Sexual Assault, Trauma and Posttraumatic Stress Disorder

Trauma

There’s a word that most people do not like to talk about. For some, it is because they just simply do not want to talk about it, and for others, it is because they have experienced some type of trauma, that has impacted their life so greatly that it causes great stress to bring it up. The person may feel vulnerable if they open up. They may feel judged. They may feel sadness, hopelessness, worthlessness, and a lack of control over the situation. Whatever they may be experiencing, those emotions are valid, they may just be telling a story that does not match up exactly with the reality of the current circumstances.

Trauma is an injury that occurs to tissue caused by an external force to the body or a psychological behavioral state of mind resulting from severe mental or emotional stress (DSM). In today’s time, women are still subject to many stereotypes regarding sexuality. Victimization and objectification for women have continued to be glorified by media outlets and large societal projects (American Psychological Association, 2007).

Many media outlets will state that sexual assault is wrong and want the victims to come forward in order to provide them with help and supports as well as prosecute the offenders. Although some women will come forward, many women will not due to fear of rejection, fear of not being taken seriously, self-blame for what happened to them, or shame. There are many myths about sexual assault and in today’s society, unfortunately people still believe them. Some women will seek counseling, while others will try to handle the emotional stress on their own. It is important for trauma victims to seek help as repressing those emotions for long periods time can have negative effects on their quality of life (Jacques-Tiura, Tkatch, Abbey, & Wegner, 2010).

What are the most prevalent symptoms exhibited after a sexual assault and how is one’s life affected? Information gathered for this paper was done by researching exactly what a sexual assault is, the signs and symptoms exhibited after the assault, what trauma includes, why some sexual assaults are not reported, and why therapy should be used to aid in the healing process. All resources were collected from scholarly journals, articles, and books.

Sexual Assault and Myths

Sexual assault is any unwanted sexual activities such as rape or unwanted touching, a wrongdoer using force, or taking advantage of a target who did not give consent. Reactions from a sexual assault can include shock, fear, anxiety, depression, and posttraumatic stress disorder (American Psychological Association, 2020). A myth is something that is not factual. Many times there are myths about women and sexual assault.

In some instances, if a woman is raped while under the influence of drugs or alcohol, then she is responsible for what happens to her; women find being forced into have a sexual encounter truly enjoy it; someone who claims rape usually wants to have sexual intercourse, but then changes their mind; only women who sleep around and spend their time in bars get assaulted; women over exaggerate what happens to them and how much it has affected their life; a woman who dresses provocatively and puts herself in a situation deserves what happens to her; if a woman does not fight back, then you cannot call that rape, and if a woman does not have immediate bleeding from cuts or bruises, then she should not be taken seriously (Ullman, 2010).

Sometimes victims of sexual assault can feel re-victimized because someone else questions their account of what happened. This can cause the victim to doubt themselves, but also re-live the traumatic incident over and over again. Regrettably, often the blame is put on the victim (Ullman, 2010).

Posttraumatic Stress Disorder

Posttraumatic Stress Disorder, also known as PTSD, is a mental health condition that follows a traumatic event. The Diagnostic and Statistical Manual, or the DSM, provides diagnostic criteria for many mental health conditions. PTSD has several criteria that need to be present in order for a diagnosis to be given.

PTSD symptoms are included but not limited to; dissociative properties, flashback, sleep disturbances, angry outbursts, problems concentrating, shame, fear, nightmares, avoidance, protective mechanisms, depression and anxiety, hypervigilance, exaggerated startled responses, and self-destructive behavior including suicide/suicidal ideations. The duration of certain criteria must one month or greater: Recurrent distressing memories of the traumatic event, recurring dreams that are related to the traumatic event, replaying the traumatic event over and over, and internal or external factors that resemble the event and triggers psychological distress (Diagnostic and Statistical Manual).

Persistent avoidance of provocations related to the upsetting incident, avoiding memories, thoughts, and feelings associated with the event, and avoiding people, places, or activities that can arouse emotional responses are often seen in trauma victims. When victims are asked about the incident, often negative alterations of their mind will worsen and they can acquire what is called dissociative amnesia. Dissociative amnesia is when a victim will suppress memories about the incident and this can cause them to ‘forget’ parts of the traumatic event.

Victims will also believe that they have done something wrong to deserve what happened to them and develop trust issues. When dealing with posttraumatic stress disorder diagnosis, a specification to whether the individual has dissociative symptoms such as depersonalization which is where one feels like they are in a dream or have experiences of feeling detached from something and derealization, which is recurring experiences of unreality of a persons surroundings such as the world around them is one-sided. Signs and symptoms that present themselves after a timeframe of six months or later after the incident is exhibited as delayed expression (Diagnostic and Statistical Manual).

Why Victims Do Not Report Sexual Assaults

According to Ullman (2010), forty-two percent of women feel shame and fear about reporting the assault that happened to them. There are four main reasons that women do not report a sexual assault: Not wanting family members or others to know what happened, a lack of proof that it occurred; fear of retaliation or punishment from the assailant or others, and fear of being mistreated by the criminal justice system.

Most women do not report an assault right away because they fear they will not be taken seriously, receive negative reactions or comments, and they do not want to acknowledge themselves as a victim. Sometimes victims are asked to re-live the incident repetitively due to doubts of occurrence from others and this can make victims feel illegitimate (Ullman, 2010). Twenty-eight percent of women see a sexual assault as their fault (Resick, 1983).

Unfortunately, in some cases where the victim comes forward about the assault, the offender is never convicted. This leads to many sexual assaults never being reported (Ullman, 2010). People are encouraged to try and seek some form of therapy in order to learn how to talk through and process through their emotions of the trauma. Some women have stated that they attempt to seek counseling but then decide against it because they are fearful of what the therapist will think of them.

The victim will essentially try to work through the sexual assault on their own because they want to feel in control. They feel like it is to personal to share, or they feel an extreme amount of guilt for burdening someone else with their problems. Some women feel that if they speak about the trauma, that will make the memories stay more focused in their mind, causing them to vividly remember the incident, whereas, if they avoid talking about the incident and suppress those emotions, then they can recover (Resick, 1983).

A great amount of psychological distress is reported to have a greater chance of an assault victim to seek help, but Jacques-Tiura, Tkatch, Abbey, & Wegner, 2010, states that victims who blame themselves for the incident tend to not seek help because they feel like it is their fault, no one can or will help them, or that they do not deserve help.

Therapy and Advocacy

When someone holds onto a traumatic event and will not speak about what they are feeling by suppressing their emotions, this means that they cannot cognitively or emotionally process them. A cognitive appraisal such as feelings or thoughts about the assault, including self-labeling or acknowledging their experiences, can affect symptoms of PTSD (Dunmore, Clark, & Ehlers, 2001).

Mental health professionals are trained to ask the sensitive questions. Individuals who voluntarily give up information on the traumatic experience that they went through, depend on what type of positive and empathetic response they may receive. Lepore, Ragan, & Jones (2000), says that individuals that talk to someone in a supportive role after dealing with a trauma situation and being vulnerable to a stressful stimulus can facilitate an adjustment and inititate healing compared to someone not opening up about their experiences.

While people think about clients and their traumatic experiences, it is important to remember the clinicians as well. Clinicians hear repeated stories of sexual assault and other traumas that are disclosed to them, and sometimes there is a negative ripple effect from the client to the therapist (Figley, 2005).

Clinicians provide support to survivors of sexual assault and they can provide resources to them, give them empathy, help them re-establish some type of control which victims desire, and to help minimize the effects of trauma (Najavits, 2002). Mental health professionals want to make a difference in people’s lives. Sometimes a ‘thank you for helping me’, ‘thank you for being there,’ and a ‘I appreciate you’, go a long way in encouraging a therapist. Therapists enjoy being able to see their clients grow and watch them heal and progress, and to be bigger in life than the trauma that they experienced (Ullman, 2010).

Research and Future Practice as a Clinician

While conducting research on topics that were found to be of interest to the student, a topic that stood out was sexual assault and trauma. The researcher wanted to find out the different reasons some sexual assaults are not reported to the authorities, the effects of trauma and how that can impact someone’s quality of life, and how they go about getting help.

The more research that was conducted, the topic did not change due to reasons of personal experience from the researcher. In an open system, organisms adapt to their current situation and hope to get the results they want by sending and receiving information from environmental factors (Smith-Acuna, 2011). The student was able to maintain an open system by keeping boundaries about topics and questions flexible by allowing input. The student kept an open mind while conducting research about the topic of choice in case research led her down a different path to explore.

The most important resources that the student felt to be useful in conducting this research was the Diagnostic and Statistical Manual (DSM), the American Psychological Association. While researching the topic, the future clinician came across symptoms of trauma victims that became personal. The clinician began to see the different things that she herself had experienced and suppressed. The researcher was able to dig in and explore the different aspects of a sexual assault and traumatic events. The student was able to see that she is not alone and that everything that she was feeling is a normal reaction to trauma and that she does not need to self-blame any longer. She realizes that she has the power to change her thought process and embrace the therapy systems in an effort to enhance healing.

The most confusing part of the research experience was trying to put all of the information together in the format that was planned in the student’s mind. As the research went on, different ideas would pop into the researcher’s mind and that would make room to expand on the previously decided research question.

The most frustrating part was having this whole idea prepared and then it changing your whole perspective because of a personal experience. The frustration sets in due to wanting to have control over situations and in reality, that is not always the case. When conducting research in the future, the student will change the way in which the research is conducted. The student can try to establish a topic on a personal level to make sure the research is interesting.

The student will also make sure the sources have authors and years included in the articles, because some of them did not have them which made it difficult to cite. The one take-away for conducting research is to keep the topic close to you. Make sure it is something that can keep the attention of the researcher, and make sure you have enough information to go along with what you want an answer to.

Conclusion

Trauma is an event that occurs to someone that can have negative effects on their overall well-being. Sexual assault can cause Posttraumatic Stress Disorder in individuals. Diagnostic criteria for PTSD can be found in the Diagnostic and Statistical Manual, or DSM. Common symptoms of PTSD are flashbacks, mood changes, dissociative properties, hypervigilance, nightmares, avoidance, depression and anxiety, unhealthy coping mechanisms, exaggerated startled responses, and suicidal ideations/self-destructing behavior (Diagnostic and Statistical Manual).

Forty-two percent of women feel shame and fear about reporting a sexual assault. The victims can feel guilt about sharing their problems with other, feel like it is their fault, fear that they do not have enough proof that an assault took place, and fear of being mistreated by the criminal justice system. Victims are encouraged to seek therapy in order to aid in the healing process by learning to talk through and express the emotions that they are feeling. Evidence shows that it is beneficial to do this instead of suppressing and avoiding those emotions.

Journaling helps trauma victims often because it gives them an outlet to express their emotions without verbally disclosing sensitive and personal information to a stranger. It can be used to express their emotions instead of keeping them bottled up inside. Holding onto and avoiding disclosure of unwanted thoughts of a traumatic event can be harmful to victims (Shipherd & Beck, 1999). “Writing about trauma of any kind can help facilitate recovery by making meaning of their experiences” (Park & Blumberg, 2002).

References

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