Rape Trauma ResponseAlso known as Rape Trauma Syndrome

“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.

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

1. A.W. Burgess and L.L. Holmstrom, 1974. Rape Trauma Syndrome. American Journal of Psychiatry : 981-86

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

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

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)

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

Acute Crisis Reaction ____________________

* Victim may also exhibit characteristics of both styles

(IMMEDIATELY AFTER – FEW WEEKS AFTER THE ASSAULT)

Responses fall into one of two main styles:1. Expressed

Victim may be agitated and restless, talk a lot, cry, swear, shout, laugh

2. 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

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

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

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

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

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

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

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

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.

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

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

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

Resolution____________________

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

(ONE - TWO YEARS AFTER ASSAULT)

Integration____________________

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

(TWO YEARS OR LONGER)

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)