Evidence of RTS was first documented by Ann Burgess & Lynda Holmstrom in 1974.
It refers to the acute phase and long-term reorganisation process that occurs as a result of forcible rape or attempted forcible rape. This syndrome of behavioural, somatic and psychological reactions is an acute stress reaction to a life-threatening situation. Although some things have changed since 1974 (eg. the term "sexual assault" is now more widely accepted than "rape", and the DSM came to recognise trauma-related disorders), the original work by Burgess & Holmstrom remains current and useful in working with adults who have been sexually assaulted during their adult life. The following outlines the phases and reactions in RTS.
Acute Phase - Disorganisation
Impact Reactions - within hours
Victims may present in a variety of ways, from
- expressed style - feelings shown in such behaviour as crying, sobbing, smiling, restlessness, tenseness, joking.
- controlled style - feelings are masked or hidden behind a calm, composed, or subdued effect.
Immediate effects - first weeks
Somatic manifestations:
- physical trauma
- skeletal muscle tension
- gastrointestinal irritability
- genitourinary disturbance
Emotional reactions that may be present:
shock, numbness, embarrassment, guilt, powerlessness, loss of trust, fear, anxiety, anger, disbelief, shame, depression, denial, retriggering, disorientation.
Reorganisation Phase
Short-term effects - up to 3-4 months
- generalised anxiety & fear.
- disturbance - of eating, sleeping, thoughts, relationship.
- disruption - to create safety eg change of phone number.
- impaired social functioning
- difficulty in maintaining/ establishing relationships.
- guilt for not preventing assault (often).
- sudden, unpredictable changes of residences and disappearances.
- negative impact of legal processes.
Intermediate effects - up to 1 year
- disruption and change in lifestyle - eg move house, change job.
- increased dependence - eg on family.
- sleep disturbance, often nightmares.
- fear and phobias eg going out or being alone, cleanliness,
- sexuality - eg body image, flashbacks, loss of enjoyment
- past rape/incest - brings up past abuse.
- "damaged" goods - eg thinks others can tell.
Long-term reactions - up to 4 years
- anger - eg towards offender, legal system, family/friends
- diminished capacity to enjoy life.
- hypervigilance to danger - eg fearful of new and risky situations.
- continued sexual dysfunction - may engage in regular sex as before, but with decreased desire and arousal, and many experience flashbacks.
Judith Herman (Trauma & Recovery, 1992) describes: "the core experiences of trauma are disempowerment and disconnection from others. Recovery, therefore, is based on the empowerment of the survivor (regaining control) and the creation of new connections"
As research indicates that some adults who have experienced sexual assault will present more regularly to GPs, many doctors find themselves hearing disclosures of sexual assault from their patients - often the first person told. This puts the GP in a key position to provide information, referral, support and counselling.
Information, literature, and consultation is available for GPs - contact the Richmond Sexual Assault Service on (02) 6620 2970.
Atosha Clancy is the project officer for the NRDGP prevention of sexual assault project.
This page was last built on 21/01/2003. It was originally posted on 18/7/1998; 6:52:25 PM.
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