Dear Dr Eve – Trauma of rape

Dear Dr Eve,
A few months ago my friend got raped and I cannot get over it.
She called me immediately after it happened. I took her to the police station and sat with
her until her family arrived. I speak with her every day and the funny thing is that she seems
to have got on with her life- she is working and going out as usual and she is even having
sex.
I have stopped having sex with my long-term boyfriend. I have lost my appetite, cannot
concentrate at work, have nightmares and am really angry all the time.
I am afraid my boyfriend will leave me. What can I do to feel sexual again?
Anonymous.

DR EVE REPLIES:

Dear Anonymous,
It is not uncommon for the person close to the rape survivor to suffer from PTSD. You are
exhibiting typical symptoms which also include insomnia, loss/increase of appetite, startle
reflex, lost memories of the traumatic event, and of course, loss of sexual desire.
Your friend’s behaviour and mood may appear weird to you: she appears to be living life
normally. And this can further exacerbate your own PTSD.
The truth is she is just managing her trauma differently from the way that you are. There is no
right/wrong here. No judgment on how to manage either rape or being a witness to a
rape – of which inadvertently you are. She is using an adaptive technique called
“Disassociation“ which allows her to avoid feeling the trauma whilst you are fully immersed
in her feelings. One cannot choose how to adapt to trauma – it happens instinctively and
differently for each person.

Let’s talk about the trauma of rape.

Regardless of age or gender, the impact of sexual violence goes far beyond any physical
injuries. The trauma of being raped or sexually assaulted can be shattering, leaving you
feeling scared, ashamed, alone or plagued by nightmares, flashbacks, and other
unpleasant memories. The world doesn’t feel like a safe place anymore. You no longer trust

others. You don’t even trust yourself. You may question your judgment, your self-worth, and
even your sanity. You may blame yourself for what happened or believe that you’re “dirty”
or “damaged goods.” Relationships feel dangerous, and intimacy is impossible. And on top of that,
like many rape survivors, you may struggle with PTSD, anxiety, and depression. Your feelings
of helplessness, shame, defectiveness, and self-blame are symptoms, not reality. 

Then there is Rape Trauma Syndrome defined as “ the psychological trauma experienced by
a rape victim that includes disruptions to normal physical, emotional, cognitive, and
interpersonal behaviour.” This cluster of symptoms can last for months or even years
afterwards. If the rape trauma lasts and lasts for a protracted period of time, it becomes
Complex Post Traumatic Stress Disorder.
Rape survivors are at high risk for developing substance abuse disorders, major depression
generalized anxiety disorder, obsessive-compulsive disorder and other mental disorders.

Commonly there are three stages that a rape survivor goes through:
ACUTE STAGE: this stage occurs days or weeks after a rape. There is no “normal” duration of
the time that this lasts.  A rape victim’s acute stage can be classified as one of three responses:
expressed (“He or she may appear agitated or hysterical, and may suffer from crying spells
or anxiety attacks)”; controlled (“the survivor appears to be without emotion and acts as if
‘nothing happened’ and ‘everything is fine”), or shock/disbelief (“the survivor reacts with a
strong sense of disorientation. They may have difficulty concentrating, making decisions, or
doing everyday tasks. They may also have poor recall of the assault. Not all rape survivors
show their emotions outwardly. Some may appear calm and unaffected by the assault

  1. THE OUTWARD ADJUSTMENT STAGE: survivors seem to resume a normal lifestyle. But
    suffer internal turmoil. 5x coping strategies at this stage include :
  2. minimization (pretending “everything is fine”)
  3. dramatization (cannot stop talking about the assault)
  4. suppression (refuses to discuss the rape)
  5. explanation (analyzes what happened)
  6. flight (moves to a new home or city, alters the self appearance

There may be poor physical health and usual PTSD symptoms.

  1. UNDERGROUND STAGE: appear to live their lives as if nothing happened. Disassociation
    and even depression may happen. This can continue for years.
  2. REORGANISATION STAGE: may return to emotional turmoil and when emotional pain
    returns, it can be very frightening.
  3. THE RENORMALIZATION STAGE: During renormalization, survivors integrate the sexual
    assault into their lives so that the rape is no longer the central focus of their lives; negative
    feelings such as guilt and shame become resolved, and survivors no longer blame themselves
    for the attack.

Anonymous, find a therapist, counsellor or a support group to be there for you as you
navigate your life through this terrible traumatic event.

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