Rape trauma syndrome
Encyclopedia
Rape trauma syndrome is a form of psychological trauma
experienced by a rape
victim that consist of disruptions to normal physical, emotional, cognitive, behavioral, and interpersonal characteristics. The theory was first described by psychiatrist Ann Wolbert Burgess and sociologist Lynda Lytle Holmstrom in 1974.
RTS describes a cluster of psychological and physical signs, symptoms and reactions common to most rape victims, during, immediately following, and for months or years after a rape. While most research into RTS has focused on female victims, males who are sexually abused (whether by male or female perpetrators) have also exhibited RTS symptoms. RTS also paved the way for consideration of Complex Post Traumatic Stress Disorder, which can more accurately describe the consequences of serious, protracted trauma than Post Traumatic Stress Disorder alone. The symptoms of RTS and Post-Traumatic Stress Syndrome overlap; however, individually each syndrome can have long devastating effects on rape victims.
a rape survivor goes through: the acute stage, the outer adjustment stage, and the renormalization stage.
According to Scarse there is no "typical" response amongst rape victims. However, the U.S. Rape Abuse and Incest National Network (RAINN) asserts that, in most cases, a rape survivor's acute stage can be classified as one of three responses: expressed ("He or she may appear agitated or hysterical, [and] may suffer from crying spells or anxiety attacks"); controlled ("the survivor appears to be without emotion and acts as if 'nothing happened' and 'everything is fine'"); or shock/disbelief ("the survivor reacts with a strong sense of disorientation. They may have difficulty concentrating, making decisions, or doing everyday tasks. They may also have poor recall of the assault"). Not all rape survivors show their emotions outwardly. Some may appear calm and unaffected by the assault.
Behavior
s present in the acute stage can include:
RAINN identifies five main coping strategies during the outward adjustment phase:
Other coping mechanisms that may appear during the outward adjustment phase include:
Some rape survivors now see the world as a more threatening place to live after the rape so they will place restrictions on their lives so that normal activities will be interrupted. For example, they may discontinue previously active involvements in societies, groups or clubs, or a mother who was a survivor of rape may place restrictions on the freedom of her children.
s (physical symptoms with no identifiable cause). Physiological reactions such as tension headaches, fatigue, general feelings of soreness or localized pain in the chest, throat, arms or legs. Specific symptoms may occur that relate to the area of the body assaulted. Survivors of oral rape may have a variety of mouth and throat complaints, while survivors of vaginal or anal rape have physical reactions related to these areas.
, and recognizing the secondary damage of any counterproductive coping tactics (e.g., recognizing that one's drug abuse began to help cope with the aftermath of a rape). Typical of male victims is a long interval between the sexual assault and the victim's seeking psychotherapy—according to Lacey and Roberts, less than half of male victims sought therapy within six months and the average interval between assault and therapy was 2.5 years; King and Woollett's study of over 100 male rape victims found that the mean interval between assault and therapy was 16.4 years.
During renormalization, the survivor integrates the sexual assault into their life so that the rape is no longer the central focus of their life. During this stage negative feelings such as guilt
and shame
become resolved and the survivor no longer blame
s themselves for the attack.
Psychological trauma
Psychological trauma is a type of damage to the psyche that occurs as a result of a traumatic event...
experienced by a rape
Rape
Rape is a type of sexual assault usually involving sexual intercourse, which is initiated by one or more persons against another person without that person's consent. The act may be carried out by physical force, coercion, abuse of authority or with a person who is incapable of valid consent. The...
victim that consist of disruptions to normal physical, emotional, cognitive, behavioral, and interpersonal characteristics. The theory was first described by psychiatrist Ann Wolbert Burgess and sociologist Lynda Lytle Holmstrom in 1974.
RTS describes a cluster of psychological and physical signs, symptoms and reactions common to most rape victims, during, immediately following, and for months or years after a rape. While most research into RTS has focused on female victims, males who are sexually abused (whether by male or female perpetrators) have also exhibited RTS symptoms. RTS also paved the way for consideration of Complex Post Traumatic Stress Disorder, which can more accurately describe the consequences of serious, protracted trauma than Post Traumatic Stress Disorder alone. The symptoms of RTS and Post-Traumatic Stress Syndrome overlap; however, individually each syndrome can have long devastating effects on rape victims.
Common stages of RTS
RTS identifies three stages of psychological traumaPsychological trauma
Psychological trauma is a type of damage to the psyche that occurs as a result of a traumatic event...
a rape survivor goes through: the acute stage, the outer adjustment stage, and the renormalization stage.
Acute stage
The acute stage occurs in the days or weeks after a rape. Durations vary as to the amount of time a survivor may remain in the acute stage. The immediate symptoms may last a few days to a few weeks and may overlap with the outward adjustment stage.According to Scarse there is no "typical" response amongst rape victims. However, the U.S. Rape Abuse and Incest National Network (RAINN) asserts that, in most cases, a rape survivor's acute stage can be classified as one of three responses: expressed ("He or she may appear agitated or hysterical, [and] may suffer from crying spells or anxiety attacks"); controlled ("the survivor appears to be without emotion and acts as if 'nothing happened' and 'everything is fine'"); or shock/disbelief ("the survivor reacts with a strong sense of disorientation. They may have difficulty concentrating, making decisions, or doing everyday tasks. They may also have poor recall of the assault"). Not all rape survivors show their emotions outwardly. Some may appear calm and unaffected by the assault.
Behavior
Behavior
Behavior or behaviour refers to the actions and mannerisms made by organisms, systems, or artificial entities in conjunction with its environment, which includes the other systems or organisms around as well as the physical environment...
s present in the acute stage can include:
- Diminished alertness.
- Numbness.
- Dulled sensory, affective and memory functions.
- Disorganized thought content.
- Vomiting.
- Nausea.
- Paralyzing anxietyAnxietyAnxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...
. - Pronounced internal tremor.
- Obsession to wash or clean themselves.
- HysteriaHysteriaHysteria, in its colloquial use, describes unmanageable emotional excesses. People who are "hysterical" often lose self-control due to an overwhelming fear that may be caused by multiple events in one's past that involved some sort of severe conflict; the fear can be centered on a body part, or,...
, confusion and crying. - Bewilderment.
- Acute sensitivitySensitivity (human)The sensitivity or insensitivity of a human, often considered with regard to a particular kind of stimulus, is the strength of the feeling it results in, in comparison with the strength of the stimulus...
to the reaction of other people.
The outward adjustment stage
Survivors in this stage seem to have resumed their normal lifestyle. However, they simultaneously suffer profound internal turmoil, which may manifest in a variety of ways as the survivor copes with the long-term trauma of a rape. In a 1976 paper, Burgess and Holmstrom note that all but 1 of their 92 subjects exhibited maladaptive coping mechanisms after a rape. The outward adjustment stage may last from several months to many years after a rape.RAINN identifies five main coping strategies during the outward adjustment phase:
- minimizationMinimisation (psychology)Minimisation is a type of deception involving denial coupled with rationalisation in situations where complete denial is implausible. It is the opposite of exaggeration....
(pretending 'everything is fine') - dramatization (cannot stop talking about the assault)
- suppressionThought suppressionThought suppression is the process of deliberately trying to stop thinking about certain thoughts . It is often associated with obsessive–compulsive disorder, in which a sufferer will repeatedly attempt to prevent or "neutralize" intrusive distressing thoughts centered around one or more obsessions...
(refuses to discuss the rape) - explanation (analyzes what happened)
- flight (moves to a new home or city, alters appearance)
Other coping mechanisms that may appear during the outward adjustment phase include:
- poor health in general.
- continuing anxietyAnxietyAnxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...
- sense of helplessness
- hypervigilanceHypervigilanceHypervigilance is an enhanced state of sensory sensitivity accompanied by an exaggerated intensity of behaviors whose purpose is to detect threats. Hypervigilance is also accompanied by a state of increased anxiety which can cause exhaustion. Other symptoms include: abnormally increased arousal, a...
- inability to maintain previously close relationships
- experiencing a general response of nervousness known as the "startle response"
- persistent fearFearFear is a distressing negative sensation induced by a perceived threat. It is a basic survival mechanism occurring in response to a specific stimulus, such as pain or the threat of danger...
and or depressionDepression (mood)Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behaviour, feelings and physical well-being. Depressed people may feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, or restless...
at much higher rates than the general population - mood swingsMood SwingsMood Swings is an album by Koby Israelite released in 2005 on Tzadik.- Track listing :# "Dror Ikra" - 3:03# "Return of the Idiots" - 2:19# "It Is Not a War Here" - 7:05# "Ethnometalogy" - 5:08# "Europa?" - 2:49# "Hiriya On My Mind" - 4:53...
from relatively happy to depression or anger - extreme angerAngerAnger is an automatic response to ill treatment. It is the way a person indicates he or she will not tolerate certain types of behaviour. It is a feedback mechanism in which an unpleasant stimulus is met with an unpleasant response....
and hostility (more typical of male or masculine victims than female or feminine victims) - sleep disturbances such as vivid dreams and recurring nightmares
- insomniaInsomniaInsomnia is most often defined by an individual's report of sleeping difficulties. While the term is sometimes used in sleep literature to describe a disorder demonstrated by polysomnographic evidence of disturbed sleep, insomnia is often defined as a positive response to either of two questions:...
, wakefulness, night terrors - flashbacks
- dissociationDissociationDissociation is an altered state of consciousness characterized by partial or complete disruption of the normal integration of a person’s normal conscious or psychological functioning. Dissociation is most commonly experienced as a subjective perception of one's consciousness being detached from...
(feeling like one is not attached to one's body) - panic attacks
- reliance on coping mechanisms, some of which may be beneficial (e.g., philosophy and family support), and others that may ultimately be counterproductive (e.g., self harm, drugDrug abuseSubstance abuse, also known as drug abuse, refers to a maladaptive pattern of use of a substance that is not considered dependent. The term "drug abuse" does not exclude dependency, but is otherwise used in a similar manner in nonmedical contexts...
, or alcohol abuseAlcohol abuseAlcohol abuse, as described in the DSM-IV, is a psychiatric diagnosis describing the recurring use of alcoholic beverages despite negative consequences. Alcohol abuse eventually progresses to alcoholism, a condition in which an individual becomes dependent on alcoholic beverages in order to avoid...
)
Lifestyle
Survivors in this stage can have their lifestyle affected in some of the following ways:- Their sense of personal security or safety is damaged.
- They feel hesitant to enter new relationships.
- Questioning their sexual identitySexual identitySexual identity is a term that, like sex, has two distinctively different meanings. One describes an identity roughly based on sexual orientation, the other an identity based on sexual characteristics, which is not socially based but based on biology, a concept related to, but different from,...
or sexual orientationSexual orientationSexual orientation describes a pattern of emotional, romantic, or sexual attractions to the opposite sex, the same sex, both, or neither, and the genders that accompany them. By the convention of organized researchers, these attractions are subsumed under heterosexuality, homosexuality,...
(more typical of men raped by other men). - Sexual relationships become disturbed. Many survivors have reported that they were unable to re-establish normal sexual relations and often shied away from sexual contact for some time after the rape. Some report inhibited sexual response and flashbacks to the rape during intercourse. Conversely, some rape survivors become hyper-sexual or promiscuous following sexual attacks, sometimes as a way to reassert a measure of control over their sexual relations.
Some rape survivors now see the world as a more threatening place to live after the rape so they will place restrictions on their lives so that normal activities will be interrupted. For example, they may discontinue previously active involvements in societies, groups or clubs, or a mother who was a survivor of rape may place restrictions on the freedom of her children.
Physiological responses
Whether or not they were injured during a sexual assault, rape survivors exhibit higher rates of poor health in the months and years after an assault, including acute somatoform disorderSomatoform disorder
In psychology, a somatoform disorder is a mental disorder characterized by physical symptoms that suggest physical illness or injury - symptoms that cannot be explained fully by a general medical condition, direct effect of a substance, or attributable to another mental disorder . The symptoms that...
s (physical symptoms with no identifiable cause). Physiological reactions such as tension headaches, fatigue, general feelings of soreness or localized pain in the chest, throat, arms or legs. Specific symptoms may occur that relate to the area of the body assaulted. Survivors of oral rape may have a variety of mouth and throat complaints, while survivors of vaginal or anal rape have physical reactions related to these areas.
Nature of the assault
- The nature of the act, the relationship with the offender, the type and amount of force used, and the circumstances of the assault all influence the impact of an assault on the victim.
- When the assault is committed by a stranger, fear seems to be the most difficult emotion to manage for many people.(Feelings of vulnerability arise).
- More commonly, assaults are committed by someone the victim knows and trusts. May be heightened feelings of self-blame and guilt.
Underground stage
- Victims attempt to return to their lives as if nothing happened.
- May block thoughts of the assault from their minds and may not want to talk about the incident or any of the related issues. (They don't want to think about it).
- Victims may have difficulty in concentrating and some depression.
- Dissociation and trying to get back to their lives before the assault.
- The underground stage may last for years and the victim seems as though that they are "over it", despite the fact the emotional issues are not resolved.
Reorganization stage
- May return to emotional turmoil
- It can be extremely frightening to people in this stage to once again find themselves in the same emotional pain.
- Fears and phobias may develop. They may be related specificity to the assailant or the circumstances or the attack or they may be much more generalized.
- Appetite disturbances such as nauseaNauseaNausea , is a sensation of unease and discomfort in the upper stomach with an involuntary urge to vomit. It often, but not always, precedes vomiting...
and vomiting. Rape survivors are also prone to developing anorexia nervosaAnorexia nervosaAnorexia nervosa is an eating disorder characterized by refusal to maintain a healthy body weight and an obsessive fear of gaining weight. Although commonly called "anorexia", that term on its own denotes any symptomatic loss of appetite and is not strictly accurate...
and/or bulimia.
- Nightmares, night terrors feel like they plague the victim.
- Violent fantasies of revenge may also arise.
Phobias
A common psychological defense that is seen in rape survivors is the development of fears and phobias specific to the circumstances of the rape, for example:- A fear of being in crowds.
- A fear of being left alone anywhere.
- A fear of men.
- A fear of breasts.
- A fear of going out at all, agoraphobiaAgoraphobiaAgoraphobia is an anxiety disorder defined as a morbid fear of having a panic attack or panic-like symptoms in a situation from which it is perceived to be difficult to escape. These situations can include, but are not limited to, wide-open spaces, crowds, or uncontrolled social conditions...
. - A fear of being touched, hapnophobia.
- Specific fears related to certain characteristics of the assailant, e.g. mustache, curly hair, the smell of alcohol or cigarettes, type of clothing or car.
- Some survivors develop very suspicious, paranoidParanoiaParanoia [] is a thought process believed to be heavily influenced by anxiety or fear, often to the point of irrationality and delusion. Paranoid thinking typically includes persecutory beliefs, or beliefs of conspiracy concerning a perceived threat towards oneself...
feelings about strangers. - Some feel a pervasive fear of most or all other people.
The renormalization stage
In this stage, the survivor begins to recognize their adjustment phase. Particularly important is recognizing the impact of the rape for survivors who were in denialDenial
Denial is a defense mechanism postulated by Sigmund Freud, in which a person is faced with a fact that is too uncomfortable to accept and rejects it instead, insisting that it is not true despite what may be overwhelming evidence.The subject may use:* simple denial: deny the reality of the...
, and recognizing the secondary damage of any counterproductive coping tactics (e.g., recognizing that one's drug abuse began to help cope with the aftermath of a rape). Typical of male victims is a long interval between the sexual assault and the victim's seeking psychotherapy—according to Lacey and Roberts, less than half of male victims sought therapy within six months and the average interval between assault and therapy was 2.5 years; King and Woollett's study of over 100 male rape victims found that the mean interval between assault and therapy was 16.4 years.
During renormalization, the survivor integrates the sexual assault into their life so that the rape is no longer the central focus of their life. During this stage negative feelings such as guilt
Guilt
Guilt is the state of being responsible for the commission of an offense. It is also a cognitive or an emotional experience that occurs when a person realizes or believes—accurately or not—that he or she has violated a moral standard, and bears significant responsibility for that...
and shame
Shame
Shame is, variously, an affect, emotion, cognition, state, or condition. The roots of the word shame are thought to derive from an older word meaning to cover; as such, covering oneself, literally or figuratively, is a natural expression of shame....
become resolved and the survivor no longer blame
Blame
Blame is the act of censuring, holding responsible, making negative statements about an individual or group that their action or actions are socially or morally irresponsible, the opposite of praise. When someone is morally responsible for doing something wrong their action is blameworthy...
s themselves for the attack.
Typical statements of victims experiencing RTS
^[Citations Required]- I'm going crazy.
- I can't remember what I wanted to do next.
- I want to drink all the time, I just want to forget about it.
- I can't get to work on time or meet simple deadlines.
- I'm having nightmares and flashbacks all the time.
- I can't eat or sleep.
- All I want to do is eat.
- I'll never trust anyone again.
- All I want to do is sleep.
- Everything is just fine. Everyone is making such a big deal about this.
See also
- RapeRapeRape is a type of sexual assault usually involving sexual intercourse, which is initiated by one or more persons against another person without that person's consent. The act may be carried out by physical force, coercion, abuse of authority or with a person who is incapable of valid consent. The...
- Sexual assaultSexual assaultSexual assault is an assault of a sexual nature on another person, or any sexual act committed without consent. Although sexual assaults most frequently are by a man on a woman, it may involve any combination of two or more men, women and children....
- Post traumatic stress disorder
- Psychological traumaPsychological traumaPsychological trauma is a type of damage to the psyche that occurs as a result of a traumatic event...
- Major depressive disorder
- Complex Post Traumatic Stress Disorder