March 7, 2011
The Effects of Rape and Sexual Assault
The impact of sexual assault on the survivor and their healing depends on many factors: the nature of the assault; the number of assault episodes; the levels of physical, spiritual, and sexual violence; the relationship between the survivor and the perpetrator; and the presences of a good support system. These factors will determine their immediate needs and their resources for longer-term healing. Although the circumstances of the assault affect the survivor’s healing process, there are some common characteristics seen in many rape survivors. It is important for you to know these common reactions so that you can teach the survivor that they are not alone and help them develop a plan for healing.
Rape Trauma Syndrome
Rape Trauma Syndrome (RTS) is a specific form of a broader category of trauma response called post-traumatic stress disorder (PTSD). Although PTSD is most commonly associated with the traumatic experiences of Vietnam War veterans, it can be applied to reactions to many forms of trauma, including natural disaster, war, rape, and other forms of violent crime. RTS is specific to the experience of the rape survivor. Reactions to rape are considered separately from other forms of PTSD because of the specific nature of the trauma of rape. Rape has been described as the ultimate violation of the self, short of homicide, with the invasion of one’s inner and most private space, as well as the loss of autonomy and control.
Rape trauma syndrome has three phases that can disrupt the physical, psychological, social, and sexual aspects of the survivor’s life. These phases were first described by Ann Burgess and Lynda Holmstrom in their 1974 work on RTS. The first phase is the crisis, acute, or disruptive phase and can last from days to weeks. The second phase is the denial, recoil, or suppression phase, which lasts from a few weeks up to six months. Sometimes the survivor alternates between the acute phase and the denial phase. And finally, the third phase is the reorganization, assimilation, or integration phase in which the survivor works to reestablish order in their life and regain a sense of control in the world. This third phase can last from months to years.
- Phase I: Acute Crisis. The acute phases is the survivor’s immediate reaction to the assault and is characterized by shock and disbelief. Survivors’ expressions of these feelings might be either visible and outwardly expressed or more controlled. Whereas one survivor might sob outwardly, another might appear calm and unemotional. Some common physical issues at this stage of healing can include physical injury from the assault; tension, fatigue, and difficulty sleeping; and eating disturbances such as changes in appetite or nausea and stomach pains. Emotional reactions might include fear, shame, guilt, anger, embarrassment, revenge, and helplessness. Because the survivor is usually flooded with so many conflicting emotions, she can feel as though she is out of control or “going crazy.” One way to help a survivor experiencing acute crisis is to validate and normalize her feelings.
- Phase II: Denial. Numbing or reduced involvement with the environment is a characteristic of PTSD and the second phase of RTS. In this phase, the survivor might attempt to forget the assault and might explain that they are “over it.” This represents their desire for mastery over the assault and is an expression of the desire to move forward with life. Frequently, the survivor alternates between the denial phase and the crisis phase.
- Phase III: Reorganization or integration. This third phase of RTS frequently lasts the longest: from a couple of months to many years. The length of time this phase takes depends on how quickly she received crisis intervention, the specific nature of the assault, her past experiences of trauma, how she is treated by medical and legal professionals and rape crisis center staff, and her access to support systems, family, and friends. Symptoms of this phase of healing are psychological, social, and sexual. Psychological characteristics of this phase could include nightmares, phobias, paranoia, and compulsive behavior. Physical problems that might arise include gynecological problems, backaches, migraines, and eating disturbances. It is also common for social responses to include disrupted relationships with family, friends, and lovers. Survivors in this stage might have difficulty in sexual relationships. Although some survivors avoid sex because it reminds them of the assault, others might become more promiscuous to prove they have recovered from the rape.
One of the most empowering and comforting things to remind the survivor is that they are not alone and exactly what they are going through has been experienced by others. Because you know that so many survivors have similar reactions to sexual assault, you can reassure a survivor that they are not “going crazy,” but that their body and mind are coping with the trauma and attempting to protect them from future assault. It is important for you to continually remind yourself that each individual’s experience of the assault is unique and so is their reaction to the assault. However, being aware of the commonalities found between survivors’ reactions and using this information to educate each survivor you encounter can reduce isolation and help them understand their feelings and reactions.