What to say to a rape victim, what can we tell her that might help her begin the process of healing? After 30 years in the emergency room, this was my best attempt.
The Rape Exam
I don’t know if people associate the emergency room with rape, but that’s where most rape victims are taken first. They don’t come to us just to address their injuries, but to perform a forensic rape exam, to collect evidence.
It’s a really bad situation for everyone. The exam is, in many ways, a repeat of the assault. A woman – or sometimes a man, or a boy – must submit to much the same de-personalization, and objectification, and penetration, that they just suffered through. I can’t begin to imagine how the victim feels. I know it make me feel like crap. And you never know what to say to a rape victim, how to suppress support, compassion, and encouragement. I’m not sure much encouragement is possible at that initial stage.
But for a few years, I was on staff at the largest teaching hospital, and the busiest emergency room, in my part of the state. We examined most of the rape victims. So in addition to worrying about the suffering of the patient, the doctor has to put a busy ER on hold, and take 45 minutes or more to do a proper medical and forensic examination, and to collect specimens. And during it all, I had to struggle over what to say to the rape victim.
I got more than my share. Whatever sparse positives can be found in such a lousy situation, some of the Rape Crisis workers, all of them volunteers, requested that I do the exams. I despised the exams, and I admit with embarrassment that I often took out my frustration on the volunteers. Apparently some of them decided it was worth it; I think they recognized that as difficult as I was with them, I still tried to take care of the victims, and to treat them with as much kindness and dignity as the situation allowed.
After years of doing these exams, I realized something. Almost none of the victims had any physical injuries. Except for one particularly depressing case, a prostitute who had been beaten with a garden hose by her pimp, the victims I saw rarely had so much as a bruise or a scratch.
Their injuries were psychological. That’s not to say that the injuries weren’t real; they were all too real, and can be as debilitating as any infection, broken bone, or malignancy. Many of the victims would never completely heal. And each of them would spend years trying to accept what was intellectually obvious to her, and to everyone, from the outset: it wasn’t her fault, there is nothing wrong about her, she isn’t damaged goods.
But the victim will, nevertheless, accept the assertion of the rapist. She will feel that she is worthless, insignificant, even disposable. Only after years of effort and healing can she even begin to crawl out of that hole. So what can we say to a rape victim that might help her?
Searching for Words
After three decades of performing these exams, I was confronted by a rape case where there was nothing left to do but despair. It was a young teenager, a good student from a good family, who unfortunately lived in a poor neighborhood. The rape had taken place a week before. She had been afraid to tell her mother because of course, the victim blames herself.
So it left me with nothing to do medically. I had never realized that the rape exam, as bad as it was, at least gave me something to do. It allowed me to contribute a tiny mote of value to a very bad situation.
What should I say? It occurs to me that family and friends also ask themselves what to say to the rape victim. So I thought I would write this post.
Before continuing, there are some things we never want to say to a rape victim. And we should always say that we believe her, and try to gently remind her it’s not her fault. Most of all, we should give her love, lots of patience, and lots of time.
I have tried to do some of this in the past, but I also try to pay attention to how the patient is responding. The fact is, right after the attack the patient is in deep emotional shock, bewilderment, and a desperate need to deny all of it. It doesn’t seem to be the time for much counseling. So during the exam, I just try to be patient, and when I’m finished, I try to briefly and gently drop a seed or two that may blossom later: This wasn’t your fault. You didn’t do anything wrong, he did.
But in this case, the rape was in the past, the emotional shock was gone. So I was wondering, again, what should we say to a rape victim? I cast about for something that I could tell her that might allow her to begin healing. I stood there awkwardly for several moments, while the young lady and her mother waited quietly for the ‘wise‘ doctor to speak.
This is what came out. Looking back on it, it seems as valid as anything else I have read or heard:
Some people will tell you that everything happens for a reason. I don’t believe that. Things only happen for a reason if we choose a reason, if we design a reason. If there is anything positive to come out of this, if there is any growth or value, then it will be because you create it.
Right now, your attacker has tried to tell you what you are, and who you are. He has tried to rob you of your value as a human being. When you can take what happened to you and create sense of it, when you can reject what he thinks and instead choose to believe what you think, then you will begin to heal. Once you reclaim your own power, then you will deny him his power. You will be able to take back your dignity for yourself, and with it, you will take back your own life.
Make, or Break
I don’t know if that was the right thing to say. I also don’t know where it came from. Do muses exist? Perhaps a muse is the result of long-term subconscious rumination. It’s possible it wasn’t even a muse. Recently I came across a quote in my files from Jean Paul Sartre that I had forgotten, “Freedom is what you do with what’s been done to you.” Maybe I just remembered that, and restated it.
Anyway, some weeks later I saw her mother and she said that she was telling her daughter, “Remember what the doctor told you: this will make you or break you.” It’s not exactly what I said, but I guess it’s close enough, and if that interpretation helps the young lady, that’s fine.
Since then, I have realized that perhaps this approach can help others who are struggling. Perhaps what we say to the rape victim we could also offer to other people who are demoralized, people who have been victimized in other ways.
From time to time in the ER we see young men from a local juvenile facility. Before continuing, I have to say that I have been very impressed by the counselors who bring the kids in; by and large, these guys appear to be genuinely committed to the young men, and they work hard to help them. Some of the counselors speak from experience; many of them struggled with their own rebellious behavior and/or illegality when they were young. It’s one of our worthwhile tax expenditures that often gets missed in complaints about government waste.
Anyway, sometimes these young men have typical teenage injuries and illness. But some of them we see are there because they are deeply resentful and angry, even suicidal: they are away from their homes, they are in a strictly controlled environment, they think they will never get out, and even though the counselors monitor them as best they can, there is still bullying and fighting. When I think it appropriate, I give some these young men a version of the same talk I gave the young lady.
Because maybe it’s advice that we can all use. Rape is an extreme, something that should never happen to anyone.1)But happens all too often. There are some estimates that 1 out of 3 women, and 1 out of 7 men, were sexually abused as children. But it’s also a metaphor for what we all face in much smaller ways. We will all be violated, beaten down and humiliated, often by other people, but sometimes just by circumstances. When that happens, we all have a strong drive to climb into a hole and accept their degradation and victimization. So we have the same choice: either that adversity will carry important meaning for us, or it will be meaningless suffering.
It’s as the Buddhist aphorism suggests, “Pain is inevitable. Suffering is optional.” How we deal with our pain is up to us.
So I hope I helped the young lady, and the other people with whom I have shared this insight. But I can’t be sure. Perhaps it will help you; it has certainly helped me, at least when I remember it.
When I’m struggling and out of energy (like I am presently, probably the reason I picked this for today’s blog post), I try to remember what I told the young lady. We create the value in our lives; to quote a somewhat trite bromide, we need to figure out how to take our lemons, and make lemonade.
It doesn’t always make me feel better, but it often gets me up and moving again.
Which, I suppose, is the first step in simply living.
Photograph courtesy of Frédéric Poirot on Flickr.
Footnotes [ + ]
|1.||↑||But happens all too often. There are some estimates that 1 out of 3 women, and 1 out of 7 men, were sexually abused as children.|