Rape Trauma Syndrome

DisclaimerThis page is not here to be used as a self-diagnosis, self-identification, or promotion - it's simply here to be informational. Whether or not one self-diagnoses, self-identifies, and/or seeks a professional diagnosis is up to them.Sexual AssaultThe following page includes discussions of sexual assault and rape. If you are uncomfortable or get triggered by this topic, it is recommended to not read this page.Self-HermThe following page includes discussions of self-harm and suicide. If you are uncomfortable or get triggered by this topic, it is recommended to not read this page.

**Rape Trauma Syndrome (RTS)** is related to post-traumatic stress disorder, but is more specific to sexual assault. Individuals exposed to sexual violence often feel that their lives have changed forever and they will never come to terms with the trauma they have suffered.

Reactions and adjustment to rape are similar to those that might be experienced after other types of major life traumas. Reactions vary from individual to individual depending on the victim's age, maturity, life experience, and support systems. There is no one way that victims respond to rape.

However, most rape victims experience a predictable range of emotions following the assault, that is when rape trauma syndrome may be a factor.

## Stages of RTS

Although each individual's experience in unique, individuals experiencing rape trauma syndrome often process their trauma in a series of stages.

### Acute Stage

The acute stage can begin days or weeks after assault and generally lasts for between a few days and a few weeks. Often, victims begin experiencing symptoms of the acute stage after the initial shock of assault has worn off. Symptoms at this stage may include:

* Diminished alertness or hyper-alertness.
* Numbness.
* Dulled sensory, affective and memory functions.
* Disorganized thought content.
* Nausea and vomiting.
* Paralyzing anxiety.
* Obsession to wash or clean themselves.
* Confusion about everyday life.
* Acute sensitivity to the reaction of others.
* Thoughts of and increased risk of suicide.

### Outward Adjustment Stage

Outward adjustment often begins when the acute stage ends, and can last for a few months to several years, if it is not interrupted. During this stage, the victim may outwardly appear to have "moved on" from assault, but this stage is marked by serious inner turmoil. Victims may employ a wide range of coping mechanisms, including:

* Minimization, pretending "everything is fine", or that the assault "wasn't a big deal".
* Dramatization, cannot stop talking about the assault.
* Suppression, refuses to discuss the incident.
* Explanation, analyzes what happened.
* Flight, moves to a new home or city, alter appearance.

Victims may show a wide variety of symptoms, but some common symptoms during this phase include:

* Poor health in general.
* Continuing anxiety.
* Sense of helplessness.
* Hypervigilance.
* Inability to maintain previously close relationships.
* Experiencing a general response of nervousness or "startled response".
* Persistent fear.
* Mood swings from relatively happy to depressed or anger, extreme anger and hostility.
* Sleep disturbances such as insomnia, vivid dreams, and recurring nightmares.
* Flashbacks and intrusive thoughts about the assault.
* Dissociation.
* Panic attacks.

Victims in the outward adjustment stage may increase their reliance on coping mechanisms, some of which may be adaptive, such as relying on the support of family and friends, mindfulness, or increased self-care, but others may be counterproductive in the long term, such as self-harm, drug or alcohol abuse, high risk sexual behaviors, or disordered eating as a way of regaining control.

During this stage, victims may feel their lifestyles being changed in a variety of ways, including:

* Sense of personal security or safety is damaged, which may lead to a changing of behaviors and abandonment of activities previously enjoyed.
* Hesitance to enter new relationships.
* Questioning sexual identity or sexual orientation.
* Disrupted sexual relationships or sexuality, including difficulty re-establishing normal sexual relations, inhibited sexual response and flashbacks to the rape during sexual activity, or hyper-sexuality.

### Underground Stage

During the underground stage, victims may work to return to their more "normal" lives. This stage may last for years, with limited disruptions to daily life, although emotional issues surrounding the assault may continue to be resolved. In the underground stage, victims may:

* Attempt to return to their lives as if nothing happened.
* Block thoughts of the assault from their minds and may not want to talk about the incident or any of the related issues.
* Have difficulty in concentrating and some depression.
* May experience some dissociation and/or symptoms of hypervigilance.

### Reorganization Stage

The reorganization stage can begin when there is an external trigger that moves a survivor from the underground or outward stage, or when there is a life transition, or for other reasons that may not be clear to the survivor or their loved ones. The length of reorganization can vary widely, and can end when a survivor returns to outward adjustment or underground, or when they are able to resolve the trauma and move to the renormalization stage. Reorganization is characterized by a return of internal and external turmoil. Friends and family may be confused by a return of feelings and behaviors in the victim that they thought were resolved. Victims may also feel surprise, fear, and confusion in this stage as strong feelings about the assault return.

Fears and phobias may be related specifically to the assailant or the circumstances of the attack, or may be more generalized. These phobias often include:

* Fear of being in crowds.
* Fear of being left alone anywhere.
* Fear of men or women.
* Fear of going out at all.
* Fear of being touched.
* Specific fears related to certain characteristics of the assailant.
* General suspicions or paranoid feelings about strangers.
* Appetite disturbances such as nausea and vomiting. Survivors may also develop disordered eating patterns at this time.
* Nightmares and other sleep disturbances.
* Violent fantasies of revenge may also arise.
* Increased thoughts and risk of suicide.

### Renormalization Stage

In the renormalization stage, survivors reprocess their experience and are able to integrate it into their lives. The sexual assault or rape is no longer a central focus, and feelings such as shame or guilt resolve. Survivors in this stage are also able to recognize and address secondary consequences of maladaptive coping mechanisms. While victims may look upon the sexual assault and its aftermath with sadness, the feelings generated by the assault in other stages are not as wrong, overwhelming, or disruptive as they once were.

## References

https://students.wustl.edu/rape-trauma-syndrome/

https://rapecrisis.org.za/rape-trauma-syndrome-rts/

https://www.crisiscenter.org/images/SAINDoc7.pdf