Rape Trauma Response

1. Rape Trauma Response Also known as Rape Trauma Syndrome

2. “The essential element of rape is the physical, psychological, and moral violation of a person. Violation is, in fact, a synonym for rape. The purpose of the rapist is to terrorize, dominate, and humiliate his victim, to render her utterly helpless. Thus rape, by it’s nature, is intentionally designed to produce psychological trauma.” Herman, Judith, 1997. Trauma and Recovery. New York: Basic.

3. Post Traumatic Stress Disorder ____________________ RTS was incorporated by the American Psychological Association as a form of PTSD in 1980 • Set of symptoms that occur in the aftermath of a trauma • Follow-up studies find that rape survivors have high levels of persistent post-traumatic stress disorder, compared to victims of other crimes.1 • A.W. Burgess and L.L. Holmstrom, 1974. Rape Trauma Syndrome. American Journal of Psychiatry : 981-86

4. Identified by Ann Wolbert Burgess & Lynda Lytle Holmstrom (1974) ____________________ • RTS is a cluster of emotional responses to the extreme stress experienced by the survivor during the sexual assault • Symptoms occur as a response to the profound fear that survivors experience during the assault • Every survivor you encounter will have at least some symptoms of RTS

5. Pre-Assault Discomfort ____________________ • Intuition • Acquaintance assaults - may feel discomfort due to sudden behavioral changes in offender • Stranger assaults - may sense they are being watched or followed • Guilt or Self Blame • Victim blaming statements • Survivors and significant others need to know that the assault is NEVER the victim’s fault and only the offender could have prevented the assault

6. During the Assault ____________________ • Feels that assault is a life threatening event • Experience intense physical and emotional reactions • Dissociation – dreamlike state/mentally detach from what is happening Frozen Fright – creates paralysis of the victim • Hyper-vigilant of their surroundings Focus on sensory details as a form of detachment (scents, sounds, colors, etc.) • Surrender = Survival (submission)

7. After the Assault ____________________ RTS occurs in two main phases: • The Acute (Initial) Phase • usually lasts anywhere from immediately after the assault to a few weeks after the assault • The Reorganization Phase • usually lasts anywhere from a few weeks to several years after the assault * Each phase is characterized by particular emotional and physical concerns that most survivors experience

8. Acute Crisis Reaction ____________________ (IMMEDIATELY AFTER – FEW WEEKS AFTER THE ASSAULT) • Responses fall into one of two main styles: • Expressed • Victim may be agitated and restless, talk a lot, cry, swear, shout, laugh • Controlled • Most of the victim’s energy is directed toward maintaining composure • Victim may sit calmly, respond to questions in a detached, logical way, and downplay fear, sadness, anger, and anxiety * Victim may also exhibit characteristics of both styles

9. Physical Symptoms ____________________ • General soreness of entire body • Pain in specific areas where the assault occurred (actual physical trauma or a psychological trauma) • Nausea and headaches • Disruption in eating or sleeping patterns • Inability to eat or sleep • Excessive overeating or sleeping • Difficulty concentrating • Nightmares and flashbacks

10. Emotional Symptoms ____________________ • Fear, guilt, embarrassment, self-blame, humiliation, vengeance, anxiety, etc. • Emotions may shift to elation or relief • Due to the wide range of emotional responses, do not judge the legitimacy of the assault based on the victim’s reactions • Expect confusion and lack of logic in survivor’s account due to nature of trauma and inability to concentrate while in crisis

11. Survivor Needs ____________________ Important for survivors to gain sense of empowerment after loss of power and control during assault: • Information regarding medical and legal options • Normalize feelings - feelings they are experiencing are not abnormal or inappropriate • Ensure safety • Recovery is possible and these feelings will not persist indefinitely • Not their fault

12. Reorganization/Outward Adjustment Phase ____________________ (FEW WEEKS – SEVERAL YEARS AFTER ASSAULT) • Often the end of acute phase will overlap with beginning of reorganization phase • Necessary for healing as it may allow the victim a mental “time-out” from the experience • Victim begins to reorganize themselves and attempt to adjust to their new life as a survivor

13. Reorganization Phase (cont’d) ____________________ • Some survivors may have difficulty returning to pre-assault social patterns – distrust toward others, increased suspicion or apprehension of men, short temper, sudden crying bouts or emotional outbursts • Minimize impact of assault or attempt to rationalize reasons for the rape • Decrease in severity and recurrence of emotional symptoms

14. Psychological Symptoms ____________________ • Denial – may be detrimental to recovery for periods longer than a few days • Depression, guilt, loss of self-esteem, negative body image, etc. • Phobic reactions to stimuli that remind survivor of assault or perpetrator

15. Physical Symptoms ____________________ • Genital injuries/Gynecological problems • Pregnancy • STIs • Long term internal and/or external injuries (broken bones, burns, cuts, etc.) • Effects on overall physical health as a result of emotional issues and depression (backaches, migraines, etc.) • Recurrence of chronic health problems

16. Social/Lifestyle Adjustments ____________________ • May avoid discussing the assault and resist contacts from persons or institutions related to the assault • Desire to return to “normal” life • Changes made to increase sense of safety – new telephone number, residence, job, schools, social groups, etc. • May lose interest in people or activities they previously enjoyed • May change appearance because they believe this may reduce future vulnerability – gain/lose weight, dress differently, change hair, etc.

17. Social/Lifestyle Adjustments (Cont’d) ____________________ Changes in sexual attitudes and practices: • May take time to separate assault from consensual sex • General indifference towards sex • Physical pain or emotional detachment during sex • Difficulty relaxing during sex • Some survivors may avoid sex because it reminds them of the assault while others may become more promiscuous to try and prove they have recovered from the assault

18. Social/Lifestyle Adjustments (Cont’d) ____________________ • About half of all survivors pre-assault sexual relationships fail within a year of the assault • May develop or relapse into prior negative behaviors in an attempt to forget about the assault – substance and alcohol abuse, self-injury, eating disorders, abusive relationships, etc. • A survivor’s social patterns after the assault depend more on the survivor’s personality and less on the actual conditions of the assault

19. Survivor Needs ____________________ • Allow them to make their own decisions about healing and recovery • Have resources available based on specific needs • Support of significant others and institutions • Reassurance that the assault was not their fault

20. Resolution ____________________ (ONE - TWO YEARS AFTER ASSAULT) • Recurrence of original acute crisis symptoms • Fear, nightmares, somatic complaints, disruption of social and sexual behavior • Behavior may appear to be a regression or “breakdown” • May be triggered by events (anniversary, legal proceedings) • Victim able to express full range of emotions about assault • Develops effective ways of coping with rape trauma and begins long term healing

21. Integration ____________________ (TWO YEARS OR LONGER) • May occur concurrently with resolution phase • Acceptance and understanding of the assault relative to future life • Integration of assault into their life as a new person with a new worldview • Survivor attempts to resume relationships, work and regain a personal sense of safety and well-being

22. Other Considerations ____________________ • These are all approximate time periods • Stages are not linear—survivors may progress or digress through one or more • Not all survivors are alike • Absence of any or all symptoms does not invalidate assault • Circumstances of assault do not determine severity of response (i.e. stranger vs. acquaintance assault)