Rape Trauma Syndrome / PTSD
Rape is the only type of crime that reliably predicts development of a psychological disorder (Post-Traumatic Stress Disorder or Rape Trauma Syndrome); 57% of all completed rape survivors develop RTS, and 16.5% still have RTS 17 years after the rape.
"Sometimes I think the feelings are more intense now than they were at first. I was on the trolley and two guys came and sat down across from me. They looked like the two that raped me. I could almost feel like I was being grabbed again. I just have to keep thinking intellectually that it isn’t going to happen. I know intellectually it won’t, but my gut reaction is so intense…I feel people are following me. I still look at every car that goes by even though I know the guys are locked up. Sometimes it gets so intense…it seems worse than it ever was."
-Rape Survivor; age 21
Three months following the rape
Definition of Rape Trauma Syndrome:
Symptoms the rape survivor experiences that are both mental (emotional) and physical. The rape survivor will experience symptoms of physically reliving the rape, fear of seeing the assailant, fear of another attack, sleep disturbances, nightmares, fear, suspiciousness, anxiety, major depression, and impairment in social functions.
Rape Trauma Syndrome has three stages:
A. Impact Stage
B. Acute Stage
C. Resolution Stage
The impact stage is the initial stage most survivors experience. The survivor may appear dazed, in a state of un-reality and struggling to comprehend the rape. There is a wide range of symptoms that rape survivors express during this time: from calm and controlling to hysterical and crying. Often the survivor will make comments like, “I can’t believe this happened to me” or some other shock-type of statement which disclaims the actuality of the traumatic event. The victim is realizing that their lifestyle has been completely disrupted. The most common reactions of this stage are:
Shock: The person appears to be on automatic pilot and may act as like they normally do. If this response does not work, then crisis sets in.
Denial: The person may refuse or avoid talking about the incident, or even try not to think about it. The person wants to forget what happened. This is usually a short-lived response.
Rationalization: Involves a lot of talking and repeating the same things over and over, often may appear to be void of emotions. It is usually a verbal processing of thoughts. A person might ask a lot of, “What if…” and “Why didn’t I…” questions.
During these first few days, the survivor may be concerned with decisions regarding medical care, police involvement, physical security, etc. He/She will probably be concerned with how significant others will respond to the assault. The survivor may still feel a loss of control. Sometimes signs of depression will serve to mask other feelings.
This stage generally lasts 4-8 weeks after the assault. During this stage, the survivor’s usual coping mechanisms have failed and a struggle to regain control is occurring. Some of the symptoms of Rape Trauma Syndrome during this acute state could include:
Fatigue, soreness, pain, etc. Some are real and some are psychosomatic. Sleep pattern disturbances are common. The survivor usually has trouble sleeping or restless nights when they wake and cannot go back to sleep. Some will have nightmares and wake up screaming, etc. Eating pattern disturbances can include decreases appetite, nausea and vomiting or stomach pains. Symptoms specific to the attack could be the mouth and throat irritation caused by oral sex, vaginal discharge, bleeding, pain, swelling, etc., caused by anal sex.
Primary symptoms include fear of death, injury, mutilation, etc. The survivor feels a combination of “thankful to be alive” and “fear of death” which is related to a loss of control. Shame, guilt, and anger are also symptoms that may be occurring.
Survivors will often try to suppress thoughts of the attack. Often when this approach is used the survivor suffers from flashbacks and nightmares. Most go through a rationalization process throughout the duration of syndrome- “What if..”, “If I had only…”, and “Why did this happen to me?”
At the end of 8 weeks, the crisis should be mostly resolved. However, the crisis may reoccur when certain triggers appear and remind the survivor of the assault. For example, testifying in court, seeing a person who resembles the rapist, or having to go for a HIV, pregnancy test, etc. can trigger a crisis response. There may continue to be a disruption in the survivor’s life. However, if symptoms continue, or get worse, a referral for professional help may be needed.
COMMON FEELINGS EXPERIENCED BY SURVIVORS
• The following are not the only emotions experienced by survivors. This is a list of a few of the most common.
Nightmares are much more prevalent following the first few weeks following the assault or during times when the survivor is dealing with a lot of trauma. During the healing process, the survivor spends so many waking hours thinking about the assault that it can become overwhelming. These thoughts can even carry over into the survivors sleeping hours, becoming nightmares. When the survivor goes to bed, the brain is still working, trying to sort out the day’s thoughts. As a survivor sleeps, the thoughts continue. Those thoughts form into dreams. Before you know it, the survivor is dreaming about the assault.
It is easy to see why the survivor is angry. His/Her power and control was taken away and the survivor is left to deal with the aftermath. In many cases, the survivor’s sense of security is stripped away, leaving the survivor feeling vulnerable. The survivor didn’t ask to have this done to them and now they are having work through all the issues surrounding the assault. The anger many be directed toward himself/herself, the rapist, therapist, family, friends, co-workers, etc.
A feeling of numbness might occur with the survivor. Many survivors state that they are on “automatic pilot”. This generally happens during the first few days following the assault.
Disbelief and denial by the survivor often occurs even when there is evidence to support the contrary: violence, forceful isolation, restraint, verbal threats, etc. Many survivors recall denying to themselves that they were being raped. Following the assault, some will make statements like, “That did not just happen to me.”
Many survivors feel betrayed by their own judgment. This can especially be true in cases of acquaintance rape. In cases of acquaintance rape, men/women that the survivor knew, men/women to whom they have trusted, men/women who they will most likely continue to see around, have turned on them in a terrible way. The feelings of self-blame begin as the survivor recognizes his/her inability to make the acquaintance rapist stop. Immediately after the rape, self-blame causes many survivors to try and shut the episode out of their minds. Also, self-blame is one of the reasons why survivors do not report the assault to authorities, in fear that others will blame them just as they blame themselves.
NOT FIGHTING BACK:
After being raped, many survivors are angry with themselves for not fighting back harder, even though, at the time of the rape, most report feeling afraid for their lives. In retrospect, they think of ways they could have fought off the attack, screamed for help, or escaped. They often replay the assault in their minds, trying to come up with a different ending.
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