14 6 . Trauma due to gender-based and sexual violence
PART I : POINTS OF DEPARTURE
6 . Trauma due to genderbased and sexual violence
Aim . To understand how gender-based and sexual violence affect survivors , the importance of respecting survivors ’ need for protection and confidentiality , and why it is difficult to talk about GBV .
Sexual violence is any sexual act that is perpetrated against someone ’ s will , and involves a range of offences , including a completed non-consensual sex act ( such as rape ), an attempted nonconsensual sex act , abusive sexual contact ( for example , unwanted touching ), and non-contact sexual abuse ( Basile and Saltzman 2009 , p . 9 ). GBV is the umbrella term applied to any harm perpetrated against a person ’ s will that results from power inequalities that are based on gender roles . In many countries the stigma of being raped can lead to punishment by the community , such as expulsion or even honour killing . This is why , as helpers , we must be extremely sensitive to a survivor ’ s need of protection and confidentiality .
GBV is a distinctive form of trauma because the violation involved is extremely invasive and gives rise to feelings of shame , self-blame and guilt . When combined with fear of being injured or killed , it is traumatising in almost all cases .
After rape , the symptoms are in general the same as those described for severe trauma disorders . The initial shock reaction may last for minutes , days , or sometimes weeks . Extreme shock reactions may include panicked agitation and confusion , or a paralysed mute withdrawn state . Subsequently , if the survivor is injured , she will start to feel pain from her injuries . Feeling dirty is another frequent reaction , which often leads to compulsive washing . Fear of injury , sexually transmitted disease and pregnancy also appear early on .
Post – traumatic symptoms appear more gradually . Intense intrusive re-experiencing of the original trauma is characteristic , and is associated with simultaneous efforts to avoid reminders of what happened . The survivor is also likely to experience increased arousal , usually from the start , and may suffer from inability to sleep , hyper vigilance , or an exaggerated startle response . For some individuals , intense reactions in the first month thereafter slowly reduce even if no help or treatment is provided .
No person is alike and responses to traumatic events such as GBV will vary . Many women and girls who have had very difficult experiences are resilient . This resilience , and their ability to join together to support one another , are important resources to build on . ( For more information on resilience , see Part III , page 128 .)
It is important to remember that social or cultural stigma , together with psychological trauma , often prevent women and girls from seeking help after GBV .