36
Healthcare Journal of Baton Rouge
| July / August 2008 Issue | healthcarejournalbr.com
Physical Symptoms Related to Sexual Assault and Abuse
Women who have experienced previous violence may fre-
quent the healthcare system, but they rarely present with
obvious trauma. Instead, they may present with unexplained
medical complaints, including the following:
Functional health problems found more frequently in women
with a history of victimization:
Chronic fatigue
Chronic musculoskeletal pain
Chronic pelvic pain
Chronic headaches
Irritable Bowel Syndrome
Premenstrual Dysphoric Disorder.
Women who have experienced violence are also more likely
to be at risk for serious long-term health problems such as
arthritis, asthma, chronic lung disease, diabetes, heart dis-
ease, liver disease, stroke, and skeletal fractures.
Psychological Symptoms
Related to Sexual Assault and Abuse
While women may seek treatment for the physiological prob-
lems listed above, they are generally reluctant to seek assis-
tance for their psychological symptoms. The best explanation
of the constellation of symptoms experienced by women who
are survivors of violence is Post Traumatic Stress Disorder.
The vast majority of women who are raped experience PTSD
in the immediate aftermath of the trauma, and PTSD contin-
ues to persist at lifetime rates between 30-50%. In addition,
over half of women abused by an intimate partner also expe-
rience PTSD. Commonly experienced symptoms include
intrusion (re-experiencing of the trauma, including night-
mares, flashbacks, recurrent thoughts); avoidance (avoiding
trauma-related stimuli, social withdrawal, emotional numb-
ing); and hyperarousal (increased emotional arousal, exag-
gerated startle response, irritability). Many women also expe-
rience comorbid mental health problems such as depression,
anxiety, and substance abuse disorders.
Referrals, Resources, and Treatment
Women who are survivors of sexual assault or intimate part-
ner violence can clearly benefit from support and counseling
to assist them in their recovery from PTSD and associated
mental health concerns. So what can a healthcare provider
do to encourage women to seek counseling? Providing infor-
mation about appropriate resources in the Baton Rouge com-
munity can be an important first step. For example, displaying
brochures from the Rape Crisis Center and the Battered
Women's Program in waiting rooms or patient lounges can be
an unobtrusive method for disseminating information. When
speaking with patients, healthcare professionals can ask sen-
sitive questions, listen carefully to women's responses, and
refrain from skepticism or victim-blame. Some local resources
are highlighted below:
Rape Crisis Center–
Provides an advocate to assist the vic-
tim during the forensic exam, crisis hotline support, legal
advocacy, and individual and group counseling for survivors.
(225) 383-7273
Battered Women's Program–
Provides crisis hotline, safety
planning, safe housing, and/or protective order assistance for
women in abusive relationships. (225) 389-3001 or 1-800-
541-9706 (state-wide hotline)
The Phone–
Provides confidential counseling assistance by
phone. (225) 924-5781
Women who do choose to seek mental health counseling for
rape-related trauma or for intimate partner violence should be
aware that there are empirically-supported counseling
approaches for treating these concerns and that recovery is
possible. During treatment, effective counselors will use the
following recommended techniques: (a) provide education
about commonly experienced PTSD symptoms through psy-
choeducation, (b) facilitate the client's retelling of the event
through exposure-based techniques, (c) challenge the client's
maladaptive beliefs about her role in the event through cogni-
tive restructuring, and (d) enhance her coping skills through
anxiety management techniques. Group counseling is also
beneficial because women can receive support from other
women who have survived similar experiences.
Through counseling, women can eventually learn to view the
assault or violent relationship as a traumatic but growth-
enhancing experience that can ultimately provide them with a
more flexible world view, an increased sense of empathy and
empowerment, and enhanced coping skills for managing
future life demands. Healthcare professionals can play an
important role in opening doors so that this type of recovery
and resilience becomes possible.
v
Reference: Dallam, S. J. (2005). Health issues associated with violence
against women. In K. A. Kendall-Tackett, Ed., Handbook of Women,
Stress, and Trauma, pp. 159-180. New York: Brunner-Routledge.
1849:
Electrical stimulation
introduced as method to
treat depression.
1854:
In her continuing campaign
against the mistreatment of the
mentally ill, Dorothea Dix asks
Pope Pius IX to address the issue.
1861:
8,500 Americans
are institutionalized for
mental illness.