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Connie A. Mitchell |Abuses Produce Similar Psychological Effects in Survivors
or residential-based commercial sex operations,
personal sexual servitude, and outdoor solicitation.
Further, ST tourism involves an estimated 1.87 billion
“tourists” annually (Carolin et al., 2013). Although the
DSM-5-TR (American Psychiatric Association, 2022)
does not specifically list ST as a cause of Unspecified
Dissociative Disorders, we argue, based on the
similarities demonstrated in this comparison, that ST
victims belong in this category, particularly due to the
intense level of psychological coercion, distorted self-
views, and changes in values and personality (Doychak
&Raghavan, 2020).
ST affects a staggering worldwide total of approximately
6.3 million victims, and this figure does not include
forced marriages (International Labour Organization,
2022). Additionally, ST generates approximately $173
billion in profits (Human Trafficking Statistics, 2024),
an estimate that does not include millions in revenue
from music or films which seek to glamorize ST (see
Patrick, 2014 Withers, 2017) or from websites and
books that provide guidance to new sex traffickers
(Hassan &Shah, 2019 Ivy, 2017 Petchesky, 2012
Walters et al., 2017).
Defining ST: Pimps
Many survivors of ST report control by pimps. Pimp-
controlled prostitution has three main categories:
Romeo Pimps initially come across as a boyfriend, at
least initially. CEO Pimps operate storefront businesses,
such as massage parlors or escort services, and often
hire through deception (Smith &Coloma, 2009). The
term “Gorilla Pimp” refers to the most violent and
abusive of the types of pimps, and the Gorilla Pimp
category includes gang-controlled pimping (Frank &
Terwilliger, 2017). Gang-controlled pimping can be
the most difficult to escape due to the greater number
of individuals involved in watching and controlling
the victim (Roe-Sepowitz et al., 2014a). Additionally,
when women serve as pimps, they similarly engage in
physical and psychological coercion of victims (Roe-
Sepowitz et al., 2014b).
Defining ST: Common Sex Trafficking Terminology
Common ST terminology reveals the coercive and
derogatory nature of ST. Bender (2019) described
common familial terms used in ST: “sisters,” “wife-
in-law,” and “daddy.” The perpetrator, an individual
sex trafficker, pimp or, in some cases, an entire gang,
receives financial profit from the victim’s commercial
sex work. A group of trafficked individuals living
together forms a stable. Degrading references remain
ubiquitous (bitch, hoe, and lot lizard). A bottom bitch
is the lead woman in a stable. Living out of pocket is
keeping the proceeds for oneself while participating in
a stable. A date or trick is a sale to a buyer or john.
Going automatic is to continue dating buyers to finance
the pimp while the pimp is away. A renegade is a person
dating or engaging in prostitution without a trafficker
and therefore retaining their own profits. The system
of trafficking is known as the life. Using the term “the
life” appears to indicate that this is the only way to truly
live. Square is the dull world outside of the life. This
derogatory terminology runs throughout ST.
ST and Lifton’s Criteria
Enticement by a master manipulator remains the most
frequently used recruitment strategy in ST (Farley,
2003 Patrick, 2014 Withers, 2016). All of Lifton’s
components apply. Pimps typically exert strict control
over the environment and social encounters (i.e.,
milieu control). As noted above, ST involves loading
the language and new, group-specific vocabulary,
particularly revisions of family terms such as “daddy”
and “sister.” Pimps typically demand loyalty to
themselves (i.e., demand for purity), often protecting
ST victims if and only if an ST victim conforms to
the pimp’s demands (Horning et al., 2022). Common
tactics include spying (including through phone taps),
informing, and confession (i.e., mystical manipulation
confessions). The authoritarian pimp always has the
last word and is always right (i.e., sacred science),
and this is further reinforced by pimps’ common
perceptions of their own overwhelming power: “with
young girls, you promise them heaven, and they’ll
follow you to hell” (Annitto, 2011, p. 14). Often, pimps
force or encourage drug use and other tactics that make
victims more pliable (i.e., doctrine over person). Pimps
typically present the square world outside of ST as a
dangerous place in which people do not have value
typical consequences of these malignant environments
include changes in one’s personality and values,
particularly about people inside and outside of the life
(i.e., dispensing of existence) (Doychek &Raghavan,
2020).

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Identity Development in Sex Trafficking
Identity development in ST parallels identity
development in HCGs, particularly given the array of
tactics used to destabilize the identities of survivors of
the life—tactics associated with increased vulnerability,
suggestibility, and subservience (West &Martin, 1994).
Rhythm is a common feature of ST environments
through the pimp’s rapping or the loud rap music
(Lundstrom, personal communication, 2019 see also
Huxley, 1952/2009). Similarly, each sexual encounter
can gradually add to the destabilization of the self
(Singer, 2003 Tobais &Lalich, 1994 West &Martin,
1994), as described by Hassan (2000, 2013). Too often,
media sources glorifying pimps provide exemplars
of these destabilizing tactics (Ivy, 2017 see Marshall,
1990 Pimp C, 2011). With this array of strategies, ST
unfreezes the pre-ST identity and forges a new identity.
As also noted above, ST typically involves confessions
and testimonials to refreeze the new identity and new
social systems separate from previous family and
friends and to increase suggestibility and vulnerability
to influence and control. As in HCGs, ST victims
may view ST as a desired social group and may shift
clothing, values, and preferences to fit the life (see
Dubrow-Marshall &Dubrow-Marshall, 2015 Stein,
2016). These actions reinforce the ST identity in ways
similar to a totalistic identity and raise the same risks
of pathology (Dubrow-Marshall &Dubrow-Marshall,
2016 Hassan &Shah, 2019), particularly identity
disturbance (DSM-5-TR, American Psychiatric
Association, 2022), as discussed above.
First-, Second-, and Multi-Generation ST Survivors
ST victims who enter trafficking as adults appear most
similar to first-generation members of an HCG. When a
ST victim is coerced into the system in their early teens
near the time of apoptosis transition (Schore, 2012),
their initial status as a teen means that they often have
a combination of both first- and second-generation
attributes. Second-generation children born into a
stable are generally groomed to either be a perpetrating
pimp or a sex trafficking survivor (Lundstrom, personal
communication, 2019). Similar to members of HCGs,
these individuals may struggle to recognize coercion,
manipulation, or even the possibility that they could
live outside of the life.
ST Trauma Bonds
Although we use the term “trauma bonds,” the ST
literature emphasizes the term “trauma-coerced
attachment” (TCA).
Fear, comfort, pain, and trauma (and often love,
particularly in situations with Romeo Pimps), typically
culminate in highly emotional and abusive relationships.
As in HCGs, these exploitative relationships can create
these trauma bonds (Carnes, 2018), yet survivors of ST
face particular challenges related to trauma bonds due
to the nature of ST.
Much of the ST lifestyle involves coercion to engage
in sexual behavior, typically CSAs. McIlhaney and
Bush (2008) observed that “sex involves the entire
person, physically, mentally, emotionally, and in every
other way” (p. 81). These features of ST appear likely
to increase the impacts of triple bonds with the pimp,
other ST survivors in the family, and the family itself
(Stein, 2016). Further, “the neurochemical imprint
of... sexual experience[s] remains, often for many
years impeding the very bonding process that leads to
future healthy relationships” (p. 77). These aspects of
ST appear to increase the depth and consequences of
trauma bonds for ST survivors.
Comparing HCGs and ST
Thus far, we have considered HCGs and ST in isolation.
In this section of the paper, we compare HCGs and ST
in line with Lifton’s (1961/2014) criteria. We then turn
to comparisons of recruitment and retention strategies
in HCGs and ST.
Comparison: Lifton’s Criteria
Both HCGs and ST rely on multiple forms of milieu
control, with an emphasis on controlling the physical
context, individual thought, and all communications
among the survivor, other group members, and
TCA involves a powerful emotional dependency
on the abusive partner and a shift in world-
and self- view, which can result in feelings
of gratitude or loyalty toward the abuser and
denial or minimization of the coercion and
abuse. (Raghaven &Doychak, 2015, p. 1)