Experts agree that suicide can result from rape related PTSD, just as it can cause suicide thoughts and actions immediately after sexual assault.
In a report entitled The Garden of Truth: The Prostitution and Trafficking of Native Women in Minnesota, based on the research by Melissa Farley, Nicole Matthews, Sarah Deer, Guadalupe Lopez, Christine Stark and Eileen Hudon, the result of Post Traumatic Stress Disorder from rape is the same as occurs in war. The effects can intensify if a woman does not report the rape and in most cases, women don’t.
Data collected by The Rape, Abuse, and Incest National Network (RAINN) shows that out of every 100 rapes, only 32 are reported, only 7 lead to an arrest and only 2 are prosecuted. That means 98 rapists out of 100 walk away. “When women don’t report, which is the majority, it is because it is such a traumatic event. I used to be a prosecutor for the tribe on sexual assault and domestic violence, and the most difficult part is trying to explain to somebody what happened to you,” Janet Routzen, executive director of the White Buffalo Calf Society said. The WBCS is one of only 30 shelters for women across all reservations, and provides services to victims of domestic violence, sexual assault, dating violence, and stalking.
Routzen said the reasons women don’t report rape are multifold. “Sex for us is an intimate part of our lives and when somebody has violated you in such an intimate and horrific manner, it causes PTSD. A lot of women just ignore it, and will be depressed about it, but they don’t want to deal with it. They’ll say, ‘I don’t want to tell anyone; I don’t want to talk about these feelings because if I have to deal with them, then my whole world is going to fall apart.’
“Most rape victims are assaulted by acquaintances or a trusted family member or friend,” Routzen continued. “They also experience guilt and shame at having been violated. ‘I shouldn’t have gone there, it’s my fault,’ they’ll say. Even though they didn’t have anything to do with what happened to them, except for being in the wrong place at the wrong time.”
The reasons may keep a woman from reporting, but the result is that they often become depressed and have nightmares. Seneca sociologist Dr. Alexandra (Sandi) Pierce has been conducting research on violence against American Indian women and girls for 26 years. Author of Shattered hearts: The commercial sexual exploitation of American Indian women and girls in Minnesota, and social service program evaluator for traumatized American Indian women and girls, Pierce told ICTMN that the most common symptom reported in direct-service programs is feeling distant or cut off from other people, and that half or more describe difficulty concentrating and feeling emotionally numb, or being unable to have loving feelings for people close to them. She said, “This is the wendigo in our communities, the reason that generational trauma seems to become worse, generation after generation.”
RAINN reinforces that statement and states that the three most common effects of rape induced PTSD include a constant feeling of being in danger, reliving the event through flashbacks, dreams, or intrusive thoughts. Changing behaviors to avoid any scenarios associated with the event and losing interest in activities you used to enjoy are common. Feeling “on edge” all of the time, having difficulty sleeping, being easily startled, or prone to sudden outbursts is also common. Routzen reported that PTSD is sometimes misdiagnosed as ADHD in children who have been sexually traumatized. “It plays itself out where you think you have to medicate the child, but it’s the wrong medication, because what they need treatment for is PTSD,” she said.
PTSD can hide in other areas of a woman’s life as well. “A woman comes in because of a domestic violence situation, but the underlying issues are that she was also a victim of rape and has never dealt with it,” Routzen said. “She showed up because she was in a violent relationship, but the thing she is talking to us about is, the thing she wants to deal with, is the underlying issue of sexual assault. And a lot of women are forced to have sex in their relationship; that’s rape but it is so hard to prosecute that. You don’t hear about it as much, but we see that.”
According to Routzen, if women haven’t had any information about what triggers them, they aren’t looking at the effect PTSD may have on their current their situation. “When they just ignore it, it can just come back and start eating them up. It could be a smell, a word, something they see. I know women who were molested as children and every time they look at the ceiling they remember,” Routzen said.
PTSD can have a cumulative effect, especially for Native women. The Garden of Truth report notes that “traumatic events, combined with the historical trauma, result in extremely high rates of mental distress and substance abuse.” Routzen said substance abuse can increase a woman’s vulnerability to sexual violence. If she self-medicates PTSD with alcohol or drugs, “they may find themselves in precarious situations.”
For youth that suffer sexual violence, Routzen believes that the PTSD triggers can leave a child without resources to cope and or understanding why a trigger can cause them to fall apart. She said, “I really do believe that the PTSD could be a contributing factor to youth suicide.”
The key to surviving PTSD caused by rape and sexual violence, is to report it, if not to the police, then to a therapist or advocate. The Garden of Truth report states, “Many of the women (interviewed) felt they owed their survival to Native cultural practices. Most wanted access to Native healing approaches integrated with a range of mainstream services.”
Routzen said there are culturally relevant healing processes to deal with PTSD. Twice a year, the WBCS hosts a retreat for women at Bear Butte. “We bring in not just therapy providers, but also spiritual people to talk about issues they may be trying to deal with. We do talking circles, they do their sweats, take their prayer ties up to Bear Butte. It helps just to be around other women who have been raped too, because you feel so isolated as a victim.”
Routzen described just how deep the isolation can be. “In a shelter environment, when the women aren’t getting along — because, hey, it’s a shelter, there’s a crisis, and everything can seem chaotic — and they feel so all alone. The most common thing they say about other women in the shelter is, ‘She doesn’t know what I am going through,’ even though they are all here for the same purpose. They cannot imagine these women went through the same thing they did. To me that is so profound,” Routzen said.
“Recovery is a slow process which doesn’t come easily or without pain,” notes an extensive article by Survive.org.uk on the website of the American Academy of Experts on Traumatic Stress. “Recovery takes time.”
Healing can occur when women take the steps they need to take care of themselves, when they say, “‘My health needs to be a priority, too; we need to take care of ourselves,‘“ Routzen said. “It almost goes against our grain to say, ‘I need to put some time into me so I can be healthy,’ because that’s not what were taught as Lakota women.”
Taking a breath, Routzen added, “This is how you should take your walk through life. When you have those traumas that disrupt that path, how do we get back on that path? By putting in the time and work so you can heal, and if you don’t, I believe the same issues are going to come up again and again.”