Rape survivors represent the largest non-combat group of individuals with posttraumatic stress disorder (PTSD).3 When rape victims disclose their assaults they often risk disbelief, scorn, shame, punishment, and refusals of help, and many are concerned about the following:4
- Families knowing about the sexual assault (71 percent).
- People thinking that the assault was their fault (69 percent).
- People outside victims' families knowing about the sexual assault (68 percent).
- Their names being made public by the news media (50 percent).
- Becoming pregnant (34 percent).
- Contracting sexually transmitted infections (STIs) other than HIV/AIDS (19 percent).
- Contracting HIV/AIDS (10 percent).
Due to these fears, the pain of sexual violation is extremely isolating. Victims often question themselves and distrust the world around them. SARTs need to understand the complex issues that victims face to provide them with compassionate and emotionally supportive care.
Many victims describe the aftermath of sexual assault as an "emotional tattoo" that remains ever before them, much like a tattoo that is fixed just below the surface of the skin. Immediately following a sexual assault, many victims question whether the assault really happened or why it happened to them. The shock of sexual assault is often followed by additional questions that victims may or may not articulate out loud, such as
- Should I tell my children? My parents? My partner?
- Am I losing my mind?
- Why can't I cry?
- What if I had done something differently?
- Will I ever get over this?
- Why me?
Trauma has both objective and subjective aspects. It is useful to think of all trauma symptoms as adaptations. Symptoms represent a victims' attempt to cope the best way they can with overwhelming feelings. Severe trauma can have a major impact on the course of victims' lives. For example, according to the National Women's Study, rape victims are 4.1 times more likely than non-crime victims to have contemplated suicide and 13 times more likely to attempt suicide.5 Sexual assault victims may frequently see the world as an unsafe place, distrust others, have difficulty with decisionmaking, isolate themselves, and harm themselves.
Victims often fear responses from friends, family, colleagues, the public, and criminal justice providers. For example, according to one victim, "When the police officer responded to my 9-1-1 call and transported me to the hospital for a medical forensic exam, my neighbors were standing outside. I was sure they thought I had been arrested. Then, when I returned to work and was on the elevator with people I knewI felt like I had a scarlet ‘R' in the middle of my forehead. I felt branded by my assault and was confident that my scarlet R was all they saw."6
In addition to feeling stigmatized, victims frequently struggle with personal questions such as
- What will happen if my family, friends, employer, or faith community find out?
- Will I be arrested for outstanding warrants (e.g., parking violations)?
- Will I be arrested for using a substance before the assault?
- Will this be reported in the newspaper?
Victim responses to sexual assault are uniquely individual and extremely varied. Some of the responses may include continued contact with perpetrators, delayed responses, flat affects (severely reduced emotional expressiveness), or use of humor. Although lay people (e.g., jurors) may perceive these responses as counterintuitive, they are very common responses to trauma.