Clarity became a stronger part of her narrative as she was able to get away from Brad, “him being gone I could see how my life would improve, just being able to feed myself or making sure I had what I need, a shower, whatever it was”. This is reflected even as Camara shared that the turning point for her exiting was Brad being murdered, because she was finally able to move forward without fear of being pulled back into a world of exploitation again. The voice of clarity resounded strongly when she spoke about her ongoing healing journey in a way that is full of conviction saying, “I don’t want to be that person. I want to be something more than that. I want to be a good mom”. We were struck by the power of this statement when juxtaposed with voices of oppression and disconnection, which reflected Camara’s lack of voice, self-knowledge, and autonomy. Camara’s voice of clarity has guided her healing journey, beginning as a voice of recognition and self-awareness of what she is feeling, and moving to a voice of knowing and understanding of what she needs to move forward saying, “I have to deal with all this baggage and trauma”. The voice of clarity at the end of her narrative is represented by her acknowledgement of both what has happened to her and confidence in her abilities to overcome the trauma of Brad and sexual exploitation and heal. I have a voice I’m allowed to say no HEALING AFTER SEX TRAFFICKING 68 I deserve it I want to continue I can do it The voices of healing in Camara’s narrative speak together as she speaks about her continual healing. They say together, “I’m at the point now where I’ve accepted the fact that these things have happened to me, but I’m not going to let that define who I am”. As Camara speaks about healing as courage to love herself and be patient with herself, she speaks with selfcompassion and clarity. She speaks with certainty that she knows she is worth care and love and is giving that to herself saying, You have to be patient with yourself, like you’re going to have ups and downs, but its part of healing. It’s okay to cry. It’s okay to feel emotions, and everything that comes along with it…. You have a right to feel what you feel. Camara’s experiences at the recovery program have helped her learn how to build healthy relationships and connect with herself. She also said that the program has given her life skills, parenting skills, and that it has helped her dream of a future again for her and her son. Camara teaches us the importance of second chances, compassion from others and an amazing amount of resilience that she possesses. By reconnecting with the promise that she made as a child Camara has fought to be a loving mother to her son and through that has learned that her needs have value as well. Camara brought in a prayer box that she had created as her symbol of her healing journey, saying that it symbolized her ability to create things, and having her son’s footprints on it symbolized her hope for her future with him. HEALING AFTER SEX TRAFFICKING 69 Figure 4. Healing image, prayer box, Camara. In our follow up interview Camara shared how her healing journey has continued at the program she is in. She expressed that she identified with what was found in her interview and shared that it was reassuring to have things put into words that she had felt but had not been able to verbalize. Camara spoke about her continuing healing in learning how to put boundaries up in her relationships with others and also with herself where she would take time away from things that would be too overwhelming for her. In hearing the themes that emerged throughout all the interviews she identified with the voice of confusion especially even though it was not a voice that emerged specifically in her interview. She said that hearing the stories from other survivor’s also helped her feel less isolated as she stated that it can be challenging when people do not understand or can relate to her story. She expressed that this was the first time that she has been able to share her story in this way and was proud of herself for being able to do it and it encouraged her in her healing journey. HEALING AFTER SEX TRAFFICKING 70 Emily. Figure 5. Healing Poem, Emily. Artwork by Megan Snopek. I first met Emily at our interview on a cold, snowy day where it would have been more than reasonable to reschedule our interview. Despite the weather, Emily still showed up ready to share her story. Emily is a Caucasian woman in her 20’s and as she sat across from me, she shared that she was both excited and nervous to share her story of sexual exploitation. Emily was only 14 years old when she entered treatment for a substance use addiction and was told about prostitution by someone else her age as a way to fund her addiction. As Emily began to make advertisements for herself on the Internet things began to get out of control as she experienced violence and blackmail forcing her to continue giving one of her customer’s sex. Emily questioned if because she did not have a pimp she was really exploited. As Emily spoke about her experiences of selling her body we were first introduced to the voice of shame. As HEALING AFTER SEX TRAFFICKING 71 Emily shared about her life as a teenager using substances and selling sex the voices of shame, disconnection, and oppression were the most prominent. Emily’s voice of shame was recognized as she spoke about entering the world of prostitution saying, “I saw how fucked up she was from it, but I still went ahead and did it anyway”. While Emily stated that she willingly entered into this world, addiction, violence, and shame were what kept her there. The I-poem below illustrates this cycle in Emily’s life. You get the guilt You want to use You need more money You go do it You feel guilty Shame silenced Emily as a teenager from telling her parents what was going on, and this voice is heard as she stated, “I thought I would get in trouble if I told anybody”. It was due to shame and fear that Emily harboured the fear and guilt from a violent customer alone. Not only did the voice of shame silence Emily in her past, but also it continues to be a barrier for her in present healing journey. She shared that she has spoken to her counsellor and other women in treatment centres about her experiences in prostitution but shame silences her from telling most people what happened to her. She shared that it even makes her question if she was at fault for being exploited, because she initially sought customers out. It’s hard not accepting fault for it. Like feeling you’re, like you teased him or did something. I don’t know. The guilt and shame, it’s hard to move past. Even though I tell other people in similar situations it’s not their fault, it’s really hard to accept that for yourself. It is my fault because I did put myself there. HEALING AFTER SEX TRAFFICKING 72 The voices of shame and disconnection are often heard together in Emily’s narrative. The voice of disconnection was defined by the research team as disconnection from self and disconnection from others. Emily shared how she internalized other people’s words that compared her to her sisters, and how that prevented her from connecting with them. As shown in the quote below, it also created a barrier in her relationship with herself: I really, really didn’t like myself. I didn’t want to look at myself. I would not take pictures of myself I was kind of just going around and everybody would always just compare me to my sisters and how they were doing so well. And you were brought up the same. Why the fuck are you fucking up so bad? I started telling myself that. The voice of disconnection was also heard as Emily disconnected from herself in the form of dissociation or with substances and used them to numb her from her circumstances. She said, “It feels like that wasn’t even me, and I’m just watching it as a movie. It’s really weird”. Emily’s voice of disconnection was also recognized as she spoke about her experiences in prostitution, as noted by the use of the pronoun of “you”, saying, “Even if the money part isn’t there it’s still putting yourself out there as an object….and then feeling like that’s the only thing you’re good for”. The voice of oppression is often heard alongside the voices of shame and disconnection, and emerged when Emily described how things quickly got out of control when a man filmed her during sex using a weapon. Emily was forced to continue having sex with him for months and felt powerless in the situation. She shared that even now, knowing that he still has that video is something that she still thinks about. While she struggles with self-blame for her situation, we heard the voice of oppression in her narrative. Even though Emily exited prostitution the voice of oppression continued to follow her and show up in other relationships she has with males. HEALING AFTER SEX TRAFFICKING 73 From romantic relationships that turned abusive, to an experience with a male therapist when she was an adolescent who raped her, Emily experienced many years of oppression and exploitation from men in her life. She shared that these other traumas have taken the spotlight in her life and made it difficult for her to go back and heal some of the hurts that she experienced while being sexually exploited: I kind of stepped away from NA because the same kind of situation would happen where I would find men or men would find me and I felt trapped into doing things that I didn’t want to do….Yeah like ‘can you give me a ride home?’ and yeah sure, I’ll give you a ride home, and it would turn into ‘I’m not getting out of your car until we do this’….Even when I wasn’t putting myself out there I felt like people would seek me out. It felt like there was something wrong with me, like there was a big label on me, ‘vulnerable’. As Emily’s narrative unfolds the voice of oppression diminished to the background of her story. While Emily is free from those explicitly oppressive circumstances, she described being left with a lingering feeling of obligation to other people where she said, “I just never felt like I could ever say no to anybody”. We explored together how she felt pressure from me in the interview, as she said she wanted to make sure that I got what I was looking for in the project. As we dialogued about her what she felt my expectations were for her the voices of shame and disconnection were layered in our conversation. As we continued to talk about this, and Emily vulnerably shared her feelings of obligation towards me the voice of connection resurfaced as we were able to connect in an authentic way. As I told Emily that other women had also felt similar pressure during interviews her voice of connection grew stronger towards me and other survivors. This experience demonstrated to me that oppression and shame can be silenced through authentic and safe connection. HEALING AFTER SEX TRAFFICKING 74 The voice of connection first appeared in Emily’s story as she spoke about her dad’s support in getting her into substance treatment. Despite the challenges in her family Emily shared, “we always fight for each and other and fight for the best in each other”. As Emily’s step-mom entered her life she became another loving person who spoke life into Emily when she couldn’t do it for herself. As Emily spoke in the voice of connection she said, She was kind of an outside person that came in and loved me and was like the mom I never had. I’d always talk badly about myself and she’d come and challenge me…. She gave me some tough love and I guess loved me when I needed the love that I never got. The voice of connection surfaced again when Emily is explained how she heard from other women at the treatment centre that they had also been victims of sexual exploitation or had entered prostitution. We learned from Emily that finding others with similar experiences in the sex trade was an important factor in diminishing the shame she felt from her story. Emily also reflected that having other people who loved her until she loved herself was a key aspect to her healing journey saying, There were a couple of counsellors that just fought for me and fought to make me stay and make me come back, and then allowed me to come back after getting kicked out multiple times. There were a couple people who really didn’t give up on me. As Emily shared about her healing journey, she expressed that being loved by other people allowed her to connect better to herself. Emily reflected that her desire for a connection with other people has led her to abusive and violent relationships, however, as Emily has exited prostitution and become clean this has changed. We heard her voice of connection with herself as she described how her relationship with herself has changed since intentionally working on herself in counselling in the following I-poem. HEALING AFTER SEX TRAFFICKING 75 I started feeling I can be happy by myself I’m a whole person by myself I don’t need a man I don’t need to please a man Emily’s whole world shifted when she became pregnant, and when she spoke about her daughter we heard a new voice in her narrative. This voice was the voice of purpose, and it speaks about her hope for her future and having something to work towards. While drugs and prostitution still hold temptation for Emily, she attributed her ability to stay away from temptation to her daughter saying, She’s the reason I would never go back. I would never put her in danger…. The biggest thing that keeps me away from it is would I ever want her to find out that I did that to support her? She deserves a good life, and for her to have a good life I need to be good. She’s literally a lifesaver. As Emily described going from having no purpose to gaining a reason to live and wake up everyday after becoming pregnant we identified the voice of purpose in her narrative. Emily shared how she previously viewed herself as “selfish”, but since becoming a mom has realized that this cannot be true. Emily spoke about herself in a new way when the voice of purpose was present in her narrative and as she described her pregnancy as heard in the following I-poem. It was amazing I felt strong I felt I was HEALING AFTER SEX TRAFFICKING 76 I was going to I started I ended up I grew that I think it kind of empowered me I am more than just an object I was proud of myself I cared enough I am very selfish I met her I had her best interests I must not be that bad of a person Emily stated that she wants better for her daughter and has realized that in order to do this she needs to do better for herself. She attributed the success in working on herself to her experiences in counselling, where she has learned tools to help her cope with her past. As she has moved forward and practiced better forms of coping, having others reach out to her and acknowledge her growth has also encouraged her to moving forward. The hope and purpose that Emily feels is evident has she speaks excitedly about knowing new ways of coping with life in this I-poem: I use the tools I don’t need to do drugs I don’t need to hurt myself I don’t need to cut HEALING AFTER SEX TRAFFICKING 77 I don’t need to punch I don’t need to do those things I can express it I actually feel proud of myself I am proud of myself Emily’s story paints a beautiful picture of the redemption of a mother’s heart. Emily’s heart for her daughter allows her to not only in breaking a generational cycle of drug abuse and hurt, but also to begin to believe that she herself is worth taking care of. While Emily connects her continual healing and work on herself as a result of her daughter, we actually saw in her narrative that Emily exited prostitution and became clean before her daughter, and so it is her daughter that motivates her to continue healing. Emily vulnerably shared about the struggle she has with shame, substance use, and her desire to feel in control, which make healing after sexual exploitation a challenge. Emily continues to overcome these obstacles daily through the hope and purpose that her daughter brings to her life, and the connections she has made with people in her family and other supportive people. This was also represented by the image that Emily brought into the interview that represented healing of a picture of her daughter with Emily’s grandmother. The image is not pictured here in order to respect the conditions of confidentiality, however Emily spoke with pride and love as she shared they were her heroes and inspiration for continuing in her healing journey. Emily teaches us that the road is not easy, but the power of love, hope, and a purpose that Emily has because of her daughter allow her to continue on in her journey of loving herself and healing from sexual exploitation. Emily attended the group feedback session and shared that it was a powerful experience for her to see her words on a screen alongside other women’s. She shared that she had fear and HEALING AFTER SEX TRAFFICKING 78 shame in coming as she felt that her story might not have been good enough to be included, and yet when she saw her words as part of the study she was assured that her story was important. Emily shared that she was very happy that her love for her daughter was so evident in her healing journey and through the interview as this was the most important thing for her. Emily shared that through telling her story from the beginning for the first time she felt encouraged in her healing journey and was glad that her story would be told so others could know of the challenges of healing after sexual exploitation as well as the ways women heal. HEALING AFTER SEX TRAFFICKING 79 Tracy. Figure 6. Healing Poem, Tracy. Artwork by Megan Snopek. Tracy invited me into her home for our interview and I entered into a spiritual sanctuary that Tracy had intentionally cultivated for her safety. Calm music was playing in the background, the smell of incense floated through the air, and I was surrounded by a collection of Tracy’s artwork on the wall. From the moment I met Tracy, it was obvious to me that she had chosen to live her life in a very intentional way; everything in Tracy’s apartment had meaning, including the way her living room was arranged for our interview. On Tracy’s coffee table were many symbols and objects that have represented her healing journey over the past 14 years; many of them helped her connect spiritually to her ancestors and other guardian spirits that have HEALING AFTER SEX TRAFFICKING 80 protected Tracy throughout her journey. Tracy’s story of sexual exploitation begins with her mother selling herself to men who would also sexually abuse Tracy starting from when Tracy was 8 years old. In our phone conversation Tracy described not knowing if her mom knew that they were using her as well, and wrestles with the idea that her mom could have been exploiting her. As we began our interview Tracy explained that her mom shaped her view of love and her identity as a woman and how as an adult this became her entryway into prostitution, as she believed this was her option in life. Tracy shared that was in and out of the sex trade until she was about 28 years old and has done deeply intentional work to overcome the consequences that she has had to live with since then. As we began the analysis of Tracy’s interview the first voice that we heard in Tracy’s story was appropriately the voice of intentionality. As Tracy exited prostitution she was also forced to make choices that would keep her away from substance use and prostitution, which included making the decisions to cut off relationships that might bring her back to those dark places. The voice of intentionality was heard as she said, “I had to remove myself from her as well just cause I didn’t want to – I didn’t want to continue on that road”. As Tracy began to intentionally seek healing she began to engage in healing processes that were out uncommon in order to do what worked for her. The voice of intentionality is heard as she explained this process. The intentionality in how she receives healing is significant, as she shared how she works to ensure that no one else is hurt because of her needs: I would go into a forest and I would pick a tree…. I would walk and name it and then just start screaming and yelling at it…whatever I needed to do that wasn’t to another human being, cause I didn’t like any of that shit so I wouldn’t want to do it to someone else. HEALING AFTER SEX TRAFFICKING 81 Part of Tracy’s healing journey has been to make the daily choice of waking up and choosing to do something to work towards healing and loving herself every day. Tracy’s apartment was covered in her artwork that highlighted various aspects of her healing journey. She explained that art is one of the ways that she has learned to express herself, and one of the paintings on her wall includes her daily mantra: “I have this thing that I read every day before watching the sun come up. I created this years ago: ‘I’m loveable, I’m acceptable, I’m interesting, I understand’” (see Figure 7). Tracy also shared another painting that symbolized her healing of a fire goddess, represented in Figure 8. Figure 7. Healing Mantra Painting, Tracy. HEALING AFTER SEX TRAFFICKING 82 Figure 8. Healing image: Fire Goddess, Tracy. The voice of intentionality was heard as Tracy spoke about not only working on her own wounds, but because she believes that healing happens generationally she has also sought to do work around healing her ancestor’s wounds too. She has engaged in years of therapy and healing in order to do this, as she said that she wants to make choices of moving towards her complete healing. Tracy experienced a shift in her healing journey when she began to take initiative to work through the trauma she experienced and also the trauma that was based down to her inter-generationally. This example of the voice of intentionality is also layered with the next voice that was present in Tracy’s narrative, the voice of advocacy. Let’s heal my mom’s wounds, my grandmother’s wounds; my great grandmother’s wounds, all of that, so the women in my family and in my timeline and bloodline can heal. So that none of this shit ever happens to us ever again! It’s going to stop here. And for me, it has. Tracy’s voice of advocacy was also evident as she spoke about her childhood. She shared that even as a child she knew that she needed structure and accountability in order to do HEALING AFTER SEX TRAFFICKING 83 well in school, and so in order to get this she recounts going to her teachers and pretending that her mom wanted to have feedback for her written down so that Tracy could know how she could improve. This was an indication to our research team that the voice of advocacy was present within Tracy from a very young age. This voice grew to be an important part of her healing journey story as began to Tracy advocate for herself and other survivors. As spirituality is such an integral part of Tracy’s healing, it is not surprising that the first instance of the voice of advocacy in Tracy’s story is actually from a spiritual presence. Tracy’s told the story of a spiritual presence that advocated for her as she was beaten and left for dead by her mom’s boyfriend. Tracy stated that her experiences of a spiritual presence with her in this moment gave her strength to get up and then later go and advocate for herself against her abuser: She just kept telling me to get the strength to get up, get the strength to get up… eventually I did and that's when I realized that I was not in water, there was no water near me. There was no woman standing there with me, so I was like well that's fucking weird, and then I got the strength to get up and I walked back to the table where they were sitting…I was like ‘What else you got? You thought you knocked me down but you totally didn't’. So that strength from whatever, guardian angel I would say, has always been with me. This spiritual advocate and guardian angel deeply impacted Tracy’s healing journey, and eventually led to Tracy being able to advocate for others’ safety and healing through her spiritual practices. As Tracy explained the set up of her room to me she showed me that she was advocating for the survivor community spiritually, and while she shared that she is unable to offer counselling and support to people, she is more than willing to use her spiritual practices to help cleanse someone’s spiritual energy. HEALING AFTER SEX TRAFFICKING 84 Tracy’s experienced years of dismissal, and as she shared those experiences we noted the presence of the voice of dismissal in her narrative. The voice of dismissal presents itself through Tracy’s narrative even from her experiences as a child as she would try to share her spiritual experiences. The dismissal she experienced from others as she shared these experiences was confusing and hurtful as these experiences made her feel protected and safe. She reflected how having her mom and other adults dismiss these meaningful experiences was damaging for her and presented an obstacle in her healing. The quote below demonstrates the damage and hurt that dismissal of experiences has caused Tracy. And that’s where it’s hard, cause I was a survivor cause when you’re highly sensitive and highly intuitive then it’s like all your stories are bullshit. It didn’t matter what you were saying. So, when it was like hey, you know what, Mom I don’t think this guys a really good guy it’s like ‘you don’t know what you’re talking about, you’re 8’. Tracy has experienced additional judgment, prejudice, and dismissal against her when she was in prostitution and as a lesbian woman. Tracy uses her voice of advocacy to speak up against these injustices from people in positions of power and authority. There'd be times where I'd go to the gynaecologist have to explain that I met this guy online and this is what happened…and they'd be like ‘well you shouldn't be doing that then’. And then it's like well actually, it has nothing to do with HIM right now, we're talking about my body. And just really dismissing my body for the judgment, and that also just needs to stop. As Tracy worked towards her healing this voice of dismissal from others was internalized and she shared that began to dismiss cores parts of herself. The voice of dismissal is heard as she shared how this has presented an obstacle in her healing journey: HEALING AFTER SEX TRAFFICKING 85 I would dismiss myself by not offering myself the self-care and self-love, the nurturing aspects of it, which is very feminine. I didn't have any of that before; I didn't know how to do any of that. I just knew how to live in my masculine and survive. As Tracy shared about this self-dismissal, we also learned that this disconnection in her relationship with herself has been a necessity in Tracy’s survival from her history of exploitation and abuse. Dissociation has been a protective factor for Tracy, however, as she has worked towards healing, we heard the voice of disconnection when Tracy discussed the different parts of herself and as she distanced herself from her story using pronouns such as “you” “us” or “we” when describing events that happened to her. This I-poem illustrates the complex relationship between Tracy’s ability to dissociate and the protection that disconnection provided in her survival of abuse and exploitation: I actually really learned to remove myself from my body I didn't have to feel it I wasn't actually connected to myself I was actually living as two different people I would always talk about myself in the third person my inner child went through all of that I high-five her it's her story not mine This second I-poem shows a different side of the voice of disconnection, where disconnection no longer served an adaptive purpose for Tracy, but created a complex and disconnected relationship within herself: HEALING AFTER SEX TRAFFICKING 86 I would try to almost like, avoid myself, dismissing myself I would become the trickster Part of Tracy’s healing has been to accept all parts of herself: the good, the bad, the masculine, and the feminine. She spoke about the process of “delayering” parts of herself and constantly checking in with her motives for why she does what she does. In this process she has been able to move from a relationship of disconnection towards a relationship of ownership over her life and who she is as a person. Another voice that we heard in Tracy’s journey of healing was the voice of uncertainty. Uncertainty has made it difficult for Tracy to accept parts of herself and her past, and this voice was present especially when Tracy would speak about her mom. Tracy shared that one of Tracy’s biggest obstacles in her healing has been accepting that what happened to her was real. The voice of uncertainty is often heard beside the voice of disconnection. We understood this complex relationship between these voices as both protective and maladaptive at the same time. Disconnection and not fully accepting what happened to her has allowed Tracy her to not be overwhelmed by her experiences, especially related to her mom. Coming to terms with her mom’s role in Tracy’s experiences of sexual exploitation is painful, and the voice of uncertainty both shields her from it, while also creating more confusion for her. Tracy wrestled with this relationship in our interview, saying: I've had conversations within the last couples weeks where I was like well you know... ‘my mom didn't really do this’ but they're like ‘dude, but she really did do this’ and I'm like ‘yeah but…’ So I don't know if I'm still somewhat in denial...it’s hard to accept. HEALING AFTER SEX TRAFFICKING 87 Contrary to the voice of uncertainty is Tracy’s voice of certainty. Tracy’s voice of certainty was recognized by Tracy’s confidence as she spoke about knowing herself and her needs. The voice of certainty was often present alongside the voice of advocacy, where Tracy spoke bolding on behalf of herself and others. The following I-poem demonstrates the voices of advocacy and certainty together as Tracy knew what she needed and advocated for it in counselling in order to experience healing: I walked into her place I was like I don’t want to talk about my mom I want to talk about myself I want to learn how to move forward I don’t want to re-hash things I’m so over that I need a place to begin healing The voice of certainty is heard clearly in Tracy’s story of exiting prostitution. While there was confusion and uncertainty before, certainty is heard clearly in her narrative of choosing to exit and her beliefs about what healthy relationships should be. Whereas before Tracy was unsure about how to relate to people without using her body, she now has a certainty in the way she speaks about her future relationships, her relationship with herself, and even what she would want to pass down to the next generation. I didn’t want to die like that. I didn’t want to die alone…I finally got to a point where I was like you know what, this cycle needs to stop, cause if I ever have children and I have HEALING AFTER SEX TRAFFICKING 88 a little girl I am definitely not teaching her that’s the way to love yourself, that’s not the way to receive and give love. That’s not it at all. As Tracy described what healing means to her she spoke with certainty and confidence about honouring the unique aspects and needs of each person as they heal. She said, Don't hide the fact that you're an addict, don't hide the fact that you've done this, that you've done that. Like if you're ashamed of it then you know, don't do it. But at the same time you can't, you know. Cause there's a lot of shame in what I've done but I've also again, learned, that that wasn't mine. I've really learned that healing is, it's your own personal journey. Everybody's journey is going to be different, and honouring that for each person rather than thinking if I did it this way if you never do it this way you're never going to heal. When asked what healing means to her Tracy explained, Healing is learning to love ourselves, unconditionally. Every aspect of ourselves, dark, light, heavy, masculine, feminine, whatever…. No longer placing blame and then again, being really intentional about the steps you want to take, and if they’re not working for you, change them. This is a beautiful summary of what we have learned from Tracy in regards to the research question. Healing for Tracy means that she is able to make choices and be intentional in putting herself first. Healing comes through acceptance of all parts of herself and unconditionally loving herself. Tracy has sought out healing in various forms from spiritual practices to counselling, and has crafted what has worked for her. Tracy has found strength and purpose in advocating for herself and other survivors and this has propelled her to move forward in her healing journey. Despite the challenges of being dismissed by people, feeling uncertain HEALING AFTER SEX TRAFFICKING 89 and confused, and the disconnection she has felt in relationships with others and herself Tracy has come to a place of being confident in sharing her story of exploitation and the healing journey she has embarked on. For Tracy, she needs to be moving forward and cannot be held back by people who don’t believe her or support her. There is a beautiful movement of how the voices of certainty, advocacy and choice all work together to demonstrate Tracy’s journey of healing. Tracy becomes certain of her needs, then advocates for them, and then makes a choice to do something about them, making those needs come to pass. Tracy has shown great resilience and perseverance as she has tried so many different ways of working to heal from sexual exploitation. She has shown us that western ways of healing such as medicine and psychotherapy are important, but what has been more important for her is developing a relationship with herself and meeting her individual needs. Tracy’s story also teaches us the importance of adaptability in healing, as sometimes what she needed was outside of the contemporary forms of healing: finding a place to yell and give herself permission and space to be angry was crucial. Tracy has also shown us the value of incorporating spirituality into her healing; the value of connecting with the spiritual realm should not be dismissed as it has been invaluable to her healing. Tracy’s journey also emphasized the importance of having a platform for survivor’s to speak and share their stories. Tracy has created her own platform to speak out by creating a Facebook group and more recently attending human trafficking awareness events and completing this interview in order to have her story heard. In the follow up interview Tracy shared that she felt proud and connected to the other survivors in hearing parts of their stories and seeing their quotes. She affirmed the results that were found in her own study and since our interview had even started to be a foster parent. She connected with the theme of connecting with her inner child, and stated that she did this through HEALING AFTER SEX TRAFFICKING 90 being a foster parent, and having known what the children were going through, she sought to give them the love and care they needed. Tracy also shared that connecting to her body has been the most challenging, but also one of the most important parts of her healing journey and believed it was important to highlight. Tracy also identified with the voice of compassion and the theme of forgiveness, saying that she had now forgiven her mom for introducing her to prostitution, and that she was able to forgive herself as well for the things she had done. Tracy shared that participating in this study was a marker for her in her healing journey. HEALING AFTER SEX TRAFFICKING 91 Cory. Figure 9. Healing Poem, Cory. Artwork by Megan Snopek. Cory is in her late 40’s, and is Metis and Euro-Canadian, born and raised in Canada. We met in her empty apartment, sitting on pillows and blankets in the middle of what was her living room for 13 years. She had just moved to a new house with her partner and was still in the process of selling her apartment, which has been a constant safe haven in her healing journey. We drank coffee together on the floor as she sat across from me and shared that she had trouble sleeping last night due to feeling nervous about this interview. Cory made eye contact as she said that despite her nerves, she is ready to tell her story. As Cory filled out the forms she asked me about my interest in the topic and her story began to unfold as we talk about the hidden nature of sexual exploitation in Canada and how that differed from my experiences in Thailand. Cory shared how she entered the world of sex trafficking and exploitation by being brought into HEALING AFTER SEX TRAFFICKING 92 a sex ring by her group-home sisters at the age of 15. Cory said that she felt taken care of when she was a teenager who was looking for guidance by older men who would have sex with her and then take her out for dinner. Cory defined her story as going from “one unsafe situation to another”: from foster care, to sex trafficking, to an abusive relationship, to more abusive relationships. As Cory began to share her story of entering the world of sex trafficking we are first introduced to the voice of avoidance: We don’t see it I wouldn’t use Cory I’ve avoided thinking I really had been able to compartmentalize I wasn’t thinking about it I never really allowed myself to feel I’ve worked so hard to hide I was afraid of what I would see I’m going to be shown The voice of avoidance is heard as Cory speaks about one of the many obstacles in her healing journey: overcoming her desire to hide, suppress, compartmentalize and avoid her past experiences. This voice represents a lack of permission from within herself to think or talk about her experiences. The voice of avoidance was evident as Cory explained how she has wrestled with the tension of wanting to heal and also with the difficulty and pain associated with talking about her experiences saying, “it’s still really difficult to talk about, or even for me to go there myself”. The voice of avoidance represents the real challenges of turning towards trauma and HEALING AFTER SEX TRAFFICKING 93 uncovering the realities of sex trafficking in Canada. The exploitation that Cory was experiencing was masked as “guidance” and care by the men who exploited her, and the nature of sex trafficking make it difficult for Cory to still fully allow herself to feel what happened to her. The second voice to enter Cory’s narrative is the voice of powerless. This voice was first heard when Cory shared how she entered the sex trade and was first exploited. While Cory did not label herself as powerless, it is clear that her lack of options, or feeling like she had another option made her vulnerable to being swept up into a world of exploitation. As a teenager Cory was powerless by the circumstances she grew up in as part of the foster care system. The voice of powerless is heard when she says, “there was no one looking after me and I was just kind of left to the wolves”. Feeling powerless dictated many of Cory’s decisions and life events, where she felt that there were no other options for her life other than to work the streets. This voice of captured in the following I-poem: I was quite young I had I had to do this? I got to know I guess I felt I’m made for this I have to I started working the streets They were going to take care of me HEALING AFTER SEX TRAFFICKING 94 They were black guys I thought that was my option I was going to do in life Even as she found a way to leave her life on the streets the voice of powerless is prevalent in Cory’s story as it feels like she almost falls into each phase of her story, saying, “it’s really what saved me from working the street-that was my best option….it evolved that way”. Cory’s lack of options made it difficult for her to have agency and choice in many areas of her life and she was left going along with her best option at the time to survive, even if it meant being in an abusive relationship. Not only was Cory rendered powerless by abusive relationships, but the voice of powerless also makes an appearance in her battle with substances. This voice was present as she said, “there were drugs all around me, that was a constant thing in my life that I couldn’t get away from, or so it seemed.” As Cory tells her story her voice of connection is prevalent from the very beginning, and grows in strength as her story unfolds. She shared that she desired to feel loved by and connected to others, and this desire at first is what leads her into sex trafficking. Her craving for love and guidance made her vulnerable to the exploitation she experienced: The other girls there were already doing it, they took me to this place, and I didn’t, they didn’t say what it was, but I kind of just had an idea, they called them their sugar daddy, and there was a group of these men who would have sex with these teenagers, these young girls, these group home girls. And give them things and take them to dinner, we’d always go out for sushi. It kind of made us feel like we were being taken care of, or cared for. Group home kids who basically have each other to take care of were looking for that guidance. HEALING AFTER SEX TRAFFICKING 95 Woven into Cory’s story of being exploited are moments where she felt loved by others even those who would later be incredibly violent to her. Amidst all of the pain, violence, and darkness Cory had a love story that pulled her out of the world of sexual exploitation. It started the unlikely character of Big Bill, a fugitive from the United States, who despite being “one of the most violent men [she] knew” saved Cory’s life after she overdosed and went into a coma. After waking up she thanked him and got to know him as well as his wife and son, Little Bill, who are all on the run together. As Big Bill and his family begin to move on from where Cory is working on the streets her desire for family and connection motivated her to go with them, which allowed her to her exit prostitution. Cory and Little Bill had a relationship and eventually had a baby together, but Cory shared how it did not take long for her to be included in the cycle of abuse in Big Bill’s family. Despite this, as Cory shared her story the voice of connection was present as she spoke about her feelings of love and gratefulness for this family saying, “I was 16 when I was at my worst and they were the family that opened their door to me and always just showed me love. I’ve never forgotten that feeling of acceptance from them”. Cory explained that despite the abuse in the family it was her best option to get off the street. Love and connection motivated her to leave the streets and join Big Bill’s family, and then it was her love for her child that motivated her to leave them. When I had a baby, I realized I can’t raise a child in this life and so that’s when I started to realize I need to get out…. I finally took my baby son who’s two-ish at the time and I left on my own. I fought to…to better myself from that point; I was like I’m going to- I was determined to raise my son in a more positive life. Cory fought for her son despite her fear and struggles as a single mom alongside her battle with substance use. Cory had other tumultuous relationships along the way and learned HEALING AFTER SEX TRAFFICKING 96 and grew from them. Now, as Cory shared her story she also shared with a grin on her face that she is getting married. When Cory spoke about her relationship with James the voice of connection was strong, not only towards him but how his love for her has allowed her to love herself. I feel like he truly loves me. And it's been a journey in allowing that, I'm noticing the difference in how I think about a relationship, being in a relationship with a partner, I, I always leave people. That's been my pattern, and he's made me stay, if that makes sense. He's made me want to stay and be okay with being loved. It was Cory’s desire and belief in love and connection that continued to pull her through to her healing to eventually be able to love herself. As Cory talked about her story it was clear that not many have been let into the harsh realities that she has experienced, but with her James it has been different. She spoke confidently that, “of course my partner, I’ve told him” when we discussed how she has hid her story from most people. The voice of connection powerfully counteracts the voice of avoidance in this interaction, where despite the desire to hide and compartmentalize herself from her experiences she has allowed herself to be seen and loved in relationship. Despite her ability to overcome her tumultuous circumstances as Cory reflected on her healing journey the voice of guilt threatened to pull her back into the experiences of her past. Cory has moved forward in life, working a government job, remaining sober and being a grandmother, and yet still holds onto the guilt about the mistakes she made. Cory fought to overcome a dependence on drugs and alcohol many years after she left the streets, but unfortunately the substances that allowed her to survive her reality also became an obstacle for her over the years. She shared how she “kept falling into that path and ending up in a place that I HEALING AFTER SEX TRAFFICKING 97 didn’t think I would be in again”. Guilt colours her narrative when she speaks about her regrets about not enjoying her time with her son more, and the things she did or did not do for her son. In the present day Cory has moved beyond being a single mom on welfare, and yet as she spoke about where she is now, moving into a beautiful house with her future husband. Guilt speaks about how “the house itself is excessive” and questions if she deserves to live a life that involves a house with a yard in the light of her past. It is with the voice of guilt that Cory voices her regrets about being in volatile relationships instead of focusing on her son, and not giving him the best that he deserved. Acting contrapuntally to the voice of guilt is the voice of compassion. While Cory still carries guilt for not doing more for her son she also spoke with compassion to herself saying, Being a single mom on welfare was really, really difficult, because I was doing my very best to budget my money. I had very little money, and when you live like that… there’s not a lot of room for anything else. Cory concluded the interview by sharing some symbols of healing that have been significant to her in her journey. She shared with me one of her favourite books, a book about forgiveness and how she continues to go back to this book over many years (See Figure 10). HEALING AFTER SEX TRAFFICKING 98 Figure 10. Healing Image – Forgiveness, Cory. While she still holds guilt and regret from her past, she is also able to be compassionate and forgiving towards herself saying, “Forgiveness is an on-going thing I have to keep revisiting. Forgiveness for myself for things I did or didn’t do”. As Cory spoke about her relationships with others it was clear that compassion is an important part in her healing journey after the exploitation and abuse she has suffered by others. The voices of compassion and connection are heard simultaneously as Cory speaks about her relationship with Big Bill and Little Bill: I remember Little Bill crying, and he would hide it from me, and even at 16 I was able to see; this is a 14 year old little boy, and trying to understand his life and his situation. Big Bill was one of the most violent, scary, people that I’ve ever known. And as I got to know him over the next four years I got to know his soft side too and the good parts of him. So, I had a lot of compassion. I had a real love-hate relationship with Big Bill, his HEALING AFTER SEX TRAFFICKING 99 dad. I could see the cycle of abuse in that family…Big Bill has since passed…. And yeah, I still think about him in a good way. I think about the good qualities. There’s a lot of good things about him too, even though it was the most dysfunctional and violent home that I’ve been in. Cory’s ability to understand even the most violent of men and speak about him with compassion is a strength that has helped her through her life and healing journey. As the research team encountered Cory’s voices of connection and compassion overlapping we wrestled with the strangeness and beauty of living in the tension of having compassion and love for one’s abusers, and how Cory demonstrated that relationships are never as straightforward as they might seem. The next voice is the voice of agency, which powerfully directed her narrative and countered her voice of powerless from the beginning of our interview. Cory shared how she has recently intentionally decided to use her real name again after many years of never using it. In doing so, she has reclaimed her identity as Cory and the girl she was before she was exploited. Cory made bold choices to leave the sex trade first to leave with Big Bill and his family, and then by making a decision for herself and for her son to leave the abusive relationship that she was in. Despite the challenges that she would face as a single mom she chose to set out on her own. The contrast of the voice of agency is stark compared to powerless as shown in the following I-poem: I had a baby I wanted to keep my son I broke out of that situation I finally left that street life I started to realize HEALING AFTER SEX TRAFFICKING 100 I need to get out I finally got up and left I finally took by baby I left on my own I rented my own basement suite I was a single mom I fought I was determined I went through hell I didn’t give up I was determined As Cory reflected on the last 5 years of her life that she said have been the most healing for her it is clear that having agency has been a large part of this most recent shift for her. After an accident that left her with a severe concussion, Cory’s voice of powerless was strong, however Cory made the decision to live in Hawaii for two years after this occurred. Cory reflected that in some ways this was an escape from her life in Canada, however the voice of agency was still present in her choice of deciding that she needed to escape her life here. When she found out she was going to be a grandmother the voices of agency and connection combined in her narrative as she made the decision to come home: I came back I was going to become a grandmother I was like yep I’m coming back to work HEALING AFTER SEX TRAFFICKING 101 I’m going to live in Canada again When Cory told her story of being exploited, the voices of powerless and connection were enmeshed together, however as Cory’s story unfolded and she fought for healing the voice of agency has replaced powerless in relationship to connection. This was seen as Cory began to make choices that led her to connection that did not leave her powerless in abusive relationships, or in dependence on drugs. She has made long-term commitments to be in a relationship with someone she loves and trusts, and in doing so she made the daily choice to love him and herself through all that entails. I met James We’re getting married I do want this I want this life To have a partner I’m still very independent Allowing myself to be loved I don’t fight the little stuff We’ve decided We’re not going to break up again We heard the voice of agency strongly throughout Cory’s story of healing, and found that it was particularly strong when she spoke about her decision to use ayahuasca as part of her healing. I started researching I learned about ayahuasca HEALING AFTER SEX TRAFFICKING 102 I realized I need this I really need this! I knew I wanted to do this work I was so hesitant I was afraid What I would see What I’m going to be shown I went 2 months later I was like yep, bring it on! Sometimes as Cory spoke about ayahuasca a voice of powerless also appeared, as she is also afraid of what she would be shown and stated that she is powerless to what happens when she drinks this medicine. Despite knowing this she has made the decision to continue using ayahuasca to facilitate her healing. Cory describes ayahuasca as one of the most important aspects to her healing. She attributed engaging in ayahuasca ceremonies over the past five years to her openness to exploring her experiences of being sex trafficked as a teenager. The use of ayahuasca is yet another tension that is seen in Cory’s story. In the past Cory used drugs to numb herself from her reality saying, “I was so desperate to numb out, someone gave me something that I had no idea what it was but I took it and it made me high so I took more and more and more and ended up in a coma”. Cory spoke in the voice of agency as she described choosing to engage in her healing through ayahuasca, stating that “[ayahuasca] holds a mirror up to your face and shows what’s really going on”. This experience, though terrifying, has allowed HEALING AFTER SEX TRAFFICKING 103 Cory to connect with her experiences and integrate them into her identity now. Her experiences with ayahuasca are distinctly different from her experiences before, where her voice of avoidance would speak about hiding and compartmentalizing her teenage self. Cory’s experiences with ayahuasca have helped her do deep healing by acknowledging the depths of her pain. She described being surprised by the grief she experienced as she remembered the loss of one of her group home sister’s who was found on Robert Pickton’s farm saying, I didn’t realize how much that affected me until that ayahuasca ceremony…. The whole night was spent sobbing in pain for her. That was something I never really allowed myself to feel…that was my foster sister. Cory ended our interview speaking with the voices of agency, avoidance, compassion, and connection in a beautiful and intricate melody as she shared about her continual healing. Her choice to face her past experiences and show herself compassion has to drawn her into deeper connection with herself and we see that it is an integral part of her continued healing. This is what I wanted to look at, I need to integrate this part of my life and not shut it out so much. That part of me, the part of me especially selling my body and the feelings that I have when I was doing that, those things. It’s still hard for me to talk about and think about, but I need to start integrating. It’s so important for me to do this. The other images that Cory brought to represent her healing journey include her journal, a picture that she received from a camp that she went to, and a postcard (see figures below). She shared that she chose these images as they are “gentle” and represent her connection with the others and the earth. HEALING AFTER SEX TRAFFICKING Figure 11. Healing Image, Cory. Figure 12. Healing Image, Cory. 104 HEALING AFTER SEX TRAFFICKING 105 Figure 13. Healing Image – Journal, Cory. Cory’s stories are full of strength, resilience and healing, as we learn how she has been able to overcome intense trauma, manipulation and abuse over the years, and has engaged in a deep healing process where she has decided to face the dark parts of her experiences. One of the most central stories in her healing journey is how Cory has overcome feelings of powerlessness and began to make choices for herself and her son. Cory has also chosen to intentionally face and accept the trauma that happened to her and allow others, like her partner myself into her experiences. Through Cory’s story we learn that importance of love and connection for Cory to be able to heal after being abused, oppressed, and exploited by others. Cory’s strength resides in her ability to be compassionate to others who have wronged her and then later extend that compassion to herself as she fights to overcome guilt from her decisions as a mother. Cory recognized her need to integrate her past experiences with herself in the present in order to continue to heal from sexual exploitation, and in doing so has connected with her son, grandson, and partner to support her as she does this work. HEALING AFTER SEX TRAFFICKING 106 Following the interview another important aspect of Cory’s healing journey came to light, which is her connection to her cultural identity as Metis. Initially, as she filled out the demographic questionnaire she identified as “Canadian” and then after we had finished our interview Cory shared that she is Metis and because she did not grow up knowing this, having been in the foster care system, she forgets about it. She said that she is now learning to connect with her culture and learn how to integrate Indigenous practices into her healing. At the group feedback session Cory shared that following the interview she had experienced further healing since acknowledging her experiences as a teenager rather than burying them. Cory affirmed that the results from the individual feedback she received represented her story well. She also shared that she was especially touched by the image and poem that she received as the bear had been a significant symbol for herself and her son all through his childhood. Cory shared how she recognized herself in many of the women’s statements, including the statements on the voice of avoidance, as she had suppressed her experiences for so long, and only recently had started exploring them and accepting them as part of her identity. Cory shared that meeting the other participant was especially impactful for her, and she planned to do further reflecting on her experience to integrate this part of her journey into her healing. HEALING AFTER SEX TRAFFICKING 107 Charlotte. Figure 14. Healing Poem, Charlotte. Artwork by Megan Snopek. Charlotte and I met in her favourite coffee shop where she felt safest to tell her story. Charlotte was unmistakeable for multiple reasons, the first was that she was wearing a colourful loudly patterned dress and the second was that she had a physical disability; both of these things are large parts of Charlotte’s story of both sexual exploitation and her healing. Charlotte is in her late 40’s and was a victim of sex trafficking from the “moment of her inception”, by her mother in a rural community in Canada and was finally able to leave at 17 years old. As she described these experiences the voice of oppression became jarringly obvious. We heard the voice of HEALING AFTER SEX TRAFFICKING 108 oppression as Charlotte described a life of forced sex, forced drugs, manipulation and no control. The I-poem below illustrates the gruesome tale of how she ended up as a victim of sex trafficking: I didn’t enter it I was born into it I was thrown into it I think that was her intent from the minute of inception They were drugging me a lot They managed to control me Charlotte told a story of oppression, manipulation, ritual abuse, and sexual exploitation, and she was clear that there was no choice in these experiences because her mom was her trafficker, meaning that she could never escape the abuse. We heard the voice of oppression again as she explain her first memories of being sexually exploited: She was involved with a group of hippies who believed in ‘free love’ and by free love they meant raping children, and then having sex with each other…I remember being passed around with hippies like in a circle in the woods when I was 2 and a half… There’s no choice involved. Charlotte shared openly that she is diagnosed with Dissociative Identity Disorder (DID), and that this is a common experience for anyone else who has experienced sexual exploitation from a young age. Charlotte shared that contrary to what many people may think about DID, her ability to split herself off is what saved her and helped her survive all those years of exploitation and abuse. When Charlotte spoke about her parts and dissociating we labelled this voice as the HEALING AFTER SEX TRAFFICKING 109 voice of disconnection. We recognized it when she spoke about separating her self into parts, that she commonly labels as “multiples”: The person who was going to school was for the most part unaware of what was happening at night and what was happening at home because otherwise I couldn’t have done it, so I’m quite glad for that development, that adaptation…. To this day I say that I did something or something was done to me, I feel like I’m lying because it was another personality it wasn’t really me. Charlotte was adamant in our interview that her ability to dissociate should be seen as a protective mechanism, and that healing for her does not look like integrating between her parts, but that it is acknowledging the importance of all of her parts. At the same time, we also heard the voice of disconnection when Charlotte spoke about the lack of connection she has to her body. We heard this voice as Charlotte described the complex relationship she has with her body; she has needed to disconnect from it in order survive, and has also used exercise in the past in order to feel strong and capable again after being free from sex trafficking. Unfortunately, the damage that her body endured from those years of trafficking led to her body breaking down because of the chronic abuse and exploitation she experienced. Though her disability has been something that has provided an obstacle for her in her healing, she is also in the process of changing her relationship with her body. The voice of disconnection is heard when she speaks about her body as a separate entity from herself: So, when my body gave out I had to reassess everything…. I started to reassess the way that I had been driving, pushing myself. I realized I did have to talk about it, what happened to me…. I was trying to stop ignoring and hurting my body and start living in it. HEALING AFTER SEX TRAFFICKING 110 We heard another voice alongside her voice of disconnection that we recognized as the voice of logic. This voice was identified through the confidence and matter of fact way of speaking. Charlotte achieved a high level of education and her voice of logic was present with her through her experiences of achieving her graduate degree. Charlotte shared how this has helped her survive and get to the point where she is saying that, “I tend to cerebralize things”. At the same time, we heard Charlotte’s voice of logic as she shared that this knowledge she carries has also provided a barrier in her healing journey: Being smart does not make you immune to drug addiction, mistakes and human emotion. And I’m trying to get that into my own head. I thought I was too good to have PTSD because I understood how it worked so why couldn’t I just make it go away…. So if my emotions are symptoms of PTSD then I am symptoms not self. One of the most prominent voices in Charlotte’s narrative was her voice of injustice. This voice was filled with a demand for justice, and was full of righteous anger at the exploitation that she and others have faced. We heard this voice throughout Charlotte’s interview as she spoke about the chronic injustices that she has suffered because she is a victim of sex trafficking. The voice of injustice was particularly vocal when she shared how her disability is due to the abuse she experienced as a child and how many people refuse to acknowledge this as a reality, causing her to lose her job. We heard the voice of injustice in the following quote: It takes a village to abuse a child and that village is huge…. There were people who knew what was wrong when I was a child and never did anything including my father! That’s a bit of an impediment. I would not be disabled today if one of- you can hear a lot HEALING AFTER SEX TRAFFICKING 111 of anger. In a weird way at this point of my life I am more angry with the silent majority than with the people who have used me. Charlotte wanted to emphasize the role that people’s apathy has had in her experiences of being to be trafficked and exploited her entire childhood. Charlotte’s voice of injustice was prominent not only when she spoke about the abuse she experienced but also when she spoke about the abuse that her Jewish ancestors experienced and other victims of sexual abuse and exploitation. The next voice that we heard in Charlotte’s story was the voice of agency. This voice was noticed when Charlotte spoke about the choices she made to move forward in life and how she gained freedom. We heard this voice emerge as she spoke about how she used clothing as part of her healing journey. Charlotte has a unique sense of fashion and uses it as a form of agency and freedom in her daily life. In the quote below we heard how Charlotte’s fashion has been a way where she has found healing from oppression and abused: They don’t want you to dress like grown ups, they don’t want you to wear make up, so you just wear your normal clothes, that’s what they want. So, there was no dressing up for them unless there was some sort of fetish thing. Plus, I was forced to be naked a lot so to put things on of my choice is so healing now. Not only has Charlotte used fashion a form of exercising her agency, but she has also used her words to do the same by using her words to educate others about sex trafficking. We heard her voice of agency emerge as she spoke about being a writer, making a blog, speaking out publically about what has happened to her, and choosing to be an activist in women’s rights and gays rights communities. We heard her voices of injustice and agency intertwine as she spoke about breaking the cycle of abuse generationally saying, “they say it’s a pattern, it passes from HEALING AFTER SEX TRAFFICKING 112 generation to generation. Bullshit! I have free will, everybody has free will.” Her voice of agency spoke as Charlotte shared that giving herself permission to feel and heal how she needs to has been an essential part of her healing journey. Charlotte explained that this looks like giving herself permission to be angry because “anger connotes self-respect. If you’re angry about it, it means you know you deserved better”. The next voice that we heard was a voice of avoidance, which surfaced as she spoke about hiding and turning away from her experiences rather than accepting them. This has served as a protective mechanism and part of Charlotte’s ability to survive. We also noticed that this voice was also present when she spoke about her relationship with clothing. We heard the voice of avoidance as Charlotte shared that she used conservative clothing as a way of hiding from her past so others would not know what happened to her saying: There was a long time for me where my clothing was a disguise. I didn’t want people to know what I lived through. I felt that I could hide it by the way I dressed…. People were always shocked to see me do drugs or whatever or be lesbian. So, I had this sort of- it was my disguise because I was raised hippie, so I rebelled by dressing conservatively. We also heard the voice of avoidance as Charlotte spoke about shutting down her emotions and putting a wall between herself and her childhood. She described moving forward with her life by being successful academically and by pretending that her childhood experiences did not happen. We heard the voice of avoidance as she said, “for 10, 15 years I had just gone cerebral. And for the last sort of 10 years I had been largely celibate as well, because I was just running away from everything and it was barely me, at all”. Contrary to the voice of avoidance was the voice of connection, which represents a connection to her child-self, her body, and connection to others. We noticed that this voice was HEALING AFTER SEX TRAFFICKING 113 strongest when Charlotte spoke about her relationship with her husband, Jared. As Charlotte spoke about her husband she shared how her relationship with him has been different than any other relationship she has been in before and it has been so healing for her: When I met Jared, within a week he mentioned I just started dating a woman. I had never been in a relationship like that where they told their friends about me right away…. He knew right away that I had PTSD, and he asked me if there was anything that triggered me. And I said well the colour light blue is very difficult for me. He was JUST, he was broke, single father of two, under employed, finishing a PhD. He had just painted his bedroom light blue, gotten light blue sheets, done something nice for himself, before I visited him, I'm going to cry.... He painted, he re-painted his room and he got new bedding…. And nobody had ever done anything like that in my life. He made room for me, right away! His friends all knew, I was his...his priority. I had NEVER been that before. The voice of agency was also layered with the voice of connection as Charlotte talked about reclaiming and connecting with her body. Charlotte shared how she got a tattoo on her upper thigh in order to never have to be naked anymore. “It’s like I’m never alone. And if you ever come near that part of my body, this is my body because look at what I did, I marked it as mine”. We also heard the voice of connection as Charlotte shared that she has recently been finding connection and healing as she learned about her Jewish ancestors. As Charlotte dove into learning more about her Jewish genealogy she found strength in knowing that her ancestors also survived intense trauma and found the will to live. She described finding a memoir written by one of her ancestors and discovered that her ancestor also found strength and resiliency in HEALING AFTER SEX TRAFFICKING 114 fashion. Not only has she found healing in connecting with her ancestry, but she has also found connection in her spirituality with Judaism. Charlotte stressed the importance of her spirituality being part of her healing, but not necessary for people to have their spirituality be a certain way in order for them to heal. Charlotte shared that her connection to God is unique to her and that even the way she understands her experiences of Dissociative Identity Disorder (DID) and multiplicity is the same way she conceptualizes God: there are parts that are not understandable and we are limited in our capacity to understand God fully. Charlotte’s voice of connection was heard in many areas of her life and speaks to the importance of healing physically, emotionally, mentally and spiritually. When I asked Charlotte how she felt about the definition of healing being connected to being “whole” she responded that healing is more than that to her. She said, I think [healing is] trying to love yourself and your body and owning both of them as your own and not think that they are sullied by what was done to you…honouring whatever it is that helps you… Recognizing that you always were whole and that they tried to rip that way from you and somehow you’re still here and so they couldn’t do it. I believe that the following I-poem captures parts of Charlotte’s healing where her literal voice and her voices of agency and connection are heard together. I’m just a born writer I started speaking out I tell my story I dress up I have value I’m on the other side HEALING AFTER SEX TRAFFICKING 115 I have free will I can tell the world We can learn the importance of finding healing unique to each survivor through Charlotte’s story. Charlotte’s journey was unique because she reclaimed her childhood through fashion and using her voice as a writer when she was silenced. She uses her voice to advocate for justice not only over big issues but smaller injustices as well. She teaches us that healing looks different for each person, and that DID can be viewed as resilience rather than pathologized. She also teaches us the importance of acknowledging trauma and working holistically with survivors to address the impacts of exploitation on their minds, bodies, and souls. We learn the importance of honouring each part or personality of a survivor and how they have worked to protect her because of Charlotte’s story. Charlotte teaches us that reconnecting to a survivor’s childhood and doing the small things to love herself are equally as important as sharing her story and speaking her truth. Her choice to surround herself with people who are safe, loving and believe her has helped her find healing and has allowed her to love herself as well. Charlotte bravely stepped into relationships despite being so abused and hurt in the past, and her courage teaches us that while Charlotte has experienced many barriers and obstacles in her healing journey survivors are resilient and are able to speak for themselves and deserve to be listened to. After our interview Charlotte shared that she wanted to emphasize the importance of accepting what had happened to her, being DID, and that she was a victim as crucial parts of her healing. She also shared an image with me that she felt represented her healing, saying, “I keep seeing a bright bird, a dove or a swallow, emerging out of darkness into bright light, but also itself a source of light, almost like the holy spirit visiting Mary - in reverse”. Figure 15 shows HEALING AFTER SEX TRAFFICKING 116 the mezuzah that she has on the doorframe of her study that is a visual representation of this to her. Figure 15. Healing image, Charlotte. HEALING AFTER SEX TRAFFICKING 117 Marie. Figure 16. Healing Poem, Marie. Artwork by Megan Snopek. Marie reached out to me when she read about this project both a desire to share her story but also to connect with another advocate for human trafficking in the Vancouver area. Marie is in her late 50’s and is of Metis descent. Marie’s story begins when she is in her 20’s and a man who she knew as a child comes back to her life and began to pursue a romantic relationship with her. This courtship had a different feeling to it, and Marie reflected that even back then there was something that felt wrong, that he was controlling, manipulative, and secretive even before she married him. Marie felt helpless to say no to the marriage at that point, and while Marie has difficulty remembering many of the details she knows that there were drugs involved, and that her family was also being coerced into allowing the marriage to happen. Marie told a story of being forced to take drugs, being trafficked across borders, and memory gaps between what actually happened and why. The men who were involved in trafficking her held professional, highly esteemed jobs, and were well respected in the community for their jobs and the positions HEALING AFTER SEX TRAFFICKING 118 of power that they held. The nature of Marie’s story of being exploited and trafficked make it hard for people to believe her, and even difficult for people to want to believe her, because it would mean that the men who are supposed to be safe and trustworthy are not. This internal challenge is reflected in the voices that are present in her narrative, the first of which is the voice of disbelief. The voice of disbelief made its’ initial appearance in Marie’s narrative as a voice of disbelief from others as Marie tried to share her story and get support as a victim. We heard this voice as she said, “I was really upset one time when I phoned victims services about a decade ago I guess, or maybe just under a decade ago… “Oh, are you really a victim?” This voice was also heard from Marie herself as she talked about exploitation and trafficking, and it has tones of incredulousness about these dark realities despite her own experiences. Marie’s voice of disbelief is a true testament to the confusion and shock that surrounds the industry of human trafficking. Marie shared how it is difficult even now for her to accept the corruption that she has seen first hand as a reality, saying, “they’re getting young girls to get involved in prostitution in Fort Langley. I was just like wow, I couldn’t believe that…. You know, it was a hard thing to swallow”. The voice of disbelief represents a challenging obstacle in Marie’s journey for healing when it has come through the voices of others, especially those in authority. We heard this voice as Marie reflected on her experiences trying to tell the police what happened to her: The police, when I went to them with some of this they just turned it around and didn’t support me at all…and I thought this guy, he’s you know, not believing me or something, and I just thought wow, this is crazy. And I thought, ah, never again will I come out and try to fight this because this was just…ah… too much to bear. HEALING AFTER SEX TRAFFICKING 119 The voice of disbelief transitioned into a voice of helplessness as the weight of disbelief from others silenced Marie, rendering her helpless to receive justice and support as a victim of trafficking. Marie explained that because her ex-husband is a physician he used his position of power to further exploit her. She said, “because my ex is a physician, he can get a pass to move me around as a mentally unstable person…. He could move me around because he’s given me that label”. In the present day despite having escaped exploitation the voice of helpless still wove through her narrative as she Marie shared how she has tried to receive support. Marie explained that she received inaccurate diagnoses that led to her being taken under the mental health act, and when she spoke about her fear of this being repeated we heard the voice of helpless strongest: You know, its just been one jump through a maze of corrupt hoops to try to have some rational and try, you know, piece everything together, but when you have people that are prominent and they can have doctors in their pockets…they stick together…. It would have been good had I been able to share everything with that psychiatrist nurse, but then I thought I might implicate myself, they might do something to be to have me pulled in my the mental health act again, and that was an absolutely deplorable thing to do. This voice sheds light on how societal views, and structures can work against women like Marie in her healing journey. Marie has an intersection of vulnerabilities that have made her susceptible to being trafficked, and as we heard the voice of helpless we could hear how these vulnerabilities have also posed additional obstacles for Marie’s desire for help and justice. Marie’s position as an Indigenous woman who is uneducated in society has kept her from the same privileges and respect that someone of a different socio-economic status would likely have access to. The voice of helpless was often heard layered with the voice of oppression in Marie’s HEALING AFTER SEX TRAFFICKING 120 story. The voice of oppression is recognized when Marie shares her story of being groomed through her marriage, which led to her being trafficked. Force and control were present in the voice of oppression and were evident when Marie described how her husband was able to control people close to her, including her family: He would show up to functions that I was at almost like stalking me, getting to know people that I knew. I was dancing out in Abbotsford and my ex’s cousin was like “oh you shouldn’t be dancing with her, [to someone else] he wouldn’t like that. Things like that. It was all control… [my family was] intimidated by him and went along with him…. There were drugs being given to be by force. We heard the voice of oppression as Marie spoke about corruption in systems and people in power throughout her narrative. Not only did we heard the voice of oppression in her narrative of being exploited, but we also heard this voice in her narrative of healing, when she tried to move forward after the exploitation. Marie shared that she grew up in an abusive home, and so even though she is no longer a victim of trafficking she is still surrounded by reminders of abuse. Years after her exploitation has stopped the voice of helpless was still prominent in her story, though it has diminished significantly. Instead, Marie has a voice of advocacy that we heard strongly in opposition to voices of oppression and helpless. This was especially noticeable as Marie advocated for herself against further abuse from her step-dad, saying: I’ve been a victim of her spouse, he woke me up…. I felt really dizzy and he was in that room and I was like ‘what are you doing in here?’ and he says ‘oh, the furnace’ and I said there’s nothing wrong with the furnace, get out! We also heard the voice of advocacy as Marie shared how she has found the strength and resilience to speak up and advocate for her needs, despite the disbelief of others, and how many HEALING AFTER SEX TRAFFICKING 121 people tried to render her silent. Marie speaks of Robert, one of her traffickers, as a “terrifying man” who is able to manipulate authorities and take advantage of her and other women like her while pretending to help. Marie shares how she experienced him suggesting that she would die on the Yellowhead, like many other Indigenous women have. As an Indigenous woman Marie has experienced oppression in many forms and has a heart for other women like her. Her I-poem below is an example of how she stopped being silent and phoned the cops on Robert when he threatened her. I made a statement I told the cops I phoned the cops He was shocked I phoned the cops Marie’s voice of advocacy is a core part of who she is and how she has experienced healing. This was evidenced even the first time I met Marie and we spoke on the phone about my study as she shared her heart for sharing her story was so that other women would also be able to get help. Marie’s experience of being excluded from services and unnoticed in her exploitation has motivated her to speak up for other women like herself. The voice of advocacy was heard when she said, “These women have fallen through the cracks, the same as myself”. Marie has been in a position of authority and leadership within the Indigenous community and currently advocates for Indigenous peoples to have access to culturally sensitive and appropriate healing, as this is something she lacked. Marie is currently trying to work on gathering funding for opening up a transition house for Indigenous women in the lower mainland where they can HEALING AFTER SEX TRAFFICKING 122 have their culture recognized in their healing journey. We heard her voice of advocacy as she described her hopes for cultural healing: I’ve tried to get it implement in the hospital to make sure that there are Aboriginal workers so patients there can have their right to have Aboriginal traditions and medicine, especially food…my goal is to open up this trafficked women’s house. Marie’s voice of injustice was heard closely alongside her voice of advocacy. We distinguished her voice of injustice when she questioned and challenged receiving unfair treatment or apathy from power structures, society, or people in her life. We heard this voice as Marie voiced her anger about corrupt services that should be protecting women but are not, saying: “What is the RCMP doing about it? They have a national task force but there doesn’t seem to be a lot of convictions”. Marie’s voice of injustice was heard powerfully when she spoke about the injustices towards Indigenous women like herself and how they are more vulnerable to being exploited and treated poorly. This voice was heard as Marie questioned if her victimization was because of her race and she speaks about the corruption that is embedded in this experience: There’s a lot of Aboriginal, Indigenous women that are victims of this, and not only women but children too…there’s a lot of rings out there that cops should actually be looking for to catch…. I never did anything to this guy and for him to come at me like wha-what was his objective? What’s he trying to do? Is it because I’m part Indigenous? The final voice present in Marie’s narrative was the voice of resilience. Marie’s voice of resilience peaked through her narrative from the beginning of our interview where she explained that is able to bounce back from the rejection of the victim’s services disbelief because she is “a strong person”, to the end where she described how she moved past multiple rejections and being HEALING AFTER SEX TRAFFICKING 123 silenced as she has tried to shared her story. When I asked her how she has overcome people who have not believed her story she responded in the voice of resilience, saying: “I find people that will listen to me. My healing journey is paramount, it’s really important, and if I’m not listened to, it doesn’t matter”. Marie has continued to move forward despite the many challenges she has faced from being a victim of trafficking in Canada to not being believed. Marie’s strength and hope for a better future for herself and for other women shines through the following I-poem: I went to that cycle I finally broke that cycle I was able to say no Marie did not have a visual depiction of this, but used the image of a killer whale to represent healing to her, saying that killer whales are part of a strong family unit and her Aunt in particular has been an incredible support for her through her healing, even though other family members have not been. We believe that this image is representative of Marie’s desire to be heard, supported, and protected as she continues to heal. Marie concluded our interview reflecting on the cathartic feeling she had by sharing her story and how important it has been for her to be perceived as valid. As Marie looked forward she reflected that her next step might be to write a book about her experiences. Marie’s story speaks to the harsh realities of corruption in systems and people of power and how they have provided great obstacles to Marie as she has sought support and healing. Despite the numerous obstacles that Marie has had to overcome, Marie taught us the power of advocacy for others and how this can be an incredible avenue for her healing. Marie’s role as an advocate for people in her culture to receive culturally appropriate healing, when she herself did HEALING AFTER SEX TRAFFICKING 124 not truly shows her heart and resilience. Connecting with her culture and her faith through the Truth and Reconciliation (TRC) movement has been an important part of Marie’s healing, and we learn the importance of this for Marie as a Christian and an Indigenous woman in Canada. She also spoke about her church’s engagement in the TRC being significant for her healing. Most significant for Marie is the power of being believed as a survivor of trafficking in Canada. She has fought to find people who will listen to her, which she said she received through this project. Marie’s chronic experiences of being disbelieved and discredited have silenced her in the past but her resilience has shone through as she continues to advocate for others and herself to be supported and believed. Marie stated that having people support and believe her is what needs the most in her continued healing. In our follow up interview Marie affirmed that these voices represented her story well. She added that she found value in hearing about the voices of healing from other women as well, and emphasized again that being believed is the most important part of her story. As we discussed her story she shared that her exploitation started even before her ex-husband, and that she became vulnerable to exploitation first as she was molested at 8 years of age, and then later through another man who attacked her when she was 21 years old. Marie stated she is thankful that she is no longer in that situation but highlighted how colonization has impacted her story and made her more vulnerable to these attacks and oppression. Description of the Voices The following section will expand on the voices heard in each of the participants’ narratives and how they interact with one another. This section breaks down the voices into two categories: voices of resistance and voices of healing. This section will also situate the voices in HEALING AFTER SEX TRAFFICKING 125 the context of one another and the research question. Below is a visual representation of the voices in Table 2 and Table 3. HEALING AFTER SEX TRAFFICKING 126 Table 2. Voices of Resistance Voice Description Markers Oppression Control, manipulation and over Speaking of sexual abuse powering women’s choices in or exploitation. Participants All people or systems. Disconnection Separateness from others or Speaking about isolation, 1, 2, 3, 4, detachment from self dissociation, drugs, 6 separateness from body Confusion Questioning, uncertainty and Questioning reality, past disbelief experiences and core 1, 4, 7 identity Avoidance Suppression, evasion and Speaking of shutting compartmentalization of down, avoiding reality 5, 6 experiences Dismissal Silencing from others Disbelief or judgment 4 from professionals Shame Note: Painful feeling of distress or Speaking of self-blame, humiliation regret 3, 5 1 = Lindsay; 2 = Camara; 3 = Emily; 4 = Tracy; 5 = Cory; 6 = Charlotte; 7 = Marie HEALING AFTER SEX TRAFFICKING 127 Table 3. Voices of Healing. Voice Description Markers Participants Connection Being in relationships with self Speaking about love, 1, 3, 5, 6 or others re-connecting with body and self. Agency Advocacy Intentional choices and acting Statements of on decisions choosing and action Standing up for themselves or Speaking about for others against injustices advocating for their 1, 2, 4, 5, 6 4, 6, 7 needs Knowing Certainty, clarity and Speaking with understanding of reality confidence about 1, 2, 4, 6 beliefs, self, and reality Resilience An ability to persist despite Speaking about obstacles. empowerment and 7 persistence in adversity Compassion Grace and forgiveness Speaking about grace 2, 5 and empathy for self or others Purpose Hope for the future and meaning Speaking about in life. meaning in life, her 4 daughter Note: 1 = Lindsay; 2 = Camara; 3 = Emily; 4 = Tracy; 5 = Cory; 6 = Charlotte; 7 = Marie HEALING AFTER SEX TRAFFICKING 128 Voices of Resistance Voices that were present in this category represent the attempt to prevent healing intentionally by another person or system. Voices in this category are also voices of opposition from the self that emerged in order to protect oneself from not being negatively effected by the exploitation. The voices of resistance were heard as participants spoke about sexual exploitation, manipulation, abusive relationships, poverty, lack of life skills, judgment and disbelief from others. These voices were also heard when participants spoke about their mental health issues, including PTSD, DID, anxiety and depression, as well as substance addictions. Additionally, the voices of resistance were heard when participants shared stories of discrimination for their experiences in the sex trade, their sexual orientation, being Indigenous or part of other minority groups from members of the medical community, law enforcement, or other community members or important relationships they encountered. Voice of oppression. In each woman’s narrative there was a voice of oppression, which included feelings or situations of manipulation, force or lack of control from people or systems towards women. Voices that were included into this category were the voices of oppression (Lindsay, Camara, Emily, Tracy, Charlotte, Marie), powerless (Cory) and helpless (Marie). When women used this voice they were speaking about what it means to be helpless or powerless in situations and have their agency taken from them. This voice was used when describing how women were exploited and other abusive situations that followed these experiences. The voice of oppression was heard when women speak of being raped, sexually exploited, or held against their will. We recognized the voice of oppression when women spoke about feeling forced, obligated, or trapped using phrases such as “I had to”, “I couldn’t”, and “he forced me”. As we heard the voice of oppression in Cory’s story it represented the feelings of HEALING AFTER SEX TRAFFICKING 129 powerlessness she felt and lack of control she had over her life while being in the foster care system. When Cory spoke in this voice she said she was “left to the wolves”, which resulted in her being sex trafficked. Cory described her entering prostitution because of her desire for love and care was used against her. We heard the voice of oppression as she said, “they made it feel like they were really taking care of us…We gave payment by having sex with them, and there was one that I just couldn’t stand”. Many women identified with this experience of manipulation and coercion in their individual interviews and in the feedback session. These feelings were prevalent across all the interviews, however, each woman’s experience of oppression differed vastly from each other: in Camara’s story we heard about the typical grooming process where her boyfriend turned into her trafficker, and in Charlotte’s story she was a victim of trafficking as early as she could remember. She explained that it was her mother’s intent to traffic her for sex from “the minute of inception, if not before”. The voice of oppression was heard as she described being “literally locked in a room, chained up, and all of that and drugged up, SO many drugs…. I was very deluded”. All the women spoke about being controlled by drugs, either initially being forced to take drugs, or their desire for substances being an entrance to their exploitation. There were also experiences of women who believed that they were in control only to realize that they were not and experienced violence, abuse, blackmail and exploitation. The voice of oppression was heard in Lindsay’s story as she spoke about being manipulated by men because of her drug addiction. She shared how it was her decision to sleep with men for drugs and always felt in control, only to reflect back on her experiences to say, “I was only 13 to 15 so I probably was very manipulated….I felt if I didn’t go then something bad would happen”. HEALING AFTER SEX TRAFFICKING 130 In all the narratives the voice of oppression was strongest as participants spoke about their experiences of forced prostitution, however given the focus of the study it makes sense that this voice diminished in strength and quantity significantly in each of their narratives as participants shared their journeys towards healing. Even after exiting the prostitution the voice of oppression was still present in participant’s experiences when they shared how other people misused power against them. The voice of oppression was clear in Emily’s narrative after she had exited prostitution as the counsellor at the treatment facility she was at forced her to have sex with him. While Emily questions if this was her fault, it is clear that the power dynamic of a male counsellor and vulnerable teenage girl indicate otherwise. As the participants described their exiting process they also described the struggle of being stuck in a cycle of abusive relationships, drugs, and expectations from other people. Emily explained the confusion that she felt when she was trying to get clean and away from prostitution but kept being targeted by men in her life expecting sex from her at her NA meetings saying, “even when I wasn’t putting myself out there, I felt like people would seek me out. It felt like there was something wrong with me, like there was a big label on me ‘vulnerable’”. The voice of oppression was also heard through medical professionals, law enforcement officers and in abusive relationships where women were silenced or forced into providing sexual services. An example of this was when Marie spoke about being diagnosed by a physician with delusional disorder as she shared her experiences saying, “that’s just grand that this guy has labelled me as having this, because should I ever have to go to court, if anything happens again, it’s going to make me look like not very credible”. The voice of oppression impacted us as researchers as we reflected on the many ways oppression was silencing victims of sex trafficking and keeping them silenced. Having reflected on the way this voice manifested itself in each HEALING AFTER SEX TRAFFICKING 131 woman’s narrative in a unique way we were struck again by the resiliency that each woman possessed as she shared her story for this project as an active stance against the oppression and silencing that she had experienced for many years. Voice of disconnection. The voice of disconnection occurred when participants spoke in a detached or separated way from themselves or others. Markers used to identify this voice were when participants used the pronoun “you”, “us” or “we” when participants were speaking about their own individual thoughts, feelings or experiences. For some participants this was also heard when speaking about different parts of themselves such as “that little girl” or “my little girl”. The voice of disconnection was often heard in the form of dissociation and detachment from a core self or identity of the woman. The voice of disconnection occurred as participants spoke about feeling numb, detached, or when using substances. This was recognized when participants were unsure about their experiences saying things like, “I don’t remember”. Camara’s voice of disconnection was heard when she spoke about being sexually exploited and detaching herself from her experiences: You go into a hollow shell then you’re just a shell of a person cause it’s so much easier to be that then deal with everything that’s going on inside you. Once you’ve detached yourself from who you are for so many years it’s very hard to find yourself again. The voice of disconnection was heard in the majority of women’s narratives and even when not explicitly extracted as part of their analysis, disconnection still emerged as a prominent part of their experiences in their journey towards healing. It is important to recognize that dissociation and disconnection from reality indicates immense resilience in women as they were able to distance themselves from their experiences, remove themselves from their bodies, and even compartmentalize themselves in an extreme way in order to survive. Charlotte shared how HEALING AFTER SEX TRAFFICKING 132 her narrative is disjointed due to her dissociation and dormant and repressed personalities, saying, “we shared a body but…when I say that I quit, it’s more like she quit”. Charlotte explained that her traffickers intentionally abused her in order to make her develop DID so others would not believe her experiences. Her voice of disconnection was present as she shared about the judgment and dismissal she experienced due to her diagnosis of DID. Charlotte shared her hope that perspectives on DID and dissociation would shift as more research and understanding from survivor’s stories emerges. She expressed hope that if people understand dissociation as a form of resilience that she will be believed, despite her complicated and disjointed narrative. The voice of disconnection was heard in other participants’ narratives as they used substances to avoid the pain that was caused by their sexual trauma and tried to disconnect from their reality. Lindsay’s story evidenced this as she described trying to numb her pain, saying, “I jumped into drugs and alcohol, and hooking up with anyone who really would”. Emily also spoke about substance use in the voice of disconnection as she said: “you get the guilt and then you want to use and then you need more money to use so you go do it which makes you feel guilty”. Disconnection from body. The voice of disconnection was heard distinctly in relationship with participants and their bodies. Due to the value that was placed on their body and the sexual trauma that the women had experienced it was not surprising that they experienced a distancing and separateness from their bodies that revealed itself in their narratives. Some women spoke about their body as separate from themselves, and spoke about numbness, moving outside of their bodies, and the trauma that their body, rather than themselves, had endured. An example of this was when Charlotte said, “my body has seen so much HEALING AFTER SEX TRAFFICKING 133 suffering” and spoke about the trauma she endured as a child as well as the consequences it has had on her as an adult, which resulted in her being physically disabled. Due to this, Charlotte advocates for an understanding that physical symptoms are linked to sexual abuse and exploitation from childhood. While not all women have experienced such extreme physical consequences, their past experiences have made it unbearable for them to connect to their bodies. Tracy explained this process of intentionally disconnecting from her body to survive using the voice of disconnection saying, Being able to remove myself so I didn’t have to feel it, and then feeling it once it was done and over and I would drop back into my body and that kind of dissociation was kind of what I needed. What made me realize that I wasn’t actually connected to myself, that I was actually living as two different people. Disconnection from child-self. It was apparent to our research team that women had drawn an invisible line between themselves as adults and their identities before being sexually exploited or abused as a child. When women spoke about this disconnection from their child selves we heard the voice of disconnection. Charlotte spoke explicitly about her “littles” or child selves, and the separation she has between her adult self now and who she was as a child. The voice of disconnection was heard as she described how this surfaced strongly on her wedding day, saying, “There were a lot of parts of me that thought we were going to be owned and raped and sold all over again”. Participants shared that connecting to their child self was challenging and painful, and so in order to protect that sacred part of themselves they disconnected from it instead. Cory explained this disconnection from her child-self where she would no longer go by her real full name, almost as a way of creating a barrier between who she was and who she was living as while in foster care and as she entered the sex trade. The voice of disconnection was HEALING AFTER SEX TRAFFICKING 134 heard as she said, “there was a time where I wouldn’t use [my real name], I would get angry if someone called me that. I’ve been Cory since I was 10 or 12”. Disconnection from others. We also recognized the voice of disconnection when participants spoke about isolation or separateness from others. For some participants this occurred as they spoke about people not knowing, misunderstanding, or judging them or their experiences and the distance this caused between themselves and others. Lindsay’s voice of disconnection was heard as she spoke about her experiences after exiting and being surrounded by people who did not know her story. She described how this has been an obstacle for her healing and led to feelings of isolation and disconnection, saying, “I think feeling like I don’t fit? Yeah, especially in my Christian communities…just feeling like, I don’t know…just kind of misunderstood maybe? Or people assume different things and I’m like oh actually yeah, life has been really hard”. Emily also voiced similar experiences and we heard the voice of disconnection as she spoke about her family not knowing the extent of what happened to her saying, “they still don’t know, no…. He doesn’t get why I can’t stop, or why I couldn’t be a normal kid”. We noticed that there was a pattern of the voice of disconnection in relationships was also sometimes layered with the voice of shame as well. Years later, we heard how it is still difficult for women to share their experiences for fear of judgment from others, and despite being surrounded by community and loved ones can still lead to feelings of isolation. We noticed that this seemed to be particularly difficult for women who came from families or were in communities of privilege where abuse, drugs, and sexual exploitation were less expected and rarely verbalized. Other women, like Tracy, have intentionally chosen to disconnect themselves from some relationships in order to protect herself and her healing journey. She said, “I had to remove HEALING AFTER SEX TRAFFICKING 135 myself from her as well just cause I didn’t want to continue on that road”. Tracy spoke about the isolation and loneliness exiting held for her as she lost a community and many friends in the process, which we felt was important to highlight as we tried to understand survivor’s experiences of exiting and healing. Voice of confusion. The voice of confusion included individual voices of confusion (Lindsay), disbelief (Marie), and uncertainty (Tracy) from participants’ analysis. We recognized the voice of confusion in participants’ narratives by statements of questioning, uncertainty, and unbelief. The voice of confusion was present as women spoke about trying to remember the details of past events, or as women tried to integrate their experiences into their present identity, and as they learned to reintegrate into society and form healthy relationships. This voice was often heard when women were talking about the past and represents a struggle of acceptance of reality, such as when Tracy questions, “did that really happen?” and Marie says, “I couldn’t believe that… You know, it was a hard thing to swallow”. The voice of confusion was also heard when women spoke about trying to reconcile their past with their present identity. Lindsay’s voice of confusion demonstrated this was she questioned if past events were real of if she was just being “dramatic”. Lindsay’s voice of confusion also appeared as she spoke about her desire to know what is “normal” and “true”. Lindsay shared her inner dialogue of this confusion in our interview saying, I’m constantly in this dialogue of ‘what’s normal?’ Like, I don’t even know, and I don’t think there’s a normal for anyone but I don’t have this gauge of ‘am I doing life okay? Is this what’s supposed to happen?’ HEALING AFTER SEX TRAFFICKING 136 We noticed that patterns emerged where the voice of confusion was heard alongside the voice of disconnection, as women spoke about feeling confused about who they were, feeling disconnected from their experiences, and feeling confused about how to enter into relationships that were non-exploitive. Tracy’s voice of confusion highlighted the struggle that participants expressed about their value and worth being determined by more than just their bodies. After years of being told that her body was what made her valuable and using it help her connect with people Tracy’s voice of confusion was heard as she shared this challenge: I really struggled with where I was going to find my worth if that wasn’t going to be the way I was going to do it…. I didn’t know how to associate with people without offering my body to them. We heard uncertainty about how to function in healthy relationships in all participants’ narratives at some point, however, this was expressed much more frequently when women shared their struggles in having romantic relationships. Lindsay spoke highly of her husband and the respect he has for her and also shared that she struggles to know what is okay for her to feel in their relationship and her sex life. Her voice of confusion asked, “is it okay for me to not be feeling that right now? Is it okay for me to say no?” Other participants also voiced their struggle to know what a healthy relationship looked like after their experiences of being exploited and how to uphold healthy boundaries especially in relation to sex (Camara, Emily, Tracy, Marie). Voice of shame. The voice of shame represents a feeling of distress or humiliation often heard when wrestling with the consequences and experiences due to sexual exploitation. We recognized the voice of shame when women would say vulnerable statements followed by laughter or avoid eye contact with me during the interview. We also recognized the voice of shame by statements of self-blame, comparison, or self-criticism such as, “I should have”, “I’m a HEALING AFTER SEX TRAFFICKING 137 bad person”, or “I don’t deserve”. The voice of shame is made up of the voice of shame (Emiyl) and the voice of guilt (Cory) in women’s narratives, however we also noticed shame in the literal silences in women’s stories even if this was not coded explicitly in the analysis process. Emily used this voice more than other participants as she spoke about her experiences, and named shame specifically as something that has been a large part obstacle in her healing as she said, “I struggled with the shame for a really long time. And just feeling dirty, not feeling like a good person”. We also noticed that the voice of shame presented itself alongside the voice of disconnection in relationships. Emily’s voice of shame and disconnection spoke together as she described her interaction with her sister, saying, “She didn’t even want to hug me, she went to hug me and was like ‘oh I can’t even touch you’… I was like what the fuck is wrong with me?” When Emily talked about being raped about the voice of shame echoed the self-blame and questioning that was implicit in other participant’s narratives as she said, “it’s hard not accepting fault for it. Like feeling like you’re…like you teased him or you did something”. Themes of guilt and shame weave through participant’s stories as they feel they should have known better, or reflect on decisions they made that led them to being sexually exploited. In the process of exiting participants often had cycles of relapse or re-entering prostitution, which reinforced the voice of shame and feelings of self-blame for any subsequent violence or abuse they experienced after feeling that they had made decisions that led to them re-entering or relapsing. Voice of avoidance. We recognized the voice of avoidance as an intentional turning away in women’s stories from their experiences being sex trafficked. This voice is characterized by suppression, evasion and compartmentalization of experiences. We categorized this voice as a voice of resistance as we learned how avoidance allowed women to protect themselves from being overwhelmed by their trauma and we noted it as a protective act that led to survival and HEALING AFTER SEX TRAFFICKING 138 coping for survivors. We identified this voice through themes of avoidance, lack of internal permission, and phrases that women used including “I never allowed myself to feel that”, “I avoided”, and “I compartmentalized”. This voice was present in both Cory and Charlotte’s stories. Charlotte spoke in this voice saying, “I shut down. For a very long time. I was trying to put a wall between me and my childhood”. This experience was one that many women relate to, as in the group feedback session one woman shared that even though she did not say those words they resonated deeply with her and she felt she could have said them herself. The voice of avoidance indicates a desire to hide from the trauma and pretend it is not there. However, as Charlotte later shared, her body shut down, forcing her to explore her experiences, because cognitively she was in a state of avoidance, but her body was speaking to her. Her physical illness became the catalyst that forced her to acknowledge her experiences and led to her speaking out. The voice of avoidance was also heard when participants spoke about the hidden nature of sex trafficking and exploitation, and even their desire to hide their identities as victims of this crime. Women disguised their hurt and identities through a variety of means, from education to changing their clothing and appearances and to simply never speaking about what happened. The theme of a “disguise” or “hiding” was present in a number of women’s narratives as fear of what others would say, or lack of support or resources rendered them helpless to properly deal with their experiences. Cory also spoke in this voice as she said she felt the need to hide her past saying, One of my biggest fears was that people would find out about me and know about my sketchy past, that I was a drug addict. I’ve worked so hard to hide that from people and put on this happy demeanour and cut it out of my life. HEALING AFTER SEX TRAFFICKING 139 We learned how the voice of avoidance allowed participants to survive their circumstances and move forward, however, both Cory and Charlotte learned that they could not avoid their pasts forever. When they overcame the fear of acknowledging their experiences they were able to move forward in their healing journeys. Voice of dismissal. We defined the voice of dismissal as a voice from others that silenced and minimized women’s experiences, however this voice was also heard in participants’ own voices as they internalized the voice of dismissal from others. This voice was extracted explicitly in Tracy’s narrative, however the theme of being dismissed, disbelieved, or minimized was present in many women’s experiences. We learned that the extreme nature of sex trafficking has made dismissal a common experience for many of the survivors. The voice of dismissal presented itself when Tracy shared her story, saying, “people who haven’t experienced it either they’re just like you know, no. That couldn’t possibly happen”. Tracy is a woman who has gone outside of what might be considered typical in mental health treatments to find what has worked for her, and she spoke specifically of feeling dismissed within the counselling and healing process. She experienced dismissal particularly with receiving professional help both from mental health workers and medical professionals. The voice of dismissal was heard as she shared these experiences saying We’re so constantly told like ‘oh its okay, you’re okay, you’re supported, you’re this, you’re that’. But give us a place to scream, give us a place to yell….it almost feels like a slap in the face when they’ve got that clipboard. During the feedback sessions multiple women shared that they resonated with her experience of being dismissed by medical professionals, who were more interested in Tracy’s HEALING AFTER SEX TRAFFICKING 140 experiences in prostitution or as a lesbian rather than caring for her body. The following quote captures this experience: There'd be times where I'd go to the gynaecologist…and they'd be like well you shouldn't be doing that then. And then it's like well actually, it has nothing to do with HIM right now, we're talking about my body. And just really dismissing my body for the judgment. Tracy felt dismissed and stated that she felt that she was more of a diagnosis or spectacle than a person. In Tracy’s narrative the voice of advocacy closely followed the voice of dismissal as she learned to use her voice and stand up for herself amidst being dismissed, disbelieved, and judged. While this voice was not coded specifically in other women they all have elements of a similar pattern, where they have been dismissed or minimized and yet they participated in the interview as a way of standing up for themselves and using their voices defend their stories and their experiences as legitimate. Marie’s story also highlights this as she made a statement to the RCMP and then was dismissed, “I thought this guy is just, he’s not pushing for this, he’s you know, not believing me or something, and I just thought wow, this is just crazy”. From listening to this voice we gained insight into the continual barriers of being misunderstood and taken seriously that many survivors experience as they fight for respect from authorities and people in their lives. Voices of Healing Voices that were present in this category represent a movement towards healing or components that captured the healing journey for women. The definition of healing used as a framework for this project was the “process of becoming whole” and these voices capture the movement towards wholeness on a intrapersonal, relational, spiritual, emotional, mental, and physical level. Women provided their own personal definitions of healing that had both similar HEALING AFTER SEX TRAFFICKING 141 and different elements to it than the original framework for this study. This will be expanded on in chapter 5 of the discussion. Voice of connection. When we listened to women’s stories we heard the voice of connection emerge when women spoke about being in relationship with others or when she reconnected with herself or her body. Some of the markers of this voice included expressions of feeling heard, safe, and loved, both with others and with themselves. The voice of connection was heard in almost many of the participants’ stories (Lindsay, Emily, Cory, Charlotte), and if it was not coded in the analysis the elements of the voice of connection still wove through the participant’s narrative of healing. We noticed a theme of positive relationships with other people that preceded participants speaking in the voice of connection towards themselves. When I asked Emily what had helped her heal we heard the voice of connection as she said, “a lot of other people loving me until I loved myself”. Later, Emily shared the importance of having women and counsellors from NA and treatment facilities seeing the good in her in order for her to see it in herself. Her voice of connection was heard as she said: A few people that just saw positive things in me and kind of said similar things about me and I kind of started to believe, well if this person doesn’t know this person but they think the same thing about me and it’s good then why can’t I see it? Charlotte’s voice of connection also emerged when she was speaking about her relationship with her husband, how he made room for her and prioritized her in a way that she had never experienced before. Cory also spoke in this voice as she talked about the love that her partner has for her which has made her “want to stay and be okay with being loved”. Cory not only spoke about being okay with being loved by another person, but also how this love has helped her love herself more than she did before. HEALING AFTER SEX TRAFFICKING 142 Connection to other survivors. Women also used the voice of connection when the spoke about their connection, or desired connection to other survivors. All the women who participated in the study were given the option to attend a group-feedback session with the other survivors who participated in the study and each woman expressed excitement and interest in attending and meeting other survivors. Charlotte’s voice of connection was present when she spoke about her blog because it is designed to help her connect with other survivors. The voice of connection was also present when she spoke about reaching other survivors of sex trafficking as well as when she spoke about her ancestors as survivors of the Holocaust. We heard the voice of connection as Charlotte spoke about connecting with her Jewish ancestors and their abilities to survive the Holocaust as an important marker of her healing: That’s what I descend from…. she had lice, she was filthy, she was sick…but one day she got a bar of soap and she said one fine day I became human again. Do you know how she did it? She got back into fashion! Other survivors also found connection and healing through connecting with others in treatment centres, group sessions and in advocating for other women who are still victims of sexual abuse or exploitation (Tracy, Lindsay, Marie, Emily). Connection to spirituality. The voice of connection was also heard when participants shared about their spirituality. While all the participants in this study had differing spiritual beliefs and practices almost all of them mentioned spirituality as an important aspect of their healing. We heard the voice of connection was particularly strongly when Lindsay spoke about the love she felt from God that impacted her ability to heal, grow, and love herself. Lindsay’s voice of connection described this experience as, “there’s a higher Being that made me and loves me for exactly who I am and saw what happened, like all the details and still could accept me”. HEALING AFTER SEX TRAFFICKING 143 Tracy also shared how connecting to her ancestor’s spirits and experiencing their protection over her have been some of the most impactful moments in her healing journey. Tracy shared that she is comforted by feeling the presence of her mom, saying, “my mom knows now that she needs to protect me”. Her spiritual practices also facilitate her feeling safe and connected with herself, and she says she knows that she is “never alone”. We heard Charlotte’s voice of connection as she spoke about her spirituality and communication with God as helping her connect to herself saying, “When I try to communicate with the other parts of me….wherever I go in my head is where God lives”. We recognized that her voices of disconnection and connection are both present in this passage, as she referenced the divide between her parts, however, we also found ourselves intrigued by the way that her connection with God has helped her make sense of her complex relationship with her self. Charlotte’s voice of connection represents the bidirectional relationship that she has between herself and God, as it helps her understand the incomprehensibility and multiplicity of who God is to her, while also bringing her into connection with herself. Charlotte’s voice of connection was heard as she spoke about her faith as “having a companion and witness at all times”, and though she does not believe in an omnipotent God, spiritual connection still plays a significant role in her healing journey and has shaped her movement forward. Connection to purpose. We found that the there was a relationship between the voice of connection and a sense of purpose as participants spoke about their children or grandchildren (Cory, Emily). Emily’s voice of connection was heard as she spoke about caring for her daughter and as she spoke about having someone greater than herself to care for. Women’s voice of connection emerged as she spoke about their purpose in life and for some women this was their child (Emily, Camara, Cory), while for others the voice of connection was layered with HEALING AFTER SEX TRAFFICKING 144 the voice of advocacy as they found purpose in advocating for other survivors and telling their stories (Tracy, Charlotte, Marie, Lindsay). Connection to body. Women spoke about re-connecting to their bodies and their ability to view themselves as more than just an object after exiting sexual exploitation. When we heard the voice of connection in relation to women’s bodies we felt inspired and deeply moved by the beauty of a renewed relationship with women’s bodies. We listened in awe and appreciation this testament to women’s beauty, strength and resilience as they bravely reengaged with their bodies despite their body being the battlefield and initial source of trauma and pain. The woman who spoke most explicitly about connecting with her body was Emily, who described how her experience of breastfeeding changed her life. The I-poem describes the transformation breastfeeding had and through it we heard the clear voice of connection to her body: I felt strong I started I grew It kind of empowered me I am more than just an object The voice of connection was especially significant when Charlotte spoke about reclaiming her body by getting a tattoo. She stated that she will “never have to be naked again” and that she has claimed her body as her own through this act. This voice in participants’ stories represents a beautiful process of discovering and remembering that their bodies can be powerful, meaningful, and strong. These women have bravely re-connected to the battleground of sexual exploitation and in doing so learned that their bodies can be a source of life, power, and beauty rather than pain and violence. HEALING AFTER SEX TRAFFICKING 145 Connection to child-self. An important aspect that many of the participants highlighted was the re-connection with who they were before their trauma, and when participants spoke about themselves as children their voice of connection emerged. Charlotte explicitly spoke of “re-parenting” her child self, and doing things for her child self that would make her feel safe and happy. For Lindsay, she shared that she had specific moments of remembering and reconnecting to herself before her rape, saying “having this moment that stands out to me of like, I like that I’m funny, and I’m full of life. I remember having that thought of this actually feelings good, this feels like me again”. Lindsay’s voice of connection was present as she shared about the image of healing that she brought in for her interview of portrait of child laughing. Lindsay shared how her love of children has helped her access her inner child and has reminded her how resilient children are and how resilient she is as a survivor. Camara also shared that part of her healing journey was remembering who she was before sexual exploitation saying, “I feel like I’m picking up again, like where I left off when I was 12…. It’s fun! It’s really fun! To rediscover what I like, and what I think is funny and care about myself”. Voice of agency. As women spoke about breaking out of exploitation, cycles of abuse or systematic oppression we heard the voices of agency emerged. This voice was present as women spoke about exercising intentional choices and autonomy often in relation to choosing self and overcoming oppression and in the individual voices of choice (Camara), empowerment (Lindsay), agency (Cory), and intentionality (Tracy). We recognized this voice when women made statements about choosing and action such as “I decided”, “I did”, and “I chose” and was recognized as a strong opposition to the voice of oppression in their narratives. When this voice was used women were fighting against oppression by saying things like “I started” and “I got up and left”. This voice also made us reflect on the topics of choice, responsibility, and freedom, as HEALING AFTER SEX TRAFFICKING 146 women also wrestled with gaining autonomy after years of disempowerment and abuse. Some women wrestled with the idea that they may have “chose” prostitution, and we learned from some women that having a feeling of being in control, even if choice does not look how one might expect was an important part of their survival at the time. Charlotte used the voice of agency to describe the importance of this experience saying, [Allowing] myself to work through my own identity in relation to the stuff on my own even if I wasn’t right. So there was a time when I really, I thought well, I chose this…by the time I was 12 it was my choice laughs…what I needed to do was see myself as having, if not autonomy physically, autonomy in some ways, as a person. We noticed that despite being physically or emotionally restrained for many years many women found ways to exercise agency until they were able to make bigger decisions. When Tracy used this voice of agency she is spoke about her daily practices of choosing to have a positive mindset and believe in herself. We heard Tracy’s voice of agency as she shared her daily mantra: “I’m loveable, I’m acceptable, I’m interesting, I understand”. Camara also described the importance of daily decisions and changing her mindset as part of her healing. Her voice of agency described this as I live every day like it’s my last…. I will never ever forget what I have been through. I will always remember, and I won’t remember and be like feel bad for myself, I’ll remember and be like, I survived. We learned that healing for many women came through these choices and small ways of having autonomy. This looked different for each woman and varied from moving to a home they felt safe, decorating their homes in a certain way, getting a tattoo, choosing clothing that they want to wear, or learning a new skill. Each woman in this study exercised her agency in HEALING AFTER SEX TRAFFICKING 147 deciding to speak out about her experiences despite being silenced for many years. Many participants expressed that this was a defining moment in their healing journey. For some women they had shared their story many times, but for others their experiences of sexual exploitation were hidden from almost everyone in their life and deciding to participate in the study was the first time they shared their experiences other than with a counsellor. The voice of agency also acted contrapuntally to the voice of avoidance, where it is demonstrated an intentional choice of turning towards participants’ experiences, and as Lindsay said was “embracing” her story. The voice of agency was heard as Lindsay described healing as, “embracing what you’re going through in that moment and finding ways to love yourself in it”. We heard the voice of agency as Camara shared that she was going to work through her past experiences: “It wasn’t like “okay I’m just going to go be clean and then live my happy life, for me it was like in order to do that I have to deal with all this baggage and trauma”. Almost all the participants expressed the same theme of choosing to love themselves or be compassionate towards themselves as a major part of their healing journeys, as well as choosing to use a new perspective and reframe their experiences. This was evidenced in participants’ views of the “gift” that their experiences brought them (Lindsay, Tracy, Camara) of being more in tune with themselves or others. Agency in relationships. We heard the voice of agency as women spoke about becoming mothers and in their decision to keep their children after finding out that they were pregnant. We heard the voice of agency speak strongly as women moved into the role of mothers and begin to exercise decisions not only for themselves, but also for their children. Camara described how getting pregnant impacted her healing as “I can’t drink or numb my pain, I really have to sit down and deal with all my childhood trauma”. We also heard the voice of agency in Cory’s HEALING AFTER SEX TRAFFICKING 148 story of motherhood as she said, “I realized I can’t raise a child in this life…. I finally got up and left…. I found to better myself from that point… I was determined to raise my son in a more positive life”. The voice of agency was present as Cory spoke about her desire to keep her son and the decisions she made to get clean and move out on her own in order to care for him and protect him. We also heard this voice alongside the voice of connection and women’s decisions to enter into romantic relationships. Tracy’s voice of agency was present as she spoke about her desire for a romantic relationship and her decision to work on herself until she meets the right person, saying, “I’ve now been 5 years celibate, chosen…so if I do find a partnership I’m not triggered…I don’t have to put that on my partner”. Other participants shared similar sentiments and described making choices against engaging in sexual encounters with strangers in order to work on themselves, value their bodies, and create a better future for themselves. Voice of advocacy. As we listened for voices of healing we heard the voice of advocacy as participants described their experiences of standing up for themselves or for others against injustices. The markers we used to identify the voice of advocacy began with looking at whom the voice was speaking to as well as whom the voice was speaking for. Women who spoke in this voice said things like “I told them”, “we should be”, “they need to”, and “survivors need”. We heard the voice of advocacy when women spoke up for their needs, addressed professionals who were mistreating them, and in their experiences of reporting their victimization. The voice of advocacy was also heard as women literally spoke out against injustices through speaking at educational panels, writing blogs, working in hospitals, and working to open a transition house for women fleeing sex trafficking and abuse. Marie spoke in this voice as she described her work in the community saying, “I’ve tried to get it implemented in [the] hospital to make sure HEALING AFTER SEX TRAFFICKING 149 there are aboriginal workers so that patients have their right to have Aboriginal traditions and medicine”. Tracy also spoke in this voice as she described seeing gaps in services for survivors and for herself and speaking out, “always trying to fight and advocate for myself, being like “well no, I’m not crazy, I just need somewhere I need to, vocalize this. Like I just need to get angry”. The voice of advocacy was also heard through other people in participants’ stories, especially their counsellors. When this voice was heard from counsellors it sounded like encouraging women to report their experiences and meeting their needs when they couldn’t verbalize what they needed themselves. This voice was heard as Tracy described what her counsellor said to her: She was like you look like a shell’ and I was like, I feel like one. Okay, do you need to talk? Do you want me to drum? So she had me lying down and she took her native drum and drummed all up and down my body...so I could actually feel something. This voice was also heard in opposition to the voice of oppression, where the voice of oppression where each voice would try to overpower one another. The voice of advocacy is bolded for emphasis. They’ve pigeon-holed me I had even gone to the colleges of physicians I was sexually assaulted I made a complaint He was challenging what I had to say I went up against a doctor They didn’t want to you know, stand by me HEALING AFTER SEX TRAFFICKING 150 Despite struggling against oppression and silencing the voice of advocacy represents women’s hope for a better future and their participation in speak up for themselves and other survivors. Voice of injustice. We coded this voice in participants’ narratives when they spoke against acts of injustice and unfairness with tones of righteous anger. This became a sub-voice within the voice of advocacy as this voice also speaks out for their own needs or survivor’s needs, however presented itself in a different way when heard in Marie and Charlotte’s narratives. The voice of injustice was recognized when women questioned power structures or assertions about societal norms, or criticized the corruption of authority figures or systems. We also recognized it when women used sarcasm or swear words to emphasize their point while they spoke. I also identified the voice as I listened for the volume, tone, and cadence of the participants’ voices as they were speaking in their interview. Charlotte’s voice of injustice emerged as she spoke about reporting her exploitation saying, “I went to the police four times, they didn’t do a fucking thing. All that happened was my mom called me and yelled at me for telling”. The voice of injustice was clear when Charlotte spoke in anger about people’s apathy in stopping the injustices of child abuse, trafficking, anti-Semitism and other forms of racism. She said, “I would not be disabled today if one of … I am more angry with the silent majority than with the people who have used me”. Charlotte’s voice of agency emerged alongside her voice of injustice as she spoke about taking action against injustice: “That’s why I write…. I want to reach non-survivors. I want to make them open their God damn eyes and DO something, for the love of God DO something!” We felt the power of the voices of injustice and agency together as a powerful melody that implores people to become aware of the injustices of sex trafficking and slavery around them and calls them into action. This voice also acted as a counter melody HEALING AFTER SEX TRAFFICKING 151 against the voice of oppression and the silencing that survivors have experienced as they have tried to share their experiences. Charlotte spoke to this saying, “those who claim to care, don’t tend to want to hear from us and they want to talk over us and be the experts…. They assume that we’re all too damaged to speak for ourselves and that is unbelievably insulting.” This voice also surfaced in Marie’s narrative after the voice of oppression as she spoke about corruption in law enforcement services, “there are young girls get[ing] involved in prostitution in Fort Langley…what is the RCMP doing about it? They have a national task force but there doesn’t seem to be a lot of convictions!” This voice teaches us the importance of questioning corruption and apathy in society and coming from survivors like Marie and Charlotte is an incredibly powerful voice. It teaches us that part of healing for survivors can come through speaking up and challenging people to act upon the injustices that may not impact them directly, but have destroyed the lives of many others in their own community. Voice of knowing. The voice of knowing is comprised of the voices of clarity (Lindsay), logic (Charlotte), realization (Camara) and certainty (Tracy) as extracted from participants’ narratives. As participants described their healing journey they spoke in the voice of knowing that was characterized by having certainty, clarity, and understanding of truth and reality. We heard this voice when participants spoke with confidence about reality, their desires, or decisions. We recognized this voice when women made statements of confidence such as “I know”, “I am”, “I realize” and “I believe”. This voice was contrasted the voices of confusion, oppression and disconnection where previously participants expressed uncertainty about reality or a distance between themselves and their experiences. The participants used the voice of knowing when describing an understanding of their experiences, such as when Camara reflected on her vulnerabilities to being trafficked, “I was just craving a father figure, so I would attract HEALING AFTER SEX TRAFFICKING 152 really bad guys who would take advantage of that”. Camara demonstrated how this clarity impacted the direction of her healing saying, “I’ve accepted the fact that these things have happened to me but I’m not going to let that define who I am”. Many participants expressed the theme of an increase in self-knowledge as an important part of their healing journey. Tracy labelled this as a “delayering process” as she unpacked her experiences all the way back to her childhood, and the voice of knowing emerged in her narrative as she described gaining understanding for her actions and choices. Lindsay’s voice of knowing spoke compassionately and with understanding towards herself saying, “choice is a privilege, and when you’re hurt it’s not easy to make rationale decisions, or good decisions for yourself”. As she shared about what would have been helpful for her as a teenager she spoke in the same voice of knowing saying, “I think what would have been helpful during that time is like ‘your behaviour and what you’re choosing to do makes a lot of sense for what you’re feeling’”. We noticed that the theme of selfknowledge was marked as a turning point in many participants’ (Tracy, Camara, Charlotte, Lindsay) healing journey as they gained understanding and insight into the paths they walked. An aspect of the voice of knowing that emerged was the new realizations that came as participants learned how to do relationships differently. Tracy’s voice of knowing expressed, “I can have platonic friendships with people and maintain them, and have them be long term and healthy”. This countered statements made by her voice of confusion, which voiced uncertainty about how to relate to people without offering her body earlier in her journey. As Tracy reflected on her past experiences of searching for unhealthy ways to be heard and noticed the voice of knowing indicated insight into her relational patterns and her motivation behind relationships. In the present day Tracy’s voice of knowing stated clearly what she needs in relationships: “I need support. I need non-judgment, compassion”. HEALING AFTER SEX TRAFFICKING 153 Charlotte’s voice of knowing spoke about the importance of giving herself grace as “being smart doesn’t not make you immune to drug addiction, mistakes and human emotion”. The voice of knowing was often heard alongside the voice of connection in participants’ narratives. As participants connected with themselves they had more clarity about their identity and the reality of their experiences. The I-poem below shows Lindsay’s voices of knowing and connection together as she remembered who she was before her rape and spoke with confidence and certainty in her identity. I am I remember I remember I’m funny I’m full of life I remember I’m Lindsay The voice of knowing emerged as Lindsay spoke about her relationship with God and her faith journey. It was present as she described a time where she received miraculous healing for her broken foot. However, days after experiencing full healing her foot felt weak again, and she related this experience both to her healing from sexual exploitation and her faith in God. We heard the voice of knowing as she reflected on this parallel: I might have this really profound moment of like I feel alive and I feel better and I feel healed…‘healed’…and then…there might be another week where I feel weak and I’m not fully healed and it’s this journey. HEALING AFTER SEX TRAFFICKING 154 The voice of knowing spoke with wisdom about the complexities of healing describing the importance of self-compassion for herself, saying: “There’s going to be days and weeks and times where my healing journey looks like I’m not functioning very well and knowing I have good support and giving myself grace for it”. Voice of resilience. Foundational to this study is the understanding that all women who participated are inherently resilient and moments and themes of resilience were found throughout all narratives of women’s journeys; however, the voice of resilience was only extracted explicitly from Marie’s narrative. We recognized the voice of resilience in Marie’s story as she fought to continue sharing her story, healing, and advocating for other survivors despite rejection, disbelief, and dismissal. We recognized this voice in Marie’s healing journey when she used phrases such as “I just say no”, “I fought”, and “I just pull my socks up”. The voice was perhaps most easily recognized in context of the other voices, where the voice of disbelief or oppression would precede it and then her voice of resilience was identified as is shown in the following quote: “‘Oh, were you, are you really a victim?’ They shouldn’t even be questioning that, that’s not right to do that...It’s good that I’m a strong person because that could really trigger somebody”. Rather than being overtaken by the voices of disbelief Marie bounced back and unceasingly continued to advocate for herself and others. We also heard the voice of resilience when I asked her how she has overcome people who have not believed her story and she responded, “I find people that will listen to me. My healing journey is paramount, it’s really important, and if I’m not listened to, it doesn’t matter”. Voice of compassion. This voice was recognized as being spoken both from other people towards the participants as well as the participants towards themselves and others. Both Emily and Camara spoke about moments where they received compassion and forgiveness from HEALING AFTER SEX TRAFFICKING 155 workers at treatment centres they were clients at, and mentioned that these experiences allowed them to forgive themselves. The voice of compassion was present when participants spoke of forgiveness, empathy and understanding behind negative actions without judgement. Many participants spoke about compassion towards themselves as part of the healing process, especially learning how to give themselves grace amongst physical, mental, or emotional difficulties, however, Cory and Camara both had voices of compassion specifically extracted in their narrative. We were deeply impacted when we encountered Cory’s voice of compassion as she spoke with compassion towards Big Bill and Little Bill, two men who abused her over many years. Her ability to show compassion towards men who abused her was a gift and strength she took with her along her journey. The voice spoke alongside the voice of connection with an understanding of how the cycle of abuse was passed down generationally between them and saw the hurt each man was holding behind their actions, saying, I was able to see: This is a 14-year-old little boy and trying to understand his life and situation. Big Bill was one of the most violent, scary people I’ve ever known, and as I got to know him over the next four years I got to know his soft side too and the good parts of him. This voice also emerged when women reflected back on their experiences of sexual exploitation and extended compassion and grace towards themselves (Cory, Camara). Camara spoke in the voice of compassion as she shared about what healing means for her saying that healing is …the courage to love yourself and be patient with yourself again…. You’re going to have ups and downs but it’s a part of healing. And it’s okay to cry and its okay to feel the HEALING AFTER SEX TRAFFICKING 156 emotions and everything that comes along with it. It’s very valid feelings. You have a right to feel what you feel. The voice of compassion was often layered with the voice of agency because extending compassion to herself or to someone else who had hurt them was a deliberate choice that survivors made in their healing. We believe that it indicated the intentionality of adopting a different framework for viewing themselves and the world around them. We were touched by survivors’ choice to accept their past and give themselves love and patience for how that impacts them in the present day. Voice of purpose. This voice was defined as representing hope for the future, and was heard as Emily spoke about finding meaning in her life or investing in something greater than her. Emily was the only participant that this was specifically coded for and we heard her voice of purpose strongest when she spoke about her daughter. While this voice was only explicitly extracted from Emily’s narrative many women endorsed the same themes of having a purpose as part of their stories of healing and resilience. For some participants there was a theme of the voice of connection being layered with the voice of purpose as they spoke about their children or grandchildren (Cory, Camara, Emily). Emily’s voice of connection and purpose were heard together as she spoke about caring for her daughter. These voices were also heard as she spoke about having someone greater than herself to care for, which was her daughter. The voice of purpose stood out to us when it was in opposition to the voices of shame and disconnection. We saw the voice of purpose in Emily’s narrative pulling her out of a life of sexual exploitation and drug use through this I-poem: I would never stay clean I would tell everyone HEALING AFTER SEX TRAFFICKING 157 I’m just fooling all of you I’m her only parent I want to break that cycle I did. While this voice was not coded in other women they still spoke about their purpose in the voice of advocacy (Tracy, Charlotte, Marie, Lindsay). They found purpose in advocating for other survivors and telling their stories which has been captured earlier in this chapter. HEALING AFTER SEX TRAFFICKING 158 CHAPTER 5: Discussion The purpose of this study was to bring the oppressed voices of sexually exploited women to the forefront of counselling psychology research and to contribute an emic perspective on their experiences of healing after sexual exploitation in Canada. This study aimed to provide a platform for survivors to share their stories of healing and be empowered in this process. We believed that in conducting this study we would be able to contribute victim-informed research driven by participants’ narratives of their internalized experiences of healing, as there is a limited amount of research in the literature from survivors’ perspectives. Previous research focuses on organized or institutionalized recovery services for victims of sexual exploitation, and so this study sought to gain understanding of the complexity of both survivors’ formal and informal experiences of healing. In the process of the in-depth analysis of the interviews using the listening guide we, as researchers, were deeply touched and moved personally and collectively by the vulnerability, resilience, and strength that we encountered through the women’s stories of healing. Each woman demonstrated these qualities in a unique way as well as collectively as survivors. This chapter will begin with a section of my reflexivity as the principal researcher and how these stories and the process of this research project has impacted me. Themes that were found the women’s stories as they pertain to the relevant literature from chapter 2, contributions to the literature, and the implications of this study on clinical work will be discussed. I will conclude with a discussion about the strengths and limitations of the present study, and potential areas for future directions. Personal Comments on Researcher Reflexivity It is challenging to express in words the changes that I experienced personally and professionally, as I was stretched as I conducted this research. The framework of healing that I HEALING AFTER SEX TRAFFICKING 159 used as a foundation for the project and how I understand healing now is one example of the personal journey I have been on alongside the participants. In the beginning of this project I thought of healing as “the process of becoming whole”, however as I heard from participants, and even experienced hurt in my own life since the beginning of this project, I have realized that this definition assumes that we can be whole and that there is an end point and destination to our journeys of healing, and I have discovered that this is not the case. While some people may identify with the concept of “wholeness,” the act of becoming whole in some ways to me now feels stagnant and boxed in. Instead, I learned from the participants the importance of allowing “mess” and new ways of understanding what healing might be. The concept of wholeness does not capture the depths of self compassion and grace that I heard in women’s narratives of healing, nor does it capture the fight, determination and resilience that was also present in each woman’s narrative. While it was always my intention to use a framework that was broad enough to encompass the depths and variety of women’s experiences I realize that this definition was not able to do that. This process has also impacted my work as a clinician. For some clients there might be a specific end point, and they might identify with the definition of “becoming whole”, however, I have learned how deeply subjective healing is through this study, and how for some clients, it might mean integration of their parts separated by dissociative processes, and for others it might not. I don’t see it as my job as a therapist to impose my framework of healing on my clients, but allow them to construct it for themselves. This was reinforced further as I listened to gaps, inconsistencies, and disjointed narratives in some participant’s stories. Many participants could not remember certain details, and I found myself being caught up in my desire to understand their story in a chronological and coherent way, sometimes missing the importance of what they HEALING AFTER SEX TRAFFICKING 160 were truly saying or what their fragmented memories pointed to. As a clinician it was challenging to know why certain details in their stories did not match up and I with the research team wrestled with trying to ascertain what the facts were in each story. As women shared how people did not believe their stories, I came to understand how challenging it is for some people to believe stories they do not objectively make sense. I wrestled with my true desire to honour women’s stories and to uphold rigour in my research. I came to understand that the effects of trauma are deep and present themselves differently in each individual, and what was more important than understanding the objective truth, was to honour women’s subjective experiences of both sex trafficking and healing. As an emerging clinician I have noticed that I cling tightly to the comfort of structured goals and treatment plans that focus on symptom reduction, as they are straight-forward and require much less of myself as a person, which means that if I should “fail” as a clinician, and my client has not experienced “healing” I am protected from rejection and a sense of personal failure. Therapeutic approaches that use structured methods and interventions are of course extremely helpful in the right situations. They have also provided me with a sense of having a safety net as a therapist, and allowed me to feel a sense of accomplishment as I finish the steps and order of healing with clients. Meeting the participants for this study has challenged my therapeutic approach; I have realized that as much as clients might need certain interventions, that perhaps the goals should not simply be symptom reduction, but deeper, inner healing that for many of the participants comes from authentic relationship. While it is also my role as a clinician to help clients foster safe relationships outside of the therapeutic context, my relationship with my clients is often a starting place that provides relational safety and HEALING AFTER SEX TRAFFICKING 161 acceptance. I’ve been challenged through knowing the participants in this research to bring myself authentically into my therapeutic relationships. This study also forced me to face my privilege as an educated, Caucasian woman in Canada. Despite growing up in Canada I knew very little about colonization and the effects of it on our Indigenous peoples today. I believe this is a combination of both a lack of educational focus on this in the school systems I was part of, as well as my own ignorance due to my position of privilege. Through coming to understand that Indigenous women are disproportionately represented in the statistics of trafficked women in Canada I was set on a journey to try to understand how this came to be and what my place is in rectifying the effects of colonization today. I wrestled with feeling guilty for being Caucasian and with the fear of further offending Indigenous peoples simply with my being. This fear and guilt was reinforced as I encountered strong opinions that I should not be conducting the research as an outsider to the survivor community and as a Caucasian researcher. Opinions that I was only creating a platform for myself, rather than the women who were participating continued to force me to reflect on the nature of my project, the intersection of my privileges and the history of exploitation and colonization in research that preceded my project. As I wrestled openly with the pain that accompanied my intentions being questioned, I was met with incredible support from the community around me. I was touched and encouraged as other academics and counsellors acknowledged their own struggles as a non-Indigenous professionals desiring to help the community, and feeling paralyzed by fear of offense or repeating past mistakes. I dove into researching experiences and ethics of working with Indigenous peoples to find I was not alone. Most importantly I spoke to Indigenous people themselves about their experiences of colonization, cultural appropriation and counselling. The openness of the individuals that I HEALING AFTER SEX TRAFFICKING 162 spoke to gave me courage to keep pursuing the project, while also being more aware of the privilege I represented and proceeding more carefully because of this. I found my assumptions of privilege further challenged as I met with participants who shared many of the same demographic variables as myself. As I encountered women who were close to my age that also came from similar socioeconomic backgrounds as my own family who are survivors of sex trafficking in Canada my assumptions of vulnerabilities were challenged further. It was Lindsay who said “choice is a privilege,” in our interview and that statement has since stuck with me. I have had such privilege to choose where I would like to live, what career I would like to pursue and how I would like to make money, and these choices have gone unrecognized because I have told myself that I have earned them and worked hard to be where I am. While it’s true that I have worked hard, I have also been in a position where I was able to work hard, and make the choices I have made, whereas many people have not had this privilege. For some women it was one mistake, or being at the wrong place at the wrong time that led them down a very different path than my own, and as I have grown to understand the fragility of life I have also grown to understand that no one, including myself, is immune to being exploited or trafficked. I found myself in a place of privilege to share what I had been learning numerous times in the community, which became an important part of this experience for me. I was in a position of speaking for women who had given me the permission to share parts of their stories and what I had learned from them, as well as advocating for others like them. As I was asked to speak on a panel and interviewed for the newspaper I had the privilege of shedding light on the hidden existence of sex trafficking in Canada. I was encouraged that my community was creating spaces for this topic to be discussed. I also desire for survivors themselves to be given a HEALING AFTER SEX TRAFFICKING 163 platform to share about their experiences directly. I was encouraged as I went out into the community and asked for donations for a self-care package for the women who participated in the interview. As I shared about my project, people expressed shocked that sex trafficking happens in our community but were also willing to contribute donations. Their surprise further highlighted the hidden nature of sex trafficking in Canada. As I listened to women share their stories, I felt truly honoured to be the one who was trusted to not only listen, but to share their stories with others. Their vulnerability has inspired me to bring more of myself into this project and into my work as a clinician. While the constructivist paradigm this project operated out of allowed me to bring myself into the interviews and into this process as a person, and not merely as a researcher, I realized how vulnerable I felt in doing so. As I prepared the results and created their healing I-poems I found myself nervous to share with them what I had experienced from their stories as a person. However, my greatest joy from this project was the conversations that I had with the women that were not transcribed, as I shared their poems and letters with them. We were able to meet authentically and it is my hope that I can bring more humanness into my future research and practice with this as an inspiration. Contribution to the Literature As presented in the literature review the consequences of being a victim of sexual exploitation occur physically, psychologically, intrapersonally, relationally, and spiritually. All of the participants spoke about the various consequences they experienced through the voices of resistance, which included the voices oppression, disconnection, shame, dismissal, avoidance and confusion. Through this study we contribute rich experiences from survivors about the HEALING AFTER SEX TRAFFICKING 164 consequences of sex trafficking and the resistance they have experienced in their healing journey. Resistance to healing. Participants’ experiences of healing are consistent with both Herman’s model of trauma recovery (1992) and an unpublished master’s thesis that also utilized the listening guide (Chan, 2017). Herman’s concepts of “remembering” the trauma were captured by Chan’s categorization of some voices found in her study as voices of “turning towards” the pain. These were voices of active acceptance and mourning and demonstrated an integral part of the healing process for her participants, which was also found in the participants in this study (Chan, 2017) and will be expanded on in other sections. The voices of resistance represent a turning away from the trauma, and as mentioned, the voices of avoidance and disconnection represent an internal process of coping by turning away from their trauma and experiencing safety and stabilization. While this is a protective mechanism and has allowed women to survive it has also presented challenges in their healing journey. Participants’ experiences were consistent with the literature on physical consequences that they experience, which resulted in both a purposeful and automatic disconnection between themselves and their bodies (Farley, 2004; O’Connor & Healy, 2006). As previous research has shown, the impact of sexual exploitation on women’s bodies is extreme (RCMP, 2014) and this was evidenced in women’s stories of permanent injuries and sexual dysfunction and the development of chronic illnesses and disabilities. Charlotte specifically spoke about this incredibly challenging reality as she suffers from chronic pain, fibromyalgia and requires a wheelchair for daily travel due to her physical disabilities and pain. Additionally, substance use presents a huge obstacle in women’s physical and mental healing, and this study’s results were consistent with the literature as all participants named substances as an obstacle of their healing as they were used while being HEALING AFTER SEX TRAFFICKING 165 exploited, and often after as a way of coping and avoiding their trauma (Native Women’s Association of Canada, 2013). As was found in the research, many participants expressed a lack of connection with other people and a difficulty in trusting in people’s benevolence and desire to help, as well as feelings of isolation and fear about their stories (Herman, 1992). For many participants this was due to overwhelming feelings of shame and self-blame in their experiences and for others it was due to negative reactions of others about their stories (Tomura, 2009; Hossain et al., 2010). Some participants experienced active resistance and silencing towards them when they spoke out about their stories and none of the participants in this study had successfully pressed charges against their perpetrators. The voices of dismissal, oppression, and disconnection were present as they shared their experiences of reporting these incidents and being disbelieved, rejected, and receiving no support. These experiences led to participants shutting themselves off, using substances, and hiding their stories or identities in order to cope. All participants shared about feeling disconnected or dissociated from their experiences, and as is reflected in women’s stories, dissociation can be a barrier in women being believed and understood by others. Dissociating from their experiences was shown to be a protective factor and also a barrier in moving forward and seeking justice. The participants who spoke about this acknowledged that their narratives were disjointed, and many participants had memory gaps, which can make their stories difficult to believe and appear fictional. Not only does dissociation create a challenge in sharing their stories, but the traumatic nature of these women’s stories was also found to bring about an internal resistance within the listener both on the research team and in women’s experiences of telling their stories, to accepting their stories and reality. As the principal researcher, despite having worked with HEALING AFTER SEX TRAFFICKING 166 survivors for years, researching this field extensively, and entering the project with a commitment to believing women I still noticed an internal resistance in myself to fully accept the traumatic details of women’s stories. I believe that in part this is due to the women’s experiences being located in my own country and in close proximity to my childhood and current neighborhoods. I found myself not wanting to accept that their stories could be fully true because it would mean that the paradigm I held of a safe and just world had shifted significantly. As Canadians it may be hard for us to accept that sex trafficking and exploitation happens not only to vulnerable groups, but also to women who grow up in middle class families with few of the risk factors mentioned in the literature review (i.e. poverty, previous abuse, being Indigenous). This experience of personal resistance may contribute to the hidden nature of sexual exploitation in Canada and perpetuates the stigma, silencing, and shame that is highlighted in the literature as well as women’s narratives in this study. As was urged by the women, I hope that this research will encourage each of us to examine the resistance or doubt that may surface in hearing about sexual exploitation in Canada and the action or inaction that this causes us to engage in. It is paramount to victims’ survival that we not allow ourselves to be paralyzed by this fear or act in resistance to survivors who speak out. Experiences of healing. The present study also contributes victim-informed research to the literature around healing after sexual exploitation. As was described in the literature review, healing is conceptualized in the present study through a holistic framework addressing physical, emotional, psychological and spiritual areas of survivors’ journey. This study contributes to the literature on healing, resilience and growth of women who have survived sexual exploitation. The themes that emerged in the voices of healing in the narratives of purpose, agency, advocacy, and connection were congruent with the Circle of Courage and validated the values of belonging, HEALING AFTER SEX TRAFFICKING 167 mastery, independence, and generosity that are foundational to this model (Brendtro et al., 2005). This affirms the importance of understanding healing, wellness, and growth in this way, and how fostering these domains in survivors of sex trafficking can contribute to their healing. These values will be expanded on in conjunction to the concepts of trauma recovery from Herman (1992) and Chan (2017) of turning towards the trauma and reconnection. Turning towards. The act of turning towards their experiences was conceptualized as actions such as acknowledgement, acceptance, and integration of women’s experiences into their identity and mental schemas as was congruent with other trauma literature (Herman, 1992; Chan, 2017). The voice of agency is consistent with this concept as well as the concept of mastery (Brendtro, et al., 2005). Intentionally deciding to turn towards their experiences was an act of agency and independence and was noted as a key point in participants’ healing journeys and stemmed out of a belief that they can succeed and wanted to move forward and learn new ways of living. This act was found in all the participant’s narratives of healing and occurred in a multitude of ways and it was not a linear process. For some women this happened through traditional psychotherapy and after developing coping tools other than substances to support them through this difficult work. For many women the choice of getting clean also led them to turning towards their trauma and was the start of their healing journey. For Cory, we learned that turning towards her trauma happened through the use of ayahuasca, a hallucinogenic drug, which facilitated her facing her past and moving forward from it. Women spoke of various experiences that ignited the desire to work through their experiences and move forward in their healing. As women turned towards their experiences they began to make choices for themselves, became more independent, and spoke with the voices of knowing, agency, purpose, and HEALING AFTER SEX TRAFFICKING 168 connection. We discovered the relationships between participants and others as well as the relationship that the participant had with herself was paramount in their journey towards healing. Relationship with self. Through the use of the listening guide this study examined the way survivors relationships with themselves have changed over time. As is consistent with the literature reviewed we found that survivors often spoke of their identity or sense of self as fragmented and spoke of “losing” themselves or parts of themselves through their experiences of sexual exploitation (Herman, 1992; Van der Kolk, 2014). As participants shared about their experiences of reconnecting to themselves in their healing journeys they spoke about the importance of reconnecting to their child self and learning about their interests. This has included developing hobbies and learning new skills, which is congruent with the values of mastery and independence for encouraging growth and courage in children (Brendtro et al., 2005). For Marie in particular, she spoke about reconnecting to her culture as an Indigenous woman to experience healing. This included healing through traditional medicine and healing ceremonies, participating in the TRC movement, and advocating for Indigenous ways of healing in the public system. Through Cory we learn that re-connecting to her culture as Metis is especially important as her identity as an Indigenous woman was lost due to her experiences in the foster care system. Through these stories we are reminded again of the grave consequences of colonization and how cultural identity has been robbed from Indigenous peoples in Canada, and as they reclaim their identities as both Indigenous women and survivors they are experiencing healing. Connection. Herman’s final stage of trauma recovery is the stage of reconnection, which was congruent with the emphasis of the voice of connection that was present in many of the HEALING AFTER SEX TRAFFICKING 169 participants’ narratives of healing (1992). This theme is congruent with the value of belonging in the Circle of Courage (Brendtro et al., 2005) Many of the participants spoke with the voices of connection both in relation to themselves and with others, and shared how relationships with others were important in their healing journeys. For three participants children were a major catalyst in their healing journey; for Camara getting pregnant motivated her to leave a life on the streets behind and work on herself. For Cory and Emily, their children motivated them to persevere in their healing journey and exit abusive relationships that occurred after they had exited the sex trade; this finding was congruent with previous research on exiting and resiliency (Cecchet & Thoburn, 2014). We can see how the power of being a mother combines the values of belonging and generosity (Brendtro et al., 2005) as we hear from participants how motherhood has given them purpose and a need to protect someone else which was greater than they felt for themselves. In follow up interviews two participants who are not yet mothers themselves identified that their desire to be mothers is something that is healing for them as well. This was apparent as I shared the results with Tracy and she shared that she has begun to foster children since we had our interview. We discussed how her experiences in the foster care system have allowed her to be a good foster parent and have motivated her to care for the children well. For Lindsay, she identified with other women’s experiences of becoming mothers and shared about her desire to become a mother as well and how as she thinks about her future children she feels strong maternal instincts. She explained that these help her connect to inner child and are healing for her in her journey. As women spoke about reconnecting with their inner child we learn that for some this occurred through becoming mothers, and for others this meant “reparenting” HEALING AFTER SEX TRAFFICKING 170 themselves. Finding ways of connecting with their child self before their experiences of exploitation was a major theme seen across many participants’ experiences. The theme of connection also emerged when women spoke about their experiences of healing where having supportive people or communities encouraged them in their pursuit of healing and have kept them motivated to continue in their journeys. As is mentioned in the literature review, lack of social support leads to increased symptom severity and so this finding makes sense in light of previous research (Hossain et al., 2010). While some of these people were professionals (i.e. counsellors), healing through connection happened through all types of supportive relationships from romantic partners to family members, to fellow survivors or people in recovery. Women expressed that meeting with other survivors was helpful in their healing journey, however were also able to experience healing through people who were compassionate, loving, and encouraging towards them. These people were consistent supports to participants and did not give up on them despite the challenges they faced; for many survivors this increased their self-worth and belief in themselves that they could do it. Previous research studied women after one year of exiting and found that external support was a major factor in their resiliency and healing (Sari & Khairunnisa, 2014), and this research supports that finding and can speak to external support being an important factor longitudinally for these women’s healing. Advocacy. The voice of advocacy shows us the importance of giving survivors a platform to speak because they taught us that advocating for themselves and others is an important part of their healing journey. Charlotte explains that the assumption that survivors are “all too damaged to speak” is wrong, and that by sharing their stories of exploitation and healing they are able to educate others about these injustices with the hope of preventing further injustices from occurring. As well, this act of advocacy counters the years of silence that they HEALING AFTER SEX TRAFFICKING 171 have either been forcibly subjected to, or experienced due to stigma, shame, or other oppressive structures. The voices of advocacy align with the value of mastery in the circle of courage where women have come to the point of accepting their story to speak out against injustice. This also aligns with the value of generosity, as women who had the voices of advocacy (Tracy, Marie, Charlotte) also stated that they found purpose in advocating for others. Definition of healing. Previously, healing has been conceptualized as a reduction of symptoms, which is characterized in more medical terms. For the survivors who participated in this study, the experience of healing was more nuanced. Survivors spoke about healing being as “steps forwards and backwards”, “a journey” and “a process, not a destination”. Some also acknowledged that they would live with the consequences of their victimization for the rest of their lives in the forms of mental and emotional distress and illness, and physical and relational suffering; however, they also stated that acknowledging these consequences did not invalidate their experiences of healing. This is an important perspective for us to consider as western frameworks of healing and recovery often look at symptom reduction and linear measurements of growth and healing and yet this is not how survivors conceptualize healing for themselves. From this we learn that it would be a massive loss to measure healing in this way, as we would miss out on the strength and resiliency that is embedded in women’s journeys of pushing forward even when some indicators suggest “backwards” movement. As women shared what healing means to them, we also heard about the power of forgiveness and the way that they have changed their mindsets to view aspects of their suffering as a gift that they are able to use to learn, grow, and develop. Charlotte, who has a diagnosis of DID made it clear that, for her, integration of her parts and personalities is not a measure of healing. This reinforces the importance of viewing HEALING AFTER SEX TRAFFICKING 172 healing in a holistic and subjective manner rather than through the lens of symptoms (or parts) reduction. We have learned so much from the bravery and resilience of the participants in this study and it is important that we allow what they have shared with us to change us. They have taught us about the nature of healing, which is reflected in the starting place of our definition of healing to a final definition that I have compiled from all the survivor’s voices in this study. I asked each of women what healing meant to her and the participants answers are heard together in the following definition: Healing is your own personal journey. It’s embracing what you’re going through, doing the hard work, and carrying on and telling your story. Healing is having the courage to love yourself and your body and honouring just that you’re alive. While this is only a small fragment of what their journey’s have been, I believe it speaks powerfully of their resilience in this process, as they continue to fight despite the many trials they need to overcome, and make the choice to love themselves in the process. I believe this is an important definition to reflect on as we work to honour women’s experiences and voices in the research about them and learn about the beauty and complexity of healing for survivors. Terminology in literature. Part of turning towards their trauma happened when their experiences were given the appropriate label of “exploitation” or “trafficking.” For many participants reaching out to participate in this study was a challenge in itself, and many of my telephone screenings involved defining what exploitation or trafficking actually meant. It was apparent that survivors themselves often would not label what happened to them as “trafficking” despite their experiences matching the definition of trafficking according to the Canadian Criminal code. This was attributed to feeling that their story wasn’t “bad enough” or due to HEALING AFTER SEX TRAFFICKING 173 conceptualizing sex trafficking as being moved across borders or locked up. This perspective from victims may help explain the low reported statistics of victims in Canada. The fact that victims themselves often do not know how to correctly label what happened to them as trafficking contributes to the silence and disempowerment inherent to the industry of prostitution. Additionally, survivors wrestled with the concept of choice, privilege, and lack of options as contributors to their situations. Charlotte represents this struggle as she spoke about convincing herself that she was “choosing” this for herself at 12 years old, and then later defines healing as learning “to accept how helpless you were” and “forgiving yourself for whatever you’ve had to do to get by”. While self-blame has been found in other literature as a coping strategy for survivors of sexual abuse, the participants teach us that moving beyond that and understanding who is truly at fault is an important step for her healing. It is with those words that we begin to wrestle with the concept of choice and privilege alongside survivors, and it is my hope that through this project we can have a deeper understanding and appreciation for victims of trafficking, and look at the nuances of their situations rather than what appears at the surface. Survivors described the experience of being dismissed, judged, or misunderstood because of their experiences either while in the sex industry or after, when dealing with the consequences of their victimization. Many participants identified with what Tracy had shared about being judged and dismissed in the medical field. This speaks to the importance of treating the person holistically even when the focus is on one specific part of woman’s healing journey, such as her physical health. For many women the term “survivor” was seen to be an empowering label that some are still working to integrate into their identity; for others this was not the case. In the course of recruitment I spoke with one woman who was unable to participate due to distance, however we HEALING AFTER SEX TRAFFICKING 174 dialogued about her choice of using the word “victim” rather than “survivor” in order to acknowledge what she has overcome. This again speaks to the unique aspects of healing for each survivor and how this journey is a process that is particular to each woman, and that the words that are used to describe the experiences surrounding sexual exploitation are nuanced and should be chosen carefully. Clinical Implication Counselling psychology views research and practice as mutually informative (Counselling Psychology Association, 2009); it is thus imperative for survivors’ own voices to be heard in the research seeking to understand their experiences so that they may be the ones influencing effective responses to trafficking. While this was not a clinical study, the present research has many implications for counsellors, especially those working with survivors of sexual exploitation in Canada. As the research team was comprised of counsellors and graduate counselling students, the experience of immersing ourselves deeply and purposefully into participants’ lived experiences of sexual exploitation and healing deepened our abilities to empathize with and understand people with vastly different life experiences than our own. Engaging in the practice of intentionally listening for silences, power dynamics and complex relationships while our clients speak is a valuable experience for counsellors to bring into their therapeutic practice. Reflecting on this experience also allows clinicians to build greater awareness for their own inner experiences with their clients and allows them to be personally shaped by their clients’ experiences. As mentioned, engaging in this work challenged me to examine my own biases around how I conduct myself as a therapist and shifted my paradigm of knowing objectively to a paradigm of knowing subjectively and intuitively I faced challenges and my own resistance to HEALING AFTER SEX TRAFFICKING 175 believe some stories due to the inhumanity that was apparent. As a research team, we also wrestled with the challenge of “believability” when women came forward whose narratives were incoherent, disjointed, and objectively did not make sense to us. Some women’s stories appeared significantly fragmented which initially made us question if these stories were true or perhaps simply consequences of mental illnesses. We came to a place as a research team of commitment to believing and understanding that while specific details may not make sense to us, we were witnessing the deep effects and consequences of traumatization. Our ability as clinicians to “make sense” of our clients’ stories unfortunately misses the point of honouring our clients subjective experiences and how they tell and experience their stories. While the disjointed nature of trauma can make clinical work more challenging, I encourage clinicians to focus on meeting clients in their own subjective realities rather than being swept away by curiosities and desires for an objective truth and coherent narrative. I also encourage clinicians to join me in moving outside of western conceptualizations of “success” in psychotherapy as we encounter this population of integration or disappearance of personalities as we work with parts, DID and child-states. These are appropriate goals if they align with the client’s goals, however, I caution us to be wary of our need for symptom reduction rather than honouring our client’s stories to feel accomplished. We must align with their desires to honour their own stories and the parts that they developed that represent their resilience and self-protective capabilities amidst their trauma. While there was only one extracted voice of resilience in the analysis I want to highlight again, the underlying assumption that each survivor is incredibly resilient and that as we heard the obstacles each woman has overcome this should be celebrated. Entering therapy with the stance that survivors are resilient, no matter what their current struggles and obstacles are is crucial to empowering survivors in their journeys. HEALING AFTER SEX TRAFFICKING 176 The Circle of Courage provides an excellent foundation for clinical work and support of survivors, and the values that Brendtro and colleagues (2005) advocate for may be helpful in supporting survivors as well. As we learned from survivor’s stories the values of generosity, mastery, belonging, and independence are not only important in cultivating courageous youth but also are important in survivor’s healing journey. Relational connectedness was an important factor in healing for participants, meaning that it is incredibly important to build the space and capacity for connection within the therapeutic relationship. Many survivors speak to the deep impact that some counsellors had in their healing journeys. As was also suggested in the literature, this occurred through traditional forms of counselling including teaching coping skills, providing psychoeducation on trauma as well as using trauma therapies such as OEI and EMDR to help survivors process their trauma (Clawson & Dutch, 2008). One participant also spoke about receiving Lifespan Integration therapy, which she found healing as she worked specifically with her younger self and experiences. The participants who spoke about their counsellors with a deep appreciation spoke about connecting to them as humans rather than professionals. When counsellors were more interested in a diagnosis than facilitating a safe space and relationship Tracy describes this experience as unhelpful saying, “it almost feels like a slap in the face when they've got that clipboard”. Participants who found counselling helpful spoke about forming a deep connection, trust, and understanding with their counsellors and therefore it is important for clinicians to be informed of the challenges survivors face in forming these connections as the therapeutic relationship was incredibly healing for some survivors. Survivors valued counsellors that met them as humans rather than professionals and in order to provide best practice to our clients and this population I believe that this means we must step outside of the safety of our “professionalism” in the therapeutic relationship. As I clinician I HEALING AFTER SEX TRAFFICKING 177 empathize with the fear of what might happen if I care too much for my clients, as termination is almost inevitable in the therapeutic relationship. Not only that, but this population has higher risk of re-exploitation and even death compared to most populations we might work with, increasing the risk of emotional pain and even self-blame for clinicians. The risk of caring too much and too deeply is higher with this population and so some clinicians may fear steps out of the professionalism and formalities we engage in in order to keep ourselves safe. One example of this is when Lindsay shared a powerful experience where her counsellor shared how much she enjoyed working with Lindsay in counselling. Lindsay shared that this experience made her feel valued as a person and worthy of receiving help. She reflected that she did not feel like a burden to her counsellor after hearing that her counselling actually liked working with her. These selfdisclosures are valuable in humanizing the therapy process for survivors. We may also fear burnout that comes with working too heavily with traumatized populations should we change our therapeutic approach. To be clear, this is not a call to abandon our code of ethics, but it is a challenge to reflect on whether we are using our professional identity to distance ourselves unnecessarily from giving clients the human connection we are capable of providing. Like all therapy and therapeutic relationships this will differ for each clinician, and so I offer this as an encouragement to search yourselves alongside me as I also question what it means to engage authentically and genuinely with my clients. We learned from survivors that agency and flexibility are important in the survivor’s healing journeys, and so for clinicians this means creating safe environments and providing flexible care for survivors to ensure that we meet their needs and allow them to direct their healing process. Again, this may include non-traditional forms of psychotherapy, from engaging in drumming, body work, or even screaming with our clients. It might be smashing plates in a HEALING AFTER SEX TRAFFICKING 178 forest, or attending cultural or symbolic ceremonies with our clients; regardless of what the activity was, participants in this study were clear that the therapists that helped them most are the ones who go beyond traditional talk therapy. We need to adopt a commitment to learning with our clients and what they need and helping facilitate that This study has also shown us that the role of connectedness goes beyond the therapeutic relationship and extends to supportive family members, friends, romantic partners, and other community members in a survivors’ life. As counsellors we can have a role in helping clients to establish these connections and even in supporting the support systems of the survivors. Many supporters may wonder the best way to support a survivor, and while this research was not focused on specific interventions either clinically or in the community themes emerged from participants stories that we can learn from. Many survivors spoke about the importance of being believed, and despite the challenges that one might encounter in believing a survivor I encourage an openness to hearing their story non-judgmentally. Examining our assumptions about choice and privilege of choice is an important step for not only clinicians and researchers with this population but for all professionals and family members and friends. We have learned how difficult relationships are for survivors after being exploited and abused, often by someone that they trusted, and this is important for supporters to keep in mind as they journey alongside survivors. Being consistent, patient, and listening without judgment can help alleviate the shame and stigma many survivors feel in their situations. Women in this study spoke highly of their romantic partners who were understanding of their trauma and patiently worked through this with them. Survivors spoke about the fear of relationships and intimacy and the challenges this has presented in their relationships. Survivors HEALING AFTER SEX TRAFFICKING 179 may be re-learning boundaries and need patience through this process, especially as they make the decision to enter sexual relationships. It is also important that supporters of survivors are ensuring that they are gaining support themselves, as survivors also spoke about the challenges they had in relationships post-exiting. Parents and family members of survivors may feel pressure or anxiety to ensure the safety of survivors even after they are in a safe situation. As a clinician and researcher I encourage supporters to be aware of healthy boundaries with survivors. Too rigid of boundaries that were not co-created with the survivors may cause survivors to feel trapped, out of control, and have a lack of agency. While the intentions of safety are benevolent, rigid caring may have the opposite effect of the intended outcome and remind the survivor of her previous conditions. Supporters have a unique opportunity to demonstrate healthy boundaries in their relationships with survivors and I encourage open discussions with survivors around needs and boundaries in order to facilitate and grow healthy relationships and support survivors in their healing journeys. In order to connect non-judgmentally, it is important for clinicians to understand the systemic forces and personal vulnerabilities that have predisposed and perpetuated sexual exploitation for their clients. The reflexive process that the researchers engaged in as part of this project is an important process for counsellors working with this population as well, to be willing to sit with the discomfort they may feel, their biases and preconceived notions about sexual exploitation. It is important for clinicians to be educated on the cycle of sexual exploitation as it appears in Canada. Evidenced in the stories of participants in this research, correctly identifying victims of sexual exploitation can be challenging. However, we also learned that properly labelling sexual exploitation for what it is has the potential to be empowering for survivors; in some cases, it may be the role of the counsellor to help survivors accurately name the HEALING AFTER SEX TRAFFICKING 180 experiences as trafficking or exploitation. These stories also call for counsellors to advocate for survivors and alongside survivors as we recognize the silencing and disempowerment that survivors experience due to shame, stigma, and dissociation. Counsellors are encouraged to provide education in their communities on the effects of trauma and especially in the justice system so that survivors can be supported in reporting their victimization. While many survivors did not mention group therapy specifically, they all expressed a deep interest in meeting one another and deep appreciation for hearing about other survivors’ journeys through the feedback sessions. This points to the importance of building relationships within the survivor community in order to facilitate connection, normalize experiences and build social support. Creating a safe space for survivors to connect with one another, such as with group counselling or other life skills programs could have a great impact on survivors’ healing. Survivors expressed feeling isolated even within women’s mental health programs due to the unique nature of their experiences and indicated a desire to have a place where they could meet other survivors who could understand what they had gone through. The participants in this study represent a variety of intersecting minority groups (i.e. Jewish, Indigenous, LGBTQ+). As counsellors it is important that we are providing culturally competent services to our clients in order to support an individual’s notions of healing and wholeness. Given that the study took place in Canada and there is an overrepresentation of Indigenous women who are victimized by sex trafficking, it is particularly important that counsellors build cultural awareness and consideration into their practices when working with Indigenous clients. As mentioned in the review of the literature, the loss of cultural identity presents a unique challenge to Indigenous survivors and should inform clinical work with these clients. Indigenous participants in this study did not receive culturally informed treatment and HEALING AFTER SEX TRAFFICKING 181 expressed the desire for cultural integration into their counselling experiences and believed that this would have helped facilitate their healing. It is equally important for non-Indigenous counsellors to facilitate the connection of Indigenous clients with their communities and heritage and/or engaging in cultural activities with one’s clients as part of journeying with them in their healing. This includes ensuring one has cultural awareness that is needed to work with this population. This includes taking every step possible to avoid perpetuating colonization, including examining one’s biases and assumptions about the culture, knowing the history of colonization and also bringing a willingness to learn about the indigenous cultures (Duran, 2006). For counsellors who may be part of majority culture or represent privilege it is important to consider the projection that may occur in the counselling setting with this population. As a researcher, I experienced a range of reactions towards myself as described in the previous section and I found that it was important for me to examine my own feelings of guilt around colonization and the privilege that I held in order to authentically encounter my participants. I encourage counsellors who are preparing to do this deeply personal work of journeying alongside survivors of sex trafficking to do the same. As I also wrestled with Duran’s question in this process, I also wish to advocate for other clinicians to ask yourselves: “how can you guide someone who is alienated if you are alienated from yourself?” (2006, p. 45). This self-examination may be painful, uncomfortable and stressful, however, as I learned from the present study it is essential in supporting survivors. Strengths and Limitations The principal researcher experienced some challenges in recruitment of a proportional representation of Indigenous women for this study. Sexually exploited women are a very HEALING AFTER SEX TRAFFICKING 182 vulnerable population and because of this I experienced a number of barriers and resistance in recruitment. Counsellors, program directors, and other people in the survivor community raised questions of my intentions behind the project and questioned colonizer motives. Given that I, the principal researcher, am a Caucasian woman attending a Christian university the history of colonization and discrimination towards both Indigenous and LGBTQ+ population provided a barrier in recruiting an accurate proportion of Indigenous women for this study or women who identified as LGBTQ+. While I was explicit in my intentions to provide a platform for sexually exploited women to share their experiences in counselling psychology research I still experienced challenges in recruiting participants from Indigenous backgrounds. The resistance to the research highlights the importance of ensuring that the research is not only ethical in practice but also in intention as this population has experienced a cycle of re-victimization and exploitation over their vulnerabilities. I was also struck by the protective nature of the communities of Indigenous peoples and survivors and could see amazing strength and protectiveness from the people who were part of these communities. As this was my initial research project in the field with this population I experienced a number of people expressing concern and questioning my intentions, and in the future making these more explicit to all members of the public could assist in alleviating concern from members of the public and the survivor community. In this study two of the seven participants have Indigenous heritage, which allowed for Indigenous voices to be heard in this study. However, hearing more from Indigenous women is highly important. Achieving proportional representation of Indigenous voices or specifically focusing on Indigenous’ women’s experiences are suggestions for future research. This may be more easily accomplished by an Indigenous researcher or a non- HEALING AFTER SEX TRAFFICKING 183 Indigenous researcher who has spent more time integrating and investing in Indigenous communities. While the study did not reach a proportional sample size of Indigenous women there was a rich diversity in the sample of participants in other domains. Participants ranged from 22 and 59 years of age, and had been sexually exploited from between 1.5 and 25 years. At the time of the interviews women had been exited between 1.5 and 32 years. Through these survivors’ experiences, we were able to learn what healing means for women at varying times since their exiting. Additionally, the women who were part of this study all had very different stories of sexual exploitation, which allowed this study to shed light on various ways in which women are sexually exploited in Canada. While conducting this study, we realized that certain exclusionary criteria was limiting and the original wording of “trafficking” and the associations connected to this word may have resulted in self-exclusion by some women who fit the study’s criteria, due to the fact that they did not yet label their experiences with this terminology as defined in the criminal code. As well, the idea of “forced” prostitution brought up challenges for women in the interview who voiced feeling their experiences were not “bad enough” or violent enough to fit this study. Since it was not my intent to minimize or compare women’s experiences of exploitation, certain wording was changed in order to be more inclusive of women’s experiences. As the research progressed, the research team reflected on their previous assumptions about sexual exploitation in Canada. After conducting the interviews with women, we have achieved a better understanding of the confusion and dismissal that the women experienced due to a lack of understanding and mis-labelling of their victimization from people in the community and professionals. It is important that we use terminology that validates and empowers survivors, HEALING AFTER SEX TRAFFICKING 184 where we name what happened while also being open to how they self-identify. Some women may choose to use terminology like voluntary prostitution, exploitation or trafficking depending on their experiences and as we have learned experiences of sex trafficking vary greatly, not only between women, but also within each woman’s story. Giving women agency in choosing their own terminology for their stories honours the varied identities and life contexts of women who are trafficked. Based on Morrow’s (2005) criteria for ontological authenticity of improving, maturing and expanding individuals’ constructions and the feedback from participants after their interviews and in the follow up interviews this study upholds this criterion for rigour. Participants all spoke about having learned something about themselves and their stories because of the interview, and many shared that telling their story sharing their story was cathartic and reminded them of their strength and resilience. Many participants also spoke about the interview being a marker in their healing journey and stimulating them to move forward in their lives and their healing journey. This study was unique in design in that it worked to bring survivors together in solidarity and also bring the community into their healing. The survivors who met each other expressed gratitude and encouragement in being able to share this experience together, and the survivors who received individual follow up meetings shared similar sentiments after hearing the results of the survivors together. I brought the community into this project by asking the community for donations in order to provide self-care packages for the women following the initial interview and was greatly encouraged by the response of the community. Women shared that this was an encouraging gesture for them as they felt the support of the community in their healing journey. The women also expressed feeling encouraged by the illustrated poem that they received which a HEALING AFTER SEX TRAFFICKING 185 local artist volunteered her skills towards. The principal researcher was also privileged in being able to use the research to speak alongside one of the participants at a community awareness campaign about sex trafficking, and in the local paper raising awareness of the issue in Canada. The study not only brought survivors together but also worked towards bringing the community into their healing and de-silenced the issue of sexual exploitation in Canada. The study also had the strength of having co-researchers speak into this project in order to uphold the criteria of fairness. The study is shaped by multiple perspectives of myself as the principal researcher, the research team, my supervisors and of course the women in the study. While each co-researcher was unique and holds their own perspectives and experiences, they were all part of the counselling psychology profession and did not identify as being sexually exploited. Further research could benefit from researchers from a variety of disciplines or by including researchers that were considered “insiders” of the population being studied. The study was limited by time and location as participants reached out from outside of the researcher’s local area and as interviews were to be conducted in person the researcher was unable to include their voices. Conclusion Sex trafficking is a hidden issue in Canada, where the assumption is that exploitation occurs predominately in foreign countries. The present research provides evidence that sex trafficking impacts Canadians of all socio economic statuses, ethnicities, and ages. As awareness of sexual exploitation has been increasing in developed countries like Canada, research showing the consequences of sexual exploitation on victims has also increased. While it is important for us to understand the consequences and barriers that women experience in their healing, there has been a lack of understanding on how women themselves experience healing. Research on HEALING AFTER SEX TRAFFICKING 186 program development, healing within Indigenous communities, and with men or transgendered victims of sex trafficking is also needed. It is my intention to continue sharing the results of this study to increase awareness of sexual exploitation in Canada and through doing so, decrease the stigma and judgment that victims experience in telling their stories. This is accomplished through listening to survivor’s themselves and acknowledge their resilience in enduring their experiences and telling their stories. They have shown us the beauty of their endurance and choice to love themselves in the process. Brene Brown (2012) speaks about the act of turning towards the dark parts of life in her book Daring Greatly saying, “Only when we’re brave enough to explore the darkness will we discover the infinite power of our light” (p. 60). My hope for this study was to shed light on women’s resiliency and strength in their healing journeys and provide survivors insight to the field of counselling psychology. Through listening to women’s stories of healing I have become hopeful that despite the multitude of devastating consequences that occur due to the victimization of women in the sex trade that women are able to experience healing. They have shown that this is possible through the support of people in their lives, with their faith and spirituality, in re-connecting with their child self and their bodies. They have taught us that by embracing who they are and accepting that their experiences have happened, but do not define them, they are able to be compassionate towards themselves and find courage to tell their stories and love themselves. In sharing both the dark and light parts of their stories they have shown tremendous bravery as they have advocated for themselves and other survivors and have spoken up against the oppression, silencing, and violence that had been part of their narratives for so long. It is now of the utmost importance that us as clinicians, Canadians, and humans also turn HEALING AFTER SEX TRAFFICKING 187 towards both the light and the dark parts of their stories in order for us to better listen and support survivors and take action against the injustice of sexual exploitation. HEALING AFTER SEX TRAFFICKING 188 REFERENCES A New Day Youth and Adult. (2017). Human trafficking statistics Canada. 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Sex trafficking is one of the world’s fastest growing criminal trades, with estimates of $32 billion annually (International Labour Organization, 2008) and is defined as “forcing, deceiving, or coercing a person to perform a commercial sex act” (A21, 2018). This often takes the appearance of forced prostitution, however, there is difficulty in determining who is a victim of sex-trafficking and exploitation and who is working in prostitution not by force or coercion, but either by free-will, or out of desperation and lack of options (Canadian Women’s Foundation, 2014). Sexual exploitation. According to the Canadian Criminal Code and Bill C-46, in section 153 sexual exploitation only pertains to young persons under the age of 18. Sexual exploitation is defined as an offence for sexual purposes on the body of a young person, or where the young person is coerced to touch another body for sexual purposes. The offence is by a person who is in authority over the young person, or whom the young person has a relationship of dependency on. (Criminal Code, 2017). Prostitution. Prostitution is the practice of exchanging sexual services for payment (RCMP, 2014). Prostitution is distinguished from sex-trafficking in that not all people who HEALING AFTER SEX TRAFFICKING 199 engage in prostitution are victims of human trafficking; however, all people who are trafficked for sex are forced into prostitution (RCMP, 2014). Exiting. The term exiting is used to describe the transition process of women leaving the sex industry (EVE, 2011). While this term is applied for women who have not been trafficked, for the purposes of this paper this term refers to women escaping or exiting from the sex trade where they have been forced to work in the sex industry against their will (Hickle, 2017; IOM, 2017). Indigenous. In this paper the term Indigenous includes those who identify as First Nations, Métis, Inuit and Non-status Indians in Canada. Childhood sexual abuse. Childhood sexual abuse is defined as any unwanted sexual contact between a child and an adult who is in a position of power over the child, however, childhood sexual abuse differs from sexual exploitation in that the abuse is not used for a commercial gain (Knight, 1990). Grooming. Grooming refers to the process which traffickers use power, manipulation, and in some cases forge a trauma bond in order to control their victims. The grooming process has four stages as outlined by O’Connor and Healy (2006): ensnaring, creating dependence, taking control, and total dominance. These stages will be expanded on further in the literature. The term “seasoning” is also used in some literature to describe the same process (Herman, 1992). Re-trafficking. This refers to the process where a victim escapes their trafficking situation only to be trafficked again at a later time (Loomba, 2017). Rates of re-trafficking vary and are difficult to estimate given the nature of the problem, and range from 21%-50% depending on the geographical location and demographic of victims (IOM, 2010) HEALING AFTER SEX TRAFFICKING 200 Sex work. Sex work refers to exchanging sexual services either directly (services for the individual) or indirectly (i.e. pornography) (Gerassi, 2015). This can involve persons of any gender and can occur in a variety of ways including working in strip clubs, brothels, working in private homes, or escorting. Trafficker. According to the RCMP, “traffickers for sexual exploitation are considered as pimps, as they typically engage in pimping activities” (2014, p. 7). Pimping turns into trafficking when the pimp engages in conduct which would suggest to the person that if they do not comply harm will occur to themselves or someone else (RCMP, 2014). John. The term “john” normally refers to the man who is purchasing sex. Other terms used in the literature are “buyers” “clients” “customers” to refer to the person purchasing sex (Canadian Women’s Foundation, 2014). These terms are used interchangeably throughout the literature but refer to the same person (Canadian Women’s Foundation, 2014) Victims and survivors. Some literature refers to a person who has been sexually exploited and trafficked as a “victim” of human trafficking, while others make the argument that these people should be referred to as survivors (Loomba, 2017; Canadian Women’s Foundation, 2014). For the purpose of this paper, those who have survived sex trafficking will be referred to as sex trafficking survivors (STS), to acknowledge their agency and resiliency after being rescued and exiting sex trafficking (Loomba, 2017). The term victim will be used for persons who have not been rescued from human trafficking, or in reference to the time they were under control of various traffickers and persons. HEALING AFTER SEX TRAFFICKING 201 APPENDIX B: The Grooming Process O’Connor and Healy (2006) lay out the grooming process for recruitment into trafficking in four steps: ensnaring, creating dependence, taking control, and total dominance. Ensnaring is the initial stage where the trafficker makes contact with the girl by impressing her and winning her trust and claiming the status of being her boyfriend. Next, he creates dependence on himself by persuading her to get rid of relationships and things that are important to her from her previous life, and even going as far as changing her name in order to isolate her from her previous life and identity (O’Connor & Healy, 2006). In the third stage “taking control” the trafficker will become controlling over even the basic needs of a victim including her eating, her attire, and will enforce rules using threats and demand that she prove her love and devotion. The final stage of grooming is known as “total dominance” and is characterized by the trafficker convincing his victim to have sex with a friend or other person, and that he needs her to earn his money (O’Connor & Healy, 2006). During this stage the trafficker may begin to control his victim through “debt bondage” (Canadian Women’s Foundation, 2014). This occurs when the trafficker tells his victim that she needs to pay him back for all the things he gave her during their “courtship” including drugs, gifts, clothes, money for travel, etc. (Canadian Women’s Foundation, 2014). The organized techniques of the trafficker to establish control over the victim are focused on disempowerment and disconnection, and meant to destroy the victim’s sense of self (Herman, 1992). While these are the prevalent reported experiences of recruitment for sex trafficking in Canada, this in no way is all encompassing or prescriptive of all women’s experiences of sex trafficking in Canada (Herman, 1992). HEALING AFTER SEX TRAFFICKING APPENDIX C: The Circle of Courage 202 HEALING AFTER SEX TRAFFICKING 203 APPENDIX D: Three Stages of Trauma Recovery in Psychotherapy Safety. The goal of Herman’s initial stage of trauma recovery, safety is to create a secure therapeutic relationship where the client experiences safety with the therapist (1992). In this stage the therapist may address certain symptoms caused by the trauma such as nightmares, intrusive thoughts or images about the event, and other forms of conditioned avoidance while working on restructuring the client’s assumptions about herself and the world (Herman, 1992; Van der Kolk, 2014; Tedeschi, 1999). Before experiencing healing from trauma the mind, body, and brain need to feel safe enough to let go of what has happened, which highlights the importance of creating a safe therapeutic place in stage one (Van der Kolk, 2014). Ensuring survivors have autonomy and agency over their healing process is extremely important, and they should never be forced to go at a pace or to places they do not want to (Herman, 1992; Steele & Kuban, 2017). Remembering. When the survivor has established enough safety that she will not be retraumatized by talking about her experiences, she can move on to the second stage of trauma recovery, remembrance and mourning (Herman, 1992). Physical wounds that are ignored will continue to manifest and cause pain, likewise, so will trauma narratives that go unspoken (Kwee, 2011). Though painful, the act of remembering and facing their trauma helps survivors integrate parts that have been disconnected into a coherent whole of their life narrative (Herman, 1992; Kwee, 2011). Survivor’s memories of trauma are often disjointed and difficult to connect into a meaningful narrative, which is often reflective of the survivor’s disconnected experience of herself (Kwee, 2011). As survivors take ownership of their experiences, they experience empowerment through re-defining their identity from victims to survivors (Herman, 1992; HEALING AFTER SEX TRAFFICKING 204 Ratican, 2001). In this phase survivors also mourn pieces of their life that have been destroyed, and reflect on hopes for their future, and integrate experiences of loss and hope into their narratives (Kwee, 2011; Herman, 1992). Reconnection. In the final stage of trauma recovery, reconnection, the survivor has come to terms with her past, and focus on reconnecting to herself, others, and life (Herman, 1992). Healing through reconnection occurs in the context of relationships and community (Van der Kolk, 2014; López‐Zerón & Blow, 2017; Schultz et al., 2016), and is the dynamic process of reaching inwards, and learning to be oneself, while reaching outwards, and learning to be with others (Kwee, 2011). This poses challenges for trauma survivors with experiences of repeated relational and sexual trauma, and points to why establishing safety within the therapeutic relationship is the initial step for survivors to later experience reconnection in other relationships. HEALING AFTER SEX TRAFFICKING APPENDIX E: Recruitment Poster 205 HEALING AFTER SEX TRAFFICKING 206 APPENDIX F: Phone Interview Script Hello __________! My name is Amy Kobelt and I am the principal researcher in this study investigating the healing experiences of women who have survived sex trafficking in Canada. I am conducting this research through Trinity Western University as a graduate student of the Masters of Arts Counselling Psychology program. Thank you so much for contacting me and for your interest in participating in the research. The purpose of this interview is to find out that this research project is a good fit for you and your experiences. I want you to know that your participation is completely voluntary and that you are still able to back out the research process and of answering these questions at anytime. I understand that it is difficult to talk to someone you haven’t met before about your personal experiences over the phone, so I am just going to ask you a few questions to ensure you meet the criteria for participation in the study. 1. Can you let me know how you heard about this study and what your interest is in it? 2. How old are you? 3. Have you been a victim of sex trafficking or sexual exploitation in Canada? 4. How long has it been since you have exited your trafficking situation? 5. Are you comfortable and willing to talk about your experiences related to being trafficked in an in-person interview of 1-2 hours? 6. Everyone has a different story of healing and what that looks like. Would you say that you have experienced healing from your experiences of being trafficked for sexual exploitation? HEALING AFTER SEX TRAFFICKING 207 7. Do you think that talking about your experiences will cause high levels of distress and create safety risks for you? Do you have a support network in place if you become stressed following the interview? Thank you so much for participating in this telephone screening with me and for your interest in this study. I will let you know about participating in the study as soon as possible. If anything that we talked about today caused you to have a negative reaction and feel distress I have a list of free and low-cost counselling services. Fraser River Counselling 7600 Glover Rd., Langley, BC V2Y 1Y1 (604) 513-2113 Burnaby Counselling Group 3701 Hastings St., Burnaby, BC V5C 2H6 (604) 430-1303 Thrive Life Counselling and Wellness 9220 Glover Road Unit 210 (Box 483), Langley, BC V1M 2R8 778) 239-2962 Trafficking and Prostitution Specific Services: REED – Resist Exploitation Embrace Dignity Vancouver, B.C. (604) 753-9929 email: adria@embracedignity.org Deborah’s Gate Vancouver, B.C. – (604)-915-5678 SARA: WEAVE – Women Exiting Abuse Violence and Exploitation Abbotsford and Mission - 604-746-3301 Free counselling services, support groups and legal counsel: HEALING AFTER SEX TRAFFICKING 208 abbotsfordSTV@saraforwomen.ca; MissionSTV@saraforwomen.ca If you are interested in getting involved in an organization of women who were formerly sexually exploited who desire to educate others about their experiences here is the contact information for that: EVE – Formerly Exploited Voices Educating http://www.educating-voices.com/ Contact: info@educating-voices.com HEALING AFTER SEX TRAFFICKING 209 APPENDIX G: Informed Consent THE HEALING JOURNEY AFTER SEX TRAFFICKING Principal investigator: Amy Kobelt, M. A. Student in Counselling Psychology, Trinity Western University. Contact number: 604-603-3888. Contact email: amy.kobelt@mytwu.ca Supervisor: Janelle Kwee, PsyD, Faculty of Graduate Studies, Trinity Western University. Contact number: 604.513-2121, ext. 3870. Contact Email: Janelle.Kwee@twu.ca Purpose: The purpose of this study is to listen to the experiences of women who have survived experiences of sex trafficking in Canada and to gain an understanding for how they have been able to experience healing. This study hopes to learn from survivors’ how their relationship with their self has changed since exiting and throughout their healing journey, and how the self has both made it difficult to heal, but also allowed each survivor to get to where she is today in her healing journey. This study is also interested in learning about the relational, systemic, and sociological factors that have assisted women in their healing journey, as well as gaining an understanding on what has provided obstacles for women within those same factors. This study is designed to give women’s voices a platform to inform the academic and clinical communities in how best to support survivors of sex trafficking. This study’s purpose is to learn what healing means to women who have experienced sex trafficking in Canada, rather than assume what this means based on past research and clinician definitions, as I believe this is a unique and subjective experience. Procedures: The research will be conducted with willing participants who desire to share their stories of surviving sex trafficking in Canada and who meet the criteria and fit of this study after a phone screening with the principal researcher. Should you meet this criteria an in-person HEALING AFTER SEX TRAFFICKING 210 interview will be scheduled at the location of your choosing that will last from 1-2 hours and be video or audio recorded for transcription at a later time. The interview will begin by asking you for context of your study and your experiences of sex trafficking, and then move into questions focused on your healing journey. These questions will be guided by the research purpose of understanding how survivors have experienced healing, and ask specific questions about both obstacles and helpful people, factors, and resources, as well as internal resources and resilience within your self. Following the end of the interview you will be able to select a pseudonym so that during the transcription all identifying information will be removed, and your pseudonym will be used instead to protect your confidentiality. You will be given the opportunity to aid in the interpretive process of the data analysis through a “member check” where the researcher will ask for your input and insight into the analysis and ensure that the findings accurately reflect your experiences. Upon completion of the study the results will be made available to you if you would like. Potential Risks and Discomforts: As mentioned previously part of this interview will be focused on understanding the context from which you came from as surviving sex trafficking, which may bring up distressing memories or be uncomfortable to remember. However, these experiences are not the focal point of this study, and the researcher seeks to gain context for where you have come from, not to create further distress. All interviews will be conducted by the principal researcher who has training in counselling psychology and experience in working with victims of sexual trauma. The principal researcher will not be providing counselling services herself, however, these experiences have given her the capacity to create a safe space for you in sharing your story and provide support throughout the interview process if you should be triggered by speaking about your experiences. The researcher will allow provide you with HEALING AFTER SEX TRAFFICKING 211 referrals to counselling services should you become uncomfortable and distressed after sharing your experiences. Potential Benefits to Participants and Society: Participating in this study will allow researchers, academics, and clinicians to better understand the healing journey of survivors of sex trafficking. There is a lack of survivor-informed research in the academic and clinical world of counselling psychology, and thus by sharing your story you are able to inform helpers on how best to assist current and future survivors of sex trafficking in Canada from the perspective of someone actually receiving the care and support they are providing. The researcher also hopes that through sharing your story of healing that you will be reminded of your inner strength and celebrate how you have over come the obstacles in the way of your healing. The research also provides an opportunity for you to reflect on what was helpful and unhelpful in your own healing journey. This research aims to focus on the strength and resilience of survivors and add your voice to the academic world of counselling psychology. Confidentiality: Any information that is obtained in connection with this study and that can be identified with you will remain confidential and will be disclosed only with your permissions or as required by law. Any recorded files and transcripts of interviews will be kept on a password-protected computer with an additional encryption of the file. When data is transferred from the computer it will be transferred on an encrypted USB drive. Paper copies of the transcripts will be kept in a locked filing cabinet in a locked office. Electronic files and paper copies and transcripts will be deleted and shredded upon completion of the research until Trinity Western University has approved this study as meeting all of its requirements for completion of a thesis for the Masters of Arts in Counselling Psychology program. HEALING AFTER SEX TRAFFICKING 212 Contact Information about the study: If you have any questions or concerns about the study, or desire any additional information you may contact Amy Kobelt at 604-603-3888 or amy.kobelt@mytwu.ca, or her research supervisor Dr. Janelle Kwee at 604.513-2121, ext. 3870 or Janelle.Kwee@twu.ca Contact for concerns about the rights of the research participants: If you have any concerns about your treatment or rights as a research participant, you may contact Elizabeth Kreiter in the Office of Research, Trinity Western University at 604-513-2167 or by email researchethicsboard@twu.ca. Consent: Your participation in this study is voluntary and you have the right to refuse to participate or choose to withdraw from the study at anytime through communication over the phone, email, or in person. Refusing to participate or choosing to withdraw from this study will not affect your relations with the researcher or research team negatively. Please note that withdrawal from the research will not be possible after the researcher has included your information into the dataset, however, your identity will be protected throughout the research process through the use of your selected pseudonym. Signatures: Your signature below indicates that you understand the above information and are satisfied with the answers to any questions you may have and that you have received a copy of this consent form. Your signature also indicates that you consent to participate in this study and that your responses may be used and kept for further use after completion of the study. ____________________________________________ Research Participant Signature _______________________ Date ________________________________________________________________ Printed Name of Research Participant HEALING AFTER SEX TRAFFICKING 213 APPENDIX H: Demographic Questionnaire Name: _______________________________________________ Pseudonym: ___________________________________________ Current age: ___________________________________________ Ethnic Background: _________________________________________________ Highest level of education completed: __ Elementary School __ Some High School __ Completed High School __ Some University or Post-Secondary __ Completed Diploma or Trade Certificate __ Completed Bachelors Degree __ Some Graduate School __ Completed Graduate Degree __Other: __________________________________________________________ Occupation: _______________________________________________________ Religion: _________________________________________________________ Age you were sexually exploited: ______________________________________ Length of time spent sexually exploited: _________________________________ Age you exited: ____________________________________________________ HEALING AFTER SEX TRAFFICKING 214 APPENDIX I: Interview Guide Thank you for being here today and being willing to share about your healing journey. As you know, this is a voluntary study, and you are able to quit at anytime during the research process. If there are questions you feel uncomfortable answering please let me know, as you are in no way obliged to participate in this study if you find yourself becoming too distressed or uncomfortable. If you need to stop at anytime and take a break you can just let me know. As you know, this study is looking at healing experiences of survivors of sex trafficking, however, before beginning I’m just going to ask you a few questions about yourself now, and what happened before you exited in order to gain some context for your story. Feel free to share as much or little as you would like. 1. How were you trafficked for sexual exploitation? 2. How did you exit? How old were you when you exited? Thank you for sharing that part of your story with me. Now we are going to move on to the main portion of the interview. Sometimes it can be hard to capture the full story and meaning of something as deep and personal as your healing journey. This is why you have been asked to bring in a visual representation of what healing means to you, or something that is important from your healing journey. If you haven’t had a chance to do that, you can use the supplies we have here to do so before we talk further about your healing journey. 1. Tell me about your experience of healing since in the process of leaving sex trafficking? a. What have been the most defining moments (or people, or situations)? b. How have your relationships with others changed in the process of healing? c. How has your relationship with your self changed over this journey? HEALING AFTER SEX TRAFFICKING 215 2. Stepping back and thinking about your journey, what would you say have been the biggest obstacles to your healing? a. What people have made healing difficult? b. What structures or systems have limited you? c. What resources have you lacked? d. What have been the obstacles within yourself? 3. How have you been able to overcome these obstacles so far? a. What is most valuable to you now? b. Who has been involved in your journey of healing? c. What structures, systems, or resources have helped you? d. What, in yourself, has helped you overcome the challenges you have faced in experiencing healing? 4. As you imagine the future, what stands out as the most important part of your continued healing? 5. We’ve explored what your healing journey has looked like so far. Given your experiences, what does healing mean to you? How does this relate to the visual you have created/brought in with you today? a. Prompt: How do you personally define or understand it? 6. Is there anything else you want me to know that you feel is important to share about your journey to healing? HEALING AFTER SEX TRAFFICKING 216 APPENDIX J: Debrief Script Thank you so much for participating in this study and sharing your story with me. It has been an honour to hear about your healing journey and how you have overcome so many obstacles in order to get where you are today. Your vulnerability and bravery has truly touched me. After I have completed an initial analysis of the interviews if you are interested I would love to share the results with you and make sure that they accurately reflect your experiences before moving forward in sharing the results. That portion of the research can either be taken place as another in-person meeting or over the phone if that is more convenient for you. Please let me know if you are interested in hearing about the results. Also, if anything that we have talked about has caused you distress and you are in need of some support I have a list of free and lowcost counselling and support services for you. If you have any other questions about the research you can contact me at amy.kobelt@mytwu.ca HEALING AFTER SEX TRAFFICKING 217 APPENDIX K: List of Services for Participants Thank you again for participating in this study. Here are a list of local resources that offer free or low-cost counselling services or provide other services to women who have experienced violence and exploitation. Free and Low-Cost Counselling: Fraser River Counselling 7600 Glover Rd., Langley, BC V2Y 1Y1 (604) 513-2113 Burnaby Counselling Group 3701 Hastings St., Burnaby, BC V5C 2H6 (604) 430-1303 Thrive Life Counselling and Wellness 9220 Glover Road Unit 210 (Box 483), Langley, BC V1M 2R8 778) 239-2962 Trafficking and Prostitution Specific Services: REED – Resist Exploitation Embrace Dignity Vancouver, B.C. (604) 753-9929 email: adria@embracedignity.org Deborah’s Gate Vancouver, B.C. – (604)-915-5678 SARA: WEAVE – Women Exiting Abuse Violence and Exploitation Abbotsford and Mission - 604-746-3301 Free counselling services, support groups and legal counsel: abbotsfordSTV@saraforwomen.ca; MissionSTV@saraforwomen.ca HEALING AFTER SEX TRAFFICKING 218 If you are interested in getting involved in an organization of women who were formerly sexually exploited who desire to educate others about their experiences here is the contact information for that: EVE – Formerly Exploited Voices Educating http://www.educating-voices.com/ Contact: info@educating-voices.com HEALING AFTER SEX TRAFFICKING 219 APPENDIX L: Research Member Confidentiality Agreement As an assistant to this study on “The Healing Journey After Sex Trafficking” I understand that I have great responsibility in keeping all things pertaining to participant identification and data in this study confidential. I agree to use great discretion and intentionality to ensure that participant information remains confidential, including encrypting and password protecting electronic data, storing paper copies of research documents in locked cabinets when not in use, and not disclosing and sharing information with those outside of the research team. I acknowledge that I have been trusted with information from vulnerable participants who may have safety risks related to their identities and their stories. I am willing and to uphold the confidentiality agreement outlined in this document, understanding that in breaching this confidentiality there may be serious risks and repercussions to participants. Such confidential information includes, but is not limited to, the following: . Participant identification and their stories . Computer Passwords . Field notes . Data gathered and transcripts and analysis I have read the above Confidentiality Agreement and am willing to be bound by its terms both during and after my work with this study. ___________________________________ Research Assistant Signature _______________________ Date ________________________________________________________________ Printed Name of Research Assistant HEALING AFTER SEX TRAFFICKING ___________________________________ Witness Signature 220 _______________________ Date ________________________________________________________________ HEALING AFTER SEX TRAFFICKING 221 APPENDIX M: Participant Feedback Handout Women’s Experiences of Healing What are female survivors of sexual exploitation stories of healing, strength and resilience? What voices are present in their stories? Voices of Resistance: Voices that were present in this category represent the attempt to prevent healing intentionally by another person or system. Voices in this category are also voices of opposition from the self that emerged in order to protect oneself from not being negatively affected by the exploitation. Disconnection: This voice represents separateness from others, as well as separateness or detachment from self or experiences. “You go into a hollow shell that you’re just a shell of a person ‘cause it’s so much easier to be that then deal with everything that’s going on inside you. Once you’ve detached yourself from who you are for so many years it’s very hard to find yourself again. Lots of people don’t. Many, many girls don’t” Confusion: Confusion is characterized by voices questioning, uncertainty and disbelief. This voice is often heard when talking about the past and represents a struggle of acceptance of reality or identity. “I really struggled with where I was going to find my worth if that wasn’t going to be the way I was going to do it…I didn’t know how to associate with people without offering my body to them cause that’s what my mom did.” Oppression: This voice of control, manipulation and over powering women’s choices, and is represented in people or systems that take away women’s choices and voices. HEALING AFTER SEX TRAFFICKING 222 “I am being told what to do and I was going to say I never felt like completely manipulated, I felt like it was my own choice, but at the same time I was only 13…so I probably was very manipulated” Avoidance: This voice is characterized by suppression, evasion and compartmentalization of experiences. It has been shown to be a protective act where women to compartmentalize what has happened for survival and coping. “I shut down. For a very long time. I was trying to put a wall between me and my childhood….For 10, 15 years I had just gone cerebral…I was just running away from everything and it was barely me at all”. Shame: This voice represents a painful feeling of distress or humiliation when wrestling with the consequences and experiences due to sexual exploitation. “I struggled with the shame for a really long time. And just feeling dirty, not feeling like a good person.” “I have a lot of regrets thinking I wish I could have enjoyed more time with my kid instead of needing to be like we need to survive here, I was really desperate” Dismissal: Dismissal is a silencing voice from others, which is also recognized and heard through being internalized to self. “There'd be times where I'd go to the gynaecologist have to explain that I met this guy online and this is what happened…and they'd be like well you shouldn't be doing that then. And then it's like well actually, it has nothing to do with HIM right now, we're talking about my body. And just really dismissing my body for the judgment, and that also just needs to stop.” Voices of Healing: Connection: This voice emerges when women are speaking about relationships with others, or when in connection or re-connection with herself or her body. HEALING AFTER SEX TRAFFICKING 223 “I feel like he truly loves me. And it’s been a journey in allowing that, I’m noticing the difference in how I think about a relationship, being in a relationship with a partner….I always leave people. That’s been my pattern...and he’s made me stay….He’s made me want to stay and be okay with being loved.” “There were a couple of counsellors that just fought for me and fought to make me stay and make me come back, and then allowed me to come back after getting kicked out multiple times. There were a couple people who really didn’t give up on me”. “Taking care of yourself as a way of honouring yourself….doing things for yourself that would have made the child in you happy” “Having this moment that stands out to me of like, I like that I’m funny, and I’m full of life. I remember having that thought of this actually feelings good, this feels like me again” Agency: This voice emerges through exercising intentional choices and making decisions, often in relation to choosing self and overcoming oppression. “I have respect for myself and I have values….if people don’t fit into those values then I’ll distance myself or not continue talking to them. And I have the ability to recognize that now and put boundaries up and stuff and if people’ done like that that’s fine”. They don’t need to be in my life” “I’ve now been 5 years celibate, chosen…so if I do find a partnership I’m not triggered…I don’t have to put that on my partner”. Advocacy: This voice is heard when standing up for oneself or for others against injustice or advocating for needs. “We do have a right to stand up, we do have a right to say no, we do have a right to say maybe ...and then if it happens and if we’re not liking it to be able to say no again” “I would like to see more structure for Indigenous people with mental health and addictions….to make sure that people who are going through mental health and addiction are able to have their culture recognized.” HEALING AFTER SEX TRAFFICKING 224 Compassion: This voice represents grace and forgiveness from others as well as towards oneself. “You have to be patient with yourself, like you’re going to have ups and downs, but it’s part of healing. It’s okay to cry. It’s okay to feel emotions, and everything that comes along with it….you have a right to feel what you feel.” “Forgiveness is an on-going thing I have to keep revisiting. Forgiveness for myself for things I did or didn’t do.” Resilience: This voice represents bouncing back from continual oppression, and it represents an ability to persist despite obstacles of dismissal, disbelief and oppression. “If I’m not listened to it doesn’t matter… I find people that will listen to me.” Knowing: This voice speaks with certainty, clarity, and understanding of truth and reality. “There’s a higher Being that made me and loves me for exactly who I am. And saw what happened, like all the details and still could accept me….I have room to change and no longer be identified with that”. “I’ve accepted the fact that these things have happened to me but I’m not going to let that define who I am.” Injustice: This voice is heard speaking against acts of injustice and unfairness with tones of righteous anger. “Oh were you really a victim?” They shouldn’t even be questioning that, that’s not right to do that.” “Those who claim to care, don’t tend to want to hear from us and they want to talk over us and be they experts. They assume that we’re all too damaged to speak for ourselves and that is unbelievably insulting.” Purpose: This voice represents hope for the future, and is heard when speaking about finding meaning in life. HEALING AFTER SEX TRAFFICKING 225 “She’s the reason I would never go back. I would never put her in danger…The biggest thing that keeps me away from it is would I ever want her to find out that I did that to support her? She deserves a good life, and for her to have a good life I need to be good. She’s literally a life saver”. Definitions of Healing “Healing is...you’ll never be “healed” healing is that, it’s healing. It’s a journey. It’s going to be up and down, so I think healing is embracing it’s going to come with highs and lows, but there’s not like steps forwards or steps backwards, but healing is embracing where you’re at right now. Saying like, “I’m really hurt and I’m going to fight for life….Healing is embracing what you’re going through in that moment and finding ways to love yourself in it.” “I used to think that I was like you got to a certain point and you’d be all better. But now I’ve realized it’s something you’re going to have to work on your whole life. And instead of looking at it as something you have to work on, you get to work on yourself, instead of having to work on yourself. Like I get to feel better… Healing is hard and it’s different for everybody.” “All of us need healing… I think just taking time to be aware, self-care and practicing selfcare whether it’s little things you do for yourself or like going on a retreat….and also doing the hard work that you don’t want to look at, the dark aspects of our being, we all have them. To me it’s like we need to be willing to look at that stuff and also know that okay, back off a little bit and hold yourself” “It’s a process, not a destination….it’s a process of doing better and better but never as well as we’d like to, not even close. And it’s not even linear, there are times when it gets worse….it overall improves, I think trying to love yourself and your body and owning both of them as your own and not think that they are sullied by what was done to you...Honouring just that you’re alive. “Healing is carrying on and telling my story to whom I feel comfortable and trusting and knowing I’m not the only one out there that’s gone through this….I find that healing in itself, that I know I’m not alone, I’m not the only one” HEALING AFTER SEX TRAFFICKING 226 “Communicating clearly what that looks like and what feels like and if you can’t speak it in words, create it, make sounds, somehow be able to release that from our bodies…Healing is your own personal journey. Everybody’s journey is going to be different. And honour that for each person.” “The courage to love yourself and be patient with yourself again….You have to be patient with yourself, like you’re going to have ups and downs but it’s a part of healing. And it’s okay to cry. It’s okay to feel the emotions and everything that comes along with it. It’s very valid feelings. You have a right to feel what you feel.