Rape: Interruption of the therapeutic process by external stress.

Abstract

Psychotherapists see limited numbers of sexually assaulted people. The following case presents a previously undescribed situation of rape during the period when psychotherapy was ongoing. Its importance lies in the opportunity presented to use data gathered before and subsequent to the rape to place the event in perspective. As well, a situation has been provided to develop and test an approach to treatment when the material being dealt with results from an actual tragedy rather than a fantasy.Rape is commonly denned as sexual contact between a man and an unwilling woman other than his wife, with violence or the threat of violence. The literature contains a number of articles on the medico-legal aspects of diagnosis, definition and the preparation of testimony (Bornstein, 1963). Attention to the attacker has often exceeded concern for the victim. Halleck (1962) presents one of the few articles with guidelines for managing the victim of a sexual assault. Only very recently has there been an epidemiologic study of rape and a public health program to aid victims (Hayman et al., 1967(Hayman et al., , 1968).

Psychotherapists' Knowledge About and Attitudes Toward Sexual Assault Victim Clients

“…therapists who usually, sometimes, or almost never felt that sexual assault should be a focus of treatment; (b) therapists who would sometimes use each of seventeen treatment strategies (seventeen different variables; treatment strategies are listed in results section; strategies included were selected as a representative, although not exhaustive, listing of common treatments); (c) time therapists would use each of these strategies (therapists gave a percentage next to each treatment strategy, estimating how frequently they would use that strategy). The treatment strategies selected were drawn from the literature on current treatments for sexual assault victims (e.g., Kilpatrick, 1984), literature on past treatments which have been used with sexual assault victims (e.g., Deutsch, 1944;Werner, 1972), and a representative sample of treatment approaches used with many psychotherapy patients, as suggested by a group of clinicians.…”

“…While Freud (1896) originally believed that sexual victimization caused women to develop hysteria and other neuroses, under the social pressures of his time, he later denied that his patients had actually been sexually assaulted, claiming instead that many women fantasize about and unconsciously desire rape during the course of normal feminine development (Freud, 1906). Discussions of women's "rape fantasies," "incest impulses," and "masochism" are quite prevalent in the psychological literature since Freud (e.g., Coons & Milstein, 1984;Deutsch, 1944;Factor, 1954;Sloane & Karpinski, 1942;Werner, 1972). Most recently, feminist researchers have been concerned that the inclusion of the diagnostic category of Self-Defeating Personality Disorder in the appendix of the revised third edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1987) could be used by therapists who accept traditional myths and stereotypes to blame women for sexual assault (e.g., Caplan, 1987).…”

Effects of a Rape Experience: A Longitudinal Study

“…Given this neglect of the topic, it is not surprising that much of the early research was underdeveloped methodologically. The bulk of this early research consists of single or a few case histories (e.g., Factor, 1954;Symonds, 1976;Werner, 1972) and exploratory, relatively unsystematic studies (e.g., Burgess & Holmstrom, 1974a;McCombie, 1976;Notman & Nadelson, 1976;Queen's Bench, 1975;Sutherland & Scherl, 1970;Peters, Note 4). The Sutherland and Scherl (1970) and Burgess and Holmstrom (1974a) studies received greatest attention because they were the first to identify the impact of rape on victims, prompting us to review their findings and methodology.…”

Psychotherapy with Vietnam veterans and rape and incest survivors.

“…Although Freud and Breuer originally saw rape and incest as traumatic emotional experiences, in his later work Freud focused on women's unconscious desires to be seduced against their will by powerful male figures. Thus, until recently, psychoanalytically oriented therapists focused on rape-and incest survivors' unconscious desires for assault (e.g., Factor, 1954;Werner, 1972). Bart (1975) reports that most rape survivors treated with psychoanalytic techniques feel worse after psychotherapy.…”