12 year old female has a 30% risk of being sexually assaulted
Victim response to unexpected violence
Momentary shock and disbelief.
Frozen, frightened response.
Compliant, ingratiating behavior. (submissive)
Working class victims are more likely to fight back.
Shattered assumptions in survivors
A belief in personal invulnerability.
A perception of the world as fair (sense of justice).
A view of themselves in a positive light.
Male versus female victim response
Women feel greater shame than men - men tend to feel that they submit to the gun rather than the person
Women expect more of themselves
Men fantasize revenge; women fantasize further harm.
Abused boys become adult aggressors. (Turn passive into active, today’s catcher is tomorrow’s pitcher)
Abused girls become adult victims. (Replicate childhood experience)
Disorders Resulting from Rape
Post Traumatic Stress Disorder
Traumatic Event
Involves actual serious injury or a threat to the physical integrity of one's self or others; and
The person's response involved intense fear, helplessness, or horror.
Reexperiencing the Trauma
Recurrent and intrusive recollections, recurrent distressing dreams, flashbacks, intense distress at reminders, physiologic reactivity to reminders.
Symptoms of Avoidance
Efforts to avoid thoughts and feelings, efforts to avoid activities and places, inability to recall some of the trauma
Symptoms of Numbing
Diminished interest in activities, feelings of detachment or estrangement, restricted range of affect, sense of foreshortened future
Symptoms of Increased Arousal
Insomnia, irritability or anger, difficulty concentrating, hypervigilance, exaggerated startle response
Acute Stress Disorder
Traumatic event, dissociative symptoms, reexperiencing the trauma, avoidance, anxiety or increased arousal, distress or impairment, lasts for 2-28 days
: pseudo-adjustment; resumption of work; guilt -- blaming of self for ingratiating behavior and poor judgment.
Long-term effects
: motor activity (e.g., changing residence), nightmares, phobic reactions, sexual problems, mistrust of men, persistent feelings of vulnerability.
Rape victim symptoms 12-30 months later
Suspicion of others 75%
Restricted going out 60%
Fear of being alone 50%
Sexual difficulties 50%
Sleep problems 25% (including nightmares)
½ have sexual difficulties
¼ have sleeping problems
¼ feel "sadder, but wiser" (lose sense of fairness).
Rape PTSD risk factors
Brutality of assault
Perception of life treat
Lack of support system
Self blame
Immediate intense emotions
Older age
Rape victims have a 80% chance of getting PTSD. (Men in Vietnam had a 23% chance for PTSD) Women have a greater consciousness of crime in our society. Fear of AIDS as well (0.5% chance)
Treatment of the rape victim
Inquire about feelings at each step of the rape.
Encourage early return to routine activities.
Suggest that the survivor seek out understanding people for support.
Offer emotional support in a non-judgmental manner.
Refer to a Rape Crisis Center.
When a victim presents in the ER
- be sensitive (aware that this victim isn’t just a trauma, but a rape), have a woman present so the victim does not relive the trauma of a man violating her, use language which does not make her an active participant (i.e. not "Did you put your mouth on his penis?" rather "Did he put his penis in your mouth?"
Counter-transference feelings toward victims
- massive denial (discount severity), intellectualization, over-identification with the victim (get so upset they make premature assumptions and advice).
Benefits of learning self-defense
- minimize feelings of vulnerability, increase sense of control, increases self-esteem.