with the after effects of rape is a nightmare.
The physical hurts can often soon be mended,
but it's the inner pain that people can't see
that takes longest. It's also the hardest to
deal with because it's not like healing after
surgery, there is no set time limit. The emotional
scars can stay with us a lifetime.
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.
Traumatic experiences bring
to the fore survival skills which are valuable
and useful at the time of the trauma, but which
usually become less valuable, less useful and
less effective with time. Sometimes survivors
become stuck in problem behaviors when their
pain is not acknowledged, heard, respected,
or understood. Denial plays a great part here
(it didn't happen, or it shouldn't affect you).
Put-downs, dismissal of the pain, mis-diagnosis
and other forms of secondary wounding keep survivors
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.
Society has it's own way of
dealing with trauma which can both be belittling
or denying. For a survivor to be told that what
happened to them wasn't that bad, or was no
big deal or continually being told it was time
that they were over it, or just try and forget
it ever happened cause secondary wounding in
trauma survivors. It reinforces the mistrust
of everyone and everything that trauma evokes
in all survivors who no longer can believe that
the universe is fair or just.
This ability to do whatever
it takes to survive is instinctive. We all have
it, and in traumatic enough situations, it will
come out or we die. Extreme situations which
trigger this reaction again and again may cause
survivors to do things in order to survive which
can be hard to look back on later.
Similarly shutting down feelings
in order to do whatever it takes to survive,
or do your job and help others survive, is a
reality based survival skill. Numbness is the
answer. It is effective. It will help you live.
Unfortunately when survivors
numb their fear, despair and anger, all their
feelings, even good ones, are numbed. Numbness
is comfortable. Thinking about what they have
been through is so painful survivors wind up
avoiding thinking about, feeling, or doing anything
that reminds them of the trauma. For example,
if they feel the trauma was their fault they
may spend the rest of their life having to be
right so they won't ever be at fault again.
If they were happy when the trauma hit, they
may avoid happiness forever.
for diagnosis of PTSD
- These are simple guidelines
that may help you to work out if you are suffering
from post traumatic stress disorder. I will
go into more detail later.
- The survivor must have experienced
or confronted with an event that involved
actual or threatened injury, or a threat to
their physical integrity. i.e. rape.
- The survivor must show symptoms
of intense fear, helplessness or horror.
- The survivor must experience
distressing recollections of the event. i.e.
- The survivor persistently
avoids things that remind them of the event.
- The survivor must be show
significant distress or impairment by the
event, either in their social occupational
or other important areas of functioning.
- Persistent symptoms of increased
arousal (not present before the trauma) as
indicated by at least two of the following:
difficulty falling or staying asleep; irritability
or outbursts of anger; difficulty concentrating;
hyper vigilance; exaggerated startle response.
- Symptoms must last at least
often present in Rape Trauma
- Intense fear, helplessness,
- 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".
- Distressing 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 numbness, detachment
or "unrealness" about everything.
- A lack of emotion or inability
to feel love or care about anything.
- A feeling of depression
- 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
- 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
- A feeling of being dirty,
- 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 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 recognize 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 behavior to them.
Sometimes after a flashback
trauma survivors are aware of what triggered
especially if someone else observes the behavior
and recounts it to them, or if it is a recurring
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
accurate and inaccurate, literal and symbolic,
information and should always be interpreted
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
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 suppress
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
behaviors 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 means that the trauma
will continue to control their behavior without
their being aware of it. Depression is a common
product of this inability to resolve painful
The survivor part of us is
not able to listen to "reason". It
is going to be constantly looking for danger
from now on whether or not others think it is
reasonable. Real physiological changes occur
in the brains of survivors which make them quick
to react. In order to live through the trauma,
survivors may develop the capacity to go from
being completely fine into a killing rage in
seconds. That defensive mechanism helps them
Some survivors may stop sleeping
soundly. Sleep can get you killed, so they won't
take the risk. Survivors may be uncannily able
to read the moods of those around them because
the moods of their abusers defined their lives.
Sometimes they also become hyper vigilant, searching
for physical danger everywhere they are and
all of the time.
Due to hyper vigilance and
lack of sleep, it is hard for survivors to concentrate
on everyday things. They may do poorly in school
and in their everyday lives that leads them
to believe they are stupid or inept when actually
they have a symptom of PTSD.
Survivors often react faster
and more completely to sudden noises or movements.
These are lifesaving skills that the survivor
feels they need while they are still at risk.
These are reality based, effective survival
skills. They keep you alive. They don't go away
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 minimized 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.
You can't rush survivors and
we must not dismiss their pain. Instead of comparing
pain, survivors and survivor groups are encouraged
to respect each other's pain and to focus on
what they have in common and to share recovery.
Each person's unique experience and pain is
PTSD symptoms, numbing, hyper
vigilance and flashbacks, are strong hints that
you need to get help! They helped you survive,
but they do not go away by themselves. People
have to alter their lives to control them. They
can become both ineffective and a source of
It takes time to get better.
Getting better is the reward for taking the
time to recover. Getting better, however, is
a slow process. The state of almost constant
physiological arousal which many trauma survivors
live in makes it difficult for them to take
in the kind of information needed to heal. This
is part of the brain chemistry of survivors.
It is not resistance or stubbornness on their
part. People can talk about changing but all
survivors may see is their lips moving. The
words and concepts make no sense. They are incapable
of taking what is being said on board because
they are too busy taking in information for
their survival. Things like who is in the room,
where are they sitting, where is the door, which
is the quickest way out, do they look hostile
or friendly, how are they reacting to me?
Until they start to feel safe
a survivor won't be able to react to anything
or anyone. They have to feel safe and feel as
though there is an element of trust there. When
they have been treated with respect, not discounted,
not pushed to hurry up and recover, which are
secondary wounding experiences and make PTSD
worse, they will feel safe and know it because
they will be able to hear and understand what
the therapist or group is saying in a new way.
When they can hear, survivors
can begin to work on safety issues. They can
begin to understand and protect themselves from
triggers. They can learn to handle emotions
such as anger and fear. Survivors can develop
the capacity to respond rather than react, like
having a pause button instead of an on-off switch.
Searching for the right help is important. You
need to be comfortable enough with the therapist
or group. On the other hand searching for the
perfect group or a therapist who will never
make a mistake can put off recovery for life.
The therapist or group is not going to fix you.
They will however provide you with information
and a variety of coping skills, but it is you
who does the work and heals.
There are many forms of therapy
available to survivors. Two of the most common
used are cognitive/behavior therapy and psychodynamic
psychotherapy. Cognative/behaviour therapy involves
focusing on ways of correcting the survivor’s
painful and often intrusive patterns of behavior
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 "desensitized"
to the trigger and is no longer afraid of the
tends to focus on helping the survivor to look
closely at the way behavior 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
Each person heals in their
own way, there are no hard and fast rules, just
as there is no pill that can cure PTSD. Yes
drugs can be used to help with the side effects
of PTSD, like helping sleeplessness or hyper
arousal. Unfortunately there is no simple clear
cut solution for such a complex phenomenon.
I firmly believe that survivors have to confront
what has happened to them, and by repeating
this confrontation, learn to accept the trauma
as part of their past. There is no magic wand.
However counseling and therapy can help to find
an easier path through the trauma and set you
on the path to healing.