Let’s put an END to VIOLENCE & ABUSE WORLDWIDE!

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UPLIFTING HEARTS, MINDS & SOULS (HUMS)

EFFECTS OF ASSAULT & ABUSE

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UPLIFTING HEARTS MINDS & SOULS (HUMS) website provides general information that is intended, but not guaranteed, to be correct and up-to-date. The information is not presented as a source of legal advice. You should not rely, for legal advice, on statements or representations made within the website or by any externally referenced Internet sites. If you need legal advice upon which you intend to rely in the course of your legal affairs, consult a competent, independent attorney. HUMS does not assume any responsibility for actions or non-actions taken by people who have visited this site, and no one shall be entitled to a claim for detrimental reliance on any information provided or expressed.

Effects of Sexual Assault

Sexual assault is an incredibly personal and destructive crime.  Its effects on victims and their loved ones can be felt psychologically, emotionally, and physically.  They can be brief in duration or last a very long time.  It is important to remember that there is no one “normal” reaction to sexual assault. Every individual's response will be different depending on the situation. In this section, we have explained some of the more common effects that a victim may experience. View one of the pages below to learn more about the effects a victim may experience.

Adult Survivors of Childhood Sexual Assault

There are many reactions that survivors of rape and sexual assault can have. But for adult survivors of childhood abuse there are reactions that may either be different or stronger than for other survivors. CAVEAT: The following descriptions are meant to serve as a general guideline for how a victim of sexual assault might react in a time of pain or crisis. It is important to recognize, however, that each victim of sexual assault will have his or her own life experiences and personality that will influence how he or she react to the assault.

Reactions

There are many reactions that survivors of rape and sexual assault can have. But for adult survivors of childhood abuse there are reactions that may either be different or stronger than for other survivors. These include:

Setting Limits/Boundaries

Because your personal boundaries were invaded when you were young by someone you trusted and depended on, you may have trouble understanding that you have the right to control what happens to you.

Memories/Flashbacks

Like many survivors, you may experience flashbacks.

Anger


This is often the most difficult emotion for an adult survivor of childhood sexual abuse to get in touch with.

As a child your anger was powerless and had little to no effect on the actions of your abuser. For this reason you may not feel confident that you anger will be useful or helpful.

Grieving/Mourning

Being abused as a child means the loss of many things- childhood experiences, trust, innocence, normal relationship with family members (especially if the abuser was a family member).

You must be allowed to name those losses, grieve them, and then bury them.

Guilt, Shame, and Blame

You may carry a lot of guilt because you may have experienced pleasure or because you did not try to stop the abuse.


There may have been silence surrounding the abuse that led to feelings of shame.

It is important for you to understand that it was the adult who abused his/her position of authority and should be held accountable, not you.

Trust

Learning to trust again may be very difficult for you.

You may find that you go from one extreme to the other, not trusting at all to trusting too much.

Coping Skills

You have undoubtedly developed skills in order to cope with the trauma.

Some of these are healthy (possibly separating yourself from family members, seeking out counseling, etc.)

Some are not (drinking or drug abuse, promiscuous sexual activity, etc.)

Self-esteem/Isolation

Low self-esteem is a result of all of the negative messages you received and internalized from your abusers.

Because entering into an intimate relationship involves trust, respect, love, and the ability to share, you may flee from intimacy or hold on too tightly for fear of losing the relationship.

Sexuality

You likely have to deal with the fact that your first initiation into sex came as a result of sexual abuse.


You may experience the return of body memories while engaging in a sexual activity with another person. Such memories may interfere in your ability to engage in sexual relationships which may leave you feeling frightened, frustrated, or ashamed.

Reference
This section was adapted from materials provided by the Texas Association Against Sexual Assault.

 
Battered Woman Syndrome

A controversial concept, battered woman syndrome is a model that was developed by Dr. Lenore E. Walker to describe the mindset and emotional state of a battered woman. NOTE: While men are also victims of domestic violence, the concept of battered woman syndrome typically refers only to women. For this reason, the following description will follow this format but recognizes that the same or a similar mindset could hold true for battered men as well.

A controversial concept, battered woman syndrome is a model that was developed by Dr. Lenore E. Walker to describe the mindset and emotional state of a battered woman. A battered woman is a woman who has experienced at least two complete battering cycles as described in dating and domestic violence.

Battered women stay in these dangerous relationships for a variety of reasons including:

still being positively reinforced by the "honeymoon" phase of the battering cycle

·        

          economic dependence upon the batterer


·         belief that they can keep the peace


·         fear of danger if she were to leave


·         threats made by the batterer to hurt her or her children if she left


·         loss of self-esteem


·         depression or loss of psychological energy necessary to leave


According to Walker's The Battered Woman Syndrome (p. 95-97, 1984), there are four general characteristics of the syndrome:

1.      The woman believes that the violence was or is her fault.

2.     The woman has an inability to place responsibility for the violence elsewhere.

3.     The woman fears for her life and/or her children's lives.

4.     The woman has an irrational belief that the abuser is omnipresent and omniscient.

More recently, Battered Woman Syndrome has also been associated with post-traumatic stress disorder in that domestic violence involves exposure to severe trauma and so the reactions of a battered woman may be due to flashbacks or other intrusive experiences from previous traumatic events so that the woman believes that she is in danger, even if she is not.

This syndrome has been used as an explanation for reactions to abusive situations in court cases but has also been used as an educational tool in order to raise the awareness of the impact that domestic violence can have on women.

Body Memories

Body memories are when the stress of the memories of the abuse experienced by an individual take the form of physical problems that cannot be explained by the usual means. What are Somatic (Body) Memories?

Body memories are when the stress of the memories of the abuse experienced by an individual take the form of physical problems that cannot be explained by the usual means (medical examinations, etc.).

These maladies are often called "psychosomatic symptoms" which does not, as many people think, mean that it is "in your head." Rather, it means that the symptoms are due to the connection between the mind and the body.

Physical problems that can come of these somatic memories include headaches, migraines, stomach difficulties, light headedness/dizziness, hot/cold flashes, grinding of teeth, sleep disorders, etc.

These maladies can often be frustrating for the survivor of a sexual assault who is experiencing them as they are difficult to diagnose and cure and may add to the difficult experience of recovery. 

Borderline Personality Disorder

Borderline Personality Disorder is one of the most controversial mental illness diagnoses in Psychology today. Borderline Personality Disorder is one of the most controversial mental illness diagnoses in Psychology today. There are several different theories as to why an individual develops Borderline Personality Disorder and how it should be treated (or even if it can be treated).

What is Borderline Personality Disorder?

While people with Borderline Personality Disorder are often funny, witty, intelligent, and the life of the party, they are also known for their inconsistent behavior and often chaotic lifestyle.

There are a number of different definitions of Borderline Personality Disorder but most agree it can include:

·         a fear of being abandoned or alone which can lead to frantic efforts to avoid such a state of being

·         intense and unstable relationships which swing between idealization and devaluation

·         unstable self-image or sense of self

·         impulsivity (e.g., substance abuse, reckless sexual encounters, binge eating, reckless driving, extreme spending)

·         suicidal or self-mutilating thoughts or behaviors

·         extremely unstable moods that last from a few hours to a few days

·         inappropriate or overwhelming anger and rage

·         transient, stress-related paranoia or dissociative symptoms

·         hypersensitivity to nonverbal communication and expression

For more information, visit the National Institute of Mental Health's article on Borderline Personality Disorder.

References:
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (p.710, 2000).
National Institute of Mental Health. Borderline Personality Disorder: Raising questions, finding answers. Bethesda (MD).

Complex PTSD

Diagnosis necessary to describe the symptoms experienced by survivors of long-term trauma such as child sexual abuse and prostitution. Dr. Judith Herman developed the concept of Complex PTSD. She argues that this new diagnosis is necessary to describe the symptoms experienced by survivors of long-term trauma such as child sexual abuse, prostitution, and organized child exploitation rings.

The National Center for Post-Traumatic Stress Disorder has a very helpful Fact Sheet on Complex PTSD. Complex PTSD

Julia M. Whealin, Ph.D. and Laurie Slone, Ph.D.

Differences between the effects of short-term trauma and the effects of chronic trauma?

The diagnosis of PTSD accurately describes the symptoms that result when a person experiences a short-lived trauma. For example, car accidents, natural disasters, and rape are considered traumatic events of time-limited duration. However, chronic traumas continue or repeat for months or years at a time. Clinicians and researchers have found that the current PTSD diagnosis often does not capture the severe psychological harm that occurs with such prolonged, repeated trauma. For example, ordinary, healthy people who experience chronic trauma can experience changes in their self-concept and the way they adapt to stressful events. Dr. Judith Herman of Harvard University suggests that a new diagnosis, called Complex PTSD, is needed to describe the symptoms of long-term trauma. Another name sometimes used to describe this cluster of symptoms is: Disorders of Extreme Stress Not Otherwise Specified (DESNOS).

Because results from the DSM-IV Field Trials indicated that 92% of individuals with Complex PTSD/DESNOS also met criteria for PTSD, Complex PTSD was not added as a separate diagnosis. Complex PTSD may indicate a need for special treatment considerations.

What are examples of types of captivity that are associated with chronic trauma?

Judith Herman notes that during long-term traumas, the victim is generally held in a state of captivity, physically or emotionally. In these situations the victim is under the control of the perpetrator and unable to flee.

Examples of captivity include:

Concentration camps
Prisoner of War camps
Prostitution brothels
Long-term domestic violence
Long-term, severe physical abuse
Child sexual abuse
Organized child exploitation rings

What are the symptoms of Complex PTSD?

The first requirement for the diagnosis is that the individual experienced a prolonged period (months to years) of total control by another. The other criteria are symptoms that tend to result from chronic victimization. Those symptoms include:

Alterations in emotional regulation

This may include symptoms such as persistent sadness, suicidal thoughts, explosive anger, or inhibited anger

Alterations in consciousness

This includes things such as as forgetting traumatic events, reliving traumatic events, or having episodes in which one feels detached from one's mental processes or body

Changes in self-perception

This may include a sense of helplessness, shame, guilt, stigma, and a sense of being completely different than other human beings

Alterations in the perception of the perpetrator

For example; attributing total power to the perpetrator or becoming preoccupied with the relationship to the perpetrator, including a preoccupation with revenge

Alterations in relations with others

Variations in personal relations including isolation, distrust, or a repeated search for a rescuer

Changes in one's system of meanings

This may include a loss of sustaining faith or a sense of hopelessness and despair

What other difficulties do those with Complex PTSD tend to experience?

Survivors may avoid thinking and talking about trauma-related topics because the feelings associated with the trauma are often overwhelming.
Survivors may use alcohol and substance abuse as a way to avoid and numb feelings and thoughts related to the trauma.
Survivors may also engage in self-mutilation and other forms of self-harm.

There is a tendency to blame the victim.

A person who has been abused repeatedly is sometimes mistaken as someone who has a "weak character."

Because of their chronic victimization, in the past, survivors have been misdiagnosed by mental-health providers as having Borderline, Dependent, or Masochistic Personality Disorder. When survivors are faulted for the symptoms they experience as a result of victimization, they are being unjustly blamed.

Researchers hope that a new diagnosis will prevent clinicians, the public, and those who suffer from trauma from mistakenly blaming survivors for their symptoms.

Summary

The current PTSD diagnosis often does not capture the severe psychological harm that occurs with prolonged, repeated trauma. For example, long-term trauma may impact a healthy person's self-concept and adaptation. The symptoms of such prolonged trauma have been mistaken for character weakness. Research is currently underway to determine if the Complex PTSD diagnosis is the best way to categorize the symptoms of patients who have suffered prolonged trauma.

Recommended Reading

Trauma and Recovery: The Aftermath of Violence from Domestic Abuse to Political Terror, by Judith Herman, M.D. (1997). Basic Books; ISBN 0465087302

References

Ford, J. D. (1999). Disorders of extreme stress following war-zone military trauma: Associated features of Posttraumatic Stress Disorder or comorbid but distinct syndromes? Journal of Consulting and Clinical Psychology, 67, 3-12.

Herman, J. (1997). Trauma and recovery: The aftermath of violence from domestic abuse to political terror. New York: Basic Books.

Roth, S., Newman, E., Pelcovitz, D., van der Kolk, B., & Mandel, F. S. (1997). Complex PTSD in victims exposed to sexual and physical abuse: Results from the DSM-IV field trial for Posttraumatic Stress Disorder. Journal of Traumatic Stress, 10, 539-555.


Depression

There are many emotional and psychological reactions that victims of rape and sexual assault can experience. One of the most common of these is depression. There are many emotional and psychological reactions that victims of rape and sexual assault can experience. One of the most common of these is depression.

The term "depression" can be confusing since many of the symptoms are experienced by people as normal reactions to events in their life. At some point or another during one's life, everyone feels sad or "blue." This also means that recognizing depression can be difficult since the symptoms can easily be attributed to other causes. These feelings are perfectly normal, especially during difficult times.

Depression becomes something more than just normal feelings of sadness when the symptoms last for more than two weeks. Therefore, if you experience five or more of the symptoms of depression over the course of two weeks you should consider talking to your doctor about what you are experiencing.

The symptoms for depression include:

·         Prolonged sadness or unexplained crying spells

·         Change in appetite with significant weight loss (without dieting) or weight gain

·         Loss of energy or persistent fatigue or lethargy

·         Significant change in sleep patterns (insomnia, sleeping too much, fitful sleep, etc.)

·         Loss of interest and pleasure in activities previously enjoyed, social withdrawal.

·         Feelings of worthlessness, hopelessness, or inappropriate guilt

·         Pessimism or indifference

·         Unexplained aches and pains (headaches, stomachaches)

·         Inability to concentrate, indecisiveness

·         Irritability, worry, anger, agitation, or anxiety

·         Recurring thoughts of death or suicide

Depression can affect anyone of any age, gender, race, ethnicity, or religion. Depression is not a sign of weakness, and it is not something that someone can make him/herself "snap out of."

Reference:
American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders: Text Revision, fourth edition, 2000

Dissociative Identity Disorder

Dissociation is a mental process in which a person's thoughts and feelings may be separated from his or her immediate reality. Before explaining what Dissociative Identity Disorder (formerly known as Multiple Personality Disorder) is, we first must define dissociation.

Dissociation is a mental process in which a person's thoughts and feelings may be separated from his or her immediate reality.

Most mental health practitioners believe that dissociation exists on a continuum. At one end of the continuum, are instances of dissociation that many people experience such as daydreaming or highway hypnosis. At the other end, though, is chronic and complex dissociation which may impair an individual's ability to function in the "real" world.

According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (p. 529, 2000), Dissociative Identity Disorder (DID) is:

A.                The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self).

B.    At least two of these identities or personality states recurrently take control of the person's behavior.

C.    Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.

D.   The disturbance is not due to the direct physiological effects of a substance (e.g., blackouts or chaotic behavior during Alcohol Intoxication) or a general medical condition (e.g., complex partial seizures). NOTE: In children, the symptoms are not attributable to imaginary playmates or other fantasy play.

While the causes of DID are not entirely known, it is believed that the disorder stems from physical or sexual abuse in childhood. It is believed that children develop this disorder when during abusive situations they slip into dissociative states in order to remove themselves from the situation. If the abuse continues over time, it is believed that children may then begin to split into alter identities during these times of dissociation.

For more information, visit the National Alliance on Mental Illness's article on Dissociative Identity Disorder.

Reference:
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision

Flashbacks

Flashbacks are when memories of past traumas feel as if they are taking place in the current moment. Flashbacks are when memories of past traumas feel as if they are taking place in the current moment.

These memories can take many forms: dreams, sounds, smells, images, body sensations, or overwhelming emotions. This re-experience of the trauma often seems to come from nowhere and, therefore, blurs the lines between past and present, leaving the individual feeling anxious, scared, powerless, or any other emotions that they felt at the time of the trauma.

Some flashbacks are mild and brief, a passing moment, while others may be powerful and last a long time. Many times the individual does not even realize that he or she is having a flashback and may feel faint or dissociate.

What Helps During a Flashback?

If you realize that you are in the middle of a flashback:

Tell yourself that you are having a flashback and remind yourself that the actual event is over and you survived.

Breathe. Take slow, deep breaths by putting your hand on your stomach and taking deep enough breaths that your hand moves out with the inhalations and in with the exhalations. This is important because when we panic our body begins to take short, shallow breaths and the decrease in oxygen that accompanies this change increases our panicked state. So increasing the oxygen in our system can help us to get out of the anxious state we are in.

Return to the present. Take time to use your five senses to establish where you are in the present. Look around you and take note of the colors in the room. Listen to the sounds that are happening around you. Smell the smells that are in the room with you. Feel the clothes on your skin and take note of how different parts of your body feel (hands, feet, etc.).

Recognize what would make you feel more safe. Wrap yourself in a blanket, shut yourself in a room, whatever it takes to feel as if you are secure.


Get the support of people you can trust. If you can, ask someone for help and support in this time of vulnerability.

Take the time to recover. Let yourself have the time to get back to feeling comfortable and in the present. This may take a while and that is ok. If you like, take a nap, some time for yourself, or whatever it is that would help you feel safe and more comfortable.


Be good to yourself. Know that you are not crazy and are not doing anything wrong- it takes time to heal.


Post-Traumatic Stress Disorder

PTSD is not a rare or unusual occurrence, in fact, many people experience PTSD as a result of a traumatic experience such as rape or sexual assault. Post-traumatic Stress Disorder (PTSD) is a normal human reaction to an extreme or abnormal situation. Each person has a different threshold for what is perceived as a traumatic event. PTSD is not a rare or unusual occurrence, in fact, many people experience PTSD as a result of a traumatic experience such as rape or sexual assault.

You may be experiencing PTSD if, following an event where you experienced or were confronted with actual or threatened injury or a threat to your physical integrity, you have:

shown symptoms of intense horror, helplessness, or fear

experienced distressing memories of the event (e.g., flashbacks, including nightmares)

regularly avoided things or triggers that remind you of the event (e.g., people, places, things, etc.)

shown significant impairment or distress due to the event


shown at least two symptoms of increased arousal (e.g., sleep difficulties, difficulty concentrating, hypervigilance, an exaggerated startle response, or irritability or outburts of anger/rage)

experienced these things for at least a month

The National Center for PTSD has extensive information on PTSD, including information on Coping with PTSD and tips on What You Can Do.

Coping with PTSD and Recommended Lifestyle Changes for PTSD Patients

Joe Ruzek, Ph.D.

Coping with PTSD

Because PTSD symptoms seldom disappear completely, it is usually a continuing challenge for survivors of trauma to cope with PTSD symptoms and the problems they cause. Survivors often learn through treatment how to cope more effectively.

Recovery from PTSD is an ongoing, daily, gradual process. It doesn't happen through sudden insight or "cure." Healing doesn't mean that a survivor will forget war experiences or have no emotional pain when remembering them. Some level of continuing reaction to memories is normal and reflects a normal body and mind. Recovery may lead to fewer reactions and reactions that are less intense. It may also lead to a greater ability to manage trauma-related emotions and to greater confidence in one's ability to cope.

When a trauma survivor takes direct action to cope with problems, he or she often gains a sense of personal power and control. Active coping means recognizing and accepting the impact of traumatic experiences and then taking concrete action to improve things.

Positive coping actions

Actions that help to reduce anxiety and lessen other distressing reactions. Positive coping actions also improve the situation in a way that does not harm the survivor further and in a way that lasts into the future. Positive coping methods include:

Learning about trauma and PTSD

It is useful for trauma survivors to learn more about PTSD and how it affects them. By learning that PTSD is common and that their problems are shared by hundreds of thousands of others, survivors recognize that they are not alone, weak, or crazy. When a survivor seeks treatment and learns to recognize and understand what upsets him or her, he or she is in a better position to cope with the symptoms of PTSD.

Talking to another person for support

When survivors are able to talk about their problems with others, something helpful often results. Of course, survivors must choose their support people carefully and clearly ask for what they need. With support from others, survivors may feel less alone, feel supported or understood, or receive concrete help with a problem situation. Often, it is best to talk to professional counselors about issues related to the traumatic experience itself; they are more likely than friends or family to understand trauma and its effects. It is also helpful to seek support from a support group. Being in a group with others who have PTSD may help reduce one's sense of isolation, rebuild trust in others, and provide an important opportunity to contribute to the recovery of other survivors of trauma.

Talking to your doctor about trauma and PTSD

Part of taking care of yourself means mobilizing the helping resources around you. Your doctor can take care of your physical health better if he or she knows about your PTSD, and doctors can often refer you to more specialized and expert help.

Practicing relaxation methods

These can include muscular relaxation exercises, breathing exercises, meditation, swimming, stretching, yoga, prayer, listening to quiet music, spending time in nature, and so on. While relaxation techniques can be helpful, they can sometimes increase distress by focusing attention on disturbing physical sensations or by reducing contact with the external environment. Be aware that while uncomfortable physical sensations may become more apparent when you are relaxed, in the long run, continuing with relaxation in a way that is tolerable (i.e., interspersed with music, walking, or other activities) helps reduce negative reactions to thoughts, feelings, and perceptions.

Increasing positive distracting activities

Positive recreational or work activities help distract a person from his or her memories and reactions. Artistic endeavors have also been a way for many trauma survivors to express their feelings in a positive, creative way. This can improve your mood, limit the harm caused by PTSD, and help you rebuild your life. It is important to emphasize that distraction alone is unlikely to facilitate recovery; active, direct coping with traumatic events and their impact is also important.

Calling a counselor for help

Sometimes PTSD symptoms worsen and ordinary efforts at coping don't seem to work. Survivors may feel fearful or depressed. At these times, it is important to reach out and telephone a counselor, who can help turn things around.

Taking prescribed medications to tackle PTSD

One tool that many with PTSD have found helpful is medication treatment. By taking medications, some survivors of trauma are able to improve their sleep, anxiety, irritability, anger, and urges to drink or use drugs.

Negative coping actions

Negative actions help to perpetuate problems. They may reduce distress immediately but short-circuit more permanent change. Some actions that may be immediately effective may also cause later problems, like smoking or drug use. These habits can become difficult to change. Negative coping methods can include isolation, use of drugs or alcohol, workaholism, violent behavior, angry intimidation of others, unhealthy eating, and different types of self-destructive behavior (e.g., attempting suicide). Before learning more effective and healthy coping methods, most people with PTSD try to cope with their distress and other reactions in ways that lead to more problems. The following are negative coping actions:

Use of alcohol or drugs

This may help wash away memories, increase social confidence, or induce sleep, but it causes more problems than it cures. Using alcohol or drugs can create a dependence on alcohol, harm one's judgment, harm one's mental abilities, cause problems in relationships with family and friends, and sometimes place a person at risk for suicide, violence, or accidents.

Social isolation

By reducing contact with the outside world, a trauma survivor may avoid many situations that cause him or her to feel afraid, irritable, or angry. However, isolation will also cause major problems. It will result in the loss of social support, friendships, and intimacy. It may breed further depression and fear. Less participation in positive activities leads to fewer opportunities for positive emotions and achievements.

Anger

Like isolation, anger can get rid of many upsetting situations by keeping people away. However, it also keeps away positive connections and help, and it can gradually drive away the important people in a person's life. It may lead to job problems, marital or relationship problems, and the loss of friendships.

Continuous avoidance

If you avoid thinking about the trauma or if you avoid seeking help, you may keep distress at bay, but this behavior also prevents you from making progress in how you cope with trauma and its consequences.

Recommended Lifestyle Changes – Taking Control

Those with PTSD need to take active steps to deal with their PTSD symptoms. Often, these steps involve making a series of thoughtful changes in one's lifestyle to reduce symptoms and improve quality of life. Positive lifestyle changes include:

Calling about treatment and joining a PTSD support group

It may be difficult to take the first step and join a PTSD treatment group. Survivors say to themselves, "What will happen there? Nobody can help me anyway." In addition, people with PTSD find it hard to meet new people and trust them enough to open up. However, it can also be a great relief to feel that you have taken positive action. You may also be able to eventually develop a friendship with another survivor.

Increasing contact with other survivors of trauma

Other survivors of trauma are probably the best source of understanding and support. By joining a survivors organization (e.g., veterans may want to join a veteran's organization) or by otherwise increasing contact with other survivors, it is possible to reverse the process of isolation and distrust of others.

Reinvesting in personal relationships with family and friends

Most survivors of trauma have some kind of a relationship with a son or daughter, a wife or partner, or an old friend or work acquaintance. If you make the effort to reestablish or increase contact with that person, it can help you reconnect with others.

Changing neighborhoods

Survivors with PTSD usually feel that the world is a very dangerous place and that it is likely that they will be harmed again. It is not a good idea for people with PTSD to live in a high-crime area because it only makes those feelings worse and confirms their beliefs. If it is possible to move to a safer neighborhood, it is likely that fewer things will set off traumatic memories. This will allow the person to reconsider his or her personal beliefs about danger.

Refraining from alcohol and drug abuse

Many trauma survivors turn to alcohol and drugs to help them cope with PTSD. Although these substances may distract a person from his or her painful feelings and, therefore, may appear to help deal with symptoms, relying on alcohol and drugs always makes things worse in the end. These substances often hinder PTSD treatment and recovery. Rather than trying to beat an addiction by yourself, it is often easier to deal with addictions by joining a treatment program where you can be around others who are working on similar issues.

Starting an exercise program

It is important to see a doctor before starting to exercise. However, if the physician gives the OK, exercise in moderation can benefit those with PTSD. Walking, jogging, swimming, weight lifting, and other forms of exercise may reduce physical tension. They may distract the person from painful memories or worries and give him or her a break from difficult emotions. Perhaps most important, exercise can improve self-esteem and create feelings of personal control.

Starting to volunteer in the community

It is important to feel as though you are contributing to your community. When you are not working, you may not feel you have anything to offer others. One way survivors can reconnect with their communities is to volunteer. You can help with youth programs, medical services, literacy programs, community sporting activities, etc.

Pregnancy

If you were recently raped, you may have concerns about becoming pregnant from the attack. If you were recently raped, you may have concerns about becoming pregnant from the attack. If the assault happened a long time ago, you may have concerns about a pregnancy that resulted from the assault.

If you were recently assaulted:

The decision of what to do is yours to make. If you need additional information in order to make a decision, consider:

·         Talking to a trusted friend or family member

·         Or visiting Medline Plus

If you were assaulted in the past:

If you were assaulted in the past and there was a resulting pregnancy, you may have some residual feelings about the pregnancy. It is important to understand that any of these (and other) feelings are normal.


Rape Trauma Syndrome

Rape Trauma Syndrome is a common reaction to a rape or sexual assault. It is the human reaction to an unnatural or extreme event. Rape Trauma Syndrome is a common reaction to a rape or sexual assault. It is the human reaction to an unnatural or extreme event.

There are three phases to Rape Trauma Syndrome
1.     Acute Phase

This phase occurs immediately after the assault and usually lasts a few days to several weeks. In this phase individuals can have many reactions but they typically fall into three categories of reactions:

1.      Expressed- This is when the survivor is openly emotional. He or she may appear agitated or hysterical, he or she may suffer from crying spells or anxiety attacks.

2.     Controlled- This is when the survivor appears to be without emotion and acts as if "nothing happened" and "everything is fine." This appearance of calm may be shock.

3.     Shocked Disbelief- This is when the survivor reacts with a strong sense of disorientation. He or she may have difficulty concentrating, making decisions, or doing everyday tasks. He or she may also have poor recall of the assault.

2.     The Outward Adjustment Phase

During this phase the individual resumes what appears to be his or her "normal" life but inside is suffering from considerable turmoil. In this phase there are five primary coping techniques:

1.      Minimization- Pretends that "everything is fine" or that "it could have been worse."

2.     Dramatization- Cannot stop talking about the assault and it is what dominates their life and identity.

3.     Suppression- Refuses to discuss, acts as if it did not happen.

4.     Explanation- Analyzes what happened- what the individual did, what the rapist was thinking/feeling.

5.     Flight- Tries to escape the pain (moving, changing jobs, changing appearance, changing relationships, etc.).

There are many symptoms or behaviors that appear during this phase including:

·         Continuing anxiety

·         Severe mood swings

·         Sense of helplessness

·         Persistent fear or phobia

·         Depression

·         Rage

·         Difficulty sleeping (nightmares, insomnia, etc.)

·         Eating difficulties (nausea, vomiting, compulsive eating, etc.)

·         Denial

·         Withdrawal from friends, family, activities

·         Hypervigilance

·         Reluctance to leave house and/or go places that remind the individual of the assault

·         Sexual problems

·         Difficulty concentrating

·         Flashbacks

All of these symptoms and behaviors may make the individual more willing to seek counseling and/or to discuss the assault.

3.    The Resolution Phase

During this phase the assault is no longer the central focus of the individual's life. While he or she may recognize that he or she will never forget the assault; the pain and negative outcomes lessen over time. Often the individual will begin to accept the rape as part of his or her life and chooses to move on.

NOTE: This model assumes that individuals will take steps forward and backwards in their healing process and that while there are phases it is not a linear progression and will be different for every person.

Suicide

If you are currently thinking about suicide, or know someone who is, please reach out for help. If someone you know is thinking about suicide

Get help!
If you are currently thinking about suicide, please reach out for help!

·         Talk to someone you trust

·         Do you have a friend or relative that you can talk to?

·         Do you have a counselor or therapist that you can call?

·         Is there someone else in your life that you can talk to (a religious leader, coach or teacher)?

·         Suicide hotline

If there’s no one in your life that you feel comfortable talking to about your suicidal thoughts, call the National Suicide Prevention Lifeline at (800) 273-TALK.

·         Your call will be confidential, and the counselors there can help!

·         Call 911 or go to the hospital


If you have already taken steps to harm yourself or feel that you can’t stop yourself from committing suicide, call 911 or go to the emergency room.

·         Tell the person on the phone or the front desk at the emergency room that you are suicidal.

If you are not thinking about committing suicide right now, but have thought about it in the past or are afraid that you might start, please get help!

·         Reach out to friends, family or someone you trust. Let them know that you are going through a rough time.

·         If you aren’t ready to talk to someone face-to-face, call the National Suicide Prevention Lifeline any time at (800) 273-TALK.

The counselors there can talk to you about ways to resolve the situation that has made you think about suicide and can connect you with resources to help you.

·         Survivors of sexual assault can also call (800) 656-HOPE or visit the Online Hotline.

·         Find a counselor or therapist who can help you figure out how to resolve your situation.

·         If you have health insurance, your insurance company can give you the number of a counselor.

·         If you are a student, the school counselor or counseling center will have counselors that you can talk to.

·         If you work, or if your spouse works, you may have access to an employee assistance program that provides counseling. Ask your human resources person.

·         If you don’t have health insurance, or none of these options works, call your local health department (you can find their phone number in the Blue Pages of your phone book). They can connect you with counselors.

·         Get rid of the means.

·         If you have been thinking about committing suicide and you have obtained the means to commit suicide, please get rid of it. If you have a gun, give it to someone you trust. If you have pills, flush them down the toilet. Do whatever it takes to keep you safe!

Remember: if you have taken steps to harm yourself or you feel that you cannot avoid hurting yourself, call 911 or go to the emergency room!