CHAPTER 1
What Do I Say When a Client Discloses?
Sara, 22, was driving to visit her sister in another town. Stopped at a red light, three young men jumped in her car, put a gun to her head, directing her to drive to a deserted road where all three raped her. Injured and in shock, she managed to get herself to a hospital where she received help. Ten years later, however, she is the veteran of numerous failed relationships and has been fired from two jobs. When she sought therapy, the therapist suggested she join Alcoholics Anonymous to deal with her drinking problem. She says she has, before she considers "a more permanent solution" but is still plagued with flashbacks, panic attacks and hyper-vigilance.
Lorna is a petite 57 year old with the slightest trace of a Southern accent. When she talks about how her uncle raped her at the age of five, and continued to do so until she was eight, her eyes still fill with tears. She recalls that when she told her mother about the terror she felt when her uncle was around, her mother slapped her. Married to an abusive man for forty years now, she has been in and out of therapy for years, but her therapists told her the abuse happened so long ago, "it wasn't relevant" to her problems of depression and over-eating.
To anyone who knows him, Geoff appears to be the picture of calm and success. A school principal who is much in demand as a motivational speaker for adolescents, few know that his sexual abuse at the age of 8 by a family friend, and molestation by his priest at 14, has left him with a lifetime of nightmares, suicide attempts, and self-medication with alcohol. Too ashamed of the many doubts regarding his sexuality and depression to disclose his childhood abuses to the medical professionals who treated him over the years, he finally called a suicide hotline in tears. The mental health professional who responded suggested he see a psychiatrist for anxiety medication.
According to the united States Department of Justice:
• One out of four girls and one out of six boys are sexually assaulted by the time they are 18 years old and 30% of child victims are between the ages of 4 and 7;
• One in four college women have been assaulted or suffered an attempted assault;
• 86% of women, 93% of teens, and 97% of people with disabilities who were assaulted knew their attackers;
• One in five children are solicited sexually on the Internet;
• An estimated 39 million survivors of childhood sexual abuse exist in America today;
• Arrests are made in only 37% of cases and only 2.5% of rapists are convicted.
But this problem is not restricted to the united States or even war-torn Third World countries where women and children are routinely raped by invaders. According to the united Nation's Secretary-General's 2006 In-Depth Study on Violence Against Women, it is estimated that one out of five women will become victims of sexual assault during her lifetime – worldwide – including such "civilized" countries as Great Britain, Switzerland, and Australia.
Sexual assault and abuse is a social epidemic, labeled "the" most underreported crime by the united States Department of Justice, and is the deep, dark, dirty secret that is often at the root of substance abuse, depression, and suicide attempts.
It is also such a frightening topic for therapists that often, when a client discloses a sexual assault to his or her counselor, said counselor may unintentionally confound the problem by panicking, minimizing the psychological fallout from the abuse, and choosing to treat the symptoms – the substance abuse, depression, mood swings, hyper-vigilance, trust issues, and relationship problems – rather than the assault itself.
Why? Because even well-meaning and experienced counselors are misinformed and reluctant to delve into an area where they have little or no training. And as human beings, they — like all of us — are also products of their own cultures, religions, families of origin and social upbringing.
First – an important definition: rape is the social term; sexual assault is the legal term. From the 1920s until 2011, The FBI's Uniform Crime Report (UCR) defined rape as "carnal knowledge of a female forcibly and against her will." This definition covered only penetration of a woman's vagina by a penis, and excluded other forms of sexual violence.
In January 2012, revisions to the UCR's definition was broadened to expand the type of victims and cover multiple forms of sexual violence. The new definition of sexual assault is "penetration, no matter how slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without the consent of the victim." (FBI, 2012).
In addition, most states have their own statutes governing the definition of sexual assault that might include the following language: Sexual Assault is any vaginal, oral or anal sex without the victim's consent, or with a victim who is unable to give consent (i.e., a victim under the age of 16, mentally impaired, or whose mental faculties is impaired by drugs or alcohol).
Despite a popular culture that flaunts graphic sexual situations (television and the media) and continually minimizes sexual assault through jokes and innuendo ("Get her drunk; maybe you'll get lucky!" – clearly satisfying the definition of sexual assault in that she may be incapacitated and unable to give consent), sexual assault is not an easy or polite subject about which to talk when the talk is serious. In fact, it is downright frightening.
As early as the 1970s, Susan Brownmiller was writing about the devastating effects for women of the widespread and 'insidious' fear of rape, and a study conducted in Queensland, Australia in 1992 on 412 subjects concluded that a fear of rape/sexual assault could be termed a "universal...
