Finding and Choosing a Therapist My story and hints from the VA

When I got my C-file 20 plus years later I started having flash back dreams about the Rape and I then became very depressed and called the Suicide Hotlines: Thats were I started my MST rediscover. So now I had to get help well it was not easy first the rape center I was sent to was for Women who were sexually assault and domestic violence and they said in their info that they worked with women, men and children after 3 visits I was told that the Director said the women did not like a man in the waiting room and I would have to find someone else. I think it was more about no insurance or money. I was talking to my VA  doctor and he said to go to the VA mental health clinic in Brick NJ. My trip to Brick was hard for me first I had to get a appointment with the Mental Health Clinic which was very stressful for me as when I was in Basic Training I was sent to the Mental Health Clinic for a break down from being sick and my rape. I made it to Mental Health and thanks to a great staff I felt welcome and my therapist and
psychiatrist were straight with me that they were not the best people to deal with Military Sexual Trauma which is a event not a disorder and that every VA medical center has a Military Sexual Trauma Coordinator to oversee the screening and treatment referral process so my psychiatrist placed a call to the VA medical center in East Orange NJ who then had her call the VA medical center at Lions NJ  and after 20 minutes with no help she said she would call the VA medical center in Bay Pines Fla and let me know at my next visit she started me on meds for PTSD; and other anxiety disorders; Depression and other mood disorders. When I went back to her she gave me the telephone number at Bay Pines and said good luck! as she was still waiting for a answer I called that day and a very nice social worker gave me the number for the MST Coordinator at Lions and East Orange who referred me to the Vet Center in Bloomfield NJ which is about a hour and a half from my home. I started to go to a therapist but do to many factors it was not working for me. The Vet Center opened a new center in Lakewood NJ which is about 15 minutes from my home and I started with a new therapist there in Oct 2010 I have made great progress with this therapist and now also have group therapy for male survivors. Sorry I tend to be long winded what I was trying to say is you have to find who is right for you. Here is some info from the VA website Finding and Choosing a Therapist  

Listed below are resources to help you choose and locate a therapist who is right for you. A professional who works well with one person may not be a good choice for another person. A special section for Veterans is included.

Finding a therapist

There are many ways to find a therapist. You can start by asking friends and family if they can recommend anyone. Make sure the therapist has skills in treating trauma survivors.

Another way to locate a therapist is to make some phone calls. When you call, say that you are trying to find a provider who specializes in effective treatment for PTSD, such as cognitive behavioral therapy (CBT).

• Contact your local mental health agency or family doctor.
• Call your state psychological association
• Call the psychology department at a local college
• Call the National Center for Victims of Crime's toll-free information and referral service at begin_of_the_skype_highlighting              1-800-FYI-CALL      end_of_the_skype_highlighting. This service uses agencies from across the country that support crime victims.1-800-FYI-CALL
• If you work for a large company, call the human resources office to see if they make referrals.
• If you are a member of a Health Maintenance Organization (HMO), call to find out about mental health services.

Some mental health services are listed in the phone book. In the blue Government pages, look in the "County Government Offices" section. In that section, look for "Health Services (Dept. of)" or "Department of Health Services." Then in that section, look under "Mental Health."

In the yellow pages, therapists are listed under "counseling," "psychologists," "social workers," "psychotherapists," "social and human services," or "mental health."

Information can also be found using the Internet. You may find a list of therapists in your area. Some lists include the therapists' areas of practice. Listed below are some suggested websites:

• Center for Mental Health Services Locator. This services locator is on the Substance Abuse and Mental Health Services Administration (SAMHSA) website. The site also provides a Frequently Asked Questions about mental health.
• Anxiety Disorders Association of America* offers a referral network. begin_of_the_skype_highlighting              (240) 485-1001      end_of_the_skype_highlighting.(240) 485-1001
• ABCT Find a Therapist Service*. The Association for Advancement of Behavioral and Cognitive Therapies (ABCT, formerly AABT) maintains a database of therapists.
• Sidran* offers a referral list of therapists, as well as a fact sheet on how to choose a therapist for PTSD and dissociative disorders. begin_of_the_skype_highlighting              (410) 825-8888      end_of_the_skype_highlighting. (410) 825-8888

Your health insurance may pay for mental health services. Also, some services are available at low cost according to your ability to pay.

Help for Veterans

VA Medical Centers and Vet Centers provide Veterans with mental health services. These services may cost little or nothing, according to a Veteran's benefits and ability to pay. Following discharge after deployment to a combat zone, you should enroll for VA services. You are then qualified for care for conditions that may be related to your service.

VA PTSD Program Locator: Use this online tool to find a PTSD Treatment program or VA PTSD treatment specialist at a VA facility near you. You can also go online to read more about services at Vet Centers.

Other resources include:

• The VA Health Benefits Service Center toll free at begin_of_the_skype_highlighting              1-877-222-VETS      end_of_the_skype_highlighting1-877-222-VETS
• The Vet Centers' national number begin_of_the_skype_highlighting              1-800-905-4675      end_of_the_skype_highlighting1-800-905-4675
• VA Mental Health for Returning Veterans
• VA Returning Service Members (OEF/OIF) Page
• My HealtheVet

VA Medical Centers and Vet Centers are listed in the phone book. In the blue Government pages, look under "United States Government Offices." Then look for "Veterans Affairs, Dept of." In that section, look under "Medical Care" and "Vet Centers - Counseling and Guidance."

Finding a support group

The National Center for PTSD does not provide PTSD support groups. Many local VA Medical Centers have various types of groups. Listed below is information on how to find support groups online or in your area.

• Anxiety Disorders Association of America* offers a self-help group network.
• National Alliance for Mental Illness* (NAMI) has a website with information for those with mental illness. You may also find family support groups in different states.
• About.com's PTSD Forum* An online discussion forum.

Choosing a therapist

There are a many things to consider in choosing a therapist. Some practical issues are location, cost, and what insurance the therapist accepts. Other issues include the therapist's background, training, and the way he or she works with people.

Some people meet with a few therapists before deciding which one to work with. Most, however, try to see someone known in their area. Then they go with that person unless a problem occurs. Either way, here is a list of questions you may want to ask a possible therapist.

• What is your education? Are you licensed? How many years have you been practicing?
• What are your special areas of practice?
• Have you ever worked with people who have been through trauma? Do you have any special training in PTSD treatment?
• What kinds of PTSD treatments do you use? Have they been proven effective for dealing with my kind of problem or issue?
• What are your fees? (Fees are usually based on a 45-minute to 50-minute session.) Do you have any discounted fees? How much therapy would you recommend?
• What types of insurance do you accept? Do you file insurance claims? Do you contract with any managed care organizations? Do you accept Medicare or Medicaid insurance?

Who is available to provide therapy?

There are many types of professionals who can provide therapy for trauma issues. Below we describe some of the most common of these professionals.

Clinical Psychologists

Psychologists are trained in the area of human behavior. Clinical psychologists focus on mental health assessment and treatment. Psychologists use scientifically proven methods to help people change their thoughts, feelings, and behaviors.

Licensed Psychologists have doctoral degrees (PhD, PsyD, EdD). Their graduate training is in clinical, counseling, or school psychology. In addition to their graduate study, licensed psychologists must have another 1 to 2 years of supervised clinical experience. A license is granted after passing an exam given by the American Board of Professional Psychology. Psychologists have the title of "doctor," but they cannot prescribe medicine.

Clinical Social Workers

The purpose of social work is to enhance human well-being. Social workers help meet the basic human needs of all people. They help people manage the forces around them that contribute to problems in living.

Certified social workers have a master's degree or doctoral degree in social work (MSW, DSW, or PhD). To be licensed, clinical social workers must pass an exam given by the Academy of Certified Social Workers (ACSW).

Master's Level Clinicians

Master's Level Clinicians have a master's degree in counseling, psychology, or marriage and family therapy (MA, MFT). They have at least 2 years of training beyond the 4-year college degree. To be licensed, master's level clinicians must meet requirements that vary by state.

Psychiatrists

Psychiatrists have a Doctor of Medicine degree (MD). After they complete 4 years of medical school, they must have 3 to 4 years of residency training. Board certified psychiatrists have also passed written and oral exams given by the American Board of Psychiatry and Neurology. Since they are medical doctors, psychiatrists can prescribe medicine. Some also provide psychotherapy.

Till next time remember what Winston Churchill said

"IF YOU'RE GOING THROUGH HELL, KEEP GOING"

VISIT OUR WEBSITE 

www.mendmst.org

July 12, 2010 New Regulations on PTSD Claims

1
July 12, 2010
New Regulations on PTSD Claims
Quick Facts: This new rule is for Veterans of any era.
The new rule will apply to claims:
o received by VA on or after July 13, 2010;
o received before July 13, 2010 but not yet decided by a VA regional office;
o appealed to the Board of Veterans' Appeals on or after July 13, 2010;
o appealed to the Board before July 13, 2010, but not yet decided by the Board; and
o pending before VA on or after July 13, 2010, because the Court of Appeals for Veterans Claims vacated a Board decision and remanded for re-adjudication.
QUESTIONS AND ANSWERS
“Stressor Determinations for Posttraumatic Stress Disorder”
1. What is Post-Traumatic Stress Disorder (PTSD)?
Post Traumatic Stress Disorder (PTSD) is a condition resulting from exposure to direct or indirect threat of death, serious injury or a physical threat. The events that can cause PTSD are called "stressors” and may include natural disasters, accidents or deliberate man-made events/disasters, including war. Symptoms of PTSD can include recurrent thoughts of a traumatic event, reduced involvement in work or outside interests, emotional numbing, hyper-alertness, anxiety and irritability. The disorder can be more severe and longer lasting when the stress is human initiated action (example: war, rape, terrorism).
2. What does this final regulation do?
This final regulation liberalizes the evidentiary standard for Veterans claiming service connection for post traumatic stress disorder (PTSD). Under current regulations governing PTSD claims, unless the Veteran is a combat Veteran, VA adjudicators are typically required to undertake extensive record development to corroborate whether a Veteran actually experienced the claimed in-service stressor. This final rulemaking will simplify and improve the PTSD claims adjudication process by eliminating this time-consuming requirement where the claimed stressor is related to “fear of hostile military or terrorist activity,” is consistent with the places, types, and circumstances of their service, and a VA psychiatrist or psychologist, or contract psychiatrist or psychologist confirms that the claimed stressor is adequate to support a diagnosis of PTSD.
3. What types of claims for VA benefits does the final regulation affect?
The final regulation will benefit Veterans, regardless of their period of service. It applies to claims for PTSD service connection filed on or after the final regulation’s effective date, and to those claims that are considered on the merits at a VA Regional Office or the Board of Veterans’ Appeals on or after the effective date of the rule.
4. Why is this final regulation necessary?
The final regulation is necessary to make VA’s adjudication of PTSD claims both more timely and consistent with the current medical science.
5. How does this final regulation help Veterans?
The final regulation will simplify and streamline the processing of PTSD claims, which will result in Veterans receiving more timely decisions. A Veteran will be able to establish the occurrence of an in-service stressor through his or her own testimony, provided that: (1) the Veteran is diagnosed with PTSD; (2) a VA psychiatrist or psychologist, or a psychiatrist or psychologist with whom VA has contracted confirms that the claimed stressor is adequate to support a PTSD diagnosis; (3) the Veteran's symptoms are related to the claimed stressor; and (4) the claimed stressor is consistent with the places, types, and circumstances of the Veteran’s service and the record provides no clear and convincing evidence to the contrary. This will eliminate the requirement for VA to search for records, to verify stressor accounts, which is often a very involved and protracted process. As a result, the time required to adjudicate a PTSD compensation claim in accordance with the law will be significantly reduced.
6. How does VA plan to monitor the need for examiners in various regions of the country, and how does VA plan to respond if is determined that more examiners are needed in a particular region?
The Veterans Health Administration (VHA) has written in to the FY11-13 Operating Plan the need for additional staff to support doing adequate, timely exams. VHA proposes: “A8. Increase mental health field staff to address the increase in C&P examinations and develop monitoring system to ensure clinical delivery of mental health services does not decrease in VHA.“ Specifically, VHA has requested 125 clinicians for FY11 with additional 63 staff in FY12 if the need exists. If the Operating Plan and the proposed budget are approved, VA proposes asking the Veterans Integrated Service Networks (VISNs) to develop plans for distributing the funds in order to ensure adequate coverage at sites based on number of claims being processed; the VISNs are well positioned to determine these regional needs.
7. How does the regulatory revision affect PTSD service connection claims where an in-service diagnosis of PTSD has been rendered?
The new regulation does not apply to the adjudication of cases where PTSD has been initially diagnosed in service. Rather, under another VA rule, 38 CFR § 3.304(f)(1), if a Veteran is diagnosed with posttraumatic stress disorder during service and the claimed stressor is related to that service, in the absence of clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the Veteran's service, the Veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor.
8. Is the new regulation applicable only if the Veteran's statements relate to combat or POW service?
No. The rule states that the stressor must be related to a “fear of hostile military or terrorist activity,” and the claimed stressor must be “consistent with the places, types, and circumstances of the veteran’s service.”
9. What circumstances will still require stressor verification through DoD’s Joint Services Records Research Center (JSRRC) , VBA’s Compensation &Pension Service (C&P Service), or other entity if a Veteran claims that his or her stressor is related to a fear of hostile or terrorist activity?
The regulatory revision will greatly lessen the need for undertaking development to verify Veterans’ accounts of in-service stressors. Now, stressor development may only need to be conducted if a review of the available record, such as the Veteran’s service personnel and/or treatment records, is inadequate to determine that the claimed stressor is “consistent with the places, types and circumstances of the veteran’s service.” In such circumstances, the Veterans Service Representative (VSR) will determine on a case-by-case basis what development should be undertaken.
However, it is anticipated that in the overwhelming majority of cases adjudicated under the new version of § 3.304(f), a simple review of the Veteran’s service treatment and/or personnel records will be sufficient to determine if the claimed stressor is consistent with the places, types, and circumstances of the Veteran’s service. We also believe that, in some cases, a Veteran’s separation document, DD-Form 214, alone may enable an adjudicator to make such a determination.
10. As the regulatory revision seems to require an enhanced role for the examining VA mental health professional, whose role is it to determine whether the claimed stressor is consistent with the Veteran’s service?
VA adjudicators, not the examining psychiatrist or psychologist, will decide whether the claimed stressor is consistent with the Veteran’s service.
11. Is a Veteran's testimony about “fear of hostile military or terrorist activity” alone sufficient to establish a stressor?
Yes, if the other requirements of the regulation are satisfied, i.e., a VA psychiatrist or psychologist confirms that the claimed stressor is adequate to support a PTSD diagnosis and that the Veteran's symptoms are related to the claimed stressor, and the stressor is consistent with the “places, types, and circumstances of the Veteran’s service.”
12. Are the stressors accepted as adequate for establishing service connection under new § 3.304(f)(3) limited to those specifically identified in the new regulation?
No. The examples given in the revised regulation do not represent an exclusive list in view of the use of the modifying phrase “such as” that precedes the listed examples. Any event or circumstance that involves actual or threatened death or serious injury, or a threat to the physical integrity of the Veteran or others, would qualify as a stressor under new § 3.304(f)(3).
13. How will the Veterans Health Administration (VHA) work with Veterans Benefits Administration (VBA) on the new regulation?
VHA was actively involved in discussion with VBA of the new regulation and fully supports the new regulation. The new regulation will provide fair evaluation for Veterans whose military records have been damaged or destroyed, or for whom no definitive reports of combat action appeared in their military records, even though they can report such actions and it is reasonable to believe that these occurred, given the time and place of service. This will be especially beneficial to women Veterans, whose records do not specify that they had combat assignments, even though their roles in the military placed them at risk of hostile military or terrorist activity. This means that more Veterans will become eligible for VA care and thus be able to receive VA care for mental illness related to their military service, as well as receiving full holistic health care.VHA will work actively with VBA on implementing the regulation. VHA staff’s main role is as clinicians conducting C&P interviews to establish diagnoses and obtain other information to be used by VBA raters to determine the outcome of claims. The new regulation will not change the diagnostic elements of the C&P interview, but may change what additional data are collected for use by VBA raters.http://www.va.gov/PTSD_QA.pdf

Myths about male rape and Military Sexual Trauma

There are numerous frequently accepted myths about male rape and in all probability more so than there are about female rape. These myths have the effect of minimizing the gravity of the crime, and the accountability of the perpetrator.

These myths about male rape also have an effect on the way men think about themselves when they have been assaulted, and, sadly, the way those men are treated by many other individuals.

Understanding the facts about male rape can give the male rape victim the strength to counteract their fears and, we hope, will enable more men to ask for the information and counseling support that they so rightly ought to have. Knowing what are the myths and facts about male rape, may also help others understand how to respond to those male rape victims.

Here are a few of the facts about, and some of the most frequent myths about male rape and men who are raped.

Read them all at the link.

More

The National Centre for Victims of Crime has this report on “Male Rape” that gives these shocking statistics:

• About 3% of American men – a total of 2.78 million men – have experienced a rape at some point in their lifetime (Tjaden & Thoennes, 2006).
• In 2003, one in every ten rape victims was male. While there are no reliable annual surveys of sexual assaults on children, the Justice Department has estimated that one of six victims are under age 12 (National Crime Victimization Study, 2003).
• 71% of male victims were first raped before their 18th birthday; 16.6% were 18-24 years old, and 12.3% were 25 or older (Tjaden & Thoennes, 2006).
• Males are the least likely to report a sexual assault, though it is estimated that they make up 10% of all victims (RAINN, 2006).
• 22% of male inmates have been raped at least once during their incarceration; roughly 420,000 prisoners each year (Human Rights Watch, 2001).

The report elaborates:

Nicholas Groth, a clinical psychologist and author of Men Who Rape: The Psychology of the Offender, says all sexual assault is an act of aggression, regardless of the gender or age of the victim or the assailant. Neither sexual desire nor sexual deprivation is the primary motivating force behind sexual assault. It is not about sexual gratification, but rather a sexual aggressor using somebody else as a means of expressing their own power and control.

Much has been written about the psychological trauma associated with the rape of female victims. While less research has been conducted about male rape victims, case research suggests that males also commonly experience many of the reactions that females experience. These reactions include: depression, anger, guilt, self-blame, sexual dysfunctions, flashbacks, and suicidal feelings (Isley, 1991). Other problems facing males include an increased sense of vulnerability, damaged self-image and emotional distancing (Mezey & King, 1989). Male rape victims not only have to confront unsympathetic attitudes if they choose to press charges, they also often hear unsupportive statements from their friends, family and acquaintances (Brochman, 1991). People will tend to fault the male victim instead of the rapist. Stephen Donaldson, president of Stop Prisoner Rape (a national education and advocacy group), says that the suppression of knowledge of male rape is so powerful and pervasive that criminals such as burglars and robbers sometimes rape their male victims as a sideline solely to prevent them from going to the police.

There are many reasons that male victims do not come forward and report being raped, but perhaps the biggest reason for many males is the fear of being perceived as homosexual. However, male sexual assault has nothing to do with the sexual orientation of the attacker or the victim, just as a sexual assault does not make the victim survivor gay, bisexual or heterosexual. It is a violent crime that affects heterosexual men as much as gay men. The phrase “homosexual rape,” for instance, which is often used by uninformed persons to designate male-male rape, camouflages the fact that the majority of the rapists are not generally homosexual (Donaldson, 1990).

 More

Male Rape

Facts about Men and Rape

• Men get raped by other men and even women
• Rapists who rape men are heterosexual in 98% of the cases
• Both homosexual and heterosexual men get raped
• In all parts of society (not just in prisons)
• Men are less likely to report rape

Most of us grow up thinking that rape happens only to women.
If male rape survivors think so too, they may feel isolated and alone.
If people in our community believe that, they may further this sense of isolation on the part of male rape survivors.
Men usually share many of the same feelings of female sexual assault survivors. They may feel:

• guilty
• powerless
• concern regarding their safety
• denial
• shock
• anger

There are, however, special issues that may be different for men:

• concerns about sexuality and/or masculinity
• medical procedures
• reporting to law enforcement
• telling others
• finding resources and support

Strong or weak, outgoing or withdrawn, homosexual or heterosexual, old or young, male or female; no one does anything that justifies sexual assault.

Myths about Men and Rape

No matter what was said or done or worn, no one "asks for" or deserves to be assaulted. Sexual assault has nothing to do with someone's present or future sexual orientation. Sexual assault is a crime of violence and power, not of lust or passion.
Unfortunately, many doctors, nurses, and law enforcement officers do not realize that men as well as women may be sexually assaulted. This may affect the way they treat men who have been raped. Sometimes a stereotyped view of masculinity, rather than the physical assault of the crime becomes the focus of the medical exam or law enforcement investigation.
Two myths about homosexuality may also affect the way men are treated. Many people wrongly believe that only gay men get raped. Many people also believe that assaults against men are committed only by gay men. Both of these are myths, not facts, but they may affect the way male rape survivors are treated, and/or how male survivors feel about the assault and themselves afterwards.

What Can We Do

• Recognize that men and boys can and will be sexually assaulted.
• Be aware of the biases and myths concerning sexual assault.
• Recognize that the harmful sex-role stereotypes which create narrow definitions of masculinity, as well as lies about homosexuality, make it difficult for male survivors to disclose about being raped.
• As individuals and as a community we must work to combat and challenge these attitudes.
• It is important that male rape survivors have support around them and that they be able to make their own decisions about what course of action to take.

 MALE RESPONSIBILITY FOR RAPE AND RAPE AWARENESS
Unfortunately, most men do not recognize that there is a problem here, and fewer still acknowledge responsibility for any part of it. As a result, rape is seen, if at all, as a "women's issue." The impression remains that men are in no way connected to sexual assault, neither in its occurrence, nor through its effects, nor by its causes.

ONE IN THREE WOMEN AND ONE IN SEVEN MEN... WHAT DOES THIS MEAN

It is important that men learn to see how this cultural reality by itself has great impact on our lives. Men are connected to this world in which women and men are assaulted and men are connected to the women who are forced to adjust their behavior accordingly. These connections--through the effects of sexual violence against women--should not be for men a "women's issue." As women are affected whether or not they are actually raped, men's lives are greatly changed whether or not they are actually assailants.

WHERE DO ALL THESE RAPISTS COME FROM?

Men rape. This Is Fact One, and no discussion of sexual assault should distract us from this reality. Historically, men have always denied and evaded Fact One. This is Fact Two, and no discussion of the causes of sexual assault should deflect us from this responsibility.
Recognition of reality and acknowledgment of responsibility can come with great difficulty to most men. Evasions, denials, and defensiveness, however, miss the point and simply will no longer suffice.

SEXUAL OBJECTS MAKE SEXUAL TARGETS

The story of sexual assault in our culture is not just about rape. Rapist are not born, they are made. And remade. And the culture which makes "them" also makes "us."
The question of why some men rape is thus connected to the question of why sexual violence is tolerated. This connection exists at a double intersection: between attitudes and actions, between violence and notions of masculinity. Men are all connected to these intersections because this is where they have grown up as men.
Men have the power collectively to end rape.
Unfortunately, so far, this male collective appears to be composed mainly of men who rape, men who hold attitudes similar to rapists, and men who undoubtedly do care in their own personal lives, yet remain quiet in the community where rape occurs.
The raising of the question is far more important than its phrasing. Consider....,
HOW WOULD OUR LIVES BE DIFFERENT IF THERE WAS NO SEXUAL VIOLENCE?

HOW MEN CAN HELP PREVENT RAPE:

• examine your own attitudes about women and men that may reflect misconceptions about rape
• assertively interrupt jokes, comments or actions that lead to attitudes or situations that can cause rape
• assist women with precautions that decrease their chances of becoming victims
• support women's actions to take charge of their own lives; to be confident and strong
• listen to women's feelings about being victimized

ACTIONS MEN CAN TAKE:

• If a woman says "no" to your sexual advances, respect that "no" at face value. Do not accept the myth that "no" means "yes."
• In a dating or intimate relationship communicate clearly how you feel and what you want. Do not assume your date or partner feels the same way. Respect the other person's feelings and needs.
• Be aware of situations that increase a woman's vulnerability. How would you respond if you witnessed an intoxicated woman at a party being escorted by two or three men to a bedroom.
• Confront men who are harassing women on the street or at a party. Point out sexist comments and behavior with your friends and coworkers.
• Tell men that you do not think rape jokes are funny.

If you feel uncomfortable confronting other men on sexist issues, then get in touch with other men who share your views. Build your confidence in how you feel and learn how you can make an impact by being an example.

Whether or not WE as individuals are violent, WE support and encourage THE MEN who rape both by the actions that support a sexist society and the inaction that condones the violence. If WE work together to educate ourselves and THE MEN around us about the devastating effects of rape and sexual assault and how WE can eliminate the violence and sexist attitudes that precipitate rape WE can make it end.

LEARN TO RECOGNIZE EMOTIONS IN YOURSELF AND OTHERS

Violence generally does not erupt from nowhere. There are clues when anger is becoming unmanageable. The ways people handle their anger are divided into two general categories:

Stuffers:

Those who stuff anger down inside themselves and deny its presence, suffer feelings of low self esteem, and self doubt, intellectualize their situations. They become progressively withdrawn, depressed, tense, until it becomes too much and they explode in violence.

Escalators:

Escalators are easier to identify. They begin their sentences with "you." They blame and call names. Eventually their anger escalates into a blow-up and violence.

Identifying these signs early allows more options for change.

IMMEDIATE ALTERNATIVES TO VIOLENT BEHAVIOR

If you are feeling out of control with your anger and think you may hurt someone or yourself, you can do something immediately to squash the impulse and leave yourself better able to deal with problems:

• call someone
• meditate or do breathing exercises to relax
• take a cold shower, or relax in a hot bath
• work on a hobby
• go into another room and scream
• complete or begin projects around the house or yard
• take a "time out" and leave the scene completely for a designated time
• hit a pillow
• take a walk
• exercise

LIFESTYLE CHANGES TO MODIFY VIOLENT BEHAVIOR

• develop a daily decompression time from work to home
• establish regular family fun time
• develop a positive self-confidence so that you can be assertive rather than aggressive in communicating
• reduce the number of factors which reinforce violence in your life
• identify activities which produce a lot of stress in your life and work on eliminating or modifying those activities
• examine the addictions in your life which may increase the chance for violence
• develop good health habits: eating, sleeping well and daily exercise can make a difference
• develop fun time for yourself
• identify groups which may provide you with support in dealing with particular problems
• take self-help classes in communication, parent education, etc..
• think of long term changes you wish to make to decrease the stress in your life

Overview
Society is becoming increasingly aware of male rape. However, experts believe that current male rape statistics vastly under-represent the actual number of males age 12 and over who are raped each year. Rape crisis counselors estimate that while only one in 50 raped women report the crime to the police, the rates of under-reporting among men are even higher (Brochman, 1991). Until the mid-1980s, most literature discussed this violent crime in the context of women only. The lack of tracking of sexual crimes against men and the lack of research about the effects of male rape are indicative of the attitude held by society at large -- that while male rape occurs, it is not an acceptable topic for discussion.

Historically, the rape of males was more widely recognized in ancient times. Several of the legends in Greek mythology involved abductions and sexual assaults of males by other males or gods. The rape of a defeated male enemy was considered the special right of the victorious soldier in some societies and was a signal of the totality of the defeat. There was a widespread belief that a male who was sexually penetrated, even if it was by forced sexual assault, thus "lost his manhood," and could no longer be a warrior or ruler. Gang rape of a male was considered an ultimate form of punishment and, as such, was known to the Romans as punishment for adultery and the Persians and Iranians as punishment for violation of the sanctity of the harem (Donaldson, 1990).

A. Nicholas Groth, a clinical psychologist and author of Men Who Rape: The Psychology of the Offender, says all sexual assault is an act of aggression, regardless of the gender or age of the victim or the assailant. Neither sexual desire nor sexual deprivation is the primary motivating force behind sexual assault. It is not about sexual gratification, but rather a sexual aggressor using somebody else as a means of expressing their own power and control.
Much has been written about the psychological trauma associated with the rape of female victims. While less research has been conducted about male rape victims, case research suggests that males also commonly experience many of the reactions that females experience. These reactions include: depression, anger, guilt, self-blame, sexual dysfunctions, flashbacks, and suicidal feelings (Isley, 1991). Other problems facing males include an increased sense of vulnerability, damaged self-image and emotional distancing (Mezey & King, 1989). Male rape victims not only have to confront unsympathetic attitudes if they choose to press charges, they also often hear unsupportive statements from their friends, family and acquaintances (Brochman, 1991). People will tend to fault the male victim instead of the rapist. Stephen Donaldson, president of Stop Prisoner Rape (a national education and advocacy group), says that the suppression of knowledge of male rape is so powerful and pervasive that criminals such as burglars and robbers sometimes rape their male victims as a sideline solely to prevent them from going to the police.

There are many reasons that male victims do not come forward and report being raped, but perhaps the biggest reason for many males is the fear of being perceived as homosexual. However, male sexual assault has nothing to do with the sexual orientation of the attacker or the victim, just as a sexual assault does not make the victim survivor gay, bisexual or heterosexual. It is a violent crime that affects heterosexual men as much as gay men. The phrase "homosexual rape," for instance, which is often used by uninformed persons to designate male-male rape, camouflages the fact that the majority of the rapists are not generally homosexual (Donaldson, 1990).

In a well-known study of offenders and victims conducted by Nicholas Groth and Ann Burgess, one-half of the offender population described their consenting sexual encounters to be with women only, while 38 percent had consenting sexual encounters with men and women. Additionally, one-half of the victim population was strictly heterosexual. Among the offenders studied, the gender of the victim did not appear to be of specific significance to half of the offenders. Instead, they appeared to be relatively indiscriminate with regard to their choice of a victim -- that is, their victims included both males and females, as well as both adults and children (Groth & Burgess, 1980). The choice of a victim seemed to be more a matter of accessibility than of sexual orientation, gender or age.

Many people believe that the majority of male rape occurs in prison; however, there is existing research which shatters this myth. A study of incarcerated and non-incarcerated male rape victims in Tennessee concluded that the similarities between these two groups would suggest that the sexual assault of men may not be due to conditions unique to a prison and that all men are potential victims (Lipscomb et al., 1992).

Research indicates that the most common sites for male rape involving post-puberty victims are outdoors in remote areas and in automobiles (the latter usually involving hitchhikers). Boys in their early and mid-teens are more likely to be victimized than older males (studies indicate a median victim age of 17). The form of assault usually involves penetration of the victim anally and/or orally, rather than stimulation of the victim's penis. Gang rape is more common in cases involving male victims than those involving female victims. Also, multiple sexual acts are more likely to be demanded, weapons are more likely to be displayed and used, and physical injury is more likely to occur, with the injuries that do occur being more serious than with injured female rape victims (Porter, 1986).
Definition
Sexual assault and rape include any unwanted sexual acts. The assailant can be a stranger, an acquaintance, a family member, or someone the victim knows well and trusts. Rape and sexual assault are crimes of violence and are used to exert power and control over another person. The legal definitions of rape and sexual assault can vary from state to state (National Center for Victims of Crime, INFO LINK, No. 70. However, usually a sexual assault occurs when a someone touches any part of another person's body in a sexual way, even through their clothes, without that person's consent. Rape of males is any kind of sexual assault that involves forced penetration of the anus or mouth by a penis, finger or any other object. Both rape and sexual assault includes situations when the victim cannot say "no" because he is disabled, unconscious, drunk or high.

In some states, the word "rape" is used only to define a forced act of vaginal sexual intercourse, and an act of forced anal intercourse is termed "sodomy." In some states, the crime of sodomy also includes any oral sexual act. There are some states that now use gender-neutral terms to define acts of forced anal, vaginal or oral intercourse. Also, some states no longer use the terms "rape" and "sodomy," rather all sex crimes are described as sexual assaults or criminal sexual conduct of various degrees depending on the use and amount of force or coercion on the part of the assailant (National Center for Victims of Crime, INFO LINK, No. 70).
Victims' Response
It is not uncommon for a male rape victim to blame himself for the rape, believing that he in some way gave permission to the rapist (Brochman, 1991). Male rape victims suffer a similar fear that female rape victims face -- that people will believe the myth that they may have enjoyed being raped. Some men may believe they were not raped or that they gave consent because they became sexually aroused, had an erection, or ejaculated during the sexual assault. These are normal, involuntary physiological reactions. It does not mean that the victim wanted to be raped or sexually assaulted, or that the survivor enjoyed the traumatic experience. Sexual arousal does not necessarily mean there was consent.

According to Groth, some assailants may try to get their victim to ejaculate because for the rapist, it symbolizes their complete sexual control over their victim's body. Since ejaculation is not always within conscious control but rather an involuntary physiological reaction, rapists frequently succeed at getting their male victims to ejaculate. As Groth and Burgess have found in their research, this aspect of the attack is extremely stressful and confusing to the victim. In misidentifying ejaculation with orgasm, the victim may be bewildered by his physiological response during the sexual assault and, therefore, may be discouraged from reporting the assault for fear his sexuality may become suspect (Groth & Burgess, 1980).

Another major concern facing male rape victims is society's belief that men should be able to protect themselves and, therefore, it is somehow their fault that they were raped. The experience of a rape may affect gay and heterosexual men differently. Most rape counselors point out that gay men have difficulties in their sexual and emotional relationships with other men and think that the assault occurred because they are gay, whereas straight men often begin to question their sexual identity and are more disturbed by the sexual aspect of the assault than the violence involved (Brochman, 1991).
Male Rape as an Act of Anti-Gay Violence
Unfortunately, incidents of anti-gay violence also include forcible rape, either oral or anal. Attackers frequently use verbal harassment and name-calling during such a sexual assault. Given the context of coercion, however, such technically homosexual acts seem to imply no homosexuality on the part of the offenders. The victim serves, both physically and symbolically, as a "vehicle for the sexual status needs of the offenders in the course of recreational violence" (Harry, 1992, p.115).

If You Are a Victim
Rape and sexual assault include any unwanted sexual acts. Even if you agree to have sex with someone, you have the right to say "no" at any time, and to say "no" to any sexual acts. If you are sexually assaulted or raped, it is never your fault -- you are not responsible for the actions of others.

Richie J. McMullen, author of Male Rape: Breaking the Silence on the Last Taboo, encourages seeking immediate medical attention whether or not the incident is reported to police. Even if you do not seem injured, it is important to get medical attention. Sometimes injuries that seem minor at first can get worse. Survivors can sometimes contract a sexually transmitted disease during the sexual assault, but not suffer immediate symptoms. Even if the symptoms of that disease take weeks or months to appear, it might be easily treated with an early diagnosis. (If you are concerned about HIV exposure, it is important to talk to a counselor about the possibility of exposure and the need for testing. For more information about HIV transmission and testing, contact the Centers for Disease Control National HIV/AIDS Hotline. Check the contact list at the end of this bulletin for the phone number and address information.)

Medical considerations making immediate medical attention imperative include:

• Rectal and anal tearing and abrasions which may require attention and put the you at risk for bacterial infections;
• Potential HIV exposure; and
• Exposure to other sexually transmitted diseases.

If you plan to report the rape to the police, an immediate medical examination is necessary to collect potential evidence for the investigation and prosecution.

Some of the physical reactions a survivor may experience in response to the trauma of a sexual assault or rape include:

• Loss of appetite;
• Nausea and/or stomachaches;
• Headaches;
• Loss of memory and/or concentration; and/or
• Changes in sleep patterns.

Some of the psychological and emotional reactions a sexual assault survivor may experience include:

• Denial and/or guilt;
• Shame or humiliation;
• Fear and a feeling of loss of control;
• Loss of self-respect;
• Flashbacks to the attack;
• Anger and anxiety;
• Retaliation fantasies (sometimes shocking the survivor with their graphic violence);
• Nervous or compulsive behavior;
• Depression and mood swings;
• Withdrawal from relationships; and
• Changes in sexual activity.

Survivors of rape, and often of attempted rape, usually manifest some elements of what has come to be called Rape-Related Posttraumatic Stress Disorder (RR-PTSD), a form of Posttraumatic Stress Disorder (PTSD). Apart from a small number of therapists and counselors specializing in sexual assault cases, few psychotherapists are familiar with the symptoms and treatment of RR-PTSD. For this reason, a rape survivor is usually well-advised to consult with a rape crisis center or someone knowledgeable in this area rather than relying on general counseling resources. The same applies to those close to a rape victim, such as a partner, spouse or parent; these persons become secondary victims of the sexual assault and have special issues and concerns that they may need assistance in dealing with effectively.

Local rape crisis centers offer male sexual assault victims direct services or referrals for services, including: counseling, crisis services and support services. Victims may contact their local rape crisis center, no matter how long it has been since the rape occurred. Counselors on staff can either provide support, or help direct the victim to trained professionals who can provide support. Most rape programs are staffed by women; however, some programs have male and female counselors. If you prefer one or the other, make that preference known when you initially contact the program. Whether or not they have male staff on call, almost all rape crisis centers can make referrals to male counselors sensitive to the needs of male sexual assault survivors. In addition, many communities across the country have support groups for victims of anti-gay violence.

Counseling can help you cope with the physical and emotional reactions to the sexual assault or rape, as well as provide you with necessary information about medical and criminal justice system procedures. Seeking counseling is an important way to regain a sense of control over your life after surviving a sexual assault. Contact your local rape crisis program even if services are not expressly advertised for male rape survivors. The number can be found in your local phone book listed under "Community Services Numbers," "Emergency Assistance Numbers," "Survival Numbers" or "Rape."

Sexual assault and rape are serious crimes. As a sexual assault survivor, you have the right to report the crime to the police. This decision is one only you can make. But because authorities are not always sensitive to male sexual assault victims, it is important to have a friend or advocate go with you to report the crime for support and assistance.
 
References
Brochman, Sue. (July 30, 1991). "Silent Victims: Bringing Male Rape Out of the Closet." The Advocate, 582: 38 - 43.

Bureau of Justice Statistics. (1997). Criminal Victimization in the United States, 1994. Washington, DC: Bureau of Justice Statistics, U.S. Department of Justice.

Bureau of Justice Statistics. (March 1985). The Crime of Rape. Washington, DC: Bureau of Justice Statistics, U.S. Department of Justice.

Donaldson, Donald. (1990). "Rape of Males," in Dynes, Wayne, ed. Encyclopedia of Homosexuality. New York: Garland Publications.

Groth, A. Nicholas and Ann Wolbert Burgess. (1980). "Male Rape: Offenders and Victims." American Journal of Psychiatry, 137(7): 806 - 810.

Groth, A. Nicholas and B. A. Birnbaum. (1979). Men Who Rape: The Psychology of the Offender. New York: Plenum.

Harry, Joseph. (1992). "Conceptualizing Anti-Gay Violence," in Herek, Gregory and Kevin Berrill, eds. Hate Crimes: Confronting Violence Against Lesbians and Gay Men. Newbury Park, CA: Sage Publications.
Isley, Paul. (1991). "Adult Male Sexual Assault in the Community: A Literature Review and Group Treatment Model," in Burgess, Ann, ed. Rape and Sexual Assault III: A Research Handbook. New York: Garland Publishing, Inc.
Lipscomb, Gary H. et al. (1992). "Male Victims of Sexual Assault." Journal of the American Medical Association, 267(22): 3064 - 3066.

McMullen, Richie J. (1990). Male Rape: Breaking the Silence on the Last Taboo. London: GMP Publishers Ltd.

Mezey, Gillian and Michael King. (1989). "The Effects of Sexual Assault on Men: A Survey of 22 Victims." Psychological Medicine, 19(1): 205 - 209.

National Center for Victims of Crime. (1992). "Rape-Related Posttraumatic Stress Disorder," INFO LINK, Arlington, VA.

National Center for Victims of Crime. (1995). "Sexual Assault Legislation," INFO LINK, Arlington, VA.

Porter, Eugene. (1986). Treating the Young Male Victim of Sexual Assault. Syracuse, NY: Safer Society Press.
Bibliography
Allers, Christopher et al. (1991). "HIV Vulnerability and the Adult Survivor of Childhood Sexual Abuse." Child Abuse and Neglect, 17: 291 - 298.

Baker, Timothy and Ann Burgess, Ellen Brickman and Robert Davis. (1990). "Rape Victims' Concerns About Possible Exposure to HIV Infection." Journal of Interpersonal Violence,
5(1): 49 - 60.

Bradway, Becky. (1993). Sexual Violence Facts and Statistics. Springfield, IL: Illinois Coalition Against Sexual Assault.

Burgess, Ann and Timothy Baker. (1992). "AIDS and Victims of Sexual Assault." Hospital and Community Psychiatry, 43(5): 447 - 448.

Comstock, Gary. (1991). Violence Against Lesbians and Gay Men. New York: Columbia University Press.

Fuller, A. Kenneth and Robert Bartucci. (1991). "HIV Transmission and Childhood Sexual Abuse." Journal of Sex Education & Therapy, 17(1).

Gostin, Lawrence et al. (1994). "HIV Testing, Counseling, and Prophylaxis After Sexual Assault." Journal of the American Medical Association, 271(18): 1436 - 1444.

Jenny, Carole et al. (1990). "Sexually Transmitted Diseases in Victims of Rape."
The New England Journal of Medicine, 322(11).

National Center for Victims of Crime. (1992). Looking Back, Moving Forward: A Program for Communities Responding to Sexual Assault. Arlington, VA: National Center for Victims of Crime.
National Center for Victims of Crime and Crime Victims Research and Treatment Center. (1992). Rape in America: A Report to the Nation. Arlington, VA: National Center for Victims of Crime.
For additional information, please contact:
Centers for Disease Control National HIV/AIDS Hotline
American Social Health Association
P.O. Box 13827
Research Triangle Park, NC 27709
(800) 342 - AIDS
(800) 344 - SIDA (Spanish)
(800) 243 - 7889 begin_of_the_skype_highlighting              (800) 243 - 7889      end_of_the_skype_highlighting (TDD)
Provides information 24 hours a day, 7 days a week, about HIV/AIDS and will send free, written information, including legal services, counseling and therapies.
Men's Resource Center
12 Southeast 14th
Portland, OR 97214
(503) 235 - 3433 begin_of_the_skype_highlighting              (503) 235 - 3433      end_of_the_skype_highlighting

Men Stopping Rape
306 North Brooks Street
Madison, WI 53715
(608) 257 - 4444 begin_of_the_skype_highlighting              (608) 257 - 4444      end_of_the_skype_highlighting

National AIDS Clearinghouse
Centers for Disease Control
P.O. Box 6003
Rockville, MD 20849
(800) 458 - 5231 begin_of_the_skype_highlighting              (800) 458 - 5231      end_of_the_skype_highlighting
(800) 243 - 7012 begin_of_the_skype_highlighting              (800) 243 - 7012      end_of_the_skype_highlighting (TDD)
Distributes a variety of educational materials to the public. Provides expert referrals.

National Coalition Against Sexual Assault
125 N. Enola Drive
Enola, PA 17025
(717) 728 - 9764 begin_of_the_skype_highlighting              (717) 728 - 9764      end_of_the_skype_highlighting

National Crime Victims Research & Treatment Center
Medical University of South Carolina
171 Ashley Avenue
Charleston, SC 29425
(843) 792 - 2945 begin_of_the_skype_highlighting              (843) 792 - 2945      end_of_the_skype_highlighting

National Gay & Lesbian Task Force
2320 17^th Street, NW
Washington, DC 20009
(202) 332 - 6483 begin_of_the_skype_highlighting              (202) 332 - 6483      end_of_the_skype_highlighting

Your state Attorney General, county/city prosecutor, or county/city law enforcement:

Check in the Blue pages of your local phone book under the appropriate section heading of either "Local Governments," "County Governments," or "State Government."


INFO LINK ©: A Program of the National Center for Victims of Crime.

All rights reserved.

Copyright © 1997 by the National Center for Victims of Crime. This information may be freely distributed by electronic communication, provided that it is distributed in its entirety and includes this copyright notice, but may not be reprinted or distributed by any other means without the express written consent of the National Center for Victims of Crime.

To we talk again remember what Winston Churchill said

"IF YOU'RE GOING THROUGH HELL, KEEP GOING"

ptsd and rape trauma syndrome

As I search for info on the web I find stories about all types of syndromes related to Rape now MST is not only Rape but defined by the our Government as Military Sexual Trauma  

What is military sexual trauma (MST)?

In both civilian and military settings, service members can experience a range of unwanted sexual behaviors that they may find distressing. These experiences happen to both women and men. "Military sexual trauma" or MST is the term used by the Department of Veterans Affairs to refer to experiences of sexual assault or repeated, threatening acts of sexual harassment.
The definition of MST used by the VA is given by U.S. Code (1720D of Title 38). It is "psychological trauma, which in the judgment of a VA mental health professional, resulted from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment which occurred while the Veteran was serving on active duty or active duty for training." Sexual harassment is further defined as "repeated, unsolicited verbal or physical contact of a sexual nature which is threatening in character."
In more concrete terms, MST includes any sexual activity where you are involved against your will. You may have been pressured into sexual activities. For example, you may have been threatened with negative consequences for refusing to go along. It may have been implied that you would get faster promotions or better treatment in exchange for sex. You may not have been able to consent to sexual activities, for example, if you were intoxicated. You may have been physically forced into sexual activities. Other MST experiences include:

• Unwanted sexual touching or grabbing.
• Threatening, offensive remarks about your body or your sexual activities.
• Threatening and unwelcome sexual advances.

If these experiences occurred while you were on active duty or active duty for training, they are considered to be MST.


MST PTSD FROM RAPE

PTSD

post-traumatic stress disorder is a normal emotional and psychological reaction to trauma (a painful, shocking experience such as rape, war or a natural disaster) that is outside of a person's normal life experiences.

Anyone who experiences a traumatic event can suffer from PTSD. PTSD can affect survivors of war, violent attacks, rape, car or plane accidents and natural disasters and can also affect people who witness these events.

Symptoms of PTSD include recurrent memories or flashbacks of the trauma, nightmares, insomnia and/or lack of interest in family, friends or hobbies. They may suffer from depression. They may also suffer from survivor guilt, have overwhelming emotions, and be irritable or jumpy.
rape trauma syndrome

Immediate reactions after a rape may vary. Some rape survivors remain controlled, numb, in shock, denial disbelief. They present a flat affect, quiet, reserved, and have difficulties expressing themselves. Other rape survivors respond quite differently - being very expressive and verbalizing feelings of sadness or anger. They may appear distraught or anxious and may even express rage or hostility against the medical staff attempting to care for them.

Various factors may aid or inhibit the survivors ability to resolve the issues associated by the rape. Positive feelings of self-esteem, good support systems, previous success in dealing with crisis and economic security all enhance her ability to heal. Survivors who can minimize, (deal with one small segment of the problem at a time ) often find success. Certainly survivors moved to action gain confidence as they implement decisions. But survivors who suffer with chronic stress, lack of support systems and prior victimization struggle less successfully to resolve their issues. Negative self-esteem often hinders their progress and paralyze their efforts. These victims often use maladaptive methods to deal with their stress. These factors hamper their ability to resolve the issues of the rape and move beyond it.

Rape victims can suffer a significant degree of physical and emotional trauma during the rape, immediately following the rape and over a considerable time period after the rape. A study of rape victims has identified a three-stage process, or syndrome, that occurs as a result of forcible rape or attempted forcible rape. This syndrome is an acute stress reaction to a life-threatening situation that can last from two years to a lifetime. It is also often known as rape trauma syndrome or rape related post traumatic stress disorder, rrpstd.

The acute phase begins immediately and lasts up to several days after the attack. The survivor feels violated and fearful and may be depressed�even suicidal. The victim struggles with feelings of loss of control and may note changes in appetite, sleep habits or social functions. Survivors may note change in their sexual patterns at this time.

The Acute Stage: This stage occurs immediately after the assault. It may last a few days to several weeks. During this stage the victim may:
seem agitated or hysterical or s/he may appear totally calm (a slogan that s/he could be in shock).
have crying spells and anxiety attacks.
have difficulty concentrating, making decisions, and dolling simple, everyday tasks.
show little emotion, act as though numb or stunned.
have poor recall of the rape or other memories.

In the second stage, it seems that survivors begin to resolve their issues. This stage is also called the "flight to health." But denial frequently masks the under lying problems as survivors make an effort to re-establish the routines of their life and bring back some semblance of control. Sometimes, in an effort to feel back in control, rape victims make dramatic changes in lifestyle or environment. They may quit a long-standing job or move to a new location to get a fresh start. They may dramatically change their appearance; cut their hair or perhaps change the colour. None of the changes brings about the security they search for as nightmares and phobias emerge. They work hard to suppress the feelings because dealing with them is so very painful.

The Outward Adjustment Stage: During this stage the victim resumes what appears to be from the outside her/his "normal" life. Inside, however, there is considerable turmoil which can manifest itself by any of the following behaviours:
continuing anxiety.
sense of helplessness.
persistent fear and/or depression.
severe mood swings (e.g. happy to angry, etc.).
vivid dreams, recurrent nightmares, insomnia.
physical ailments.
appetite disturbances (e.g. nausea, vomiting, compulsive eating).
efforts to deny the assault ever took place and/or to minimize its impact.
withdrawal from friends and/or relatives.
preoccupation with personal safety.
reluctance to leave the house and/or to go places which remind the victim of the rape.
hesitation about forming new relationships with men and/or distrustful or existing relationship.
sexual problems.
disruption of normal everyday routines (e.g. high absenteeism at work suddenly or, conversely, working longer than usual hours; dropping out of school; travelling different routes; going out only at certain times).


But the feelings do not go away as easily as before. Their re-surfacing introduces the third stage of the rape trauma syndrome. The client no longer denies the issues; she/he may want to talk about what happened. The client finds themselves more willing to accept counselling and get in touch with the feelings and emotions associated with the rape. Survivors may feel overwhelmed as they attempt to deal with feelings they struggled to suppress since the assault. Often some sensory stimulation triggers memories that call to mind the sexual assault. Suddenly the survivor seems to be re-living the trauma as the rape comes to life again. Nightmares, phobias, depression, reoccurring thoughts and sexual dysfunction monopolize her thoughts. She / he feels anxious to talk about it; to deal with it and is ready to seek therapy although she may not understand why the issues surface at that time. The stages are not linear and can vary as the victim works their way through. Survivors find themselves taking one step forward and two back as they vacillate between stages and labour to find their way.


The Resolution Stage: During this stage the rape is no longer the central focus in the victim's life. The victim begins to recognize that while s/he will never forget the assault, the pain and memories associated with it are lessening. S/he has accepted the rape as a part of her/his life experience and is choosing to move on from there. Some of the behaviours of the second stage may flare up at times but they do so less frequently and with less intensity. In this fashion the person who has survived has moved from being a " victim" to a "survivor".

While some survivors move forward and take control of their lives, other continue to suffer and may even develop post traumatic stress disorder ( rape trauma syndrome ) as result of the rape. They struggle with reoccurring thoughts about the trauma and find themselves in a state of hyper vigilance; easily startled and always anticipating another attack. Nightmares, flashbacks, and sleep disturbances disrupt their lives. Constant efforts to avoid the memories of trauma literally control their existence. Some rape survivors have post-traumatic stress disorder for years and need continuous counselling and support.

Recovery Takes Time

Survivors recover in stages. They may start with one stage, go to another, and go back. Each person processes the event his or her / his own way. Survivors are not to blame for the crime committed to them by another person. We cannot control the actions of another person. Survivors need a safe environment to work through their fears. You can help by providing the survivor with pace and time to recover.

The info about is from http://www.aest.org.uk/survivors/rts.html till we talk again remember what  
Winston Churchill said

"IF YOU'RE GOING THROUGH HELL, KEEP GOING"