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Emotional and Psychological Impact of Rape

Rape Trauma Syndrome and PTSD

Although every survivor you encounter will be unique, many will have one thing in common: Rape Trauma Syndrome (RTS). Identified by Ann Wolbert Burgess and Lynda Lytle Holmstrom, RTS is a cluster of emotional responses to the extreme stress experienced by the survivor during the sexual assault. More specifically, RTS is a response to the profound fear of death that almost all survivors experience during the assault. RTS occurs in two phases:

1. The Acute (Initial) Phase , which usually lasts anywhere from a few days to a few weeks after the attack.

2. The Reorganization Phase , which usually lasts anywhere from a few weeks to several years after the attack.

Often, the end of the Acute Phase will overlap the beginning of the Reorganization Phase. Each phase is characterized by particular emotional and physical concerns that most survivors experience.

The Acute Phase:

During this phase, survivors experience a complete disruption of their lives, responding to the fear of death they experienced. They may display any of a number of disparate emotional responses. They may cry, shout, swear, laugh nervously, discuss the weather, or sit calmly. Responses may vary depending on any one of a number of external circumstances. No response is inappropriate! However, responses fall into one of two main styles:

Expressed : Survivors that use the Expressed style, openly display their emotions. They may be agitated and restless, talk a lot, cry, swear, shout, laugh, etc. Any emotion is appropriate--because they have their own way of responding.

Controlled : Survivors that uses the Controlled style, contain their emotions. Most of the survivor's energy is directed toward maintaining composure. They may sit calmly, respond to questions in a detached, logical way, and downplay their fear, sadness, anger, and anxiety. Both of these styles of emotional response reflect different ways of dealing with a crisis. They may also exhibit characteristics of both styles.

In general, the survivor's initial response to the assault will be shock and disbelief. They may appear numb. Far from being inappropriate, this response provides an emotional "time-out" during which the survivor can acknowledge and begin to process the myriad components of the experience. A survivor who was assaulted by an acquaintance may have a particularly difficult time overcoming shock and disbelief. If the assault was particularly terrifying or brutal, the survivor may experience an extreme shock response and completely block out the assault.

Following the shock and disbelief most survivors initially experience, they may experience a variety of emotions or mood swings. They may feel angry, afraid, lucky to be alive, humiliated, dirty, vengeful, degraded. All of these responses, as well as the many that are not listed, are normal. In short, whatever they feel is valid because they feel it, and it is how they express reaction to the rape crisis.

Physical concerns of the Acute Phase

Usually, the survivor will report a general soreness throughout the body. They will also report pain in the specific areas of the body that were targeted during the assault. These specific pains may be the result of actual physical trauma, or may be a psychosomatic response. Both reasons are equally valid and real.

The survivor will probably notice a disruption in usual sleeping and eating patterns. They may not be able to eat or sleep, or may eat more than usual and be unable to stay awake. They may report nightmares in which the survivor relives the assault. These may evolve into dreams in which the survivor takes the violent role in some way, in effect reclaiming the control lost during the assault. Although both types of dreams may upset them, dreams are part of the healing process. Sexual assault is such a traumatic event that the survivor may dream about it in some way throughout his/her life.

The Reorganization Phase

During this phase of RTS, the survivors reorganize themselves and life after the sexual assault. Basically, they learn to cope again. Several factors influence the survivors' abilities to reorganize their lives after the sexual assault:

Personality . What coping mechanisms do they already possess? How successfully have they coped with stress and trauma in the past?

Support System . Do they have a strong system of friends and family for emotional support? Are they being treated with empathy? Do they feel they can go to them?

Existing Life Problems . Do they have a drinking or drug problem? Are they experiencing a divorce or other break-up? Do they have emotional or psychological problems? Even if the survivor had these life problems under control prior to the assault, the trauma of the assault may reactivate them.

Prior Sexual Victimization . Was the survivor assaulted previously, especially within the last two years? If so, recovery may be much more difficult.

Emotional Concerns of the Reorganization Phase

The concerns the survivor has may fall into any of four groups:

Social Concerns

They may experience some difficulty returning to pre-assault social patterns. They may feel an increased distrust toward others in general and an increased suspicion of men in particular. They may have a shorter temper, or easily break into tears. Some reactions may be the result of a specific component of the assault. For example, if the survivor was assaulted while alone, they may want to be with other people constantly. If they were gang-assaulted, they may withdraw socially and rely on a few significant others for companionship and support. The survivor's social patterns after the assault may depend less upon the conditions of the assault and more upon the survivor's personality. Many survivors feel a strong need to "get away." They may visit parents. They may move, especially if they were assaulted at home. They may change jobs or leave school. All these actions are "normal" in that they represent what the survivor needs to do in order to regain control over life.

Psychological Concerns

Denial of the effects of the assault, or of the assault itself, is a common reaction during the reorganization phase. Denial may be a component of the survivors' recovery, since it gives them space to catch their breath before beginning the stressful task of processing and resolving the trauma. Denial that lasts longer than a few hours or days, however, is detrimental to their recovery.

Depression, guilt, and a general loss of self-esteem are all common psychological reactions. These symptoms suggest that they have turned their anger inward, and that they have unresolved fears. Remind them that they are in no way responsible for the assault and that nothing they did could ever justify the violence they have experienced. Encourage them to direct these negative feelings toward the assailant and away from themselves.

The survivor may experience phobic reactions to stimuli that remind them of the assault or their assailant. Phobic reactions are extreme manifestations of anxiety. For example, if survivors were assaulted outdoors, they may be afraid to leave the house. If the assailant had alcohol on his/her breath, this odor may remind survivors of the assault and make them nauseous. They may experience a general paranoia, or panic attacks.

Sexual Concerns

The assault may disrupt the sexual life of the survivor because sex, which usually involves pleasure, was instead used as a weapon to humiliate, control and punish. It will probably take some time for the survivor to disassociate the sexual assault from consensual sex. Acts the assailant forced that the survivor was not used to doing will probably cause particular difficulty. Survivors may experience physical pain during sex, have difficulty relaxing, or be generally indifferent to sex. At the other extreme, they may desire sex all the time. Most likely, their behavior will fall between these two extremes. If the survivor was a virgin at the time of the assault, they may have a heightened fear of their first consensual sexual encounter.

Survivors may be concerned about their partner's reaction to them after an assault. They may wonder if their partner will feel differently toward them. Because of the range of stresses the survivor experiences after an assault, consensual sexual relationships and other friendships can be placed under heavy strain. Current statistics indicate that about half of all survivors lose their love relationships within a year of sexual assault.

Physical Concerns

The survivor may report continuing gynecological/genital problems. If they were physically beaten, the survivor may continue to experience pain. Sexually transmitted diseases can be a further concern, as well as pregnancy. Nightmares may also continue. If nightmares continue in a manner that makes them lose sleep or that fills their waking hours, they might want to consider counseling.

Long Term Effects of Trauma: Post Traumatic Stress Disorder

Post Traumatic Stress Disorder (PTSD) is a clinical diagnosis often ascribed to people who have experienced extreme or prolongued exposure to stress such as physical/emotional/sexual abuse, violence, war, natural disasters etc. Symptoms of PTSD include depression, sleep disturbances, flashbacks, or erratic mood swings.

 

If you or someone you know has been hurt:

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After an Assault

 

This project was supported by Grant No. 2002-WA-BX-0011 awarded by the Office of Violence Against Women and the U.S. Department of Justice. Points of view in this document are those of the author and do not necessarily represent the official position or policies of the U.S. Department of Justice.