Does this statement surprise you? Most people associate post-traumatic stress disorder (PTSD) with war and are surprised to learn that sexual assault (including rape and childhood sexual abuse) is actually more likely to cause PTSD. Even though sexual assault is at the forefront of our nation's attention thanks to the #MeToo movement, this fact has not been a part of the conversation and it needs to be.
I can't count the number of times that a client has wondered aloud why they can't move past trauma, "I mean, it's not war." Or, "I know it can't be PTSD since I wasn't at war, so I don't know what's wrong with me." It is absolutely mind-blowing to them when I tell them that, actually, sexual assault is more likely to cause PTSD and I explain why.
I can see the self-judgment melting away in their surprised faces. I can see the stigma and shame of seeking help lessen. They express such relief at knowing. All of which underscores how vital it is that the general public be educated on this subject.
ESPECIALLY when you consider that ONE IN THREE WOMEN and one in six men experience sexual assault in their lifetime.
Think about the women in your life that you care about. Now figure out how many constitute a third. If your math skills are really good, do the same for men. Spoiler alert - it's a LOT.
So this is not esoteric knowledge that doesn't really apply to you. From a public health perspective, from a caring-about-the-people-in-your-life perspective and perhaps the I've-lived-through-this perspective, this is essential information that everyone needs to know and share with others.
Before I go on, I want to explicitly say that war is absolutely terrible. It leaves significant invisible wounds and causes a great deal of PTSD. I worked for years with combat veterans and have a huge amount of respect for their bravery in their recovery. In no way am I saying that war is "less than" in the trauma department. All traumas are terrible and there is zero shame in needing help recovering from a trauma, regardless of what type.
That being said, there are several important differences between sexual trauma and war that underlie the differences in rates of PTSD:
1. The Enemy is Someone You Know and Trust
With war, you know who the enemy is and you know they're going to try to hurt you. You expect it. And you prepare the best you can (though, let's be honest, nobody can fully prepare for what war is like).
With sexual assault, there isn't a known enemy trying to hurt you. It's generally someone you know. Usually a partner, relative, friend, boss, or coworker. Over 8 in 10 sexual assaults are by someone known to the victim. The creepy stranger popping out of the bushes that you see on TV? Exceedingly rare.
Not only do you not expect this person to hurt you, you expect them to have your back and be trustworthy.
So with sexual assault, you have both shock and betrayal. As if trauma wasn't bad enough already.
2. Survivors are usually silenced, shamed, and blamed.
If there's one thing we've seen play out over and over again with all the sexual assault news stories, it's how both the perpetrators and the public silences and blames survivors.
Many survivors report the assault and are not believed, threatened, or blamed. Far more survivors don't report it because they know these are the likely results, having seen this play out over and over in the media and among people they know.
Still others don't report it because of an internal sense stigma or shame. This is also a side-effect of our victim-blaming culture.
When you're blamed for your trauma, through comments about what you might have been wearing, what time of night it was, or if you were drinking, it creates a huge amount of guilt and shame that makes the trauma that much more upsetting.
While people may disagree with war for a variety of reasons, nobody blames the individual soldier for the war. They are not blamed for their trauma. While it is still difficult for soldiers to talk about the trauma, they don't avoid the subject for fear of being blamed.
When survivors are afraid to talk about the assault for fear of very likely consequences, or are silenced by threats and victim-blaming, it both increases shame and guilt, and also cuts them off from the lifeline of support. Support after a trauma is one of THE biggest factors in determining whether a person will be able to recover or not.
3. Trauma Happens in Isolation
In combat, you are one of many people in the same situation, fighting the same battle. You aren't in it alone and other people just get it, even if you don't talk about it. You know it's not just you going through it and it is a shared experience.
With sexual trauma, outside of situations where a group is sexually assaulted, the survivor is the only person enduring the trauma. There is nobody in the trenches with them. There aren't other people there for support. It is incredibly isolating. And when it seems it's happening to "just you" it makes it easier to blame yourself or to believe others who blame you.
Apart from veterans who were drafted, like the Vietnam veterans, people choose to enter the military, knowing there is a chance they will go to war. Some of them even want to go to war and some may have some degree of influence over the type of work they do in the service.
When you are sexually assaulted, someone has taken away your choice.
When you consider these differences between war and sexual trauma, it is easier to understand how it makes perfect sense why sexual assault is more likely to cause post-traumatic stress. The only type of trauma more likely to cause post-traumatic stress than sexual assault is torture (some sexual assault and war experiences do involve torture).
If you are reading this as a survivor, my hope is that my words have helped you to be more gentle with yourself and offer yourself some compassion. Regardless of the type of trauma, you deserve healing.
For everyone else, I hope this helps you better understand and have empathy for what the survivors in your life (and there definitely are, even if you don't know who they are) are going through.
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Befriend Your Body with Dr. Linda Baggett
Blogging with expertise, compassion, and humor (and occasional swearing) about all things trauma, sexuality, body image, and diet culture from a feminist, Health at Every Size perspective with psychologist Dr. Linda Baggett.
Dr. Linda Baggett