Victims of crimes often suffer from a host of emotional reactions. Research indicates that the psychological effects of being deliberately violated or injured generally are worse than physical injuries and financial losses. Further, it appears that sexual crimes generally cause more severe psychological reactions than both violent crimes and property crimes.

What is rape?

From a legal point of view, rape is defined as one person forcing another, without this person's consent and using violence or threatening violence, to have intercourse or other forms of sexual activity. The same definition applies if the person is violated while in a vulnerable state such as sleep, unconsciousness, intoxication, physical or mental disability. Any present or previous relationship between the parties is irrelevant.

The majority of victims of sexual assault are women, and the perpetrators are almost always men. Rape can be categorized in different types:

Stranger rape: For example, when a woman is assaulted by a stranger outdoors, or by a man who entered her home.

Acquaintance rape: The man and the woman may know each other fairly well or only casually. Often happens in connection with or after a party or date.

Gang rape: May occur as an attack or during private parties. Gang rapes may be preplanned to varied degrees, but some planning always takes place. May have a motive of revenge, for example to put an independent woman in her place. Also occur ini war as a calculated strategy.

Marital rape: The husband refers to his "marital right" to sex, threatens with violence or divorce or demand sex after being abusive, when she does not dare say no. He may also simply force himself on her, despite her resistance and protests.

There are also two types of hidden sexual assaults:

• The victim acknowledges to herself and perhaps also to others that she has been raped, but refuses to press charges for different reasons.
• The situation matches the legal definition of rape, but the victim, for different reasons, does not see it as such.

It is difficult to accurately determine how many rapes occur because the number of unreported rapes are presumed to be very high (especially rapes where the perpetrator is an acquaintance). Rape is often associated with strangers, when in fact, research shows that in most cases the victim and the assailant know each other. A considerable number of rapes are presumed to occur within marriages. However, marital rape is still a subject very much taboo and is most likely the least recognized type of sexual assault.

Physical and psychological effects of rape

Some common physical injuries from a rape include pain, bruises, irritation and tenderness in the vaginal area, vaginal and anal bleeding, and sometimes tears in the vaginal-rectal area. If the victim has been thrown to the ground there may also be other injuries such as skin insults and contusions.

The victim often suffers intense emotional reactions immediately after a rape. These can be described as personal crises where the victim relives the fear, agony or anxiety, mixed with emotional numbness. For most rape victims, the reactions begin days or weeks after the rape and decrease after two to six months. However, disturbing emotions combined with low self-respect and sexual dysfunction may last for a year or more for some.

Defense mechanisms such as denial, suppression and dissociation are common among rape victims.

The function of suppression is to block out the strong emotions and thereby escape the painful feelings for a short time which can be psychologically very exhausting.

Denying or putting the worst parts of the assault out of the memory allow the victim to avoid the immediate distress.

Dissociation is a defense mechanism which can be employed during painful physical or psychological abuse impossible to escape. As a survival technique, it provides a feeling of "leaving" one's body, making the trauma harder to remember, especially the details.

Defense mechanisms like these may affect the victim's ability and motivation to talk about the abuse they suffered. This is something which must be considered by professionals during questioning, by health care personnel, researchers as well as when evaluating research results.

Other long-lasting traumatic reactions following rape may be hyper-vigilance, avoidance of certain thoughts, feelings and situations that remind the victim of the abuse, and strong reactions to sudden mental images. Avoidance behaviors serve as a psychological defense against severe anxiety and tend to be long-lasting. Research shows that a person's normal work-capacity may be disrupted for as long as eight months after the rape.

One of the most common effects of rape is depression, which can last for months. Suicidal ideation and attempts to suicide occur, and sleep disturbances are common, especially if the victim was assaulted in her own bed.

Some examples of how a victim's lifestyle may change after rape are that she may stop opening the door if alone at home, stop using the laundromat, avoid going out after dark, and avoid social interactions, especially with men.

Some research indicates that the consequences of spousal rape are longer-lasting than stranger rape because it is perpetrated by a trusted individual whose trust is now also damaged. Ongoing violence and rape within a close relationship may result in effects comparable to those of torture and war. Due to the repeated violence, the effects become even more difficult to work through, leading to yet deeper wounds. Many times, marital rape involves a combination of several types of crimes, such as physical harm, threats and property damage. All this often intensify the trauma.

Importance of the environment

The recovery process after a rape largely depends on reactions by family, friends and professionals. It is important for the victim to be able to talk about the assault without being interrupted, questioned as a person, and that the trauma is not minimized or explained away. Therapy may be necessary to help the victim work through the traumatic experience. It is important that the woman is not made to feel guilt or responsibility after a sexual assault (which harms instead of helps) and to help her understand the real reasons for rape.

The immediate care by health care professionals and doctors is also very important. Some important points to cover are:

• The patient must be informed about examinations and tests that will be done and why (to document injuries and secure evidence).
• The patient must never be left alone in the waiting area, and the waiting time should be kept as short as possible.
• The patient must be informed that certain questions have to be asked, and why it is necessary to ask them.
• The immediate social situation must be evaluated. Does the patient have someone to stay with her over night? Does she wish to be admitted to the hospital or need to stay home from work? Was a police report filed?

Unfortunately, reactions from society often involve some blame of the victim's own behavior. It is not unusual that the victim blames herself for the rape, and the public's attitude may increase this feeling. Blame and doubt by the public most likely stem from their own psychological defense system rather than from an uncaring attitude. This mind-set is partly a result of an unconscious conviction that those who behave appropriately will escape trouble, which also strengthen our own sense of security and control. Another reason is that placing blame on the victim relieves oneself of the responsibility to take action and help.

Resistance and self-defense

The perpetrator's first objective is to gain control of the victim so the rape can be completed. Some strategies are physical violence, threatening violence, scare-tactics and the use of alcohol or other drugs. Another strategy is that the perpetrator first attempts to gain the victim's trust and create a situation she can not get out of. Strategies vary, depending on the situation, the relationship between perpetrator and victim as well as on the perpetrator's intent.

All investigations clearly show that women who have been raped tended to avoid to resist. This is true for both marital and stranger rapes. No resistance is presumed to be the best defense, but the lack of resistance could be held against the victim later in court. Research in this area points to two things:

• Attempts by the woman to defend herself against aggression and rape in her own home are seldom successful. Physical resistance is also rare within a marriage.
• To actively defend oneself and physically and verbally resist the perpetrator decrease the risk for completed rape by a stranger. By and large, the risk for injuries does not appear to be higher because the woman resisted, even if the common belief is that it is "safest" not to resist. Traditionally, women learn that no resistance is the best strategy in a rape situation. However, there are two obvious problems with this viewpoint. First, the non-resistance may be used against them in court; and, second, new research shows that women who physically resist an assault by a stranger have a good chance to avoid being raped.

Research like this must never be interpreted in a way which places resonsibility on those who are unable to or too afraid to resist or whose resistance was not effective. The fact is, and must always be, that the perpetrator is responsible for his actions. This is especially relevant when speaking of rape within the marriage, where resistance appear to be both more dangerous as well as rare.

The most successful resistance strategies often talked about are kicking the assailant hard between the legs, pulling his hair, poking him hard in the eyes, and digging with the nails or other objects. At the same time, the woman must also try to find a way to escape. As a result of the newer research, girls and women are now more often encouraged to take self-defense classes.

However, this type of resistance does not appear to have the same effect on rape within the marriage. Men who assault and rape women in close relationships must be held accountable and be prosecuted. They should also be offered appropriate individual or group psychotherapy. Women and their children also need help and support to leave an abusive relationship, and offered better protection as well as psychotherapy if needed.

Who rapes and who is raped?

Rapists come from all areas of society. Many times, they live in normal relationships with other women. Research has been done to find specific biological and/or personal reasons to why men rape, but the results vary. Therefore, it is difficult to determine a particular biological reason or personality trait of the typical rapist.

It is not, generally, the practice to look to the victim for reasons for a crime, except when it comes to sexual assaults against women where it is common. Women who are raped are not considered psychologically different (which is often the case with rapists). Instead, they risk being regarded as having poor judgment and/or character. It is difficult to find a basis for such assumptions in any research, and the only effect is that the blame and responsibility are placed on the woman, making it harder for her to work through the trauma.

Victims of rape are found in all classes of society and are of all ages. However, one common factor emerges: women who have been raped were more often sexually abused as children. Here, the childhood trauma is presumed to have impaired the instinct of self-preservation, which in turn may affect their ability to avoid dangerous situations. Overall, however, rape victims do not seem to differ from women who have not been raped, so it is difficult to determine the importance of this connection.

Attitudes toward sexuality and rape

The attitude toward rape changes over time and vary in different cultures. The view on male and female sexuality in one society at a certain period has always been and still is directly related to the attitude toward rape. When speaking about sexuality and rape, it is very important to consider the way men and women are portrayed in media, advertising, movies and music videos, in pornography and violent pornography. It is also important to remain critical toward myths of sexuality, such as that a man's sexual drive is an uncontrollable natural force, or that women say no but mean yes.

Society's attitude toward sexuality and rape is reflected in its laws, but perhaps for the most part in the legal process itself. One example of that these two do not always correspond, is that questions about the victim's behavior, dress, ability to say no in a way the perpetrator understands, etc., are raised in court, despite the fact that according to Swedish law, the woman's behavior prior to the assault is irrelevant. Another example is that even though the law considers intoxication a vulnerable condition, research indicates that women are commonly regarded as less believable, both in social and legal respects, if they were intoxicated when the rape occurred.

Following are some links about men's violence against women, abusive relationships, and important information in a crisis.