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 You may experience emotional as well as physical shock, which could be exhibited in controlled and withdrawn behavior, or highly expressive behavior such as crying, screaming, or shaking.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.
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.
HOW CAN I REACH OUT TO OTHER PARENTS OF SURVIVORS?
Too often survivors and families are siloed and isolated in seeking justice for sexual assault. If you are a parent -- anywhere in the world -- and care about supporting your survivor, we are here for you. You are not alone.
While many institutions and perpetrators have well-worn play books to disparage survivors and deny their actions, the script needs flipping. We believe survivors’ should no longer be ostracized from their communities, but rather, supported, and perpetrators’ held accountable. We're in the process of creating a group for parents that is a safe place for us to connect and build community and culture change.
If you are interested in joining us please email firstname.lastname@example.org and we'll get in touch!