PTSD - Post Traumatic Stress Disorder/Rape Syndrome

Post Traumatic Stress Disorder in Rape Survivors 


source: http://www.hku.hk/crime/cb_pbl/ptsd.htm 

What is PTSD? 

PTSD is a reaction to being exposed to an event which is outside the range of normal human experience. Sometimes it is referred to as post traumatic rape syndrome too. It is a normal human emotional reaction to an abnormal situation. Everyone reacts differently to different situations and it doesn't have to be a life threatening experience for someone to respond in this way. It just has to be perceived by the victim as a traumatic event. It is a psychological phenomenon. It is an emotional condition, from which it is possible to make a full and complete recovery. 

PTSD affects hundreds of thousands of people who have been exposed to violent events such as rape, domestic violence, child abuse, war, accidents, natural disasters and political torture. It is normal to be affected by trauma. There is help, and it is ok to ask for help. PTSD is not rare. It is not unusual. It is not weak to have PTSD. 

Symptoms may come on soon after the trauma or fifty years later. That is what is meant by the post in PTSD. It is normal too for symptoms to come up again when faced by further trauma and in very stressful times. It is normal to be affected by trauma. 

Symptoms often present in Rape Trauma 

Intense fear, helplessness, or horror. Repeated and distressing recollections of the event, including images, thoughts, or perceptions. Unable to distinguish between past events and reality. Such incidents are often called "flashbacks" Distressig and or frightening dreams about the event. Associating various words, happenings, or "triggers" to the actual event which then causes a "flashback". Avoidance of anything that may "trigger" a flashback including not talking about the attack itself. Pretending it never happened, and an inability to recall anything about the attack, "denial". A feeling of numness, detachment or "unrealness" about everything. A lack of emotion or inability to feel love or care about anything. 

A feeling of depression and isolation. A change in sleep patterns. More often or not the ability to sleep or stay asleep for any length of time. A lack of concentration. Avoidance of being touched, and shying away from loved ones. Sudden movements may startle. A lack of trust in anyone, even close family or partners. More irritable than usual. Outbursts of anger and crying. Mood swings. A feeling of low self esteem and confidence. A feeling of being dirty, or disgusting. Deep embarrassment or shame. Sometimes self blame for events. Bitterness and morbid hatred of the perpetrator, with a preoccupation of how to harm or humiliate them. Loss of appetite or a change in eating patterns. 


Intrusive Symptoms:Flashbacks 

Intrusive symptoms can be described as those where the traumatic event "intrudes" into everyday life, and is re-experienced. These symptoms are often referred to as Flashbacks. The event is so real and so vivid it feels like the person is actually experiencing the trauma all over again. It is happening right in front of their eyes, and they can't tell what is reality and what is memory. 

These flashbacks can range in severity from mild and brief to long and strong. They can involve both sensory perceptions and motor re-enactment too. During a flashback you may experience vivid images, strong smells, or noises. Some may even involve actually acting out a traumatic experience. Many times trauma survivors don't recognise that they are having a flashback nor remember afterwards what happened. It is not unusual for someone to faint or dissociate during a flashback and be unable to recall any part of the experience, even when a witness describes their behaviour to them. 

Sometimes after a flashback trauma survivors are aware of what triggered especially if someone else observes the behaviour and recounts it to them, or if it is a recurring situation. 

Sometimes these flashbacks occur as nightmares or bad dreams too. There is some evidence to suggest that traumatic nightmares occur in the earlier, lighter stage of sleep than other dreams, and are more easily recalled upon waking. Traumatic dreams may however contain both accurate and inaccurate, literal and symbolic, information and should always be interpreted with caution. 

Sometimes there is no actual reliving of the trauma itself, but instead survivors experience a sudden painful emotional breakdown. These can involve crying, anger or fear for no apparent reason, and can occur repeatedly like flashbacks. Sometimes a flashback can involve just having feelings that are far more intense than a situation calls for but would have been appropriate in the original traumatic situation. 

The important thing to remember about flashback experiences, especially those related to abuse and rape survivors, is that they can make you feel as afraid, as helpless, and as out of control as you were during the actual trauma, even if you don't consciously remember it. Others have the experience of losing their sense of where the flashback stops and reality begins? 

Avoidance Symptoms:triggers 

Symptoms of avoidance can be described as an emotional numbness or coldness towards people who are close to us. Survivors shut people out, or push them away. This in turn affects their relationships with those who are often the ones who are trying hardest to help. When survivors are coping with flashbacks it takes a lot of energy to try and suppers the flood of emotions that threaten to overwhelm them. They find that they have no real emotion left for anyone else, and often feel emotionless or numb towards everyone else. Inability to recall important aspects of the trauma, is another of the ways avoidance and numbing may work. This means the person cannot remember exactly what happened. Many trauma survivors forget in order to survive. 

Survivors may also have learned to dissociate, to literally not be there, to survive. They automatically "switch off" during a stressful situation because it is too painful to deal with. 

Numbness makes it hard for survivors to take care of themselves. Feelings are there to tell us how to do that. If you can't tell what you feel, you can't choose healthy behaviours for yourself. Another symptom is avoidance of situations or activities that may trigger reminders of the traumatic event. These are commonly referred to as "triggers" Other symptoms may worsen when a situation or activity occurs that reminds them of the original trauma. Often the survivor is unable to identity a trigger without help from someone who knows about their traumatic experience. 

Triggers can be people, places, sounds, images, feelings, smells, tastes, films, animals, the tone of someone's voice, body positions or sensations, weather conditions, time factors, or any combination of things that even remotely resemble traumatic experiences. They can be as subtle, complex and obscure as clues in a good detective novel. 

Survivors can become so scared of particular situations that their daily lives are ruled by their attempts to avoid them. PTSD sufferers' inability to work out grief and anger during the traumatic event mean that the trauma will continue to control their behaviour without their being aware of it. Depression is a common product of this inability to resolve painful feelings. 

Recovery 


Recovery is a slow process which doesn't come easily or without pain. The survivor must be heard, feel they are understood, believed and find the ability to reconnect to a community. Recovery takes time. The survivor sets the pace. Recovery is not a race, and can't be given a set time limit. Recovery doesn't erase the trauma as if it had never happened, it just makes it easier to deal with. 

Further trauma will always affect survivors. PTSD symptoms may come back during times of further stress, but the negative effects can be minimised as the survivor learns what they are and feels able to take care of themselves.. True healing is knowing it is okay to ask for help again. 

Recovery is about learning better ways of coping with trauma and letting go of fear, even fear of change. Slow growth is good growth. 

There are many forms of therapy available to survivors. Two of the most common used are cognitive/behaviour therapy and psychodynamic psychotherapy. Cognitive/behaviour therapy involves focusing on ways of correcting the survivors painful and often intrusive patterns of behaviour and thoughts. This is achieved through teaching them relaxation techniques and examining their mental process. This can involve exposing the survivor to certain triggers in a controlled environment until they are "desensitised" to the trigger and is no longer afraid of the situation. 

Psychodynamic psychotherapy tends to focus on helping the survivor to look closely at the way behaviour and experience during their traumatic experience violated them. Often the way a survivor differentiated between their individual personal values and the reality of what they experienced during the traumatic event can result in PTSD. This therapy aims to resolve the conscious and unconscious conflicts that evolved from the trauma. They also work on building self confidence and esteem, self control and an all round renewed pride in themselves and their abilities. 

(See also EMDR - a more recent psychodynamic therapeutic intervention.) 

[ Back ]