The present research was designed to describe women's experience of sexual trauma and its aftermath as it relates to difficulties in coping with the trauma. A small, but heterogeneous, sample of survivors seeking treatment was interviewed in an unstructured format and encouraged to present their story of what had happened and what it had meant to them. The definition and examples of 14 themes are presented. They provide evidence that sexual trauma confronts the individual with affects and meanings which are extremely difficult to manage and which may have long-term effects. The themes are discussed in reference to general psychological processes involved in the response to acute stress, the cultural context of sexual trauma, and the implications for the psychotherapeutic treatment of sexual trauma victims. © 1988 Plenum Publishing Corporation.