What the Cosby Case Can Teach Us About Rape Trauma Syndrome


For decades, we’ve been under the impression that America’s (former) favorite TV dad, Bill Cosby, had a lot to teach us. In recent weeks, his ethos has declined, but I hope we are still learning. The high-profile Cosby sexual assault cases should raise public awareness about the tragedy of isolation resulting from rape. Last week, I posted a blog about one silver lining: the survivors who have spoken up have made it safer for other women to talk about their sexual assaults.

I’ve often been accused of optimism, but it’s required in my field, and it’s essential to learn and grow and fight against injustice. Lately, I can’t help but perceive another benefit to these detailed public disclosures: they are raising awareness of the often long-term effects of sexual assault on survivors. The story of these women has proven that we don’t, as a culture, talk about rape enough (though it happens all too regularly). And if we don’t talk enough about the act of rape, we certainly don’t talk enough about the after-effects.

The trauma from assault can impact a rape survivor psychologically, emotionally, and physically. Symptoms consistently experienced are clustered together into what is known as Rape Trauma Syndrome. There are three recognizable stages to Rape Trauma Syndrome: acute, outward adjustment, and integration/resolution.

The acute or crisis stage occurs immediately after the assault. It may last a few days to several weeks and may subsequently return over the course of years. Common to this stage are anxiety attacks, mood swings, depression, disturbances in sleeping and eating patterns, feeling emotionally “numb,” and poor recall of the assault. When I volunteered on a rape and battering hotline, I usually had the overnight shift, taking calls between 11:00 pm and 4:00 am. You would be surprised at how many women called for support during those hours. And they were rarely calling because they had just experienced a rape; they called because they found they could not sleep weeks or even months after a rape. Because the women Cosby assaulted were victimized so many years (in most cases, decades) ago, the symptoms of the acute or crisis state of RTS are not the focus of the New York Magazine article.

It does, however, reveal a great deal about the latter stages of RTS, such as the outward adjustment stage. This can last from a month to many years. In this stage, survivors attempt to resume a normal lifestyle and put the assault behind them. Sometimes they appear to have succeeded, but internal turmoil may still manifest in a variety of symptoms including denial, anxiety, depression and substance abuse. The Cosby assault survivors exhibit symptoms of this stage, as it can last for many years.

Survivor Marcella Tate gives an example of her denial: “I understood at the time that it was wrong, and I didn’t really know what. I pushed it down and it resided in a very private place. It affects your trust with other people. You push it down and you don’t deal with it.” Tate’s very language—“and I didn’t really know what”—speaks to the power of silence surrounding sexual assault. Many women lack the language to even understand what happened, let alone talk about it; moreover, to deal with this confusion, she “pushed it down,” a handy metaphor for denial.

Lack of trust, is of course, a byproduct of anxiety. Tate’s issues relating to trust are echoed several times in these accounts. Chelan Lasha explains, “And I would cry all the time, all the time. After that, I didn’t know who to trust and who not to trust. I have nightmares.” And Sunni Wells agrees, “It really affected my trust. My mother didn’t believe me initially, either. You’ve been hurt to a level that a lot of people don’t really understand. Still, to this day.” PJ Masten shares how the experience impacted her ability to establish relationships: “Survivors of rape have a very difficult time having intimate relationships. I was in my 20s. I could never have a real relationship. It was like a black, disgusting tumor—a secret tumor.” Though Masten seems to have a cognitive understanding of the impact of rape, knowing what “survivors of rape” experience, she has nevertheless lived her life unable to trust enough to develop a long-term relationship.

This is the case for many women, one that leads to a deep sense of isolation and loneliness, resulting in a kind of secondary trauma. To cope with these feelings, more than one of the Cosby accusers referenced issues with substance abuse and addiction. Linda Joy Traitz explains, “Eighteen is very young. It took me a long, long time to come to terms with the fact that it was him, it wasn’t me. Life has not been easy for me. I had addiction problems as I got older.”

The last stage in RTS is Integration and Resolution. In this stage, the assault is no longer the central focus of the survivor’s life; however, the feelings of the first two stages may reappear at any time. The return of those feelings is often due to re-stimulation of memories of the assault. This can happen several years later and cause fear and confusion.

Again, we can see how this stage manifests for some of the Cosby accusers. Just the mention of something related to Bill Cosby causes flashbacks and turmoil for survivor Sammi Mays: “When I see a Jell-O pudding, it comes flooding back.” Survivor Joan Tarshis comments on her physical reaction to someone even referencing Cosby: “People would mention a joke that he said: ‘Wasn’t that funny?’ And all the while, my stomach would just be churning.” These experiences indicate how even something innocuous can trigger the trauma of sexual assault and inundate the survivor with a feeling of shame, horror, and fear.

Tamara Green feels angry about the lack of understanding for her lingering symptoms of RTS: “People go, ‘Why haven’t you gotten over it?’ But you might as well ask a combat soldier why he doesn’t forget the Battle of Guadalcanal. There was someone trying to harm him, someone trying to kill him, and they never get over it, they just learn how to cope with it.”

Indeed, her analogy is a good one. Most of us are familiar with Post-traumatic Stress Disorder (PTSD), as it is frequently diagnosed in veterans of war. PTSD is defined as a mental health condition triggered by experiencing or seeing a terrifying event. Symptoms of PTSD include prolonged feelings of anxiety, stress, or fear. Other symptoms and behaviors connected to this disorder are depression, self-harm, flashbacks, and substance use and abuse. Sound familiar? Rape Trauma Syndrome is a specific kind of PTSD in which the brain processes being physically overpowered and violated in a reasonable and predictable way: it acknowledges a life-threatening occurrence and prepares the brain for similar future events.

Since everyone knows someone who has survived a sexual assault, it’s important we all understand the psychological aftermath of these assaults in order to best support the survivors in our lives.

Healing can and does take place, but two things need to happen. The first is acknowledgment of the pain and symptoms. It is not normal to always feel afraid or constantly be in a state of anxiety. The second is to seek professional help. If you or anyone you know is suffering from RTS, it’s important to get help to end the suffering, no matter how long ago it started.

These women’s stories remind me of why I started Esteem. The long-term effects of rape enrage me and incite me to prevent these assaults. The impact of sexual assault is not short-term, and its effects reach beyond the primary victim, causing secondary harm to those she is close to. Indeed, it has a ripple effect, touching everyone in the survivor’s life, as it impacts careers, parenting, and the ability to sustain healthy, intimate relationships.

In one day, an Esteem self-defense class can provide students with the skills needed to avoid, deter and resist assault and prevent a long-term struggle with RTS. Our trainings empower teens and women to walk through the world with less fear and more confidence and help them live a life free of trauma and enriched with healthy productivity and hope.

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