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Abstract
Victims of rape routinely are acknowledged to need counseling but not psychotherapy; if psychotherapy is provided, the major focus is on preexisting psychopathology. The author examines these assumptions and presents a different formulation based solely on an in-depth examination of the many levels of the trauma. Case material reveals the typical symptoms, conflicts, and defenses found in rape victims. The author makes recommendations for psychotherapeutic technique, especially in regard to difficulties in forming a therapeutic alliance.
... Ces questions troublent Jonathan et paraissent tellement envahissantes que les trois objectifs d'une psychothérapie tels que précédemment discutés s'appliquent dans son cas. À la suite d'auteurs tels que Rose (1986) et Everstine-Sullivan et Everstine (1989, il y a lieu de penser que le bouleversement vécu par Jonathan est si important que seule une démarche psychothérapique psychanalytique individuelle qui viserait à le libérer du joug des conflits inconscients qui l'habitent apparaît indiquée. En effet, ni des approches de groupe ni des approches axées sur des comportements ou des cognitions précises centrées sur le trauma de la victimisation ne sauraient le soulager. ...
... Comme le soulignent Baril (1983), Rose (1986) ainsi que Everstine-Sullivan et Everstine En ce sens, lorsque une psychothérapie s'impose, il importe que le traitement proposé corresponde le plus étroitement possible aux besoins individuels reconnus suite à l'évaluation. ...
... Guilt and shame surrounding the abusive experience is expressed almost universally by the adolescents in the group (Browne & Finkelhor, 1986;Rose, 1986). They feel they are to blame for the abuse in some way. ...
... Also common are feelings of distrust (Browne & Finkelhor, 1986;Rose, 1986). The teens describe tremendous difficulties in trusting others. ...
This article describes a support group of two years' duration for physically, sexually, and emotionally abused adolescents in an inpatient unit at the University of Michigan Child and Adolescent Psychiatric Hospital. Group characteristics, group dynamics, and emotional reactions of the adolescents are discussed. This experience suggests that a support group does not necessarily need a homogeneous membership, as the literature often indicates, to be successful.
... atic stress disorder (cf. Horowitz, 1976). Jaffe (1968) observed that concentration camp survivors sometimes described themselves as "semistuporous robots" (p. 312). Frankenthal (1969) noted that prisoners endure their situation by detaching themselves from their immediate surroundings and reliving better times, an observation echoed by Frank (1973). Rose (1986 reported that depersonalization, including out-of-body experiences, and other dissociative forms are commonly reported by rape victims (but no statistical data was provided). More systematically, Hillman (1981) described the frequent appearance of dissociative symptoms in 14 correctional officers held hostage in a violent prison riot. D ...
... Interestingly, these visual experiences are not unlike those reported by highly hypnotized persons in a minimum-suggestion hypnotic context (Cardefla, 1988). The extensive literature on so-called "near-death experiences" also contains many reports of perceptual alterations in connection with actual or perceived threat to one's life, including out-of-body experiences and other changes in the phenomenal self (Noyes & Kletti, 1977 ), which have also been anecdotally reported in connection to such other traumatic events as rape (e.g., Rose, 1986). There is also anecdotal evidence of absence of or decrease in pain sensation during or shortly after a disaster (e.g. ...
We present proposed changes to the dissociative disorders section of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders and review the concept of pathological and nonpathological dissociation, including empirical findings on the relations between trauma and dissociative phenomenology and between dissociation and hypnosis. The most important proposals include the creation of two new diagnostic entities, brief reactive dissociative disorder and transient dissociative disturbance, and the readoption of the criterion of amnesia for a multiple personality disorder diagnosis. We conclude that further work on dissociative processes will provide an important link between clinical and experimental approaches to human cognition, emotion, and personality.
... Guilt and shame surrounding the abusive experience is expressed almost universally by the adolescents in the group (Browne & Finkelhor, 1986; Rose, 1986). They feel they are to blame for the abuse in some way. ...
... Also common are feelings of distrust (Browne & Finkelhor, 1986; Rose, 1986). The teens describe tremendous difficulties in trusting others. ...
This article describes a support group of two years' duration for physically, sexually, and emotionally abused adolescents in an inpatient unit at the University of Michigan Child and Adolescent Psychiatric Hospital. Group characteristics, group dynamics, and emotional reactions of the adolescents are discussed. This experience suggests that a support group does not necessarily need a homogeneous membership, as the literature often indicates, to be successful.
... Sexual assault is defined as "any form of sexual contact without voluntary consent, and that violates a person's sense of autonomy, control and mastery over their body" [45]. The prevalence of PTSD due to sexual assault is 50%, making it the most common trauma resulting in PTSD in women [46]. ...
Trauma exposure is one of the most important and prevalent risk factors for mental and physical ill-health. Prolonged or excessive stress exposure increases the risk of a wide variety of mental and physical symptoms, resulting in a condition known as post-traumatic stress disorder (PTSD). The diagnosis might be challenging due to the complex pathophysiology and co-existence with other mental disorders. The prime factor for PTSD development is exposure to a stressor, which variably, along with peritraumatic conditions, affects disease progression and severity. Additionally, many factors are thought to influence the response to the stressor, and hence reshape the natural history and course of the disease. With sufficient knowledge about the disease, preventive and intervenient methods can be implemented to improve the quality of life of the patients and to limit both the medical and economic burden of the disease. This literature review provides a highlight of up-to-date literature on traumatic stress, with a focus on causes or triggers of stress, factors that influence response to stress, disease burden, and the application of the social-ecological public health model of disease prevention. In addition, it addresses therapeutic aspects, ethnic differences in traumatic stress, and future perspectives, including potential biomarkers.
... Unwanted sexual experiences are often measured along a continuum, including categories of unwanted sexual contact (e.g., kissing or fondling), verbal coercion, attempted rape, and rape, presumed to reflect the least to most severe experiences. Different methods of coercion: arguments and pressure, misuse of authority, alcohol or drug intoxication (separate questions for attempted and completed acts), and physical force used by the perpetrator has been conceptualized to vary in extent of trauma perceived [2]. Another distinction was attempted on the basis of forcible and incapacitated rape. ...
... 1 In their 1974 American Journal of Psychiatry article, Burgess and Holmstrom reported that there was little information on the physical and psychological effects of rape or how to manage the treatment of a survivor of sexual assault in the psychiatric literature. 1 In the past, rape survivors were thought to need only counseling-that is, direct, problem-focused treatment-rather than broader, more in-depth treatment such as psychotherapy and, if the survivor did undergo psychotherapy, the major focus was on preexisting psychopathology. 2 The United States Centers for Disease Control and Prevention (CDC) estimates that sexual violence affects one in three women and one in four men over the course of their lifetimes. 3 The treatment of survivors of sexual assault gains benefits from several general and specialized types of psychotherapy including psychodynamic psychotherapy, traumafocused cognitive-behavioral therapy (TF-CBT), and eye movement desensitization and reprocessing therapy (EMDR). ...
Sexual assault and abuse can result in severe physical and emotional trauma to the victim. Deploying targeted psychotherapeutic treatment that is individualized for the survivor is important to achieving optimal patient outcomes. There are several valid and evidence-based treatments available for posttraumatic stress disorder (PTSD) and interpersonal difficulties that can result from sexual abuse and assault. In this article, the authors discuss psychodynamic psychotherapy, trauma-focused cognitive behavioral therapy (TF-CBT), and eye movement desensitization and reprocessing therapy (EMDR) for the treatment of patients following sexual assault and abuse. The authors also provide practice points on common issues in the management of the treatment of sexual assault survivors, including transference, countertransference, and avoiding retraumatization. Composite case vignettes are used to illustrate treatment techniques.
... Unwanted sexual experiences are often measured along a continuum, including categories of unwanted sexual contact (e.g., kissing or fondling), verbal coercion, attempted rape, and rape, presumed to reflect the least to most severe experiences. Different methods of coercion: arguments and pressure, misuse of authority, alcohol or drug intoxication (separate questions for attempted and completed acts), and physical force used by the perpetrator has been conceptualized to vary in extent of trauma perceived [2]. Another distinction was attempted on the basis of forcible and incapacitated rape. ...
... Studies have found that most patients with DD report a history of childhood trauma, usually involving physical and/or sexual abuse (Saxe et al., 1993). Physical and/or sexual abuse is reported in 88.5-96 percent of DD patients (Rose, 1986), and higher rates of suicide or chronic self-cutting are found in DD patients with early trauma than in other psychiatric conditions (van der Kolk, Perry, & Herman, 1991). Most DD patients experience suicidal ideas and behavior. ...
Preclinical studies indicate that stress early in life can cause long-term alterations in brain development. Studies have shown alterations in the brain functions of patients after experiencing trauma. Our aim is to examine whether the integrity of white matter tracts might be affected in dissociative disorder (DD) patients. A total of 15 DD patients and 15 healthy controls were studied, with the groups matched by age and gender. Diffusion-weighted echoplanar brain images were obtained using a 1.5 Tesla magnetic resonance imaging scanner. Regions of interest were manually placed on directional maps based on principal anisotropy. Apparent diffusion coefficient and fractional anisotropy (FA) values of white matter were measured bilaterally in the anterior corona radiata (ACR) and by diffusion tensor imaging in the genu and splenium of the corpus callosum. Significantly lower FA values were observed in the right ACR of DD patients versus healthy individuals. We also found an association between bad paternal relationships and lower FA in the genu of the corpus callosum in female patients. Alterations in the right ACR suggest that diffusion anisotropy measurement can be used as a quantitative biomarker for DD. Paternal relationships may also affect the brain’s microstructure in women with DD.
... It has also been asserted that the partners of sexually assaulted women may come to view the victims as 'damaged goods', who were 'contaminated' by their sexual contact with another man (Rose, 1986). A husband who felt this way might be less likely to seek to be intimate with his wife. ...
Extemsive research has been conducted regarding factors contributing to the breakdown of marriage, focusing on problems such as infidelity, domestic violence, money problems and mid-life crises. This study explores a new question: does crime victimization contribute to the dissolution of marriage? Unique information from a national panel survey, the National Crime Victimization Survey, was analyzed in a longitudinal format to determine whether married crime victims were more likely than non-victims to become divorced or separated in the six to twelve months following the crime. Logistic regression analysis indicated that crime victims were generally more likely to experience marital disruption. Robbery victims were 2.7 times more likely (significantly so) than non-victims to be divorced or separated within six to twelve months of the crime, while this risk was non-significantly higher for burglary, assault, and theft victims. Those victimized by their spouse were nearly nine times more likely to later be divorced or separated. Assault victimization had a more detrimental impact on marriage for women than for men. Otherwise, the effects of victimization were similar for men and women. Although it has been speculated that sexual assault could jeopardize marriages because some husbands would view their victimized wives as ‘damaged goods’, we found no significant effect on marital disruption. We speculate that men in recent times may have become less likely to devalue victimized women in this way.
... Treatment services, struggling to understand how to treat crack addiction and how to care for women addicts, face yet another new task in program development: care for those who suffer from trauma-spectrum disor- ders. The development of trauma treatment for such women must build on both the experience of treating posttraumatic stress disorder in veterans (Haley, 1985; Scurfield, Corker, Gongla, & Hough, 1984) and the growing experience of treating sexual abuse (Rose, 1986). That body of work would suggest that peer support will be a critical element in recovery. ...
The involvement of women in crack cocaine abuse has had a severe impact on their health, the health of their children and the stability of their communities. Of particular concern has been the development of a system of barter in which crack‐for‐sex exchanges are the means through which women obtain the drug. Earlier studies have suggested that drug abuse may be related to and exacerbated by trauma. In the project described herein, we interviewed women crack users in Harlem to study the relationship between trauma, crack use, and crack‐related sexual behavior. Results suggested the existence of three types of trauma: (1) traumas that predate the respondent's onset of crack use; (2) traumas that were the direct sequelae of crack use; and (3) stigma trauma, that is, trauma that results from membership in a despised or oppressed group. We observed a complex inter‐relationship involving crack use, crack‐for‐sex transactions, and these three types of trauma. Treatment of the eventual co‐morbidity of trauma and addiction is an urgent challenge.
... We would, therefore, postulate that women previously abused would be at an elevated risk of revictimization within an institutional setting. The effects of rape have almost exclusively been studied among younger to middle-aged women (Burgess & Holmstrom, 1974;Calhoun & Atkinson, 1991;Rose, 1986), leaving us with almost no knowledge of the effects of sexual assault on older women. If the case reported by McCartney and Severson (1997) is found to be typical, however, we will find that the effects of rape experienced by older women may well be pervasive and debilitating, often leading to severe restrictions in independence and quality of life. ...
Little is known and less is written about post-traumatic stress disorder (PTSD) in institutionalized older adults, especially in the context of their past exposure to child sexual assault. The behavioral and psychological manifestations displayed by child sexual abuse survivors are considered especially in the context of possible symptom reactiva- tion throughout the life course. Analysis is offered of the ways in which aging itself and the organizational practices of long-term care institu- tions may serve to reactivate and exacerbate long-dormant child sexual abuse thoughts, feelings, and symptoms in residents. Specific recom- mendations for needed research as well as nursing home staff training, programming, and policy are put forward. (Article copies available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: Website: © 2003 by The Haworth Press, Inc. All rights reserved.)
This article has discussed the most common sequelae of victimization with regard to incest, rape, and battering. Although legislators and law-enforcement officials have traditionally been viewed as having primary responsibility for the prevention and control of violence, it is now known that physicians must also act in this regard. Their action is especially required with regard to victim assessment and treatment. Physicians serve as the entry points not only to the health care system, but also to other resources for victims of violence. By identifying their victimized patients and by understanding the antecedents of their patients’ symptoms, physicians can go much further in meeting their patients’ needs for physical, mental, and social well-being. Given the scope and impact of violence, physicians have a moral and ethical obligation to inquire about the possibility of current violence, past violence, or both in their patients’ lives.
This is the book that started an are of research and practice of compassion fatigue, secondary traumatic stress and stress reactions, vicarious trauma, and most recently compassion fatigue resilience
The literature on the theory and clinical implications of posttraumatic stress disorder (PTSD) has grown enormously over the past 10 years, yet clearly in striking contrast to the relative paucity of literature regarding psychometric assessment. There are few psychological instruments in use which have adequate norms for the evaluation of PTSD, particularly for nonmilitary traumatic events. Currently, there is much evidence that many kinds of “civilian” disasters (e.g., rape, violent assault, natural disasters, hostage situations, etc.) can produce a stress response (Green, Lindy, & Grace, 1985; Horowitz, 1976, 1985; Krystal & Niederland, 1968; Sales, Baum, & Shore, 1984).
A crisis may be defined as a “functionally debilitating mental State resulting from the individual’s reaction to some event perceived to be so dangerous that it leaves him or her feeling helpless and unable to cope effectively by usual methods.”1 Family physicians would add “debilitating physical State,” for often the crisis we see involves somatic complaints with or without psychological distress signals. There are many situations, such as bereavement, pregnancy loss, or family violence, that will precipitate crises in our patients and their families. Often, the family physician is the person of first contact and is responsible for the initial crisis Intervention. Principles of crisis management have been developed to assist clinicians in their approach to the patient in crisis. The physician should become knowledgeable about typical reactions to precipitating events. He will need to explain the range of responses and provide anticipatory guidance. By attending to physical and emotional complaints, a physician can evaluate his patients and help them in their return to a fully functional, gratifying life.
Multiple personality disorder (MPD) and posttraumatic stress disorder (PTSD) were formulated in medical consciousness at about the same time that modern psychiatry was being molded by its Age of Giants. During this period of 1880 to 1920, MPD was pulled from its millennia-old identification with demonology and possession into the rational spheres of psychology (Ellenberger, 1970). The “cowardice” of warriors who relived scenes of terror in sweating nightmares acquired a new etiology in the trenches of World War I, namely, “shell shock,” later to become the “combat fatigue” of World War II, and the PTSD of today. All too often throughout history the MPD and PTSD patient shared similar fates: isolation or death for the “possessed,” rejection or execution for the craven. Until recently, however, it was not realized that MPD and PTSD had two similarities in etiology and phemonenology: origin in exposure of the victim to shattering psychological trauma—in childhood in the instance of MPD, in later life in PTSD—and the subsequent need for the person to dissociate as a coping mechanism.
The popular concept of "the inner child" and "inner child work" will be evaluated and compared to various theories of personal development, including object relations, self psychology ,Jungian and dissociation theories. It will be suggested that much of what is being accessed in such work is compatible with these theories and may be at least ego-state based rather than just a pleasing visualization or metaphor. Terminology clarifications and cautions as well as directions for effective hypnotic approaches will be outlined.
objective: The article reviews the relationship between rape and mental disorders specially Posttraumatic Stress Disorder, Methodology: Published original articles and selected reviews. Literature was surveyed using MEDLINE and LILACS. Results: Despite of operational difficulties in estimating and identifying, the prevalence of rape is significant; it is related to disfunctional behaviour patterns and a increased risk to develop psychiatric disorders. Posttraumatic Stress Disorder, the most frequent consequence of rape, is described in its clinical picture, course, risk factors and incidence. Conclusions: Because of the high prevalence of sexual assault, its pathogenic potential and the frequent victim's refusal to talk about; it is necessary for mental health professional to conduct specific assessment of traumatic abuse history.
The empowerment of women is a broadly endorsed strategy for solving a host of difficult problems, from child poverty to gender violence to international development. The seventeen international scholars in this multi-disciplinary volume offer thoughtful critiques of the notion of empowerment based on their studies in twenty countries in all regions of the world. The comparative introduction places concepts of empowerment in the context of models of the market and of community, showing how contradictions in these models as they are enacted on the ground provide both spaces and constraints for women. The chapters consider opportunities for women in the context of globalization, resurgent nationalism and politicized religion, cultures of masculinity, and the HIV/AIDS epidemic in Africa. They show how initiatives at national or global levels are transformed by local cultures and power structures, and demonstrate the fruitfulness of tensions between universal values of human rights and contextualized understandings. This landmark, multi-disciplinary collection of original studies by distinguished international feminist scholars will be an essential addition to the fields of Political Science, Women's Studies, Economics, Sociology, International Development, and Environmental Studies.
In this existential-phenomenological investigation seven women were interviewed about their experiences of recovering from rape trauma. The purpose of the study was to discover the meaning of recovery from the perception of the victim, how recovery is experienced, and what contributed to the growth and recovery of the woman who has been raped. Transcribed interviews were analyzed using a hermeneutic process. The thematic structure of a woman's recovery from rape comprises three main themes: reaching out, reframing the rape, and redefining the self. These findings are important to professionals working with women who have been raped because it is the raped woman, rather than the clinician, who is able to define what constitutes recovery.
In an effort to address research challenges posed by the study of coping with extremely stressful life events, this chapter will outline a conceptual framework provided by a dynamic consideration of immediate and long-term coping with trauma and will consider the relationship of coping to psychological well-being. Although we consider such a fremework to be useful and necessary, we will also point to limitations of current research in operationalizing such a framework, especially as it relates to extreme stress and long-term adaptation. Specific illustrations of the suggested paradigm will be provided from the literature and from our study of coping efforts of Holocaust victims during the period of victimization and by survivors in the aftermath of the Holocaust.
How do clinicians identify with culture in the clinical encounter? Medical textbooks reify certain patient demographics without considering their salience to the clinician-patient interaction. Previous research on cultural transference and countertransference likewise presume that culture belongs exclusively to the clinician or the patient. More recent scholarship has departed from the supposed objectivity of each party toward the intersubjectivity of the relationship. This article modifies Ogden's notion of the analytic third to suggest the coconstruction of the cultural third for further explorations into shared and different cultural meanings within therapy.
Over the last 30 years, major advances have been made in our understanding of how bio-logical factors and sociocultural influences contribute to gender differences, gender identity formation, and gendered role behavior. Sensitivity to the psychological effects of changing family structure and workforce composition, the contribution of reproductive events, and the high rates of exposure to trauma in women is essential for optimal psychiatric assessment and treatment planning. This knowledge has not been systematically integrated into residency training. The authors present an outline for a curriculum in gender and women's issues, including educational objectives, learning experiences through which residents could meet these objectives, and recommended readings. The authors also discuss potential obstacles and suggest helpful strategies for implementing the proposed curriculum.
Little is known and less is written about post-traumatic stress disorder (PTSD) in institutionalized older adults, especially in the context of their past exposure to child sexual assault. The behavioral and psychological manifestations displayed by child sexual abuse survivors are considered especially in the context of possible symptom reactivation throughout the life course. Analysis is offered of the ways in which aging itself and the organizational practices of long-term care institutions may serve to reactivate and exacerbate long-dormant child sexual abuse thoughts, feelings, and symptoms in residents. Specific recommendations for needed research as well as nursing home staff training, programming, and policy are put forward.
A training programme in rape crisis intervention for lay therapists (members of Rape Crisis in Cape Town) is described and evaluated. Apart from this experimental group (N = 8), there were two control groups: one consisting of members of Rape Crisis who did not attend the programme (N = 9) and the other consisting of people who were not members of Rape Crisis and had not attended the programme (N = 8). Levels of facilitativeness (FAC) and action orientatedness (ACT) that subjects were able to offer before and after the programme were assessed, using a modification of the instrument developed by Carkhuff. The levels of FAC that subjects were able to offer were not affected by the programme. Members of Rape Crisis offered significantly lower levels of FAC than those subjects who were not members of Rape Crisis, both before or after the programme. The programme appeared to increase the levels of ACT that subjects were able to offer. Theoretical and practical explanations for, and implications of, these results are examined.
This paper is part of a larger study of reported and unreported crime on the campus of East Carolina University. The survey was conducted during the Spring of 1994, and involved a total sample of 760 respondents. Those questions dealing with rape, other sexual offenses, stalking, and lewd phone calls were used to determine the level of both reported and unreported incidents, and the relationship of such experiences to the students' overall fear of crime, and avoidance of night classes. Overall, students exhibited an extremely high concern about crime. Students who reported having received lewd and/or threatening phone calls were the most concerned and reluctant to take night classes.
A four-phase group plan is presented to help survivors of childhood sexual abuse move beyond dissociative coping to more effective coping strategies. A group format provides the opportunity for survivors to receive feedback about the extent to which they dissociate, help in understanding what triggers them to dissociate, and the impact dissociation has on relationships. Group members also learn active coping strategies and have the opportunity to practice new behaviors within the safety of the group. Outcomes include increased self-acceptance, awareness, and self-control.
A number of case reviews and observations have reported on the effects, on counsellors, of working with victims of violence. In this study two groups of counsellors, sexual assault counsellors (n = 41) and counsellors from a range of other therapy areas (n = 32), were compared on a number of measures including the Maslach Burnout Inventory, Ways of Coping Scale and a Beliefs and Values Questionnaire. The results indicate that sexual assault counsellors experience greater emotional exhaustion and use more escape/avoidance coping strategies. Responses concerning beliefs and values are discussed in terms of McCann and Pearlman's constructivist self-development model and indicate support for the concept of vicarious traumatization. Implications of these findings for Sexual Assault Services are discussed.
This article examines countertransference in the assessment and treatment of recovery from traumatic incidents of adulthood, with specific focus on victims of violent crime. It reviews Freud's impediment theory, with particular attention to implications concerning empathic strain and vicarious traumatization. It introduces Wilson and Lindy's Type I Countertransference (avoidance), Type II Countertransference (overidentification), and their respective manifestations. It then proposes a Type III Countertransference (communicative) that applies a more totalistic perspective that utilizes concepts of splitting, projection, projective identification, and intersubjectivity. It differentiates between countertransference orientations to trauma that are content-based or processed-based as well as those that may be figure or ground. Finally, it presents some common countertransference reactions and roles that become enacted and therefore have treatment implications, examines the interaction between therapeutic and real relationships as contributors to those scenarios, and presents case examples. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Provides practical guidelines for therapy using music combined with appropriate hypnotic words to guide attention and experience along a congenial pathway into hypnosis. In its simplest use in the hypnotic situation, music makes an effective and widely acceptable deepening technique and clinicians are advised to begin with this use of music to acquire their own communication skills in the area. Music can also be used as the primary focus of attention for induction as well as deepening, and, when hypnosis is achieved, it can be a very effective vehicle for carrying verbal suggestions, a primary stimulus for production of emotional experiences, or a background for therapeutic fantasy, guided imagery, or imaginal rehearsal. Music can also provide a safe and appropriate vehicle for self-hypnosis in stress-management. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Applies a model of consciousness based on the behavior of certain neural networks to explore mechanisms that result in dysfunctions in consciousness. These mechanisms are offered as a basic conceptual framework for describing the dysfunction of consciousness seen in 2 psychiatric disorders with prominent dissociative features: multiple personality disorder (MPD) and posttraumatic stress disorder (PTSD). These mechanisms provide a model of the role of trauma in dissociative dysfunctions of consciousness. Consciousness in neural network terms can be approximated by the sequence of stable states through which a net passes in response to changing environmental constraints, whereas dissociation represents a relatively discontinuous jump from one state to another. The persistence of traumatic schemata, their easy reactivation, and the dissociative features found in MPD and PTSD can be modeled via parallel distributed processing. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The management of the sexual assault victim is a complex challenge for the emergency physician. A combination of medical, forensic and psychological consequences for the victim require a well prepared, team based approach which includes doctors, nurses, counsellors, police and others. Protocols for the reception of the victim in the emergency department, the medical assessment and subsequent follow up must be in place before the victim's arrival. The most important aspect of caring for the survivor is to ensure that she (or he) is in control of the manner in which support is provided. This review details the important aspects of the provision of medical care, the forensic evaluation and the psychological effects of the sexual assault.
The present research investigated the question of how therapists’attitudes toward sexual assault victims predict their inferences about and treatment of clients. In addition, this study asked the following questions: (a) What percentage of female psychotherapy clients have been victims of sexual assault? (b) What treatment approaches are therapists using with victims and what attitudes toward victims do these therapists hold? (c) On the average, which demographic groups of therapists hold the most positive views of victims and are the most knowledgeable about working with victims? The results of the study indicated that therapists who held negative attitudes toward victims were more likely to endorse victim-blaming themes and therapeutic treatments which blame victims for sexual assault. Of therapists’current female clients, 18.5% (n= 257) had been sexually assaulted at some point in their lives. On the average, therapists were knowledgeable about working with victims and showed positive attitudes toward victims.
This paper gives an account of the relationship between hypnosis, hypnotizability, dissociation and disordered eating. A detailed update of the outcome of studies employing hypnotic techniques in the treatment of the two dieting disorders anorexia nervosa and bulimia nervosa is provided. The role of dissociation and the contribution of hypnosis is evaluated.
This chapter reflects recent UK legislative proposals for the detention of dangerous individuals with severe personality disorder
as a starting point for deriving insight into the deployment of the terminology of evil in everyday discourse. We concern
ourselves specifically with the public safety role of high-security hospitals and consequent contribution to the assuagement
of collective anxieties. This, in turn, is linked to Julia Kristeva’s notion of the abject, with an analagous relationship
to anxiety containment seen in people’s encounters with horror movies.
Sexual assault occurs with alarming frequency in Canada. The prevalence of Posttraumatic Stress Disorder (PTSD) in assault survivors is drastically higher than the national prevalence of the disorder, which is a strong indication that the current therapies for sexual-assault-related PTSD are in need of improvement. Increasing knowledge and understanding of the pathologies associated with rape trauma in biological, psychological and sociological domains will help to develop more effective treatments for survivors. A dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis is observed in survivors of sexual assault and this may be a fundamental cause of the structural and functional abnormalities contributing to PTSD symptoms. Pharmacotherapies are available to treat PTSD; however, they are often inadequate or unwanted by the survivor. Psychological health is compromised following interpersonal trauma and many psychological therapies are available, but with varying efficacy. A person's cognitions have a dramatic effect on the onset, severity, and progress of PTSD following sexual assault. Sociological impacts of assault influence the development of PTSD through victim-blaming attitudes and the perpetuation of rape myths. Perceived positive regard and early social support is shown to be important to successful recovery. Education is vital in rape prevention and to foster a supportive environment for survivors. The biological, psychological and sociological impacts and treatments should not remain mutually exclusive. A better appreciation of the biopsychosocial repercussions of sexual assault will aid in developing a more holistic and individualized therapy to help alleviate the physical and emotional pain following the trauma of rape.
The phenomenon of sexual assault upon males has been largely overlooked by society.
Opsomming
Seksuele geweld van mans teenoor mans is ‘n fenomeen wat grootliks deur die samelewing misken word.
*Please note: This is a reduced version of the abstract. Please refer to PDF for full text.
This book is not available through ChesterRep. Many conscientious mental health professionals caring for disturbed patients have either unscientifically formulated for themselves notions of 'evil' to explain the behavior of their patients, or have been given patients described by judges and the press as 'evil'. Although such notions may be deemed unscientific, beyond the purview of medicine, and better suited for discussion by theologians and moral philosophers, the fact remains that these notions of 'evil' have a definite impact on the practice of psychiatry, if not all medical fields.
Of 63 sexual assault victims who were a mean 7.9 years postevent, almost two thirds (60%, n = 38) demonstrated some degree of depression. Over half (56%, n = 35) the sample also reported a history of childhood sexual abuse. Three factors had a significant positive association with higher levels of depression: nondisclosure of the assault to significant others due to concerns about stigma; the presence of children living with the victim; and a civil lawsuit pending. One factor, currently being sexually active, had a significant negative association with depression. Results are discussed from the perspective of depression, a common pathway by which unresolved sexual trauma is expressed.
We employed brief hypnotherapy to effect physical changes in patients suffering from medical disorders including allergies, rectal bleeding, systemic lupus, hyperemesis, headache, asthma, and chronic pain. We present, in language appropriate to the individual patient, considerations and suggestions to effect the release of healing biochemicals. Ideomotor signals indicated the patient's awareness of the healing. We hypothesize that the technique triggered novel state-dependent memory, learning and behavior.
The association of physical and sexual abuse with substance abuse has frequently been noted among chemically dependent women. Without diagnosis and treatment of the trauma, female substance abusers are vulnerable to relapse and/or revictimization. This paper describes a model for education and preliminary treatment of female victims of physical and sexual violence during the inpatient phase of chemical dependency treatment. The importance of addressing both addiction and trauma at the outset of substance abuse recovery is emphasized.
Sexual assault, as a crime of violence, induces a life crisis which inflicts major psychological and physiological trauma upon the victim. Lack of mutual consent is present in all sexual assaults. Post-traumatic symptoms occur immediately and for a large percentage of victims this trauma is not integrated for many years. Symptoms include the classic triad of post-traumatic stress symptoms of haunting, intrusive recollections, numbing or constriction of feelings and focus and lowered threshold of anxious arousal subsequent to experiencing intense fear, terror and loss of control. Long term effects include anxiety, depression, phobic reactions to situations reminiscent of the sexual assault, sexual dysfunction, impaired social adjustment and diminished capacity to enjoy life. Post-traumatic stress responses, symptomatology, psychodynamics and management of the victim of recent and nonrecent sexual assault are reviewed.
Rape is a violent act that inflicts injury on the very essence of the self. Reality therapy offers an applicable conceptual framework for the treatment of rape victims. Reality therapy groups minimize attention to the concept of mental illness. The warm, friendly atmosphere of the reality therapy group provides a supportive arena where the victim can tell her story, diminish her desire to withdraw from others, and recognize control over her behavior. Through her involvement she can begin to fulfill her needs to love and be loved, and feel worthwhile to herself and others.
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