The Centers for Disease Control and Prevention (CDC) have developed uniform, nonlegal definitions for sexual violence and related terms in an effort to standardize the reporting and study of these crimes. Inclusionary criteria are broad and divide these crimes into five categories, which include (1) completed nonconsensual sex acts, including penetration, to any degree, of a genital opening or anus, and sodomy, (2) attempted nonconsensual sex acts, (3) abusive sexual contact, including any intentional touching that could be construed as sexual, (4) noncontact sexual abuse, including such acts as voyeurism, harassment, and pornography, and (5) sexual violence, unspecified type. Contact is considered nonconsensual if the victim says no at any time; participates because of pressure, coercion, or intimidation; or is unable to consent because of age, intoxication, illness, being asleep, or any other disabling condition.
Under a grant funded through the CDC and the National Institute of Justice, the National Violence Against Women Survey (NVAWS) found that 1 in 6 women and 1 in 33 men reported being victims of attempted or completed rape in their lifetimes. Alarmingly, 54% of female victims reported being raped before age 18. Rape is often accompanied by other forms of physical assault, including beating, choking, kicking, and use of a weapon, to name a few. In contradiction to the stereotypical portrayal of the rapist as a stranger, in most cases the perpetrator is a current or former intimate partner, an acquaintance, or a relative. A majority of children who experience sexual violence or coercion without penetration or sodomy also know and trust their perpetrators. Estimates of childhood sexual abuse vary, but range from a low of 6% for females and 3% for males to a high of 62% for females and 31% for males.
While the majority of victims of sexual assault are female, the majority of perpetrators are male, regardless of the sex of the victim. Sexual assault and coercion are crimes of violence and abuse of power, not of sexual desire. The intention of the perpetrator is to humiliate and to control the victim, not to obtain sexual gratification from or intimacy with another person.
Survivors of sexual violence are likely to face a number of psychological challenges in their attempts to cope with and adapt to their victimization and their lack of real or perceived safety. Feelings of shame, doubt, helplessness, hopelessness, unreality, fear, and anger, to name a few, are common, and while reactions vary in relation to age and psychological resources, the experience of sexual assault has strong negative consequences for most victims. Unfortunately, it appears that few victims of sexual violence, including those who sustain physical injury, seek treatment for their difficulties.
Without treatment, individuals who have been traumatized tend to live traumatizing lives, and sexual violence tends to recur in the lives of individuals who have previously been victims, serving to confirm their lack of safety and leading to more psychological distress.
Initial concerns in the treatment of survivors of sexual violence include provision of emotional and physical safety, both in and out of therapy, monitoring for suicidal ideation, and developing a strong, trusting therapeutic relationship. Victims of rape have high rates of attempted suicide5 and often experience questionable support. Unfortunately, rape and sexual abuse appear to be among the few violent crimes for which the victim is perceived as, and often feels, partially responsible. It is important to address the issues of shame surrounding experiences of sexual violence and to help victims understand that they were not at fault. Personal safety issues should be addressed in the context of what can be done to help keep the individual safe now and in the future, with careful assessment of the survivor’s reaction to these offerings. It is essential to balance fostering a sense of control with engaging in strategies that help survivors move from an intellectual understanding of the perpetrator’s responsibility for the crime to an emotional sense of their own innocence. It can be dangerous to cultivate an attitude that “if only I had done something different, this would not have happened to me,” as it tends to feed the victim’s sense of personal responsibility for a violent act that was perpetrated against him or her. Because treatment of difficulties related to sexual violence and coercion is a specialized area, it is important that therapists choosing to treat survivors gain the required competencies.
Given the nature of our society’s attitude toward sexual violence, seeking closure through legal channels can be a disappointing and degrading process, as it is estimated that a very small percentage of rapists are incarcerated due to prosecution. It is important that therapists who treat victims of these crimes have a broad understanding of the statistics and literature related to the legal issues involved. Survivors of sexual violence should be given as much control over their decisions as possible while taking into consideration all relevant information.
- Panel on Research on Child Abuse and Neglect, National Research Council. (1993). Understanding child abuse and neglect. Washington, DC: National Academies Press.
- Tjaden, P., & Thoennes, N. (2000). Full report of the prevalence, incidence, and consequences of violence against women. Retrieved February 7, 2016, from https://www.ncjrs.gov/pdffiles1/nij/183781.pdf
- U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics. (2002). Selected findings, rape and sexual assault: Reporting to police and medical attention, 1992-2000. NCJ 194530. Washington, DC: Author.