Stage 2: The outward adjustment stage

Survivors in this stage seem to have resumed their normal lifestyle. However, they simultaneously suffer profound internal turmoil, which may manifest in a variety of ways as the survivor copes with the long-term trauma of a rape. The outward adjustment stage may last from several months to many years after a rape

Five main coping strategies during the outward adjustment phase were identified:

• Minimization (pretending ‘everything is fine’)

• Dramatization (cannot stop talking about the assault)

• Suppression (refuses to discuss the rape)

• Explanation (analyzes what happened)

• Flight (moves to a new home or city, alters appearance)

Other coping mechanisms that may appear during the outward adjustment phase include:

• Poor health in general.

• Continuing anxiety

• Sense of helplessness

• Hyper-vigilance

• Inability to maintain previously close relationships

• Experiencing a general response of nervousness known as the “startle response”

• Persistent fear and or depression at much higher rates than the general population

• Mood swings from relatively happy to depression or anger

• Extreme anger and hostility (more typical of male victims

• Sleep disturbances such as vivid dreams and recurring nightmares

• Insomnia, wakefulness, night terrors

• Flashbacks

• Dissociation (feeling like one is not attached to one’s body)

• Panic attacks

• Reliance on coping mechanisms, some of which may be beneficial (e.g., philosophy and family support), and others that may ultimately be counterproductive (e.g., self harm, drug, or alcohol abuse)

Stage 3: Lifestyle

Survivors in this stage can have their lifestyle affected in some of the following ways:

• Their sense of personal security or safety is damaged.

• They feel hesitant to enter new relationships.

• Questioning their sexual identity or sexual orientation (more typical of men raped by other men or women raped by other women.

• Sexual relationships become disturbed…Many survivors have reported that they were unable to re-establish normal sexual relations and often shy away from sexual contact for some time after the rape. Some report inhibited sexual response and flashbacks to the rape during intercourse. Conversely, some rape survivors become hyper-sexual or promiscuous following sexual attacks, sometimes as a way to reassert a measure of control over their sexual relations.

• Some rape survivors may see the world as a more threatening place to live in, so they will place restrictions on their lives, interrupting their normal activity.

Physiological responses

Whether or not they were injured during a sexual assault, survivors exhibit higher rates of poor health in the months and years after an assault, including acute somatoform disorders (physical symptoms with no identifiable cause).

Physiological reactions such as tension headaches, fatigue, general feelings of soreness or localized pain in the chest, throat, arms or legs. Specific symptoms may occur that relate to the area of the body assaulted. Survivors of oral rape may have a variety of mouth and throat complaints, while survivors of vaginal or anal rape have physical reactions related to these areas.

Nature of the assault

The nature of the act, the relationship with the offender, the type and amount of force used, and the circumstances of the assault all influence the impact of an assault on the victim. When the assault is committed by a stranger, fear seems to be the most difficult emotion to manage for many people. (Feelings of vulnerability arise).

More commonly, assaults are committed by someone the victim knows and trusts. May be heightened feelings of self-blame and guilt.

It’s important to remember that what you’re experiencing is a normal reaction to trauma. Your feelings of helplessness, shame, defectiveness, and self-blame are symptoms, not reality. No matter how difficult it may seem, just be committed to the process of healing, regain your sense of safety and trust, and learn to heal and move on with your life.