Rape Support Group
If you or someone you know has been the victim of rape, this is the place to find support and get advice. If you want, discuss your experience, share your feelings, and meet others going through a similar situation.
What is Posttraumatic Stress Disorder (PTSD)?
Posttraumatic Stress Disorder (PTSD) is an anxiety disorder that can occur after you have been through a traumatic event. A traumatic event is something horrible and scary that you see or that happens to you. During this type of event, you think that your life or others' lives are in danger. You may feel afraid or feel that you have no control over what is happening.
Anyone who has gone through a life-threatening event can develop PTSD. These events can include:
* Combat or military exposure
* Child sexual or physical abuse
* Terrorist attacks
* Sexual or physical assault
* Serious accidents, such as a car wreck.
* Natural disasters, such as a fire, tornado, hurricane, flood, or earthquake.
After the event, you may feel scared, confused, or angry. If these feelings don't go away or they get worse, you may have PTSD. These symptoms may disrupt your life, making it hard to continue with your daily activities.
How does PTSD develop?
All people with PTSD have lived through a traumatic event that caused them to fear for their lives, see horrible things, and feel helpless. Strong emotions caused by the event create changes in the brain that may result in PTSD.
Most people who go through a traumatic event have some symptoms at the beginning. Yet only some will develop PTSD. It isn't clear why some people develop PTSD and others don't. How likely you are to get PTSD depends on many things. These include:
* How intense the trauma was or how long it lasted
* If you lost someone you were close to or were hurt
* How close you were to the event
* How strong your reaction was
* How much you felt in control of events
* How much help and support you got after the event
Many people who develop PTSD get better at some time. But about 1 out of 3 people with PTSD may continue to have some symptoms. Even if you continue to have symptoms, treatment can help you cope. Your symptoms don't have to interfere with your everyday activities, work, and relationships.
What are the symptoms of PTSD?
Symptoms of posttraumatic stress disorder (PTSD) can be terrifying. They may disrupt your life and make it hard to continue with your daily activities. It may be hard just to get through the day.
PTSD symptoms usually start soon after the traumatic event, but they may not happen until months or years later. They also may come and go over many years. If the symptoms last longer than 4 weeks, cause you great distress, or interfere with your work or home life, you probably have PTSD.
There are four types of symptoms: reliving the event, avoidance, numbing, and feeling keyed up.
Reliving the event (also called re-experiencing symptoms):
Bad memories of the traumatic event can come back at any time. You may feel the same fear and horror you did when the event took place. You may have nightmares. You even may feel like you're going through the event again. This is called a flashback. Sometimes there is a trigger: a sound or sight that causes you to relive the event. Triggers might include:
* Hearing a car backfire, which can bring back memories of gunfire and war for a combat veteran
* Seeing a car accident, which can remind a crash survivor of his or her own accident
* Seeing a news report of a sexual assault, which may bring back memories of assault for a woman who was raped
Avoiding situations that remind you of the event:
You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event.
* A person who was in an earthquake may avoid watching television shows or movies in which there are earthquakes
* A person who was robbed at gunpoint while ordering at a hamburger drive-in may avoid fast-food restaurants
* Some people may keep very busy or avoid seeking help. This keeps them from having to think or talk about the event.
Feeling numb:
You may find it hard to express your feelings. This is another way to avoid memories.
* You may not have positive or loving feelings toward other people and may stay away from relationships
* You may not be interested in activities you used to enjoy
* You may forget about parts of the traumatic event or not be able to talk about them.
Feeling keyed up (also called hyperarousal):
You may be jittery, or always alert and on the lookout for danger. This is known as hyperarousal. It can cause you to:
* Suddenly become angry or irritable
* Have a hard time sleeping
* Have trouble concentrating
* Fear for your safety and always feel on guard
* Be very startled when someone surprises you
What are other common problems?
People with PTSD may also have other problems. These include:
* Drinking or drug problems
* Feelings of hopelessness, shame, or despair
* Employment problems
* Relationships problems including divorce and violence
* Physical symptoms
Can children have PTSD?
Children can have PTSD too. They may have the symptoms described above or other symptoms depending on how old they are. As children get older their symptoms are more like those of adults.
* Young children may become upset if their parents are not close by, have trouble sleeping, or suddenly have trouble with toilet training or going to the bathroom
* Children who are in the first few years of elementary school (ages 6 to 9) may act out the trauma through play, drawings, or stories. They may complain of physical problems or become more irritable or aggressive. They also may develop fears and anxiety that don't seem to be caused by the traumatic event.
What treatments are available?
When you have PTSD, dealing with the past can be hard. Instead of telling others how you feel, you may keep your feelings bottled up. But treatment can help you get better.
There are good treatments available for PTSD. Cognitive-behavioral therapy (CBT) is one type of counseling. It appears to be the most effective type of counseling for PTSD. There are different types of cognitive behavioral therapies such as cognitive therapy and exposure therapy. A similar kind of therapy called EMDR, or eye movement desensitization and reprocessing, is also used for PTSD. Medications can be effective too. A type of drug known as a selective serotonin reuptake inhibitor (SSRI), which is also used for depression, is effective for PTSD.
Posttraumatic Stress Disorder (PTSD) is an anxiety disorder that can occur after you have been through a traumatic event. A traumatic event is something horrible and scary that you see or that happens to you. During this type of event, you think that your life or others' lives are in danger. You may feel afraid or feel that you have no control over what is happening.
Anyone who has gone through a life-threatening event can develop PTSD. These events can include:
* Combat or military exposure
* Child sexual or physical abuse
* Terrorist attacks
* Sexual or physical assault
* Serious accidents, such as a car wreck.
* Natural disasters, such as a fire, tornado, hurricane, flood, or earthquake.
After the event, you may feel scared, confused, or angry. If these feelings don't go away or they get worse, you may have PTSD. These symptoms may disrupt your life, making it hard to continue with your daily activities.
How does PTSD develop?
All people with PTSD have lived through a traumatic event that caused them to fear for their lives, see horrible things, and feel helpless. Strong emotions caused by the event create changes in the brain that may result in PTSD.
Most people who go through a traumatic event have some symptoms at the beginning. Yet only some will develop PTSD. It isn't clear why some people develop PTSD and others don't. How likely you are to get PTSD depends on many things. These include:
* How intense the trauma was or how long it lasted
* If you lost someone you were close to or were hurt
* How close you were to the event
* How strong your reaction was
* How much you felt in control of events
* How much help and support you got after the event
Many people who develop PTSD get better at some time. But about 1 out of 3 people with PTSD may continue to have some symptoms. Even if you continue to have symptoms, treatment can help you cope. Your symptoms don't have to interfere with your everyday activities, work, and relationships.
What are the symptoms of PTSD?
Symptoms of posttraumatic stress disorder (PTSD) can be terrifying. They may disrupt your life and make it hard to continue with your daily activities. It may be hard just to get through the day.
PTSD symptoms usually start soon after the traumatic event, but they may not happen until months or years later. They also may come and go over many years. If the symptoms last longer than 4 weeks, cause you great distress, or interfere with your work or home life, you probably have PTSD.
There are four types of symptoms: reliving the event, avoidance, numbing, and feeling keyed up.
Reliving the event (also called re-experiencing symptoms):
Bad memories of the traumatic event can come back at any time. You may feel the same fear and horror you did when the event took place. You may have nightmares. You even may feel like you're going through the event again. This is called a flashback. Sometimes there is a trigger: a sound or sight that causes you to relive the event. Triggers might include:
* Hearing a car backfire, which can bring back memories of gunfire and war for a combat veteran
* Seeing a car accident, which can remind a crash survivor of his or her own accident
* Seeing a news report of a sexual assault, which may bring back memories of assault for a woman who was raped
Avoiding situations that remind you of the event:
You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event.
* A person who was in an earthquake may avoid watching television shows or movies in which there are earthquakes
* A person who was robbed at gunpoint while ordering at a hamburger drive-in may avoid fast-food restaurants
* Some people may keep very busy or avoid seeking help. This keeps them from having to think or talk about the event.
Feeling numb:
You may find it hard to express your feelings. This is another way to avoid memories.
* You may not have positive or loving feelings toward other people and may stay away from relationships
* You may not be interested in activities you used to enjoy
* You may forget about parts of the traumatic event or not be able to talk about them.
Feeling keyed up (also called hyperarousal):
You may be jittery, or always alert and on the lookout for danger. This is known as hyperarousal. It can cause you to:
* Suddenly become angry or irritable
* Have a hard time sleeping
* Have trouble concentrating
* Fear for your safety and always feel on guard
* Be very startled when someone surprises you
What are other common problems?
People with PTSD may also have other problems. These include:
* Drinking or drug problems
* Feelings of hopelessness, shame, or despair
* Employment problems
* Relationships problems including divorce and violence
* Physical symptoms
Can children have PTSD?
Children can have PTSD too. They may have the symptoms described above or other symptoms depending on how old they are. As children get older their symptoms are more like those of adults.
* Young children may become upset if their parents are not close by, have trouble sleeping, or suddenly have trouble with toilet training or going to the bathroom
* Children who are in the first few years of elementary school (ages 6 to 9) may act out the trauma through play, drawings, or stories. They may complain of physical problems or become more irritable or aggressive. They also may develop fears and anxiety that don't seem to be caused by the traumatic event.
What treatments are available?
When you have PTSD, dealing with the past can be hard. Instead of telling others how you feel, you may keep your feelings bottled up. But treatment can help you get better.
There are good treatments available for PTSD. Cognitive-behavioral therapy (CBT) is one type of counseling. It appears to be the most effective type of counseling for PTSD. There are different types of cognitive behavioral therapies such as cognitive therapy and exposure therapy. A similar kind of therapy called EMDR, or eye movement desensitization and reprocessing, is also used for PTSD. Medications can be effective too. A type of drug known as a selective serotonin reuptake inhibitor (SSRI), which is also used for depression, is effective for PTSD.
And this is just for starters. Ninety-five percent of rape victims meet conditions for a diagnosis of major depressive disorder following rape, leading to a suicide attempt rate of one in three women per year, each year, following rape, adding up to a 50% overall suicide ideation or attempt rate among rape victims. The level of a stress hormone called cortisol remains elevated; cortisol is a survival hormone that saps emergency calories from within body tissues. Although short-term bursts of cortisol are necessary for daily life, extended elevation can cause chronic aches and pains, joint soreness, and even weight gain as metabolism slows due to loss of lean muscle. The lifestyle effects of depression with PTSD after rape include:
Increased substance abuse
Eating disorders, including overeating, food refusal, and bingeing,
Deliberate self-injury behaviors
Onset or increase of smoking habits
Fatigue and loss of energy
Anhedonia the loss of sensations of pleasure
Exaggerated startle responses
Loss of relationship quality
Anger outbursts
Retarded motor skills/response times
Diminished ability to concentrate
Fortunately, psychology as a science has not been passive on this issue, and there is astounding knowledge now about what causes PTSD and what tested methods actually work to treat it. It's not just "how did your week go/how do you feel about that?"-type therapy.
The reason this is important to point out is that it is essential to understand that PTSD does NOT fade or "go away" over time. The world is (sadly) full of trauma survivors who are suffering years of trying to cope with PTSD by wishing it away, forcing it away (through alcohol, drugs, cutting, dissociation, and sex), ignoring it, and trying to distract themselves whenever traumatic thoughts come up. Suppressing and ignoring these symptoms is perhaps the LEAST helpful way to cope with PTSD, and yet countless rape victims suffer for years while trying to do exactly that (just look at the number of posts on DS about coping with flashbacks by trying to distract, ignore, or resist them). In fact, this will not only lengthen the duration of suffering, but it will compress the traumatic emotions until they avalanche out.
I am posting this info on PTSD because it agonizes me to see so many worthy, brilliant people suffering for years. When someone tells you that PTSD cannot fade with time or distraction, it is not a cruel statement. It hurts to hear, yes, but it is ultimately a very compassionate thing to say because it intervenes in years of future suffering as we try to suppress our trauma through willpower, distraction, and endless cycles of ineffective coping.
Flashbacks, nightmares, and other symptoms of PTSD are efforts by your mind to purge up disturbing and unresolved parts of your trauma so that you can process them, analyze them, resolve them, and thus release/extinguish their potent emotions. This is supremely difficult, but seems to be the only way to fully resolve PTSD symptoms. In other words, "the way out is through." It's antithetical to our instinct: instead of fleeing the trauma in our minds, we have to turn and face it directly, fully, consciously. This is terrifying, which is also why so many of us consider it cruel, unfeeling, and hurtful to be told that our individual efforts to suppress PTSD simply won't work, and that we have to do something very difficult to overcome it.
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sources: Saba W. Masho, Gasmelseed Ahmed. Age at Sexual Assault And Posttraumatic Stress Disorder among Women: Prevalence, Correlates, And Implications for Prevention. Journal of Women's Health. 2007, 16(2): 262-271.
Treating the Trauma of Rape: Cognitive-behavioral therapy for PTSD. p14-17.
Resnick, H. S., Yehuda, R., Pitman, R. K., and Foy, D. W. Effect of previous trauma on acute plasma cortisol level following rape. 1995 Am J Psychiatry 152;11:1675-7
Zlotnick, C., et al. The relationship between sexual abuse and eating pathology. 1996 Int J Eat Disord 20;2:129-34
www.resurrectionafterrape.org
The first way in which your trauma victimized you was to demolish your beliefs and assumptions about yourself and the world. Your sense of safety, trust, and invulnerability have been shattered, and that can make the world seem very chaotic and confusing. It can also drain your previous self-image, causing you to feel stupid, weak, childish, ugly, and alone. This will make it difficult to accept help from others, to trust, and even to see yourself as a good and worthy person.
The second way you have been hurt is one of the most difficult to overcome. This is what I call the second trauma, and it describes the daily re-injuring you receive from peoples insensitivity, lack of support, and flat-out rudeness about your trauma. If you reported your rape to a hospital or police, you may have experienced this secondary wounding during a rape evidence exam, or by having to constantly repeat your story to a detective (who is deliberately trained to challenge you about details of your story). People may be telling you that your rape wasnt real rape because your perpetrator was a boyfriend and not a psycho in an alley. They may tell you to get over it. They may even scold you for being raped, suggesting that it was your fault (when it wasnt). Ridicule at school, smirks on the face of your rapist if you see him again, rumors and gossip, and jokes are all forms of re-injury. An individual becomes a victim in the primary experience of the rape act, but can be further victimized by negative and judgmental reactions following the rape incident, write Irina Anderson and Kathy Doherty, which may prompt feelings of guilt or shame on the part of victims about their conduct in relation to the crime perpetrated against them. (Anderson, Irina and Doherty, Kathy. Accounting for Rape: Psychology, Feminism and discourse Analysis in the Study of Sexual Violence, 2008, p9-10.)
These secondary traumas are caused by ignorance, cruelty, burnout, misunderstanding, and other peoples personal issues with the subject of rape. In response to these traumas, you may even find yourself doubting your own memory (Did I imagine that? Did I misunderstand? Am I crazy?), joining with your critics against yourself (I know, I was stupid! and It was my fault. I put myself in that position. and Its no big deal.).
The third way in which your trauma will affect you is by planting a type of Im a victim and nothing more!-thinking. This is the self-rejection and self-hatred that rape victims universally experience. Im damaged goods, or nobody will want to marry someone like me or I cant take the pain anymore. God has even forgotten me. While you have little control over the first two kinds of victimization, you can learn how to overcome this part, which is good news because it is this level of harm that is most damaging and potentially fatal (through suicide, eating disorders, self-injury and addiction).
Please let me know if this is helpful info, and I will continue to add to this thread.
it took me forever to find ONE person here qualified to treat trauma/complex trauma. any info you can offer that i haven't already read on cptsd?
Cognitive-behavioral therapy...what is it? i mean, what's done during this kind of therapy? what is their method?
i'm flustered. i want to know how to control my mind and these emotions without doing what i've been doing all this time -- pushing them away and ignoring them.
at the same time, i'm looking into finding a therapist...but i haven't had any luck. =/
i'm also looking into pressing charges against my ex...but not sure if it's the "right" thing to do...
i just want all of this to go away...keep posting this kind of information, PLEASE! i feel like i'm at wits end!
Complex PTSD: Not a lot of good literature out there, and I'm not sure what you've already read. You already know the basics of it, of course, but the main differences between it and PTSD are the impacts of sustained, long-term, or repetitive trauma on the victim's personality. Thus, a wide constellation of things change: your sense of self, fragmented memories, loss of self-worth, self-harming coping skills, and even vulnerability to further victimization. Be aware, though, that a lot of psychologists see this as an overlap of Borderline Personality Disorder (BPD), and one theory (by Dr. Otto Kernberg) is that BPD is actually a form of deferred/delayed trauma. To summarize, though, CPTSD resembles BPD in the ways it shapes the person's personality (as opposed to being limited to specific symptoms of trauma), but CPTSD is a result of ongoing, systemic "betrayal" trauma (hostage, ritual abuse, constant sexual abuse, concentration camp) rather than single-episode or "life experience" trauma (war, accidents, tornado, etc.). Personally, I prefer the term "Rape trauma syndrome" (search DS for my earlier posts on that), which is just about the same thing.
Cognitive-Behavior Therapy (CBT): a very mainstream form of "talk" therapy in which your beliefs and interpretations about events is examined, challenged, and redefined. There is a lot of focus on the intrinsic "meaning" you give to events, and the ways these meanings influence your interpretations and responses to life afterward. My book, Resurrection After Rape, borrows heavily from CBT, but I also mix in some psychodynamic and "Transference-focused protocol" (TFP) in my techniques. To the patient, this means allowing exploration into spiritual and "transcendent" insights into events, using art and right-brained forms of communication, and building a very careful but deep bond between therapist and client.
Resisting labels: Yes, i agree. I resent the use of diagnostic labels for everything; we have 4" thick book (DSM-IV) of all the possible diagnoses of a person's problems, and then we hypocritically state we use a "strengths perspective" in which we build on the good of the client. Really?! After we've just cataloged their problem with a label? Perhaps this is a better option than the "PTSD" label: "I've been hurt, and it still affects me." Really, that's all your diagnosis is trying to say.
I added the "or have faced" comment because I WANT YOU ALL TO KNOW YOU CAN BE HELPED. In my earliest posts to DS I exhibit many of the signs associated with PTSD. I was hopeless, or so I thought. I was reaching out when I found DS, and I hungrily read every post and found myself in many of the words. But, more to the point...I found myself clinging to a life I hated, and I was ready to give up, or...so I thought.
One post intrigued me so much that I actually ceased an attempt at suicide while reading, and responding to the post. If you "know" me here on DS, you know to what I refer. But, in putting my actual suicide attempt on hold, I learned so much, and all of it had to do with me.
In therapy, I kept waiting for my therapist to make something happen. I kept waiting for his words to take on a Holy tone, and for some majestic moment to arrive. It didn't. What I failed to realize was that my therapist couldn't accomplish anything for me. YES, I SAID, MY THERAPIST COULDN'T ACCOMPLISH ANYTHING FOE ME. I came to realize, through some very kind encounters here on DS, that my help was within me, and my therapist is only a guide to that help. I had to quit waiting on him to fix me, and I had to take on the task...and face down the demons of my past.
My nightmares and flashbacks, which were at a feverish pitch...they are virtually gone. My numbing...my dissociation, also have made a disappearance. My negative thoughts about myself and what I have to offer the world, well, I am working on that. I had a multiple year hiatus of the symptoms of PTSD and had basically believed I was "well". My symptoms returned with a vengeance after a medical procedure and anesthesia. That was in 2006. During that time I halted family interactions, I jumped from job to job, I ended friendships through dis-association :),
and I found myself in the middle of my bed, counting pills and hoping 80-something was enough to do the job.
I know this is too many words to say what I want to say, but PTSD doesn't have to ruin your life, or end it. Your therapist, or your refusal to have one, won't 'fix' your problem. You aren't beyond hope because PTSD is such a vile presence. And Empowered is so right in the comments about facing and walking through the trauma, it is how I got to where I am today. I never worked so hard at anything, ever. I never hurt so badly, ever....not even initially, because I heaped huge amounts of self-injury on top of the injury I had suffered so many years prior. But, like Empowered said, you do not have to suffer forever with the symptoms of PTSD,and I am one of the ones who posts so frequently that you can't avoid the pain...you have to move through it, to find the life you so very much deserve. Never give up, your life is worth it!