Tag Archives: rape

Counseling Advice From Lady Gaga?


Lady Gaga has a new song about the aftermath of sexual assault. Unless you’ve been living in a cave, you likely have heard of Lady Gaga who is known for crazy getups and stunts. Known in my household as the lady who wore the meat dress, she sings these words (I’ve included just a few lines) in the song “Til it happens to you.”

You tell me it gets better, it gets better in time
You say I’ll pull myself together, pull it together, you’ll be fine
Tell me, what the hell do you know? What do you know?
Tell me how the hell could you know? How could you know?

Till it happens to you, you don’t know how it feels, how it feels
Till it happens to you, you won’t know, it won’t be real
(How could you know?)
No it won’t be real
(How could you know?)
Won’t know how I feel

Her message is clear: If you haven’t been raped or assaulted (or experienced any other sort of trauma) you can’t possibly know what it is like. And since you can’t know what it is like, stop giving superficial comfort and advice.

Is Lady Gaga right? Does she offer sound counseling advice?

Yes and no. Yes, we are far too willing to offer platitudes to people in pain and wonder why they get angry and hurt and avoid us altogether. Lady Gaga captures the sentiment of the doubly hurt–first by the initial trauma and second by foolish words. The ancient Greek Aeschylus aptly puts it this way

It is an easy thing for one whose foot is on the outside of calamity to give advice and to rebuke the sufferer

Our quips roll easily off the tongue, but they injure the already wounded. Before you speak to someone and offer your ideas, do your friend a favor and be quiet. Ask them again (and again) to tell you what they experienced (past or present tense). But I don’t think Gaga goes far enough. I would argue that EVEN IF you have experienced the same trauma as the person in front of you, stop thinking that you know what they are feeling and struggling with. You may, but you may not as well. Do not assume your experience is theirs. Listen. More than you think you need to. Assumptions of “getting it” communicate that their pain doesn’t really matter to anyone.

But also, Lady Gaga is wrong (and I get it, this is art not counseling skills training!). It is possible to help others even when you have not had their experience. As long as you approach your work with humility and the heart of a student, you can do much good. You bear witness to their experience through your reflections and observations. You can ask good questions and paint word pictures of trajectories of growth. Do not think that just because you did not have the trauma, you have nothing to offer. Offer yourself (more than your words). If you fail to offer yourself out of fear of not being adequate, you also harm by not giving the present of being understood.

But let Gaga’s anthem be a challenge to those of us, myself included, who speak before listening and who assume rather than learn. We won’t get it. But we can bear witness.

4 Comments

Filed under Abuse, christian counseling, counseling, counseling skills, Post-Traumatic Stress Disorder, sexual abuse, sexual violence, trauma, Uncategorized

PTSD “A Disease of Time”


David Davies, part of the staff of “Fresh Air” on NPR, has conducted an 35 minute interview with David Morris, a journalist who was embedded in a unit in Iraq and who suffers from PTSD resulting from an explosion he survived. David has written a book, The Evil Hours: A Biography Of Post-Traumatic Stress Disorder. If you want to better understand the experience of PTSD and its impact on a person, you should listen to this show (or read the transcript). For therapists, Morris discusses his experiences with Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT). He also describes the use of propranolol when repeating trauma stories.

Here’s a couple of my take-aways:

  • PTSD is a disease of time.

“…in some ways, PTSD is a disease of time. And a lot of people – PTSD is many things, but one of the things it is a failure to live fully in the present. And I think what happens a lot of times with traumatic – survivors of trauma is they have these compulsive returns to awful events, and they are unable to live in the now.”

  • The best treatment never removes all symptoms of PTSD

“The best we can do is work to contain the pain. Draw a line around it. Name it. Domesticate it, and try to transform what lays on the other side of that line into a kind of knowledge, a knowledge of the mechanics of loss that might be put to use for future generations.”

  • Honest reflections of the impact of PE and CPT (and why so many dropout from PE treatment)
  • Honest admission about the most common “treatment” of PTSD–alcohol (and evidence why so many end up abusing it!)
  • War traumatizes far too many but rape is 5x more traumatizing

[in discussing how helplessness/lack of control is a significant factor in the development of PTSD] “Yeah, the helplessness is one of the main predictors of who’s going to end up with PTSD and who doesn’t. And the idea that you have absolutely no control over your environment is very hard for people to deal with because, you know, you are basically completely helpless and unable to control your destiny and your survival….and that’s one thing I discovered in the book is I thought – you know, we sort of assume that PTSD is sort of the realm of soldiers and veterans, when in fact, the most common and most toxic form of trauma is rape.

…a soldier may have some control over his or her environment. They have a weapon with them; they can move; they can take cover. But oftentimes in the cases of rape, the victim is completely overwhelmed and trapped and cornered. And from the moment the attack begins, they are rendered almost completely helpless, which is interesting. And you see that in the diagnosable rates of who gets PTSD and who doesn’t. Rape survivors tend to have it almost 50 percent of the time, whereas your average war veteran – particularly for Iraq and Afghanistan veterans – the rate of PTSD diagnosis is more around 10 to 12 percent. So a rape victim – rape is, in a manner of speaking, five times more traumatic than combat.”

 

1 Comment

Filed under counseling, counseling science, Post-Traumatic Stress Disorder, Psychiatric Medications, Psychology, stories

Rape Perpetration Statistics: How common is it in SE Asia?


Just saw this UN funded study in the Lancet (you can download full-text as well) after reading this news item about the study. Stunningly, 1:4 men in the large cross-sectional study indicated they had forced sex on a woman, whether girlfriend, spouse, or stranger. They did not use the word “rape” in the study in order to get at the issue of consent. For some, rape conjures a violent act at gunpoint. However, when it is used to describe (as it should!) sex with those who are unable to consent (inebriated, too young, etc.) or those who consent unwillingly (forced spousal sex), you can see the numbers show a common belief that men need to find sexual release and that females must comply.

I also found the re-offending rates stunning. Those who commit one rape are much more likely to commit a second rape. This is of course not surprising if the society does not punish the first one nor give women the possibility of seeking justice after rape.

Does anyone know of a recent similar study done here in the US? I would like to see that too. One might hope that attitudes are different here but I suspect there is a similar if less frequent pattern here.

 

1 Comment

Filed under Rape, Sex

Telling Painful Memories: Recommendations for Counselors


[What is below was shared with Rwandan caregivers and counselors. It is written in simpler English and has no footnotes. Academically oriented readers will recognize the interventions come from narrative exposure therapy models for children].

Counselors invite others to tell their stories of pain, heartache, fears, and traumas so that they can find relief from their troubles. However, not every way of talking about past problems is helpful and some ways of talking can actually harm the person. So, it is important that all caregivers and counselors understand how to help others tell their difficult stories in ways that invite recovery and do not harm.

Good Storytelling Practices

Counselors who do the following can encourage healthy and safe storytelling of difficult events:

  1. Allow the client to tell their story at their own pace without pressure
  2. Allow the client not to tell a part of their story
  3. Use silence and body language to show interest
  4. Encourages the use of storytelling without words (art, dance, etc.) or with symbols
  5. Ensures the difficult stories start and end at safe points
  6. Encourages good coping skills before story telling
  7. Points out resiliency and strength in the midst of trauma
  8. Encourages the story to be told from the present rather than reliving the story

Unhelpful Practices

Here are some things that we should avoid doing when helping another tell a difficult story

  1. Frequent interruptions
  2. Forcing the person to tell their story
  3. Asking the person to relive the story
  4. Avoiding painful emotions
  5. Exhorting the person to get over the feelings; telling them how to feel
  6. Only talking about the trauma, ignoring strengths and other history
  7. Ending a session without talking about the present or a safe place

**Trigger Warning: rape, threatened violence

A Case Study With 2 Storytelling Interventions

Patience, a 13 year old girl, suffered a rape on her way to school last month. The rapist’s family paid a visit to the girl’s family and offered money as a token of penance. The girl’s father accepted the money because, “nothing can make the rape go away so we will take the money for now.” Patience was told by some family members to not tell anyone about the rape and to just act as if it never happened. However, Patience is suffering from nightmares, refuses to go to school, and sometimes falls down when she catches a glimpse of the rapist in town. Her father has threatened to beat her if she doesn’t return to school or help out with the chores at home. Her favorite aunt, a counselor/caregiver, learns about the rape and asks her to come for a visit in a nearby city.

[Warning: these two interventions are not designed to rid a person immediately of all trauma symptoms. In addition, these interventions must be used only after a counselor has formed a trusting relationship with the client.]

  1. Symbolic story telling. The aunt tells Patience that keeping a story bottled up inside can cause problems, like shaking a bottle of soda until it bursts out. Using a long piece of rope (representing her entire life) and flowers (representing positive experiences) and rocks (representing difficult experiences), the aunt directs Patience to tell her life story. They start with her first memories of her mother, father and two brothers. She tells of her going to school, the time when her mother got really sick but then got better again, the time when her cousins moved away, and the time when a boy told her he liked her. Patience noticed how she had many flowers along the rope and only a few rocks. Then, they put a large stone down on the rope representing the rape. Patience had difficulty saying much at all. She remembered being afraid, the weight of the man, the pain, and worry that her family would reject her. She remembered getting up and going to school and acting as if nothing happened. Her aunt noted that Patience was a strong girl—she had gone to school for a week before telling her mother. So, Patience placed a tiny flower next to the rock to represent that strength. After stopping for a cup of tea and some bread, the aunt asked Patience to notice how much more rope was left. This represented her future. Patience was surprised to see the rope and said that she didn’t think she would have a future now that she was spoiled. Her aunt encourages her to consider what she would like to be in her future. They continued to discuss this over the next day. By the time Patience returned home, she was able to see that she still had a future. Seeing the rapist still bothered her. However, she was able to go to school with two friends along a new path so that she would feel safe. Patience kept a drawing of the rope with the flowers and rocks and extra rope to remind her that she had a good future.
  2. Accelerated Storytelling. About six months later, Patience visited her aunt again. She was still going to school and able to do more chores (getting firewood and buying food in the market). However, she still suffered from nightmares and sometimes fell down when she heard footsteps behind her. This time, her aunt asked her to help create a “movie” of event. Before Patience was to narrate the rape, they first recounted the safety she felt at home before the rape and the safety she felt when she told her mother about the rape and was comforted. Next, her aunt asked her to identify all of the “actors” in the play: her mother, father, herself, brothers who went to school without her, classmates, teacher, and rapist. Patience then made a figurine out of paper for each actor and drew a small map of her village including the path from home to school. Then, the aunt asked her to tell her story as fast as she could from safe place to safe place and to only look at the figurines (and to move them along the map). Her aunt noted those places where Patience slowed down in the story. When she paused, the aunt asked her to try to keep moving. Once the story was complete (when she told her mother about the rape), she asked Patience to tell the story backwards as quickly as possible. Then, she instructed Patience to tell the story forwards again twice as fast. However, this time, Patience stopped part way through the story. She added one detail she had not disclosed before. She recalled that a young boy of about 5 was peering at them from behind some bushes. Her aunt encouraged her to finish the story and thanked her for her courage. Patience indicated that she was so ashamed of being seen in such a position. Again, her aunt thanked her for working so hard but asked her to tell her story forwards and backwards one more time. Patience noticed that she was less upset by the presence of the 5 year old than she had been the first time through the story.

1 Comment

Filed under Abuse, counseling, counseling science, counseling skills

DRC/Rwanda Trip: October 14, 2011


Day 4:

A breakfast of coffee, fruit and egg and we’re off visiting rape victims and those who help them today. First stop is the DOCS hospital (Doctors on Call for Service) run by a gynecologist, Dr. Ahuka Ona Longombe. This hospital specializes in obstetrics and in fistula surgery for rape victims. Dr. Ahuka if a larger than life, forceful personality. The ABS has done some partnering to provide the hospital with some better equipment. After touring the facility, he took us to a room to show us his PowerPoint presentation on the causes of sexual violence, the impact on women and the work they do to repair. It was a difficult slide show (with a few pictures!). If you think of rape as forced intercourse only, think again!

He showed us current stats (42,225 cases of reported sexual violence as of 2 years ago). He pointed out how these stats are very likely LOW due to stigma, violence, and the complexities of multiple reporting agencies. Victims during the reporting period are 21% little girls, 56% young women, and 23% old women.

Only 25% get treatment within the desired 3 days.

While they do HIV/STD testing and treatment, medical, surgical, nursing, spiritual, and legal care, Dr. Ahuka repeatedly begged for help for the psychological damage. As a team we discussed whether it would be possible to send two high level interns (even post grads) for 6 months to focus on training nursing and doctor staff as well as lay people from local churches who might reach out and care for the spiritual needs of these terribly traumatized women. Interns would have to be able to speak French.

Diane holding the the hand of "C" (translator at center)

Typical home with lava chunk wall

Leaving the hospital we traveled some very bumpy roads to Sister Alvera’s home. Now, all roads are bumpy in Goma. But these roads were the bumpiest. I kept expecting to lose teeth or an axle. Sister Alvera, a nun who runs an orphanage and home for raped women, was not home but they were expecting us. We came for the express purpose of talking to two women who have been treated by Dr. Ahuka for fistulas and who were willing to tell their trauma story. We were most interested to hear how they are learning to cope. The first young woman, C, had bright eyes and passion all about her. We met in her small abode, something akin to a shed in this country. She told of her rape and her treatments. Through the translator we heard how she experiences both joy and deep pain (she has been rejected by her family because of the rape). She described her struggle with dissociation as, “getting lost in my mind.” Sleeping, talking to the local pastor and being prayed for were helpful interventions. Near the end of our time with C we heard her lament that she could not find her attacker in order to forgive him. The pressure to do so seemed to eat at her. She felt she could not rest until she forgave him. Diane had the presence to respond that while she wasn’t able to find him, God could see her heart and the forgiveness in it. This seemed very meaningful to C.

"X" and her adorable baby

The 2nd woman, X, had been raped and given birth to a child. The child had been rejected but lived in the compound. Sitting with X was her new little baby who played with nearby fingers and nursed when fussy. This woman was far more triggered during our conversations. Her eyes were missing light. She did not look present. However, she described a caring husband and pastor who helped her cope with her trauma experiences.

The rain, which had been pounding down for our interviews let up just as we were getting ready to run to our vehicles to leave. A view of several green cauldrons  came into view through the puffy clouds passing by. From the Sister’s place we traveled to the local bible society office. We got to see the bibles we would be giving out the next day as well as opportunity to meet the staff. I can attest to two things about the bible society. They keep amazing records on all the widows and children they serve (food, stuffs, etc.) and they do not spend their money on expensive property. Back in 2002, their offices were destroyed by the lava eruption and now they rent rather humble space. If you give the bible society, you can expect your money to go to people and services, not bricks and mortar!

We ended the day back that the hotel with a enjoyable dinner meeting with World Relief country director, Charles Franzen, and two of his staff. Our dinner was outside under a thatch canopy and just above the loud lapping waves of Kivu. I can only describe him as a character–in the best sense of the word. He speaks Swahili but not French and has lived for many years in East Africa. We had wide-ranging conversations about Africa, Baltimore (his home town), baseball (his dislike for Dustin Pedroia of the Red Sox) and football (soccer). And of course the work of trauma recovery was a central topic this evening.

3 Comments

Filed under Abuse, Christianity, counseling, counseling science, counseling skills, Democratic Republic of Congo

Listening to trauma


Those interested in trauma recovery work in international settings where rape is used as a tool of war will find this article on CNN to be of interest. WARNING: Not for those who are easily triggered by trauma stories!

Here’s a couple of reasons to read the article.

1. Why do this work?

They believe that listening is acknowledgement — and that acknowledgment is a kind of apology. Listening, they say, is the least the world owes.

2. Impact of this work?

You will experience secondary trauma. Don’t think you won’t.

3. How to do this work?

Start with an open question: Tell me about your experience. Look them in the eye. Don’t look at your notepad. If they say, “No, I don’t want to talk,” then leave. If they say, “Yes,” and tell you horrible things, wipe the emotion from your face. Get over being surprised they would tell a stranger, you, such intimate violations.

Know they are telling you because they need to tell someone, for whatever reason. And bearing that in mind, make no promises. Different victims want different things — revenge, financial compensation, asylum, prosecution of their attackers. Tell them that you can only listen, and do only that.

Leave a comment

Filed under Abuse, Post-Traumatic Stress Disorder, Rape

Can one person do anything about mass rape?


Cover of "King Leopold's Ghost: A Story o...

Cover via Amazon

Ever notice how we can feel quite helpless when we hear about evil on a mass level? We’ve all had times when we’d rather turn away from systemic evil because we can’t stand to look at what we cannot change.

But check out the story of one Edmund Dene Morel as told in King Leopold’s Ghost: A Story of Greed, Terror, and Heroism in Colonial Africa (by Adam Hochschild, Houghton Mifflin, 1998). Most likely you’ve never heard of him or the mass destruction of 5-8 million Congolese during the reign of Leopold II, Belgian King who “owned” the Congo during the turn of the 20th century.

Instead of my summarizing this story, click the link above and read the story yourself (link goes to Amazon’s search inside, p. 1). You will see that one person who saw the problem of slavery and raping a country and did not turn away. Rather, he made it is work to tell the world and cause Americans and Europeans to rise up and force the government of Belgium to take control of that area away from their king.

Once again, the Congo is facing the destruction of some of its population–the women. The main method is not slavery but rape. The instigators are warring groups, Congolese and outsiders. The goal is to destroy by destroying families, spreading HIV and fear. Many women are raped multiple times.

What will we do?

Consider writing to your congressmen or the president or Sec Clinton to speak out about this problem. Also, you might consider giving to groups that are working in the area to care for these women and/or trying to change culture. Doctors without Borders (MSF), Amnesty International, American Bible Society, and many others are working in the area. And start with talking to your friends about this problem.

Unknown people can do much when we are willing to speak the truth.

3 Comments

Filed under Abuse, church and culture, Democratic Republic of Congo

Connecting the dots: porn and rape


A few days ago a young woman/teen was found partially clothed and semi-conscious under a Philadelphia bridge. At the time I am writing this post, it is assumed (nothing too outlandish here) that she was assaulted and raped and left for dead. Whether or not this turns out to be the exact situation for this injured woman matters not for the rest of the post. What does matter is that we know that rape happens.

How does one get to the place of treating another human being like an object and caring nothing for that person’s feelings, interests? We’d like to believe that rape, murder, slavery, trafficking, and the sort are different sorts of animals than the wee little sins we commit. But such heinous acts have exactly the same roots as “normal” objectification.

Take porn for example. On first blush, there is not any interpersonal crime in looking at a pornographic image. The assumption goes that the individuals in the pictures have voluntarily allowed themselves to be photographed and are happy with what they are doing. Of course, we know that these two assumptions are not always true. But even IF we accept the assumption, we must also accept that the viewer of the pictures cares nothing about the person in the picture. They exist for one reason only–to provide pleasure for the viewer. They have no feelings, they are only objects on a page.

The one dimensional image allows the viewer to begin the process of not seeing the other and not seeing their abuse of the other. And we are well aware of the common path of porn use. Start with a scantily clad image, move to complete nude, then to more and more dramatic pictures of sex acts which often include bondage, pain, or other grotesque acts.

Most people would have trouble watching a friend or a loved one engage in such an act, much less act out such activity on someone in pain. Most of us couldn’t just rape a stranger–at least at this point. But the root is the same: ignoring the personhood of the person in front of us. The person who is able to rape, traffick, or enslave has just been more successful in protecting themself from empathy, putting themself in the shoes of another, etc. We haven’t yet gone that far but notice that we begin such activities by our ability to objectify people on television or even in our everyday life. We murder (in our hearts) the incompetent bagger at the grocery store. We care little about his or her life. I’m not putting a passing hateful thought on par with rape but when we fail to recognize the person on the other side we begin to make it possible to deny the humanness of the other, whether a victim of a crime or the perpetrator.

Reminds me of Miroslav Volf’s quote in Exclusion and Embrace (p. 124): 

“Forgiveness flounders because I exclude the enemy from the community of humans even as I exclude myself from the community of sinners.”

3 Comments

Filed under Abuse, christian psychology, Christianity, deception, pornography, sin