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Rape Trauma Syndrome - What Everyone Should Know

Once a prisoner is raped, he is stigmatized and marked as a victim for repeated sexual assault for as long as he remains locked up. Most victims are young, straight, and non-violent, unable to defend themselves against ruthless exploitation.

It is estimated (applying the findings of previously published systematic surveys of jails and prisons where 1.2 million males were locked up in America in 1993) that some 60,000 unwanted sexual acts take place behind bars in the United States every day, victimizing in the course of a year some 130,000 adult males in prisons, 123,000 in jails, and 40,000 boys held in juvenile and adult facilities.

Full of rage and without the opportunity to receive psychological treatment for Rape Trauma Syndrome, these men and boys will usually return to the community far more violent and antisocial than before they were raped. Some of them will perpetuate the vicious cycle by becoming rapists themselves in a misguided attempt to "regain their manhood" in the same manner in which they believe it was "lost."

The number of women sexually victimized by male guards and staff or by other women is large but unknown. This article is reprinted by permission of The Safer Society Program and Stop Prisoner Rape. It is an exert from the Overview For Jail/Prison Administrators and Staff Manual . This manual may be ordered from the Safer Society Press, P.O. Box 340, Brandon, VT 05733, 802-247-3132.

Rape Trauma Syndrome (RTS), a devastating form of Post Traumatic Stress Disorder, has been recognized and described only in the past two decades. In some form and degree it affects virtually all victims of sexual assault, including ones who avoided a completed rape. Even verbal sexual aggression without physical coercion-a common experience for prisoners-can leave the targeted victim psychologically damaged. For male survivors of physical rape the disorder is likely to be severe and even life-threatening. Institutions should not delay in getting new rape victims into counseling within hours of the victimization; this is a true psychiatric emergency.

What follows is a brief description of the serious psychological injuries suffered in order to help providers and victims understand the areas where the survivor is most vulnerable to additional, albeit unintentional, traumatization caused by others who deal with him after the physical assault.

A male rape victim usually feels that he has totally lost control over even the insides of his own body, resulting in feelings of utter vulnerability and powerlessness. Control and power become key psychological issues for rape survivors. These issues are heightened for men who are brought up to expect to be able to defend themselves against attack and who consider total helplessness incompatible with masculinity (and thus intolerable). In a prison setting, the environment of control continually exacerbates this wound. Whenever decisions are made for the survivor, rather than by him, this has the effect of rubbing more salt into the open wound. For rape survivors it is therapeutic for persons in positions of authority to allow the survivor to make his own choices whenever possible, even when the alternative options presented to him are unacceptable to him. Even when the choices for the rape survivor seem like "bad" and "worse," being allowed to choose will help him combat the feeling of total helplessness that will, if left intact, defeat all attempts to improve his condition. Often this is a question of style rather than substance, but in psychological matters it is the impression that counts. Conflicts may arise over confidentiality, participation in prosecution or informing, housing placement, and so forth. Staff members should recognize that any action they take that pre-empts the victim's control is likely to aggravate the trauma and further victimize him.

Second, the victim feels that his gender identity as a male has been compromised or even demolished and reversed. All male rape survivors (except those homosexuals who previously identified them selves as feminine) are gravely affected by this perception. It results from very widespread attitudes relating to sexual penetration and defeat in personal combat (sexuality and aggression being the two primary remaining sources of male identity to most prisoners). This identity confusion is exacerbated by the daily behavior of other prisoners who are aware of the victimization and use every opportunity to remind the survivor is his supposed "loss of manhood." If allowed to continue without redress, this belief frequently leads to suicide attempts, other self-damaging behavior, or violently aggressive compensatory behavior. To prevent additional harm to the prisoner, it is important that staff persons refrain from implying any slight to the victim's masculinity. To the contrary, all persons in contact with the survivor should go out of their way to emphasize his male status verbally and through body language at every opportunity.

The third major injury, for heterosexual survivors, is related to sexual orientation confusion. Peers often spread the unfounded belief that the victim's sexual orientation is compromised or even transformed by his involuntary experience. This perception, if not countered, can also produce suicidal behavior in the rape survivor. Unfortunately, staff people frequently contribute to this belief by ailing to distinguish between homosexuals and heterosexuals who have been forced or pressured into passive sexual activity or roles. In cases where prisoners label themselves as "homosexual," staff should be careful to ascertain that this identity existed prior to confinement before repeating the label; an unsophisticated prisoner may simply be repeating what others, seeking to justify his sexual subordination, have told him, or maybe using the term to designate a temporary condition rather than a basic trait. In prison, sexual behavior, both active and passive, commonly involves prisoners who behave heterosexually both before and after confinement. Despite homophobic attitudes that may suggest otherwise, the vast majority of prisoners who are raped or who submit to sexual pressure to prevent rape are not homosexual, and being raped does not make them so. Similarly, being homosexual does not mean that pressured sex or rape can't happen. Most specifically, staff members should avoid any implication that a rape survivor might have any less interest in the opposite sex.

Suicidal impulses and actions are so common among males who have recently experienced their first or second rape that any victim should be presumed suicidal until a mental health professional determines that this is not the case. Again, in taking suicide precautions, any choices you can allow the victim to make will help him regain a sense of self-esteem and control over his life.

In most victims, RTS has been observed to proceed in a series of stages, though these are not universal. The description that follows applies to the untreated survivor; victims given effective psychotherapy or counseling may avoid the worst aspects of RTS, or be better able to control their actions and feelings.

At first the new victim, especially when removed from the site of the attack, tends to be numb, withdrawn, talks slowly or inaudibly if at all, and denies or disbelieves the experience. Some victims, however, are visibly upset and highly emotional, sometimes palpably terrified. These two states may even alternate. Feelings of helplessness and extreme vulnerability (which may appear as indifference to one's fate) are endemic; they may, together with the re-experiencing of the original terror, induce a kind of paralysis in the face of new sexual aggression; staff members must avoid interpreting such paralysis as consent. Nightmares and sleep disturbances are common. Shame, humiliation, and embarrassment are characteristic. The ability to concentrate may be lost and dissociation ("spacing out") become frequent. Memory may be temporarily impaired. Victims should be encouraged but not forced to express themselves. This stage can last up to a week, but many of its features may carry over into later stages.

The second stage displays some or all of the following features: self-worthlessness or self-contempt, self-blame for the victimization (reinforced by those around him-both staff and prisoners-who "blame the victim" in various ways), sense of being a failure, various forms of shame, severe depression, homophobic panic, anxiety, extreme insecurity, obsession with body areas involved in the rape, restlessness, urge to escape, compulsive movement, other compulsive behaviors, inability to trust (including those who are trying to help), disturbances in sexual functioning, resistance to intimacy of any kind, ambivalence towards females, fear of males, fear of being or going "crazy", fear of persecution, cynicism, social isolation, loss of motivation, anger, and rage, often with body and mind at odds (one agitated, the other calm; later switched). Personal boundaries are confused, and relationships chaotic and conflicted. Again, some of these symptoms may persist into later stages.

This stage, when outside confinement, commonly develops a marked suppression of feelings, combined with an attempt to "carry on like normal." For a prisoner who may be involved in perpetual (if less violent) sexual exploitation, who must continually compromise to avoid further gang-rape, this may show itself in mechanical compliance with sexual demands while remaining basically numb to the experience, and strong dependency with regard to his new "owner" protector. The survivor in such a situation is torn between two compelling but contradictory impulses. On the one hand, he feels a deep revulsion against his situation which urges him to rebel against his yoke and reclaim his manhood, and underneath the revulsion lies a volcanic reservoir of rage. On the other hand, he has learned that to survive he must go along with the imposed submissive role, and that a tenuous feeling of security and protection, which he desperately needs, can only be found in playing that despised role to the satisfaction of his master. Thus survival requires him to fight the psychic need to revolt. The titanic (if barely suppressed) conflict between these two imperatives is likely to result in major psychological disruption. This very often appears in areas outside the deadlocked zone of the pair relationship, such as in unexpected self-destructive behavior, aggression against third parties, futile resistance to authority, physical illness, or other apparently irrational behaviors.

In the third stage, which may be postponed until after release, the suppressed rage resurfaces and may be accompanied by violent behavior, obsession with vengeance or with the rape experience itself, belligerence towards all holders of power (including institutional staff), disturbing sexual fantasies, phobias, substance abuse, disruption of social life, self-destructive behavior and re-victimization, life-style disorganization, antisocial and criminal activity, and aggressive assertion of masculinity, including the commission of rape on others. The suppression period can last for many years, even decades. It is important that survivors be steered towards opportunities for continued treatment after release (with therapists knowledgeable about RTS), when their progress, once outside of the traumatic environment, is able to improve dramatically.

The final stage involves a partial or complete resolution of these issues and a reintegration of the self, which allows the past victimization to recede in importance, though traces will remain for the rest of his life.