post-traumatic stress disorder is a normal emotional and psychological reaction to trauma (a painful, shocking experience such as rape, war or a natural disaster) that is outside of a person's normal life experiences.
Anyone who experiences a traumatic event can suffer from PTSD. PTSD can affect survivors of war, violent attacks, rape, car or plane accidents and natural disasters and can also affect people who witness these events.
Symptoms of PTSD include recurrent memories or flashbacks of the trauma, nightmares, insomnia and/or lack of interest in family, friends or hobbies. They may suffer from depression. They may also suffer from survivor guilt, have overwhelming emotions, and be irritable or jumpy.
rape trauma syndrome
Immediate reactions after a rape may vary. Some rape survivors remain controlled, numb, in shock, denial disbelief. They present a flat affect, quiet, reserved, and have difficulties expressing themselves. Other rape survivors respond quite differently - being very expressive and verbalizing feelings of sadness or anger. They may appear distraught or anxious and may even express rage or hostility against the medical staff attempting to care for them.
Various factors may aid or inhibit the survivors ability to resolve the issues associated by the rape. Positive feelings of self-esteem, good support systems, previous success in dealing with crisis and economic security all enhance her ability to heal. Survivors who can minimize, (deal with one small segment of the problem at a time ) often find success. Certainly survivors moved to action gain confidence as they implement decisions. But survivors who suffer with chronic stress, lack of support systems and prior victimization struggle less successfully to resolve their issues. Negative self-esteem often hinders their progress and paralyze their efforts. These victims often use maladaptive methods to deal with their stress. These factors hamper their ability to resolve the issues of the rape and move beyond it.
Rape victims can suffer a significant degree of physical and emotional trauma during the rape, immediately following the rape and over a considerable time period after the rape. A study of rape victims has identified a three-stage process, or syndrome, that occurs as a result of forcible rape or attempted forcible rape. This syndrome is an acute stress reaction to a life-threatening situation that can last from two years to a lifetime. It is also often known as rape trauma syndrome or rape related post traumatic stress disorder, rrpstd.
The acute phase begins immediately and lasts up to several days after the attack. The survivor feels violated and fearful and may be depressed—even suicidal. The victim struggles with feelings of loss of control and may note changes in appetite, sleep habits or social functions. Survivors may note change in their sexual patterns at this time.
The Acute Stage: This stage occurs immediately after the assault. It may last a few days to several weeks. During this stage the victim may:
seem agitated or hysterical or s/he may appear totally calm (a slogan that s/he could be in shock).
have crying spells and anxiety attacks.
have difficulty concentrating, making decisions, and dolling simple, everyday tasks.
show little emotion, act as though numb or stunned.
have poor recall of the rape or other memories.
In the second stage, it seems that survivors begin to resolve their issues. This stage is also called the "flight to health." But denial frequently masks the under lying problems as survivors make an effort to re-establish the routines of their life and bring back some semblance of control. Sometimes, in an effort to feel back in control, rape victims make dramatic changes in lifestyle or environment. They may quit a long-standing job or move to a new location to get a fresh start. They may dramatically change their appearance; cut their hair or perhaps change the colour. None of the changes brings about the security they search for as nightmares and phobias emerge. They work hard to suppress the feelings because dealing with them is so very painful.
The Outward Adjustment Stage: During this stage the victim resumes what appears to be from the outside her/his "normal" life. Inside, however, there is considerable turmoil which can manifest itself by any of the following behaviours:
- continuing anxiety.
- sense of helplessness.
- persistent fear and/or depression.
- severe mood swings (e.g. happy to angry, etc.).
- vivid dreams, recurrent nightmares, insomnia.
- physical ailments.
- appetite disturbances (e.g. nausea, vomiting, compulsive eating).
- efforts to deny the assault ever took place and/or to minimize its impact.
- withdrawal from friends and/or relatives.
- preoccupation with personal safety.
- reluctance to leave the house and/or to go places which remind the victim of the rape.
- hesitation about forming new relationships with men and/or distrustful or existing relationship.
- sexual problems.
- disruption of normal everyday routines (e.g. high absenteeism at work suddenly or, conversely, working longer than usual hours; dropping out of school; travelling different routes; going out only at certain times).
But the feelings do not go away as easily as before. Their re-surfacing introduces the third stage of the rape trauma syndrome. The client no longer denies the issues; she/he may want to talk about what happened. The client finds themselves more willing to accept counselling and get in touch with the feelings and emotions associated with the rape. Survivors may feel overwhelmed as they attempt to deal with feelings they struggled to suppress since the assault. Often some sensory stimulation triggers memories that call to mind the sexual assault. Suddenly the survivor seems to be re-living the trauma as the rape comes to life again. Nightmares, phobias, depression, reoccurring thoughts and sexual dysfunction monopolize her thoughts. She / he feels anxious to talk about it; to deal with it and is ready to seek therapy although she may not understand why the issues surface at that time. The stages are not linear and can vary as the victim works their way through. Survivors find themselves taking one step forward and two back as they vacillate between stages and labour to find their way.
The Resolution Stage: During this stage the rape is no longer the central focus in the victim's life. The victim begins to recognize that while s/he will never forget the assault, the pain and memories associated with it are lessening. S/he has accepted the rape as a part of her/his life experience and is choosing to move on from there. Some of the behaviours of the second stage may flare up at times but they do so less frequently and with less intensity. In this fashion the person who has survived has moved from being a " victim" to a "survivor".
While some survivors move forward and take control of their lives, other continue to suffer and may even develop post traumatic stress disorder ( rape trauma syndrome ) as result of the rape. They struggle with reoccurring thoughts about the trauma and find themselves in a state of hyper vigilance; easily startled and always anticipating another attack. Nightmares, flashbacks, and sleep disturbances disrupt their lives. Constant efforts to avoid the memories of trauma literally control their existence. Some rape survivors have post-traumatic stress disorder for years and need continuous counselling and support.
Recovery Takes Time
Survivors recover in stages. They may start with one stage, go to another, and go back. Each person processes the event his or her / his own way. Survivors are not to blame for the crime committed to them by another person. We cannot control the actions of another person. Survivors need a safe environment to work through their fears. You can help by providing the survivor with pace and time to recover.
* Available at: http://www.aest.org.uk/survivors/rts.html (Abused Empowered Survive Thrive) 17.07.06
Rape Trauma Syndrome*