Survivors of sexual violence can suffer physical and emotional trauma during and after a rape or sexual assault. This phenomenon is known as Rape Trauma Syndrome (RTS). RTS is a form of Post Traumatic Stress Disorder. These same symptoms can occur with other forms of sexual violence. The severity of sexual violence is not determined by the aggressor, but by a survivor’s reaction to the event.
Rape Trauma Syndrome was initially identified by researchers Ann Burgess and Lynda Holstrom in the 1970s. The process of RTS was elaborated and the following phases were identified by Mary Koss and Mary Harvey in 1987.
Rape Trauma Syndrome has four phases:
- Anticipatory phase: Immediately before assault, the survivor may be aware of danger. They may have an “uh-oh” feeling, or an instinct of danger. Some survivors may disassociate from the experience. Often people respond with ‘fight, flight, or freeze.’ Some may try to fight back, some may try to leave the situation, and some may freeze and do nothing.
- Impact: During and immediately after the assault, survivors may do things that do not seem to “make sense” to themselves or others. Survivors describe an extremely wide range of emotions in the immediate hours following the rape.Two main styles of emotion are shown by the victims:
Expressed: victims show feelings like anger, fear, or anxiety
Controlled: feelings are hidden (more common)
- Reconstitution: the longest phase, can last for years. Reconstitution is divided into three sub-stages:
- Denial: A very natural coping mechanism.
- Symptom Formation: May include physical symptoms, nightmares, flashbacks, triggers, things that force the victim to think about the assault.
- Anger : Also plenty of hopelessness, shame, despair, depression, a sense of mourning/loss. A painful, but cathartic phase. It is during this stage that survivors begin to realize the impact the assault has had on their lives. They may use anger as a springboard for more intensive healing, such as support from a rape crisis center, support groups, or therapy. Some may focus the rage on themselves, internalizing it and utilizing maladaptive behaviors to deal with their pain, such as suicide, self-mutilation, or drug abuse. If the survivor engages in negative behaviors, the anger should be refocused appropriately on external circumstances rather than on self-blame.
- Resolution: The survivor gets to a place where the memory of assault doesn’t trip them up anymore. The survivor develops coping mechanisms to handle triggers and memories. Resolution is the assimilation of the violence into the person’s overall life experiences.
Going from phase to phase is not linear, it is fluid. Healing does not happen in a straight line; a person can move from one stage “backward” to another and then “forward” again.
Throughout all phases of RTS, a survivor may experience a wide variety of physical, emotional, and psychological reactions to the assault. The following is a list of symptoms that a survivor might have. Not everyone will develop the same symptoms.
- Vaginal/ rectal problems
- For women, changes in menstrual cycle and functioning
- For women, other gynecological and menstrual problems
- Problems with normal bowel movements after anal assaults
- Musculoskeletal pain
- Genital/urinary difficulties
- Gastrointestinal upset
- General malaise
- Disruptions in eating or sleeping
- Dreams and nightmares, either of the actual assault recurring or related dreams not of the actual assault
- Phobias, usually specific to the circumstances of the rape, including fear of crowds, of being alone, or of characteristics of the assailant
- Paranoia, or fear of everyone
- Inability to resume more than a minimum level of social functioning (e.g. only going to work or school)
- Staying home, or only going outside accompanied by someone
- Seeking more support from family, with or without disclosing the assault
- Changing the telephone number, or getting an unlisted number
- Fear of sex. Survivors for whom the assault was their only sexual experience may be afraid that sex will be like the assault. Sexually active victims may have difficulty continuing to have sex with their partner. Other survivors may have difficulty starting new relationships.
- Fear of physical contact, such as hugging
- Lack of desire
Previous or current problems stemming from psychiatric conditions, physical conditions, or behavior patterns can compound reactions to rape. Survivors can be more vulnerable to having a compounded reaction if they have had previous psychiatric symptoms, little access to a “social support” network, or simultaneous problems in other areas of their life (e.g. family, financial, or alcohol problems).