Rape Trauma syndrome

Triggers
Flashbacks
Tips for survivors
Post traumatic stress disorder

The Rape Trauma syndrome has three characteristic phases and may continue over a lengthy period of time. It is important to recognize that each survivor will go through the process at their own speed and intensity. To understand the reactions and process a survivor of sexual assault moves through, it is helpful to look at the Rape Trauma Syndrome."


The Acute Phase:
Immediately following the sexual assault, the survivor may experience a very wide range of emotional reactions, which result from being faced with a life-threatening situation. Shock, dismay, and disbelief are fairly common.
During this phase the survivor is constantly thinking about the assault. There are often a lot of triggers, flashbacks and nightmares causing the survivor to experience a wide rage of emotional reactions . These emotional reactions are most commonly manifested in one of two ways:
Expressively - obvious outward expression such as crying, shaking, tenseness, restlessness.

Controlled - the survivor appears to be quite calm and rational about the situation.
Guilt, shame, and self-blame may be expressed. Anger and hostility, not just toward the assailant, but toward the people trying to help her/him, may be present. There may be a fear of infection or if the survivor is a female a fear of pregnancy.

During the first few weeks following the assault, acute physical symptoms are often experienced which can include soreness and bruising on various parts of the body. There may be gynecological symptoms if the survivor is a female such as vaginal discharge, burning sensations, pain or itchiness. Also, the person may experience tension headaches, fatigue, stomach pains, nausea, loss of appetite, or disturbed sleep patterns such as insomnia or nightmares.

In the period immediately following the assault, the survivor may have many practical problems to deal with:
  • informing family and friends
  • physical examination
  • question of pregnancy, VD, STD or AIDS
  • fear of retaliation by assailant or fear of being alone
  • decision about pressing charges
  • concerns about publicity

Outward Adjustment:

In this next phase toward recovery, the realities of the survivor's life may be the focus while, the trauma of the assault appears to be less obvious. This is often referred to as "Denial" as the survivor is trying to get their life back on track and trying to forget about the assault.

Anxieties and fears may become less prominent as the survivor begins again to involve him/her self in their normal activities. While they may seem to have forgotten the incident and gone on with their life, there is usually a high level of denial and repression of feelings around the incident.

The survivor will most likely not care to talk about the assault during this phase. They may begin making some practical decisions around the place where he/she lives, the people she/he considers friends, her/his work associates, and activities he/she chooses to continue or discontinue.

This phase can last a few months, to a few years or several years, until such a time where the survivor experiences flashbacks which reminds them that they haven't "gotten over the assault". This event is what forces them into the next phase.


Long Term Reorganization:

In this phase the survivor acknowledges the sexual assault and seeks to reintegrate the experience into their daily life. It is during this phase that the survivor is most likely to reach out for help.

Long-term adjustment to sexual assault depends on several factors that come into play around the event. Factors may include the degree of support experienced by the survivor from friends and family, previous self-concept of the survivor, personal strength of the survivor, treatment by professionals following the assault, involvement with the criminal justice system, the survivors prior knowledge of the assault and more.

Some of the difficulties of this phase are the need to integrate a new view of the self; the survivor must accept the event realistically. The survivor must resolve feelings about the assailant and their attitudes toward the gender or their assailant in general. Often the survivor will really want to talk at this stage. Many survivors feel they are losing control because they thought they had dealt with the assault in phase two, and may think something is wrong with them because these feelings have come back. Recovery time can vary greatly since it is dependent upon a victims personal experience.


Triggers
A trigger is something that sets off a memory tape or flashback transporting the person back to the event of her/his original trauma.
Triggers are very personal; different things trigger different people. The survivor may begin to avoid situations and stimuli that she/he thinks triggered the flashback. She/he will react to this flashback, trigger with an emotional intensity similar to that at the time of the trauma. A person's triggers are activated through one or more of the five senses: sight, sound, touches, smell and taste.

The senses identified as being the most common to trigger someone are sight and sound, followed by touch and smell, and taste close behind. A combination of the senses is identified as well, especially in situations that strongly resemble the original trauma. Although triggers are varied and diverse, there are often common themes.

Sight
  • Often someone who resembles the abuser or who has similar traits or objects (i.e. clothing, hair color, and distinctive walk).
  • Any situation where someone else is being abused (i.e. anything from a raised eyebrow and verbal comment to actual physical abuse).
  • The object that was used to abuse
  • The objects that are associated with or were common in the household where the abuse took place (i.e. alcohol, piece of furniture, time of year).
  • Any place or situation where the abuse took place (ie. specific locations in a house, holidays, family events, social settings).
Sound
  • Anything that sounds like anger (ie. raised voices, arguments, bangs and thumps, something breaking).
  • Anything that sounds like pain or fear (i.e. crying, whispering, screaming).
  • Anything that might have been in the place or situation prior to, during, or after the abuse or reminds her/him of the abuse (i.e. sirens, foghorns, music, cricket, chirping, car door closing).
  • Anything that resembles sounds that the abuser made (i.e. whistling, footsteps, pop of can opening, tone of voice).
  • Words of abuse (i.e. cursing, labels, put-downs, specific words used).
Smell
  • Anything that resembles the smell of the abuser (i.e. tobacco, alcohol, drugs, after-shave, perfume).
  • Any smells that resemble the place or situation where the abuse occurred (i.e. food cooking, wood, odors, alcohol).
Touch
  • Anything that resembles the abuse or things that occurred prior to or after the abuse (i.e. certain physical touch, someone standing too close, petting an animal, the way someone approaches you).
Taste
  • Anything that is related to the abuse, prior to the abuse or after the abuse (ie. certain foods, alcohol, tobacco).

Flashbacks

Flashbacks are memories of past traumas. They may take the form of pictures, sounds, smells, body sensations, feelings, or the lack of them (numbness).
Many times there is no actual visual or auditory memory with flashbacks. One may have a sense of panic, of being trapped, or a feeling of powerlessness with no memory stimulating it. These experiences can also happen in dreams.

During the initial crisis, the survivor had to insulate her/himself from the emotional and physical horrors of the trauma. In order to survive, that insulated part of the self remained isolated, unable to express the feelings and thoughts of that time. It is as though the survivor put that part of her/his self into a time capsule, which later surfaces and comes out as a flashback, feeling just as intense in the present as it did during the crisis.

When that part comes out, the survivor is experiencing the past as if it were happening today. The intense feelings and body sensations occurring are frightening because the feelings/sensations are not related to the reality of the present and many times seem to come from nowhere.

The survivor may begin to think she/he is crazy and is afraid of telling anyone of these experiences. The survivor may feel out of control and at the mercy of her/his experiences.

Flashbacks are unsettling and may feel overwhelming because the survivor becomes so caught up in the trauma that she/he forgets about the safety and security of the present moment.


Tips for Survivors

1.Tell yourself that you are having a flashback

2. Remind yourself that the worst is over. The feelings and sensations you are experiencing are memories of the past. The actual event has already occurred and you survived. Now it is the time to let out the terror, rage, hurt, and/or panic. Now is the time to honor your experience.

3. Get grounded. This means stamping your feet on the ground to remind yourself that you have feet and can get away now if you need to. (There may have been times before when you could not get away, now you can.) Being aware of all five senses can also help you ground yourself.

4. Breathe. When we get scared we stop normal breathing. As a result our body begins to panic from the lack of oxygen. Lack of oxygen in itself causes a great deal of panic feelings; pounding in the head, tightness, sweating, feeling faint, shakiness, and dizziness. When we breathe deeply enough, a lot of the panic feeling can decrease. Breathing deeply means putting your hand on your diaphragm, pushing against your hand, and then exhaling so the diaphragm goes in.

5. Reorient to the present. Begin to use your five senses in the present. Look around and see the colors in the room, the shapes of things, the people near, etc. Listen to the sounds in the room: your breathing, traffic, birds, people, cars, etc. Feel your body and what is touching it: your clothes, your own arms and hands, the chair, or the floor supporting you.

6. Get in touch with your need for boundaries. Sometimes when we are having a flashback we lose the sense of where we leave off and the world begins; as if we do not have skin. Wrap yourself in a blanket, hold a pillow or stuffed animal, go to bed, sit in a closet, any way that you can feel yourself truly protected from the outside.

7. Get support. Depending on your situation you may need to be alone or may want someone near you. In either case it is important that your close ones know about flashbacks so they can help with the process, whether that means letting you be by yourself or being there.

8. Take the time to recover. Sometimes flashbacks are very powerful. Give yourself time to make the transition form this powerful experience. Don't expect yourself to jump into adult activities right away. Take a nap, a warm bath, or some quiet time. Be kind and gentle with yourself. Do not beat yourself up for having a flashback.

9. Honor your experience. Appreciate yourself for having survived that horrible time. Respect your body's need to experience a full range of feelings.

10. Be patient. It takes time to heal the past. It takes time to learn appropriate ways of taking care of yourself, of being an adult who has feelings, and developing effective ways of coping in the here and now.


Post tramatic stress disorder


Many people with PTSD repeatedly re-experience the ordeal in the form of flashback episodes, memories, nightmares, or frightening thoughts, especially when they are exposed to events or objects reminiscent of the trauma. Anniversaries of the event can also trigger symptoms. People with PTSD also experience emotional numbness and sleep disturbances, depression, anxiety, and irritability or outbursts of anger. Feelings of intense guilt are also common. Most people with PTSD try to avoid any reminders or thoughts of the ordeal. PTSD is diagnosed when symptoms last more than 1 month.

How Common Is PTSD?

About 3.6 percent of U.S. adults ages 18 to 54 (5.2 million people) have PTSD during the course of a given year. About 30 percent of the men and women who have spent time in war zones experience PTSD. One million war veterans developed PTSD after serving in Vietnam. PTSD has also been detected among veterans of the Persian Gulf War, with some estimates running as high as 8 percent.

When Does PTSD First Occur?

PTSD can develop at any age, including in childhood. Symptoms typically begin within 3 months of a traumatic event, although occasionally they do not begin until years later. Once PTSD occurs, the severity and duration of the illness varies. Some people recover within 6 months, while others suffer much longer.