Rape is a social reality. The Rape, Abuse & Incest National Network (RAINN) claims with reference to data researched by the U.S. Department of Justice’s National Crime Victimization Survey (NCVS) that every 107 seconds, another American is sexually assaulted. Statistics from the CDC indicate that about 1/5 of all women in the US have been raped. This fact makes it very likely that you or someone in your immediate social environment – a family member or a close friend – has experienced sexual violence at least once during their life course.

I personally have met many people coming from different social backgrounds and age groups, with different genders and sexual orientations, who all share one common experience: they all have come in contact with sexual abuse, either directly in varying degrees of severity or indirectly through the accounts of others.

But how come that some persons who experience sexual violence struggle with coping with the events and have a hard time articulating what has happened, still being overwhelmed by an experience that –to the outsider– has happened years and years ago, while others seem to have stored the memories in a safe place and can talk about and evaluate the experience with detachment?

It is not the intention of this text to put survivors of sexual assault and rape under pressure to “finally get a grip” when they have a hard time dealing with what has happened to them. Instead, it aims to help understand what a traumatic experience really is and how it affects the brain in order to help survivors of sexual violence and those close to them to get a better understanding of how the traumatic memory works. Understanding how trauma works is, among many others, an important step towards healing.

This is the first text of a two-part series, defining the term “trauma” and giving an overview on its neurophysiological effects. It is a more medical approach to the topic; text number two will present a detailed insight in the psychological consequences of trauma.

Trigger warning: This text mentions factors contributing to the development of posttraumatic stress as well as some of its symptoms such as dissociation. It does not contain graphic descriptions of sexual abuse.

What is trauma?

ptsdheadTrauma is to be distinguished from a normal stressful event. It is experienced by those affected as something so dreadful and outside of their everyday reality that there are no coping strategies to process the happenings. The consequence is a discrepancy between what is happening and the person’s resources to handle the situation. The traumatic event is accompanied by feelings of terror, power-, helplessness and immense fear. The severity of the reaction to the trauma depends on its nature.

Traumatic events include:

  • accidents
  • chronic illness or pain
  • war
  • natural disasters
  • torture
  • rape
  • domestic abuse
  • death of family member, friend, teacher, or pet

Focussing on the topic of rape, it is obvious that a car accident in which no one is killed has different long-term consequences for the person experiencing or witnessing the event than experiencing sexual violence. Concerning the traumatic effects of rape, the severity of the after-effect of the trauma depends on the age in which the person experienced the abuse as well as on the duration of the experience. Thus, a child experiencing sexual violence over an extended period of time is more likely to suffer from severe consequences of the trauma than an adult experiencing sexual violence once. Also there is a difference between experiencing rape in a country which offers the person affected the possibility to make use of medical, legal and therapeutic support in contrast to experiencing it in an extreme situation such as during times of war, which is a traumatic event on its own.

dissassociation

Risk and protective factors influence the consequences of experiencing a traumatic event

Nonetheless, it has to be stated that the ways in which a person copes with experiencing sexual assault or rape differ with regard to a number of different factors. In this context, social support becomes one of the most important factors when it comes to dealing with traumatic experiences. For example: A person who is strongly connected to its social environment and well-supported by friends and family members – both before and after experiencing sexual violence – might suffer less from the consequences of sexual violence than a person who experiences a lack of social support.

Besides social support, there are different other risk and protective factors that have an influence on how a traumatic experience as rape is processed. Those fall into three categories, which are pre (before), peri (at the time of the event) and post (after) traumatic factors.

Risk factors influencing the possibility to develop post-traumatic stress

table

https://www.rainn.org/get-information/statistics/sexual-assault-victims

brainregions
Consequences

Rape, as acute trauma, has both neurophysiological as well as psychological effects on the person experiencing it. To make this thesis more vivid, one can look at the animal kingdom, especially mammals: If a hedgehog encounters a predator – for example a marten – it will either fight, flight or freeze. The same counts for humans. This can be explained by the fact that the neurological region responsible for those basic impulses a hedgehog experiences when encountering a predator – the amygdala – developed early from an evolutionary point of view and can, therefore, be found in many mammals. This region is decoupled from the area of the forebrain – or the prefrontal cortex – which is responsible for understanding and thinking differentiated.

During a traumatic event, the amygdala automatically acts separately from the prefrontal cortex as a protective mechanism. Which one of the three possibilities a person chooses or has to choose when being threatened with or experiencing rape (or another trauma) – to fight back, escape the situation or to endure it – depends on a number of individual and contextual factors. Especially grievous trauma and learned helplessness can occur following prolonged and repeated trauma.

Nonetheless, it can be said that if a person cannot escape the situation and if the pain of the event – both physical and emotional – becomes unbearable, the amygdala region can cause dissociative behaviour in the person experiencing the abuse. Dissociation is another protective mechanism in which the brain separates the perception of self from the experience, and may lay in an internal mechanism meant to avoid overloading the brain with too much, too intense, experience at once.

There are many different neurotransmitters released during trauma, especially during rape. Rape (and some other forms of sexual abuse/abuse) has the added problem of bonding hormones like oxytocin, which are triggered by genital activity, which can have an affect on future bonding-behavior. Since we are conditioned by everything, and intense experience can condition far faster (in as little as one event), events that remind a person of traumatic events may start a processing of data the brain that had been previously filed away during disassociation.

Thus a high sensitivity towards related situations or stimulus is inherent in any type of trauma, regardless of whether we are talking about someone who was a soldier or has been raped. This can in turn lead to extreme reactions or distress when actors or events that are from or remind them of their trauma come into their present life.

Some of the hormones that are up-regulated during trauma are:

  • Epinephrine and norepinephrine (create a state of “hyperstress,” is the precursor for adrenaline)

  • Cortisol (providing energy in the form of glucose, and assisting immune functions)

  • Oxytocin (responsible for inhibiting memory consolidation, also for social attachment)

  • Vasopressin (prevents dehydration)

  • Endogenous Opioids (control pain and overwhelming emotions)

secondself

The dissociation causes a detachment between the body and the mind, leading a person to feel as if they are experiencing the abuse from outside, e.g. as if watching it happen like a spectator from a corner in the room.

Research indicates that high levels of norepinephrine, epinephrine, and endogenous opioids interfere with the storage of explicit memory, which is exemplified in our ability to reason and verbally repeat our experiences. Therefore, traumatic memories are stored in the implicit form as emotions and senses in the amygdala, making it hard to articulate the experience as the memory appears to be fragmented and composed of different incoherent sensory impressions.

Thus, survivors of abuse become haunted by feelings and senses they know are related to the trauma, but have great difficulty identifying those. These sensory impressions (so called “triggers”) bring overwhelming emotions and sometimes flashbacks and panic attacks which cause the body to return to the emergency chemical response experienced during the traumatic event. If the stress created by the trauma continues to act, base-level psychobiological changes are induced:

  • Increased levels of catecholamines (causing chronic hyperstress)

  • Decreased levels of glucocorticoids (responsible for poor immune functioning)

  • Decreased alpha-2 Adrenergic receptors (causing less regulation of stress)

  • Increased endogenous opioid levels during traumatic memory triggers (which equals up to 8 mg of morphine)

Understanding how these processes work, and how your brain becomes conditioned by experience to trigger future reactions, can help you retrain your brain. In the same way counter-conditioning therapy uses the same stimulus with another reaction to slowly rewrite the associations, you can use your experience to recondition yourself. Hopefully, even if you aren’t afflicted, you can have empathy and understanding for those that are, and do your best to not make light of their feelings or experience.

Sources: The Psychobiology of Trauma:www.healing-arts.org/tir/n-r-diehl.htm
The Rape, Abuse & Incest National Network:
www.rainn.org

On violence against transgender people: Stotzer, R. (2009). Violence against transgender people: A review of United States data. Aggression and Violent Behavior, 14, 170-179.

The Body Keeps The Score: Memory & the Evolving Psychobiology of Post Traumatic Stress by Dr. Bessel van der Kolk (MD, Harvard)
http://www.uvm.edu/~cdci/best/readings/readings2012/joyal-reading1.doc