When a person is harmed by a criminal act, the agencies that make up the criminal and juvenile justice systems have a moral and legal obligation to respond. It is their responsibility not only to seek swift justice for victims, but to ease their suffering in a time of great need.1
Sexual assault trauma is a physical and emotional violation that may result in feelings of intense fear, powerlessness, and hopelessness. Such events can be traumatic not because they are rare, but because they overwhelm the internal resources that give individuals a sense of control, connection, and meaning.2
SARTs must recognize the powerful domino effect sexual assault may have on victims' physical, social, emotional, spiritual, and economic lives and must integrate victim-centered approaches in their response. This section reviews emotional and physical responses to sexual assault, coping strategies, and stages of trauma and recovery.
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
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
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
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.
The physical responses to extreme stress can lead to hyperarousal and anxiety. When fight-or-flight instincts take over, hormones trigger a state of readiness to overcome threats to personal safety. This response is triggered without conscious thought because it bypasses the cortex (the brain's center of higher functioning) and links directly into the brain's "fear center." When victims receive signals from this center, the information instantly triggers a fight-or-flight response.
Victims of sexual assault may have a powerful ability to activate their brain's fear centers due to a network of neurons that are triggered when any of the cues present during the assault present themselves again. A trigger is something that reminds victims of the assault. Triggers may be auditory, visual, tactile, and/or olfactory links to something related to the assault. For example, triggers might be a man's voice, a look of disgust by a family member, the smell of cologne, the sight of a beard, an unwanted touch, or hearing about someone sexually assaulted on the news or at the movies.
At the sound, touch, or sight of those cues, victims can experience the same surge of neurochemicals that were triggered during the actual assault. Their hearts may begin to race, their blood pressure may spike, and their breathing could accelerate. They may find themselves wanting to flee from a health care facility or freeze in terror because law enforcement or a forensic examiner asks them specific details about the assault. These fear reactions are not conscious choices, nor overreactions. They are an automatic response triggered by traumatic memories. For this reason, it is crucial for SARTs to provide and seek information at a rate that does not overwhelm victims.
The powerful neurochemicals that trigger the fight-or-flight response have far-reaching effects, including dramatic effects on the manner in which memories are recalled. Often, a traumatized person cannot generate the kind of narrative memory that normally follows an important experience. Their memories are often fragmented, out of sequence, and filled with gaps. They may recall very specific details from particular aspects of the assault and little or nothing about other aspects. The fact that a traumatized person recalls a detail that they did not remember earlier is not evidence of fabrication. Rather, it demonstrates a characteristic way in which traumatic memories are stored and recalled.
Victims participating in the civil or criminal justice process continuously recount their traumas, appear in the courtroom where their assailants sit, and answer a multitude of intrusive personal questions. These situations can be the equivalent of activating a chemical time bomb in the victim's brain.
Take great care in responding to and interviewing victims.
Coping strategies are used to manage stress. Sexual assault victims respond with strategies that they are accustomed to using, particularly if the strategies have brought them relief in the past. Unfortunately, traumatic experiences can overwhelm a person's usual coping strategies. As a result, victims may turn to more destructive strategies to numb or distract them from emotional pain.
Unhealthy coping strategies such as the following can compromise victims' safety, health, functioning, and well-being:7
Healthy coping strategies that some survivors have found therapeutic include the following:8
There may be barriers to using some or all of these coping strategies. For example, victims of minority ethnic populations, individuals living in poverty, and victims of same-sex sexual assault may not trust the criminal justice system. Others may lack awareness of the options available to them.
Stages of Trauma and Recovery
The following stages of trauma and recovery are generalizations.9 Not all victims will follow the same patterns or the same timeframe. Each individual reacts differently. Some may never experience certain symptoms, some may fluctuate between stages, and some may become stuck in a particular stage. Use the information on stages as a guide to attain a general understanding of how victims may be feeling and what they might be experiencing.
This stage occurs during the very frightening moments just prior to the assault itself, when the victims know, without a doubt, what will happen but are totally powerless to stop it. In other words, trauma does not start after the assault; it starts before it. The concept of pre-impact terror has been used to describe the pain and suffering (beyond loss of life or limb) of airplane passengers who know the plane is going to crash (Haley v. Pan American World Airways, 746 F.2d 311, 5th Cir. 1984).
Similarly, sexual assault victims are permanently changed right before the assault happens by the intentional disregard for their physical and psychological well-being. Knowing they are powerless to stop the sexual assault and knowing that another person intends them harm can intensify the agony of rape for victims before it ever happens.
Shock or Acute Stage of Trauma
After sexual assault, victims experience numerous reactions, some of which include the following:10
Denial or Outward Adjustment
After the assault, victims may realize that their lives have changed forever. Figuring out how to move forward can be a very important first step after the crisis period. Some victims reestablish routines but have underlying, unexpressed feelings that percolate over time. While in this phase, victims attempt to make sense out of the crime and exert a lot of emotional energy attempting to resume their lives as they previously knew them.
If you are working with victims during this stage, be aware that the following issues and behaviors can surface:
This phase, sometimes referred to as the "life-falls-apart" stage, is usually triggered by an event that stirs up memories associated with the assault. When a victim seeks help at this stage, it can confuse family and friends who thought that their loved one had recovered when in fact the victim had been in denial.
Victims may experience
When victims begin to acknowledge that they had no control over what happened and were not to blame, they may begin to experience intense feelings of fear, anger, and rage. They may—
The integration phase may be the most challenging. One day, victims may announce their recovery. Another day, they may fear that they will never be what they consider to be normal again.
Eventually, most victims' intrusive memories and emotional turmoil lessen. Many victims are amazingly resilient and redefine their experiences and their lives by tapping into an inner strength they may have never known they had. When sexual assault is integrated into a victim's life as a significant life event among many other experiences, many individuals call themselves survivors, overcomers, or thrivers rather than victims.
Anniversary Reactions: A Survivor's Guide on How to Cope
Defines "anniversary reaction," provides two survivors' stories, suggests ways to cope and things families and friends might do to help, and provides resources.
How to Help
Provides information and tips for family and friends on responding to victims of rape.
If You Have Been Raped or Sexually Assaulted: Know Your Legal Rights
Gives sexual assault victims information about their legal rights in Washington State.
Reach In. Reach Out. Finding Your Resilience
Helps victims and survivors in the aftermath of violence.
Recovering From Your Crime-Related Injuries (DVD)
Provides seriously injured crime victims with general information about the criminal justice system and strategies for coping with the negative emotions that often accompany victimization.
Recovering from Sexual Assault
Covers facts about sexual violence, medical care, the emotional aftermath of sexual assault, criminal justice procedures, and crime victim compensation. Developed for residents of Indiana but can be adapted for use elsewhere.
The Road to Resilience
Describes resilience and some factors that affect how people deal with life-changing and stressful situations.
Sexual Assault Victimization
Provides an overview of sexual assault and services generally available to its victims.
Provides trauma victims and their loved ones with access to information and support.
Crime Victims' Needs and VOCA-Funded Services: Findings and Recommendations from Two National Studies
Covers victims' experiences including formal and informal sources of help, unaddressed needs for underserved victims, victims' experiences with the justice system and victim rights, and future research agendas.
First Response to Victims of Crime (DVD/VHS and Guidebook)
Describes steps that law enforcement can take, as first responders, to meet victims' needs. Sexual assault is one of the many types of victimizations covered. The special needs of older victims, child victims, immigrants, and victims with disabilities also are addressed.
Gaining Insight, Taking Action: Basic Skills for Serving Victims with Disabilities (Video and Guidebook)
Highlights how to communicate effectively with crime victims, the challenges faced by underserved victim populations, and the relationship between substance abuse and victimization.
Handbook on Justice for Victims
Helps criminal justice agencies and others who meet with victims implement victim service programs and develop victim-sensitive policies, procedures, and protocols.
Incomplete, Inconsistent, and Untrue Statements Made by Victims: Understanding the Causes and Overcoming the Challenges
Addresses why victims may make incomplete, inconsistent, or untrue statements to law enforcement and discusses how to overcome the challenges such statements pose to an investigation.
New Directions from the Field: Victims Rights and Services for the 21st Century
Incorporates views from victims, victim advocates, criminal justice practitioners, and allied professionals to form recommendations for providing justice and comprehensive services to crime victims.
The Psychological Consequences of Sexual Trauma
Describes research findings on the effects of childhood and adult sexual victimization on women's mental health.
Responding To Sexual Violence: A Guide for Professionals in the Commonwealth
Includes information about privacy and confidentiality for survivors of sexual violence.
Toolkit to End Violence Against Women
Contains recommendations for strengthening prevention efforts and improving services from numerous experts in the fields of sexual assault, domestic violence, and stalking.
Victim Responses to Sexual Assault: Counterintuitive or Simply Adaptive?
Provides information on the different responses that individuals who are sexually assaulted display as well as the different coping strategies of victims.
Gift From Within
Serves those who suffer posttraumatic stress disorder (PTSD), those at risk for PTSD, and those who care for traumatized individuals; develops and disseminates educational material.
Comprises mental health professionals, survivors of sexual abuse, and many who identify themselves as both professionals and survivors.
National Center for Trauma-Informed Care
Assists publicly funded agencies, programs, and services in shifting to a more trauma-informed environment.
The National Trauma Consortium
Functions as a clearinghouse of information about trauma and emerging best practices in trauma treatment and services and also offers training and consultation.
Provides education and training on treating and managing traumatic stress, trauma-related advocacy, and information for the public on related issues.
Gateway to Post Traumatic Stress Disorder Information
Links to four national and international organizations that provide education regarding PTSD, articles, references, mini courses, 1–800 phone numbers, and e-mail resources.
1 International Association of Chiefs of Police, 2000, What Do Victims Want? Effective Strategies to Achieve Justice for Victims of Crime, 1999 IACP Summit on Victims of Crime, Alexandria, VA: International Association of Chiefs of Police, 4.
2 Thema Bryant-Davis, 2005, Thriving in the Wake of Trauma: A Multicultural Guide, Westport, CT: Praeger Publishers, 23.
3 Rebecca Campbell and Sharon Wasco, 2005, "Understanding Rape and Sexual Assault: 20 Years of Progress and Future Directions," Journal of Interpersonal Violence 20 (1): 127–131.
4 Rebecca Campbell, 1998, "The Community Response to Rape: Victims' Experiences with the Legal, Medical, and Mental Health Systems," American Journal of Community Psychology 26(3): 355–379; Dean Kilpatrick and Anne Seymour, 1992, Rape in America: A Report to the Nation, Arlington, VA: National Victim Center.
6 SANE Training, victim experience, Tulsa, Oklahoma, 1994. Used with permission.
7 Bryant-Davis, Thriving in the Wake of Trauma: A Multicultural Guide, 146.
8 Ibid., 147.
10 This list is compiled from several different sources: the American Psychological Association (Tips for Recovering From Disasters and Other Traumatic Events), the Rape, Abuse & Incest National Network (Effects of Sexual Assault), the National Center for Victims of Crime (How Crime Victims React to Trauma), and Sexual Assault Advocate/Counselor Training (Impact of Sexual Assault).