Sexual trauma MGG2602
1. THEME 1: Definitions
Defining stress, crisis and trauma
Stress
Stress is a term that is used to describe the strain we feel at different times in our lives or in different situations.
Firstly, stress may be considered as a set of external forces impinging on the individual. Secondly, it may be
viewed as a set of psychological and physiological reactions experienced by the individual, such as a racing heart,
sweaty palms and negative self-talk.
The extent to which the individual experiences stress depends on the event itself, together with the individual’s
personality and ability to cope.
Crisis
A normal reaction that an individual has to a difficult experience that they have not had to face before. When a
person is in crisis, they feel confused, overwhelmed and unable to cope.
Trauma
1. Trauma definitions
Trauma is sudden, overwhelming and unanticipated. The individual experiences fear, helplessness, loss of control
and extreme powerlessness. The trauma-inducing situation suggests a threat of injury or death to the person or
others around them.
Defies the individual’s need for dignity, fair play, security, self-control and belonging. The most noticeable
characteristic of traumatic events is the feeling of helplessness and terror that their victims are left to deal with.
2. The effects of trauma
Overtaxes a human being’s ability to cope.
Damage mental health.
Persistent expectation of danger, an imprint of the traumatic event that does not want to fade and a
numbing response of giving up, which becomes generalised.
Wounding of emotions, will to live, beliefs about yourself and the world, dignity, and sense of security”.
Previous coping mechanisms that were used to handle stress are no longer effective or functional.
Impact on the person’s personhood, individuality and humanity.
3. Different kinds of trauma
There are different kinds of trauma:
natural disasters (floods, fire, hurricanes, earthquakes, and so on)
man-made catastrophes (war, terrorism, bus disasters and civil unrest)
unintentional violence (motor vehicle accidents and culpable homicide)
intentional violence (physical assault, sexual assault, domestic violence and hijacking) (Intentional
violence encompasses forms of victimisation involving a threat to life, health (psychological and physical)
and limb. Sexual trauma falls within this category.)
4. Direct and indirect trauma
Direct trauma – affecting the victim directly
Indirect trauma – affecting witnesses and those who have direct contact with the victim
This suggests that any person who witnesses a death, a rape or an assault of another person is at risk of becoming
traumatised.
The symptoms experienced by victims of indirect trauma can be identical to those experienced by victims of
direct trauma.
Policemen, journalists and helping professionals need to take precautions against indirect traumatisation.
Loved ones of victims of trauma may be indirect victims of trauma.
Adapted from: Tutorial Letter for Sexual Trauma, 102/0/2018, MGG2602, University of South Africa, Pretoria
,An individual may also be involved in a traumatic event as both a direct and an indirect victim. An example of this
is the child who witnesses the mother being raped while being held hostage during a robbery.
5. Single versus multiple trauma
Trauma may be the result of a single event or it may involve multiple traumas.
6. Continuous versus complex trauma
Continuous Situations where people are exposed to ongoing trauma.
trauma When people are repeatedly exposed to traumatic situations, they appear to develop a
‘‘numbing’’ response to any new or additional traumatic events, making it more difficult to
detect.
These people are often mistakenly regarded as being lethargic or depressed.
Complex Victims experience prolonged, repeated traumatic events
trauma There is usually a relationship between the victim and the offender.
Examples: woman who experiences marital rape or the child who is sexually abused by a
parent.
This form of trauma is very damaging, because the victim is under the control of the offender
and cannot escape for an extended period.
The first trauma is unexpected, but in time, the victim awaits further incidents with
enormous psychological tension.
Defining sexual trauma
any trauma of a sexual nature.
The trauma creates emotional turmoil for the survivor.
The trauma may impair the trauma survivor’s functioning in certain areas, such as self-esteem,
relationships with other people and sexuality.
These problems may only manifest much later, when the survivor develops an understanding of the
wrongness of the activities, given that his or her participation may even have been passive.
Sexual trauma may be the result of one sudden, horrifying, unexpected event, such as a rape.
In other situations, such as child sexual abuse, it may engender continuous traumatic stress and the symptoms
are likely to be more complex and long-lasting.
Some victims of sexual trauma are likely to be victims of multiple traumas.
The adult survivor of child sexual abuse is doubly likely to risk further rape, sexual harassment or battery.
Russell – Incest survivors were more likely to be raped by non-relatives than women with no incest history. Incest
survivors were also more likely to be raped and beaten, sexually abused by authority figures and subjected to
pornography-related sexual abuse.
Sexual trauma not only affects the victim, but also those people who may have witnessed it.
There are different types of sexual trauma:
1. Rape and child sexual abuse
The most obvious forms of sexual trauma are rape and child sexual abuse. ChildLine reports the following:
One in four children in South Africa will be abused sometime in childhood.
Just as many boys as girls under the age of ten years are sexually abused.
A total of 80% of the offenders of sexual abuse are known to, and trusted by, the child victims.
There has been a significant increase in young offenders (under 18) who sexually abuse children.
A total of 99% of sexual abuse perpetrators are men.
Worldwide, only 5% of offenders of sexual abuse are convicted.
In South Africa:
Children are prostituted by their parents to provide an income
Adapted from: Tutorial Letter for Sexual Trauma, 102/0/2018, MGG2602, University of South Africa, Pretoria
, Abandoned/street children engage in survival sex
children are prostituted at shebeens
children are trafficked into prostitution rings,
schoolgirls are sexually exploited by taxi drivers,
children under 18 engage in sex work on the city streets and in brothels,
2. Female genital mutilation
The partial or complete removal of any part of the genitals, and includes circumcision of female children.
The classification as sexual trauma should only be made when the victims manifest very specific symptoms that
are characteristic of trauma.
Impact of trauma
Trauma is a blend of different behaviours, feelings and physical responses.
Variables: age at the time of the incident, their relationship with the perpetrator, their gender, the duration of the
traumatic episode, the extent to which effective interventions were available, the amount of support received
after the trauma, the extent of the violence involved, their history of transcending earlier life crises, their
psychological history, their perspective on the trauma.
The body’s response to an abnormal amount of stress
Threat arouses the sympathetic nervous system, causing the person in danger to feel an adrenalin rush and to go
into a state of alert.
The person becomes ready to fight or escape the threat. When the person is unable to resist or escape, then a
traumatic reaction occurs. The person’s self-defence system becomes confused and disorganised, resulting in the
person having prolonged changes in physical arousal, emotion, cognition and memory. The person’s system goes
into permanent alert. They startle easily and usually have a strong reaction to stimuli that may be associated with
the traumatic event. Affects sleep and wakeful times.
These processes may be conscious, unconscious, or both.
Avoidance:
Reduces the emotional impact of the event.
Protects the individual from becoming emotionally overwhelmed and dysfunctional.
May result in the blocking out of information.
Prolonged use of avoidance creates emotional numbness and avoidance of certain aspects of the self and
life.
The shattering of fundamental assumptions
Individuals have assumptions about themselves and the world they live in.
These assumptions are their reality.
Influences the way they approach situations and the way they feel about the world.
These assumptions are usually positive and reassuring.
When persons experience trauma, it disrupts their beliefs about the self, human nature and the nature of the
world.
Because these assumptions are challenged, anxiety, confusion, depression or disequilibrium caused by the trauma
is further exacerbated.
The person is left with doubts about who or what to trust and what to believe.
The three assumptions that victims are forced to reconsider are:
Loss of Most people assume that they will be spared adversity.
invulnerability This assumption changes when a person experiences trauma.
The person assumes a sense of doom.
The notion that People generally assume that by being careful, honest and good they can avoid disasters.
Adapted from: Tutorial Letter for Sexual Trauma, 102/0/2018, MGG2602, University of South Africa, Pretoria
, the world is The assumption is that bad things do not happen to good people.
orderly and For something to have affected their lives, they must have done something wrong. This
meaningful leads to self-blame.
Previously held views of human decency and social justice, or spiritual views, are no longer
adequate to explain things.
Loss of positive They are overcome by helplessness, vulnerability and powerlessness.
self-image Being so powerless does little to nurture a person’s sense of self-esteem.
Trauma has a way of getting victims to blame.
Society manages to stigmatise survivors, especially those who have suffered sexual abuse,
and even the term “victim” is disempowering.
Trauma and post-traumatic stress disorder
Victims of trauma may develop a fairly recognisable group of long-term complex effects and symptoms.
The current diagnosis of PTSD using the DSM-IV (American Psychiatric Association, 1994) is made when a person
experiences an extreme trauma and develops three clusters of symptoms:
re-experiencing the trauma;
avoidance of trauma-related stimuli
symptoms of increased arousal.
The symptoms must be present for more than one month and significantly impair the person’s functioning.
The origins of the symptoms are caused by the intensity and duration of the stressful event and the meaning
attached to the event by the survivor, and are less dependent upon the person’s mental stability and
psychological state before the event.
PTSD can be acute or have a delayed onset.
Reactions may be delayed anywhere between one year and, in some cases, 40 years.
The DSM 5 criteria for post-traumatic stress disorder
The DSM 5 defines specific criteria for this diagnosis. Below is a brief summary of the criteria:
the person has been exposed to death, threatened death, actual or threatened serious injury, or actual or
threatened sexual violence
the traumatic event is persistently re-experienced
persistent effortful avoidance of distressing trauma-related stimuli after the event
negative alterations in cognitions and mood that began or worsened after the traumatic event
trauma-related alterations in arousal and reactivity that began or worsened after the traumatic event
persistent symptoms for more than one month
significant symptom-related distress or functional impairment (e.g., social, occupational)
disturbance is not due to medication, substance use or other illnesses
PTSD is commonly experienced by survivors of horrors (war veterans), victims of violent crime and survivors of
sexual abuse.
Trauma resulting from violence results in more complex trauma reactions.
The trauma arising from continuous victimisation such as sexual abuse and domestic violence appears to be the
most severe.
Some experts believe that there needs to be an expanded diagnostic concept that is more descriptive of the
complex nature of sexual abuse, as this abuse often involves prolonged and repeated trauma, resulting in
personality changes and deformations of relatedness and identity, and these survivors are more vulnerable to
repeated harm, both self-inflicted and at the hands of others
Recovery from trauma
‘‘Resilience is the ability to thrive in the face of difficult circumstances’’
Some people are able to survive trauma and to proceed without permanent emotional scarring.
Resilience is likely to develop from both internal and environmental factors.
Adapted from: Tutorial Letter for Sexual Trauma, 102/0/2018, MGG2602, University of South Africa, Pretoria