In-Hospital Sexual Assault Advocacy
Onslow Victims Center's (OVC) Hospital Advocacy responds to Onslow Memorial Hospital for adult sexual assault survivors who present initially after an assault.
The Hospital Advocate's primary role during the sexual assault case is to emotionally support the survivor so they are not alone while navigating the medical-legal process. Advocates are specially trained to provided crisis intervention, psychoeducation with a broad focus on potential elements of victimization, exploration of coping with symptoms, information about options, and linkage to community resources. The advocate will support the survivor by providing general information about the medical/legal evidence collection and legal system and help answer questions they may have about next steps.
All advocacy is survivor-centered and provided in a trauma informed approach.
From the first 24 hours to about a week or so after the assault, you may experience a feeling of acute distress and anxiety. This is the first aftershock of the attack and is the first stage of recovery. Having trouble believing that the rape even happened is very common. Women have reported a sudden need to turn to others for guidance as they come to question their capabilities.
You may encounter emotional and/or physical problems such as recurrent headaches and nightmares, nausea, confusion, paralysis, sleeplessness, loss of appetite, and fatigue. Feeling like you are in an emotional void, or being numb, may also be experienced. Dwelling on the rape and feeling dirty or being fearful that it might happen again are also very common during the first stage of recovery.
Steps for make recovery easier:
- Remember that you are most important. It does not matter what others are saying, thinking, or feeling, your well-being and health are the top priority. Try to have people around you who care about you and who support whatever decisions you make.
- Attend to the physical side of the rape. See your doctor. Medication may be needed to treat any injuries you obtained during the attack. Do not think that constant headaches, dizziness, and nausea are normal. There could also be a possibility of pregnancy and Sexually Transmitted Infections.
- As soon as possible try to resume your regular routine. This will help show you that life can and will go on.
- Make some decisions to regain some control over you life. It is okay for you to not be comfortable making decisions immediately after the attack, but make sure to take back control and be in charge of your life.
This stage begins within the first few weeks of the rape. During this time you may feel calmer overall but may still experience underlying stress. You may feel more defensive, emotionally and physically. You make see yourself as somewhat helpless and confused. Mood swings and anger are common during this stage.
You may or may not be able to feel anger toward the rapists, however if may also trouble you that you can feel anger towards your family and friends. This completely normal and does not mean in any way that you enjoyed that attack. There are many theories, which explain why some women initially have trouble feeling anger toward the rapist. It may be that the lack of anger was necessary for survival on your part. You may think that if you are not angry at your rapist that he/she will not have a reason to rape you again. Others believe that rape results in a great deal of blame and self-punishment. As such, it is hard to be angry with the rapist when you are blaming yourself.
Giving over control of your life to others may be a response to the attack as well- a sort of self imposed isolation. This can be good as it gives some time to reorder you thoughts and priorities but it can also result in loss of privacy and independence. It can make it difficult to resume your normal life and to regain the responsibility for your own thoughts, feelings, and behaviors.
Steps to make recovery easier:
- The erratic behavior you may be experiencing during this time does not mean that you have because neurotic or crazy. It is a part of the normal recovery process. Your mind is trying to make sense of the attack that has just happened.
- You can use many of the suggestions given to you during Stage 1. It is most important for you to regain control of your life as soon as possible.
In a few weeks you may start to feel fine. You may go through the day without a thought of the rape. To yourself and to others it might appear that you have recovered fully. This is called apparent readjustment. This may last a few weeks or months. During this time your mind is processing or making sense of the events of the rape, how you feel about others, and how you feel about yourself. This is a protective mechanism that lets you return to a somewhat normal lifestyle while the subconscious does the difficult work of trying to straighten out feelings and memories. This is when you may want to reestablish your previous lifestyle. You may wish to maintain your support system with friends and family and keep in touch with those you found most supportive. You can let them know that you still need their help and support.
This stage may make it feel like you have not recovered at all. It is very common to have a relapse in depression, anxiety, fear, insomnia, headaches, mood swing, distrust of men, feelings of guilt, and sexual disturbances may start to manifest themselves. This stage is called reorganization/integration and may no begin until several weeks or months after the rape. These feelings have been buried for the last several weeks in your mind and now they are resurfacing because you are in a better place to start to deal with them. It is a huge step in recovery, even though it feels like you are going backwards.
This may be the first time you feel any real anger toward your rapist. This is a completely health reaction and it will finally allow you the ability to vent this emotion. It also shows the you are putting the responsibility for the rape where it belongs; on the rapist and not on yourself. You may decide during this phase that a change in lifestyle is in order. Such decisions usually result from a need to feel safe and secure. Try to avoid extreme changes.
Begin to look into rational methods of improving you safety. Getting a dog, upgrading you locks and windows are all good, healthy reactions that are helping you regain your power and control. Your recovery will be complete when you can again enjoy those activities that were important to you before the rape. Recovery is absolutely possible, it may just take some time. However, you may also carry some aspects with you.
Post Traumatic Stress Disorder- Survivors of sexual assault may experience severe feelings of anxiety, stress or fear, known as PTSD, as a direct result of the assault.
Substance Abuse- Survivors of rape and sexual assault may turn to drugs and alcohol in an attempt to relieve their emotional suffering.
Stockholm Syndrome- Survivors may develop Stockholm Syndrome, which means that they subconsciously bonded emotionally with their attacker. They involuntarily feel very close to their abuser as a way to ensure their survival. Survivors suffering from Stockholm Syndrome may say things like "I know what he's done to me but I still love him" or "I know it sounds crazy, but I just miss her."
Depression- This is one of the most common emotionally reactions that survivors often have.
Sexually Transmitted Infections: HIV/AIDS, Hepatitis, HPV, Gonorrhea, Chlamydia, Pubic Lice, Genital Warts, and Herpes are only a few of the STIs that a survivors could contract after a rape.
Sleep Disorders- Many survivors suffer from sleep disturbances and disorders including insomnia.
Eating Disorders- Survivors can develop eating disorders after a sexual assault because they are trying to regain some control in their life and food is definitely something they can control.
Body Memories- Body memories are when the stress of the memories of abuse experienced by a survivor take the form of physical problems that cannot be explained by usual means.
Dissociative Identity Disorder: This disorder normally occurs after a traumatic event in a person's life. It is characterized by two or more distinct identities control an individual's behavior at different times.
Self-Harm/Self-Injury- Deliberate self-harm is when a person inflicts physical harm on him/herself as a means to feel something or control their life again.
Suicide: Survivors of sexual abuse or rape may experience suicidal thoughts.
Anxiety- Survivors can manifest anxiety in different forms. Sometimes is shows itself in panic attacks, agoraphobia, and irrational feelings of fear and distrust for a specific type of person.
Attachment Issues- After a violent attack, such as rape, survivors can have trouble forming meaningful relationships.
- Support his/her ability to make decisions for his/herself
- Believe his/her stories and accept their experiences are real to him/her. Let them know that they can speak family, friends, or the Sexual Assault Adovcate at Onslow Women's Center.
- Practice nonjudgmental listening and support. Respect this person's right to hold his/her own beliefs about this topic.
- Remind him/her that the victim is never to blame. No matter what she/he was wearing, where she/he was, how late it was, if she/he was drinking, if she/he was on drugs, or if the rape began with consensual activity. Rape is never justified and it is never the victims fault
- Encourage the survivor to contact the police or the District Attorney's office with any legal concerns.
- You can provide physical comfort and support (hug, hand holding, shoulder patting, etc) if the survivor initiates with you.
- Encourage the survivor to go visit their doctor or a hospital to get a Rape Kit done. If they do not want a Rape Kit done, encourage them to at least visit the doctor to make sure there are no internal injuries, STIs, or pregnancy.
- If the survivor decides to get a Rape Kit, let them know that you will go with them if they want you too.
Preparing for a sexual assault forensic exam
How long is the exam?
What happens during a sexual assault forensic exam?
Who can perform the exam?
Why should you consider having a sexual assault medical forensic exam?
If you would like to press charge against your rapist, be sure to have a Rape Kit done at your local hospital to obtain as much evidence as possible. After that call your local police and file a report against your rapist. If you are unsure if you want to press charges, in some states you can file a "blind report", which is an anonymous complaint in which the police record your account of what happened, but do not pursue an investigation. If you ever change your mind later and want to officially report you can make "blind report" an official report.