• Generation Mental Health Team

The re-traumatization by doctors that adhere to rape culture

Content warning: this blog post includes topics of sexual assault, rape, and gender-based violence. Please see our crisis page if you are in need of country-specific support.

Previously published in Women's Media Centre, GenMH Peer Advisory Board Member, Esmeralda Altmeyer, bravely shares her own immensely traumatic experience with the hope to draw attention to the issues of rape culture, and the important role of medical professionals in destigmatisation and victim support.

When I was in Spain for my gap year after high school, I was raped. I trusted my perpetrator, and had thought about hooking up with him before. But when I changed my mind he got angry and violent.

The next morning, I was devastated. I felt immense pain in my lower body and shook uncontrollably everywhere. While I didn’t (and still don’t) recall the act itself, I remembered everything else that happened before and after and knew something was wrong. I spent the next four days crying in my room. I was tremendously afraid to leave the house, both because I was afraid to see him again, and because I felt like marks of shame were visible all over me.

At first, I tried to brush off the effects of the rape on my physical and mental health. When I returned home to Germany, I even thought about getting in touch with the rape response center in my hometown, but could never pick up the phone. I felt something all too common among rape victims: that my identity and my worth were irreplaceably lost. The only thing that remained within me was the trauma and the desperate need to hide what had happened, to never tell anyone. But after two months of living with constant, intrusive thoughts, of not eating or leaving my house, I came to the realization that this was not something that would solve itself over time.

Reaching out for help was the hardest thing I’ve done in my life. My best friend, the only person I had told, made the call that saved me. Rape response centers are widespread in Germany; many cities and towns have a local one. They are mainly funded through the government and offer anonymous, free counselling and other forms of support. I was lucky enough to receive amazing help from a social worker who had extensive experience and knew exactly where to start to put me back together.

That same social worker also recommended that I consult a doctor to be put on antidepressants, but when I consulted my general doctor, she was outraged to learn about my response to my rape. While she gave me the prescription, she only did so after continuously repeating that she doesn’t understand why women (like me) don’t report our rapes and how we can’t expect anything to change if we don’t stand up for ourselves — putting the responsibility for what happened to me into my hands.

This was just the start to many discouraging experiences with medical professionals that would follow. Just two months after I met my social worker, I had to move to a new city to start university, and found myself in search for help again. My experience at the rape response center in my new town was a nightmare. I already felt uncomfortable with and nervous about sharing my experience with a stranger, and within the first ten minutes of meeting my new social worker, my fears were confirmed: She asked me to describe the details of the act of rape itself. This information is not only completely unnecessary for a social worker to know right off the bat, but was also extremely triggering for me to share. It had taken me months to even say the word “rape” out loud, and now she wanted to hear every detail?

As if this wasn’t enough, the social worker then told me that we should start working on what she called my “weak character.” My rapist had easily recognized this flaw, she said, and that had made me his target and gotten me into this situation in the first place. In addition, she advised me to beware men in general, especially at night. Placing the blame for my rape on me and then telling me to be cautious of strangers when my trust in the world was deeply shattered and I was already anxious around men in public was the opposite of what I needed to hear to be able to live a normal life again. Needless to say, I never returned to that rape response center.

I continued to try to find new, effective counselors, but doing so was a difficult journey. One female therapist, for example, told me that my thoughts and feelings were not valid after I told her I was afraid of wearing a bikini to swimming pools because the thought of men seeing my exposed body made me feel vulnerable. But after searching and searching, I finally found a good counselor who picked up where the other had left off, and started rebuilding my strength.

I am very grateful that I did ultimately find two wonderful and skilled women who helped me overcome my trauma and the PTSD that followed, but I am deeply concerned about the experiences I had to go through in between. Rape response centers usually don't offer long-term treatment, and in Germany, like in many other countries, therapists beyond these centers are in high demand. When you reduce your search to female therapists who specialize in trauma, it’s easy to find yourself calling up every therapist in town and still not being able to receive an appointment within the next three months. Even after you get an appointment, there is no guarantee that it will actually help you — and, in fact, it could push you even further into a state of destructive self-hate. I had to pick myself up countless times after failed therapy sessions when the result should have been the opposite. That reaching out for professional help could make my pain worse was the last thing I had expected. Unfortunately it is an all too common issue.

Rape is a global epidemic, as are the myths about rape that perpetuate the stigma that surrounds survivors. Rape myths, such as the idea that rape has to be physically violent or can only be committed by strangers in dark alleyways, are deeply interwoven into cultures all over the world and effectively prevent the dismantling of the rape culture that enables rape to keep happening. These myths take a lot of time and effort to unlearn.

Unfortunately, like the rest of us, medical and mental health professionals grow up in rape cultures. Even though their jobs require them to accommodate and ease the suffering of everyone in need, including rape victims, they’re not always equipped to do so. In Germany (as well as in many other Western countries) it is estimated that around 25 percent of women will experience rape or sexual violence in their lifetime, and yet medical training does not currently devote adequate resources and education to the very people expected to respond to these millions of women.

The results of this gap in training and needed response are clear and very worrying. As Courtney Ahrens, psychology professor and researcher at California State University, found in her study “Being Silenced: The Impact of Negative Social Reactions on the Disclosure of Rape,” rape victims frequently report receiving negative or unhelpful reactions from medical professionals. Furthermore, when rape survivors encounter victim-blaming behaviors or attitudes, they experience a “secondary victimization,” or what some call a “second assault” or a “second rape.” Speaking out about the assault may therefore subject survivors to further trauma at the hands of the very people they turn to for help, and they end up feeling even more silenced than they did before.

Victims should not have to regret reaching out for help. Each time that I found the courage to try a new therapist, and each time doing so was another discouraging experience, it took me months to build up the strength to try again. It was exhausting.

It has taken me the past three years to recover from the trauma of rape and its aftermath as much as I have, and I am still not fully recovered yet. Living with PTSD after rape is the most intense suffering I have experienced. It’s devastating to think that so many women have to go through that suffering alone, for so many years. The medical field needs to realize that it is alienating and in many cases actively re-harming one of the suffering groups that needs its help the most. Psychology and medical students and social workers need to learn how to accommodate people that have been through the trauma of rape or they will continue to not only be unable to help but also worsen the experiences of one out of every eight people.  

By Esmeralda Altmeyer