WASHINGTON - Bill Cosby's conviction and sentencing is seen by many as the first high-profile case to see an outcome in the #MeToo era.
The hashtag helped other victims feel empowered to speak out, but it also started a new dialogue about why victims take so long - sometimes decades - to report abuse.
"What I have seen so far is individuals who have survived traumatic events seeing these instances in the news and feeling somewhat empowered, but also re-traumatized because they are having to listen to a narrative that is occurring throughout our country over and over and over - on the news, on the radio, in conversations at water coolers," explained Alexandra Friedman, a licensed clinical social worker. "So it's a very painful thing for our country to be going through, especially for people who have been through this. But I do feel that there is a sense of connectedness of empathy and strength that those survivors are also gaining from hearing one another's stories."
Friedman has spent her career with trauma victims.
"Most people who have been assaulted really struggle to feel safe in order to talk about these things," she said. "And we don't even have statistics on people who don't report sexual abuse because the numbers simply aren't there."
More than 60 women have accused Cosby of sexual misconduct. But Andrea Constand, an employee at Temple University where Cosby was a trustee, is the only victim who brought a case to trial because with most of the other victims, the statute of limitations had expired.
"It makes it more likely for the public eye to see them as a doubtful situation," Friedman added. "You know, 'Why didn't this person come forward? They have had years to talk about it.'"
Friedman said one of the most common reasons victims don't come forward is fear of retaliation (especially if the accused is a prominent figure).
Another is guilt or shame.
"I have had so many clients say to me, 'If only I hadn't gone out that night. How could I let this happen to me?' And that's just heartbreaking to hear," said Friedman.
Re-victimization is another cost of prosecuting cases.
"Having to retell that story, go to court, be cross-examined by an attorney," Friedman explained. "Anytime anyone is having to discuss something traumatic that happened to them, it's bringing them right back to that point in their lives. Your brain is having the exact same chemical response just talking about it that you did when experiencing it."
Criminal cases require a thorough investigation, often requiring the prosecution and defense to analyze the victim's story under a microscope.
No matter the reason, there is a scientific explanation behind why a victim doesn't feel comfortable reporting, but can't move on with their live either.
"Your brain chemistry changes after you have been assaulted by someone," said Friedman. "When we are traumatized, we actually have an effect in our brain - in the amygdala - that releases stress hormones. And when we have stress hormones released in our brain, it makes it really difficult to access the parts of our brain that are involved in decision making or connecting with others around us. And we call that 'Trauma Brain.'"
Friedman said changing that trauma in any real, significant way takes years and years of work with someone the victim trusts.
"You are actually forming new neuropathways within your brain as you are processing a trauma that has occurred," she said.