WHAT DO THE STAGES OF RECOVERY LOOK LIKE?
STAGES OF RECOVERY by Colorado State University
Stage One: Initial Shock. Shock following an assault can take on many forms. You may experience emotional as well as physical shock, which could be exhibited in controlled and withdrawn behavior, or highly expressive behavior such as crying, screaming, or shaking. You may not be comfortable expressing these feelings to others.
Stage Two: Denial. Also called pseudo-adjustment, this stage may find you attempting to go on with your normal routine, wanting to forget about the assault. This denial or rationalization of what happened is an attempt to deal with inner turmoil and return to normal life.
Stage Three: Reactivation. This stage involves a re-experiencing of the feelings from Stage One, usually brought on by the triggering of memories of the assault. Feelings of depression, anxiety, and shame may increase. Other symptoms can include nightmares, flashbacks, a sense of vulnerability, mistrust, and physical complaints.
Stage Four: Anger. You may experience feelings of anger—often toward yourself, friends, significant others, society, the legal system, all men/women, etc. With skillful support, this anger can be redirected in ways that are healing.
Stage Five: Integration (Closure). As you integrate the thoughts and feelings stemming from the assault into your life experience you will begin to feel “back on track.” As a result of the support, education, and the passing of time, you will feel strengthened.
HOW DO WE CREATE AN ENVIRONMENT THAT HELPS PREVENT SEXUAL ASSAULT?
At I Have The Right To, we strongly believe that preventing sexual assault means taking action long before an assault occurs and educating our communities about healthy relationships and consent. It’s up to all community stakeholders -- parents, teachers, administrators, coaches, students to engage one another in respectful dialogue about the culture of a community.
Currently, the United States lacks a comprehensive national sex education program -- in fact, only nine states require consent to be taught as part of their sex education programs in schools. The result? Many children and teens are misinformed -- or not educated at all -- about healthy relationships, or sexual assault, leaving the media and porn industry to fuel our society with acts of misogyny and toxic masculinity which shape our culture and the sexual climate. Implementing comprehensive sex and consent education programs within communities is one of the best ways to create a safer environment. It is critical to teach and reinforce healthy social norms, as well as sex-positive relationships.
Teaching bystander intervention to student communities is also crucial. Bystander intervention ranges from getting the help of an authority figure when a situation becomes uncomfortable to explaining why a joke about rape or domestic violence isn’t funny. Even the smallest actions matter, and speaking out against inappropriate behavior gets easier every time you do it. In order to create an environment that helps prevent sexual assault, everyone must hold each other accountable while giving people room to learn from their mistakes.
Finally, we must continue the conversation writ large. Encourage members of your community to engage in tough discussions and allow people to ask questions without fear of judgment. The discussion of sexual assault prevention should not be a one-time occurrence that feels burdensome, but instead should be a topic people want to understand.
WHAT DO PTSD SYMPTOMS LOOK LIKE?
70% of adults in the United States will experience some sort of traumatic event during their lifetimes. 20% will go on to develop PTSD. That means 44.7 million adults were, are, or will be psychologically debilitated by the original trauma they suffered. It is estimated that nearly 24.4 million adults currently suffer from PTSD, but that statistic is likely understated. Many adult cases of PTSD go unreported or undiagnosed and thousands of children develop the disorder every year. (PTSD United, 2018) PTSD is officially defined as “a condition of persistent mental and emotional stress occurring as a result of injury or severe psychological shock.” The disease can be chronic (on-going and lifelong) or acute (short term), and usually manifests itself approximately 3 months after a traumatic experience. In some cases, symptoms can begin years later if painful memories are reactivated. Cases of PTSD vary in their length, time of onset, and cause, but the symptoms are consistent and can be categorized into four different groups: re-experiencing symptoms; avoidance symptoms; arousal and reactivity symptoms; and cognition and mood symptoms. Re-experiencing symptoms are characterized by flashbacks, night terrors, and invasive, disturbing thoughts, and are often accompanied by physical reactions such as sweating, shaking, and increased heart rate. They can occur at any time during the day and are triggered by seemingly benign words, objects, or events that are reminders of the trauma. The response to a painful event is only diagnosed as PTSD if it disrupts the routine and relationships of the patient, and re-experiencing symptoms are largely responsible for such disturbances. Avoidance symptoms are often the brain’s way of trying to evade the activation of re-experiencing symptoms. They involve both physical avoidances of triggering symbols, places, and situations, and emotional avoidance of the trauma, resulting in perpetuated stages of denial, during which the patient is functional but fragile. Unlike re-experiencing symptoms, which occur in brief yet agonizing eruptions, the phenomenon of arousal and reactivity is more prolonged and constant. The symptoms become integrated into the victim’s disposition. Patients become incessantly tense, constantly in fear, and easily startled. The strain and restlessness cause irritability and vulnerability that can lead to unprovoked angry outbursts. Cognition and mood are the most internal of the four categories. The symptoms give rise to feelings of hatred towards oneself or the world, warped emotions of guilt and self-blame, and dispassion for activities, people, and experiences that once provided joy. They do not just disrupt routines and relationships, but cause patients to lose their identity in the pain from which they suffer, becoming a victim, survivor, or perpetrator, but never just a person. (NIMH, 2018) In cases of PTSD caused by a sexual assault, symptoms can be especially vivid. “The way a person thinks, walks, talks, and engages is divided into ‘before assault’ and ‘after assault,’ and they are never the same,” says Kandee Lewis, executive director of The Positive Results Corporation. “There will never be a day that that person feels like themselves, the ‘before’ self.” The “after” phase induces flashbacks and dreams that lead to intense muscle pain caused by the unconscious activation of the sympathetic nervous system. It causes hyperarousal to become common and disruptive in public settings because the human body is always trying to prepare itself to face its attacker again. It creates a person transformed by shame, anger, and mistrust. (Burgess, 2018) The average occurrence of PTSD in American women is 11.1%, making them twice as likely as men to develop the disorder. According to The US National Comorbidity Survey Report, women who have survived a sexual assault have a 50% chance of experiencing PTSD at some point during their lives. Sexual assault is the most common cause of PTSD in women, and 94% of survivors will experience symptoms in the first two weeks after an assault, even if they do not develop the disorder later on. (Chivers-Wilson, 2016) Survivors of sexual assault are in a unique position because their traumas can be constantly reactivated by the world around them. Not only must they deal with triggers specific to their assault, but they must also deal with triggers that appear in the news cycle, in Hollywood, and in the government. This can cause cases of PTSD that would have otherwise been acute to become more prolonged and even chronic.