The recent Senate hearings that led to the confirmation of Justice Brett Kavanaugh were both riveting and painful for many viewers. It’s difficult to recall another time when sexual assault and its effects played such a prominent role in our national conversation.
Dr. Christine Blasey Ford’s description of her 1982 alleged sexual assault experience, and its decades-long aftermath, significantly impacted many survivors of sexual assault–especially those with symptoms of post-traumatic stress disorder (PTSD). Some even described the ubiquitous media coverage of the hearing and testimony as “triggering.”
This post will explore why the Kavanaugh confirmation proceedings provoked such significant responses from sexual assault survivors who live with symptoms of PTSD.
How Common Is PTSD in Survivors of Sexual Assault?
In the United States, research shows that 18% of women report being raped at some point during their lives. The likelihood that a woman who has been sexually assaulted will develop PTSD is estimated to be between 25% and 50%. Given that there are approximately 165 million females in the United States, some quick math suggests that between seven and fifteen million women have had (or will have) PTSD stemming from a sexual assault. (The numbers for men are lower, but still significant.) It is no surprise, then, that sexual assault is the most common cause of PTSD for women.
Living with PTSD
Many victims of sexual assault develop full-blown PTSD while others develop partial (or “subclinical”) PTSD. In both cases, reminders of the sexual assault can trigger significant and disturbing symptoms.
Many people suffering from PTSD cope with a disruptive symptom known as flashbacks, which is when the traumatic event is recalled so vividly that the person loses track of their surroundings and feels as if they are re-experiencing the event in the present moment. Flashbacks are different from merely remembering the event–they are an all-consuming experience that represents a departure from one’s regular waking life. All of the emotions felt during the event are lived again, as if the event is unfolding in the present.
Strong reactions to reminders of the traumatic event are a significant part of the PTSD experience. These reminders are called “trauma cues.” For example, loud noises can be potent trauma cues for combat veterans with PTSD.
For many survivors of sexual assault, trauma cues can include the physical location where the assault occurred as well as other things that survivors associate with the event. These often include angry men, being told one’s memories are wrong, or being vilified in response to coming forward. Unfortunately, each of these all-too-common experiences were on display during Justice Kavanaugh’s hearing.
While these aspects of the proceedings were surely difficult for Dr. Ford to endure, the large national audience meant that women across America experienced potent reminders of their own assaults and associated aftermaths. This brought up old and powerful feelings for many–perhaps millions–of American women.
Fear and Avoidance
A frequently-utilized (though unhealthy) coping strategy for many sexual assault survivors– particularly those with PTSD–is that of avoidance. Our brains are hardwired to help us avoid situations that could be life-threatening or traumatic.
The brain’s primary way of accomplishing this is through fear. For those suffering from PTSD, the fear reaction that results from experiencing a trauma cue can be incredibly strong–to the point of being very upsetting or even debilitating.
What would you do if going to a certain place provoked crippling fear? You would probably avoid that place! That is exactly what people with PTSD do, and it is typically an effective strategy–but only in the short-term. Because it helps alleviate discomfort (temporarily, at least) those with PTSD tend to overuse avoidance, which can create other problems. These can include an inability to visit certain places or to tolerate certain thoughts and emotions. As a result, memories around the traumatic event go unaddressed and unprocessed, sometimes for years.
Many sexual assault survivors who watched or heard Dr. Ford’s testimony said that old feelings and memories surfaced for the first time in years. Why would this be?The media’s extensive coverage of Dr. Ford’s testimony prevented many sexual assault survivors from continuing to ignore their old feelings and memories. This provided a unique, if also painful, cultural moment that forced survivors out of using avoidance as a coping strategy for their posttraumatic symptoms.
Changes in Thinking
Some of the most disabling symptoms of PTSD are more subtle than flashbacks or avoidance. For example, researchers and mental health providers have recently become more aware of how PTSD can change our thinking.
Changes in thinking often take the form of new and negative assumptions about oneself, others, and the world. People who have endured a sexual assault are especially vulnerable to these changes. After a sexual assault, some survivors come to believe that they are “damaged goods” or that “all men are dangerous.” Some even inappropriately blame themselves for the assault. (See below for more on this.)
Believing these things can affect every facet of a survivor’s life. Everything–from interpersonal relationships to how career decisions get made to how social lives are conducted–can be touched by changes in thinking that follow a traumatic event.
For many survivors of sexual assault, the Kavanaugh hearing only underscored how profoundly impactful their own histories with sexual assault have been on how they see themselves and others.
Triggers Resulting from the Kavanaugh Hearing
For many survivors of sexual assault, witnessing Dr. Ford being questioned about the accuracy of her memory was especially upsetting because it reminded them of their own experiences.
Others described feeling triggered at the disbelief expressed by some law-makers and the media at Dr. Ford’s incomplete recollection of the assault that allegedly occurred in 1982. For many victims who come forward about their sexual assaults, other people’s reactions play an important role in determining the ultimate impact of the event–especially if the victims encounter skepticism about their stories.
Trauma’s Influence on Memory
It is true that traumatic events can interfere with our natural memory function by either enhancing it or interfering with it. Other factors, including alcohol or drugs, can also influence a sexual assault victim’s ability to recall details about the assault. We certainly know that “date rape” drugs like Rophynol or GHB can interfere with memory or cause amnesia.
Understandably, these memory problems can be additionally upsetting for victims. For those who were given Rophynol or GHB, the inability to recall specifics is actually part of the crime that was committed against them.
Skepticism and Victim Blaming
If a survivor encounters disbelief from others when they come forward with their story, they understandably experience this skepticism as victim blaming. Additionally, some survivors blame themselves–either wholly or in part–for “allowing” the sexual assault to occur. This experience is common for rape survivors with PTSD, and is a central focus of Cognitive-Processing Therapy (CPT), which is an evidence-based treatment for PTSD that was originally developed to help survivors of sexual assault.
Survivors cope with skepticism about their assaults in one of two ways: it is either experienced as invalidating, or it leads the survivors to doubt themselves and to doubt what happened. Either of these experiences can lead to significant further difficulties for the victims.
Invalidation can be particularly damaging for children and teenagers. Even for adults, invalidating responses can teach survivors that they will not be believed in the future or even that they will be blamed. The lesson that is learned effectively cuts off the victim from an important avenue for healing: social support. For those victims who respond to skepticism from others by blaming themselves, the hurt can be even worse. Low self-worth is a common result, and can affect the victims for years to come, often in a profound fashion.
Is PTSD Treatable Many Years after the Traumatic Event?
Yes, it is!
Unfortunately, many people with PTSD assume that they are doomed to suffer with their problems indefinitely. Some assume that it’s only natural to be “skittish” about getting back in a car after living through a terrible accident. Others believe that there is no “real” help available or they may not even recognize that they have PTSD.
Additionally, numerous people wrongly assume that treatment would require medication that they are averse to taking. This view is common even among those quite sensitive to the effects that trauma can have. For example, this recent piece on trauma from the New York Times points out that “Medication can rebalance chemicals in the brain, but it can’t heal the inner self.” This is true, but it unfortunately creates the impressions that A) medication is the standard treatment for PTSD (it’s not) and that B) there are no good options for healing aside from medication. This is simply inaccurate.
There are excellent proven treatments for PTSD that do not involve medication and that typically show significant results within a few weeks or months. This is true regardless of how long ago the traumatic event occurred. Help is out there!
Please contact us if we can help you or a loved one find treatment for PTSD.