Contesting Rape Narratives: Medicalisation and the Trauma

Model of Victimhood

This dissertation is submitted for the degree of Master of Philosophy at the University of Cambridge Centre for Gender Studies.

Constance Flude, Wolfson College Supervisor: Dr. Elizabeth Foyster

Word Count: 19,996 15th July 2015

 

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Table of Contents: PREFACE LIST OF ABBREVIATIONS INTRODUCTION……………………………………………………………………6

The scope of the problem Definitions

CHAPTER 1: RESEARCH AND METHODOLOGY…………………………….8

Methodological justification Methodology Historical Method Modern Method

CHAPTER TWO: MEDICALISING THE RAPE VICTIM…………………….17

Medicalisation

Sex and Medicine in the 19th Century Rape and medicalisation

Medical Jurisprudence and Raped Women in the 19th Century Legitimate forms of speech

Rape in the Courtroom Social Scripts in the Courtroom

Competing Discourses

Hysteria Fallen Women and Corrective Reform

CHAPTER THREE: SHIFTING EPISTEMES, THE CREATION OF THE MODERN RAPE VICTIM………………………………………………………..33

Modern history

‘Breaking the Silence’ Modern Discourses

Culture of Wellness The pathologisation of victims of rape

 

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Trauma model The Neurobiological Trauma model

The Expansiveness of the Trauma Model Suppression of an alternative model

CHAPTER FOUR: IMPACT OF THE INCITEMENT TO SPEAK………….46

Incitement to speak: Confessional Society

Talking as healing Talking as potentially harmful Repetition Compulsion

Coming to terms with the labels

Labelling experience ‘Victim’ – ‘Survivor’ Diagnostic Labels

CHAPTER FIVE: WHO DO SUCH CONSTRUCTIONS SERVE?.....................64

The PTSD Brain Procrustean model of therapy Who do labels serve? Market driven model of health

CHAPTER SIX: PERFORMING ILLNESS IDENTITIES……………………..74 CONCLUSION……………………………………………………………………...79 BIBLIOGRAPHY………………………………………………………………..…83 APPENDIX ONE – List of Interviews……………………………………………108 APPENDIX TWO – Participant Consent Form…………………………………109 APPENDIX THREE – Victim, Survivor, Thriver Chart……………………….110 APPENDIX FOUR – Examples of Diagnostic Criteria Tests…………………..112 APPENDIX FIVE – Example of Presenting PTSD as a Physical Ailment……117 APPENDIX SIX – Eby et al. Table of women who attribute physical symptoms to sexual assault………………………………………………………………….118

 

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Preface:

This is the result of my own work and includes nothing that is the outcome of work

done in collaboration except where specifically indicated in the text. This dissertation does not exceed the word limit for the respective degree committee.

Constance Flude

 

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LIST OF ABBREVIATIONS:

• PTSD: Post traumatic Stress Disorder

• C-PTSD: Chronic/Complex PTSD

• DID: Dissociative Identity Disorder

• RCC: Rape Crisis Centre

• SV: Sexual Violence

• SARC: Sexual Health Referral Centre

• T: Therapist

• CFS: Chronic Fatigue Syndrome

 

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INTRODUCTION

Rape is seen as one of the most profoundly damaging and traumatising acts of

violence that can be done to a woman in modern western society. 1 For many, this

form of ‘intimate terrorism’ (Johnson & Ferraro 2000:949) represents a fate worse

than death. The self that exists post-assault is a tainted shadow, whose memory

‘haunts the conscious and unconscious’ perennially threatening to resurface whenever

‘something triggers a reliving of the traumatic event’ (Brison 2002:X). Yet, this truth

has a history (Vucetic 2011:1299). This research attempts to deconstruct unquestioned

connotations and assumptions about the nature of rape victimhood that denote the

conditions of possibility, or prognostic future, of a woman who has been raped

(Deutsch 2007:107).

Using an explicitly Foucauldian framework (delineated in chapter one) I will analyse

the processes through which the ‘rape victim’—in its current morphology—has come

to be culturally identifiable, by locating the discursive shifts in history that have made

this understanding of victimhood, and its corollary with medical understandings of

‘ill-health’, possible. This ‘history of the present’ will isolate the different scenes in

history through which rape victimhood has come to be rendered intelligible to modern

society (Vucetic 2011:1302).

Chapter two will analyse trends in the 19th century, where attempts to create a

typology of rapeable and rapacious bodies brought both the rape victim and the rapist

under the inspecting dominion of the medical profession. The creation of the rape                                                                                                                          1 The sample demographic of this research are classified according to biological sex—I.e. I am studying female rape victims. However, the types of identities associated with this form of rape victimhood are gendered. Given that violence ‘marks and makes bodies’, an analysis of women’s accounts of rape, ‘demonstrates that gender is embodied’, that the ‘body’ and the ‘category of woman’ are not simply biological givens (Baily 2001:111). Changes in material reality, of identity categories and corporeality have implications for ‘gendered identity’ that I do not have time to attend to in more than passing detail in this thesis, though what I depict is necessarily gendered.

 

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victim as an object of knowledge afforded a new ‘speaking position’ to women who

had ‘fallen owing to violence’ where, through the courtroom, they were given

‘legitimated speech’ in order to articulate their claims of injury. Chapter two also

details how the moral reform movement for ‘fallen’ women can be seen as the

beginnings of a movement towards creating a therapeutic community, stressing the

transformative potential for ‘morally ruined women’.

Chapter three delineates the shifting epistemes between the 19th century

conception of rape, and the modern ‘survivor’ movement associated with second-

wave feminism in the 1970s, and the ways these have shaped modern understandings

of trauma. This chapter explores how the claim of injury normalised the trauma model

of rape and created discourse which pathologised rape victimhood on the one hand,

whilst stressing the moral responsibility for the women ‘to be better than well’ on the

other.

Chapter four explores the modern construction of rape victimhood and how

this impacts on upon the lives of rape victims. It details the construction of the

‘confessing modern subject’ that propounds an understanding that talking about

harms is always cathartic. This chapter is concerned with identity labels and how the

women come to understand and incorporate the labels into their ‘affected identity’.

Chapter five explores the implications of this discourse on the material reality

of these women, and asks the fundamental question: whom do these discourses serve?

In each of these epochs, the rape victim and rape victimhood is made thinkable within

the confines of social, medical and legal establishments, which proffers the victims

specific socio-political and cultural forms of ‘legitimate speech’, and in turn is

‘performed’ by the women (Bourke 2010:7).

 

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CHAPTER ONE: RESEARCH AND METHODOLOGY

The scope of the problem

It is estimated that around 18% of all adult women in western society are victims of

actual or attempted rape (Kilpatrick & Acierno 2003:123;Najdowski & Ullman

2009:43). As many as 1 in 10 women will experience some form of sexual

victimisation in their lifetime (Anderson & Doherty 2008:12; Mason & Lodrick

2013:29). According to some studies as many 95% of female rape victims will be

diagnosed with PTSD—highlighting the extent to which rape is seen to be decidedly

pathological (Hauck et al 2007:83). It is therefore pivotal that the discourses that

present such bleak prognostic futures for nearly one-fifth of the adult female

population is problematised.

Definitions

In this thesis, I follow Joanna Bourke in defining rape, not in legalistic terms2 but on

the simple principle that rape is any non-consensual sex ‘act called such by a

participant’ (Bourke 2007:9). This definition is a ‘heuristic device’; it does not

prescribe the ‘correct’ definition or stand as adjudicator over the veracity of claims

(Ibid:10). Instead, such a definition affords the people involved agency over how to

define their understanding of what rape constitutes.

It is important to recognise that not all rapes are the same, sexual violence

occurs on a spectrum of severity from ritualised torture to a grey borderland between

consent/lack of consent. However, I do not wish to make claims as to how

                                                                                                                         2 Legally rape is defined in the UK under the Sexual Offenses Act 2003, as: ‘(1) A person (A) commits an offence if – (a) he intentionally penetrates the vagina, anus or mouth of another person (B) with his penis, (b) B does not consent to the penetration, and (c) A does not reasonably believe that B consents.

 

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traumatising these different experiences are, rather it is the meaning that the women

ascribe to the event that is the determining factor in how it affects them.

Though I will interchangeably use the terms ‘rape victim’ or ‘survivor’3, I do

so only with the following caveat. Such terms are value-laden and serve to both

‘enable and constrain the lived experiences of women’ (Ronai in Lamb 1999:139).

Although many researchers claim to eschew moral judgement in their use of such

terms, the same people often state that ‘many victims are survivors’ (Bourke 2007:7).

This is highly problematic. Literally speaking any woman who is raped, and survives

the event is a ‘survivor’. However, in this conceptualisation, ‘survivor’ asserts a moral

position that is reserved for those who have consciously recoded their identities from

abject victim to empowered survivor (Naples 2003:163).4 The most pertinent issue

with the terms ‘rape victim’ and ‘survivor’ is that they connote an identity position. I

strongly oppose the conflation of an act of violence with an identity position, as I

believe this discursively imposes an ontological reality onto the women that may be

harmful to their sense of selves and future lives (Taylor 2009b:13).5

Unquestioned use of such identity categories is a theft of agency over self-

definition. Within any discussion of the effects of rape and the identity associated

with rape victimhood, the women are not simply passive recipients of a discourse that

dictates the states and shapes of their lives. I do not want to problematically oppose

agency and victimhood as though they are monolithic positions associated with power                                                                                                                          3 Though I do use the terms rape victim and survivor interchangeably (because of the inescapability of such terminology), I would prefer to always use ‘victim of rape’ which formulates rape as an act rather than an identity position upon the women under study. 4 I draw upon Judith Butler’s understanding of the abject as a subject position that is ‘unlivable’ or ‘uninhabitable’, but is nevertheless a subject position ‘densely populated’ by those who are excluded from the status of normativity, but are required in discourse to demarcate the domain of the normative subject (Butler 1993:3). 5 Running through this discussion is the idea that sexual violence is ‘constitutive of subjectivity’ (Shepherd 2007:248). The violent act of rape, ‘marks and makes bodies’ (D’Cruze & Rao 2004:503) insofar as both the rape victim and the rapist are brought-into-being by being defined by the act.

 

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and powerlessness (Wood 2000:7). Following P. Jackson, I argue that it is the

(self)conceptualisation of identity, agency and lived experience of victims of rape,

that shapes the ontology of rape victimhood (in Yanow & Schwartz-Shea 2013:274).

Methodological justification

Though there is an abundance of academic work on sexual assault that covers a wide

range of themes, most research reifies the idea that rape is profoundly traumatic

(Cahill 2000:43). To suggest otherwise is seen to diminish and ‘grossly

underestimate the psychological and physical trauma’ associated with rape

(Hengehold 1991:94). Poststructuralist theories tend not to be used in sexual violence

research because people feel that destabilising the standpoint, or identity categories

through which people articulate their lived experiences co-opts the voices of

‘survivors’ and robs them of an essential experience and claims pertaining to the

reality of their suffering (Mohanty & Martin 2006:85). However, to suggest that rape

victimhood is not pre-discursively real and that people are directed through normative

prescriptions to a vocabulary and identity position of suffering which are only

possible within our current episteme is not the same as diminishing the reality of a

persons’ suffering. Rather, the deconstruction of a preconceived notion is both

affirmation of the reality as it stands and a radical undoing; allowing for new

possibilities and constructions to arise. Precisely because the act is imbued with such

immense symbolic potential, it is important not to shy away from ‘controversial

topics’.

The main challenge for feminist ethics is ‘how to deal with the tension

between care for the suffering of individuals and concern for issues of power and

oppression’ (N.Martin2001:438). Therefore, my choice in adopting a poststructuralist

 

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methodology is predicated upon my ontological presupposition that material reality is

created through discourse and my feminist politic that requires ‘evaluating’ and

‘dismantling’ oppressive structures of thought. Through a feminist-Foucauldian

approach to sexual trauma, I hope to present an understanding of rape victimhood that

neither medicalises, pathologises nor trivialises victimisation, and allows for new

conceptions of rape to be put forward.

Methodology

In constructing a genealogy of rape, I aim to make the past (and present)

representations of—and symbolic meanings attached to—rape, visible, in order to

render them ‘susceptible to critique’ and illuminate ‘taken-for-granted beliefs’ (Fraser

& Gordon 1994:311). Foucault (in Bouchard 1977:139-40) argues against the

assumption that ‘words keep their meaning’, or that ‘ideas retain their logic’. Instead,

he contends that it is important to ‘isolate the different scenes’ in the genealogical

deconstruction of a term or notion, where it has been ‘engaged in different roles’. In

so doing, one is able to look at how some thoughts and ideas linger within our

intellectual and social histories—shaping what is thinkable and knowable within a

given context—but also how ideas radically change and adapt. This highlights the

representational and contingent nature of knowledge, and will allow me to challenge

the status of truth associated with modern constructions of rape victimhood (Foucault

1972:127).

Inhered in Foucault’s conception of ‘regimes of truth’ are pivotal insights into

the ways in which discursive practices, ‘encode, construct, [and] authorise… an

aspirational and often didactic model of human identity’ (Hawthorne 2006:16). In this

view, the terms used to describe social life systematically form the ‘object of which

 

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they speak’, powerfully constituting the a priori ‘assumptions, expectations and

explanations’ that govern social life (Baxter 2003:7). Following Foucault, what is

found at the ‘historical beginning’ of term is not the ‘inviolable identity of their

origin; it is the dissension of other things. It is disparity’ (Foucault in Bouchard

1977:140). In this light, rape victimhood has no essential meaning prior to or outside

of discourse, rather ‘truth’ is ‘the sort of error that cannot be refuted because it was

hardened into an unalterable form in the long baking process of history’ (Ibid:144).

Therefore, the construction of a genealogy is predicated on the understanding that

experience of—and meanings attached to—rape, are historically constituted, and

embedded within ‘overlapping networks of relations’ that spatially and temporally

shift (Somers 1994:607).

Vucetic (2011:1300) advances the idea that a genealogy must offer ‘episodes’

in order to ‘perioditise the history of an object of study’, such episodes must be

narrated through examples ‘which are themselves reconstructed in a discourse

analysis’ of an array of historical documents. A genealogy is both an analytical tool

for socio-political research (to write the ‘political histories of truth’), but it is also an

attempt to ‘open the intellectual and political space for resistance to the dominant

regimes of truth’ (Vucetic 2011:1298). Genealogy therefore draws upon two levels of

existence: one that is of a particular historical moment where material reality is lived

(ontological); and the second theoretical, where one attempts to understand from

where we came and where we are going (epistemological) (Shoemaker 2008:13).

Therefore, to destabilise rhetorical commonplaces, a genealogical discourse analysis

must rely upon a ‘comparative method’ (Vucetic 2011:1301).

Historical Method

 

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A critical history is intended to enable us to ‘think against the present’ to disturb and

fragment the ‘mundane and quotidian roots of that which claims lofty nobility’ (Rose

1996:41). In order to isolate the given historical constellations of conditions that have

made the current understanding of rape victimhood appear natural, I have adopted the

method of a ‘textual ethnography’ (Jackson in Yanow & Schwartz-Shea 2013:274). A

textual ethnography is a disciplined reading where one engages in ‘observation’ of the

textual records in order to isolate the themes in the history of legitimation struggles

(Ibid:276). Once the themes became identifiable, I conducted a discourse analysis to

understand the processes through which meaning is made in order to understand how

the meanings attached to rape victimhood were deployed in the past, and how these

are continuous/discontinuous with modern day constructions.

During the episodes in history isolated for this research, there were struggles

over the recodification of social phenomena. Such struggles ‘leave a residue in the

form of laws, social practices, and ideologies’ creating assumptions that are ‘so

pervasive’ that they are rarely questioned (Rubin 2011:146). Through an analysis of

sources—such as court sessions, police reports and medical jurisprudence books from

both national and regional archives—I have been able to access the construction of

19th century rape victimhood.

Though most documents were ‘almost exclusively written by men’ (Taylor

2009b:23), through the ruptures, ‘accidents’ and ‘minute deviations’ (Foucault in

Brouchard 1977:146) contained in their pages, an ‘episodic, fragmentary and

contingent’ narrative of women’s social identities becomes accessible (D’Cruze

1998:9). In this way, although the texts are ‘multi-authored’, one can see glimpses of

the tropes and forms of the legitimated types of speech and identity afforded to female

 

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rape victims which have rendered visible the ‘actual and possible forms of social

organisation’ and identity as they were linguistically produced and contested

(Weedon 1997:21). Although I primarily focus on sources from the UK, 19th century

medical jurisprudence books were circulated across the Atlantic and most modern

research papers draw on both UK and US sources, despite the different contexts in

which they were deployed.

Modern Method

In order to account for the modern subjectification of the rape victim, I have—as with

the critical history—conducted a discourse analysis of a plethora of sources. I

analysed a number of online ‘survivor’ forums, in order to provide ‘voices’ of

survivors in relation to their experience that I might otherwise not have been able to

access through interviews. All the information used in this research was taken from

the public domain and I have therefore used the online aliases of the forums’ users.

Without membership, no one from the general public could gather details on the users

other than comments which are freely available online. Given that these spaces are

multinational, it has been impossible to isolate different countries for the purpose of

this study.6 Therefore, although this research is more nuanced towards the discursive

regimes of the UK (and US), the term ‘western’ is more appropriate to the

transnational nature of this research, particularly given that medical knowledge is

presented as ‘objective’ and universal, rather than ‘cultural’—and is disseminated on

this basis7. In drawing upon the comments in the online forums, I hope to provide a

                                                                                                                         6 Within an increasingly globalised world, knowledge and identities are constituted through increasingly connected and interdependent discursive and material regimes’ (Mohanty2003: 521). 7 All the research papers on medical models of rape and trauma are from various countries across the western world, and despite ‘scientific’ differences, they rarely attend to cultural understandings of rape. Instead, rape victimhood is presented in universalised terms and my research therefore attends to the universalisation of rape victimhood

 

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representation of ‘survivors’ voices that details their ‘coming-into-being’ as rape

victims (Stern 2006:183).

For the primary data sample, I conducted qualitative interviews of eight

professionals whose work relates to the provision of therapeutic services for rape

victims8. I asked open-ended questions, first finding out the particularities of their

personal experiences of working with rape victims and then focusing on the themes in

my research in a ‘non-directive’ way. I also interviewed three ‘survivors’ and

attended a ‘survivors workshop’9. I conducted semi-structured, qualitative interviews,

asking open (and not leading) questions. I chose this method of data collection

because it offers access to ‘people’s ideas, thoughts and memories in their own words

rather than in the words of the researcher’ (Reinharz 1992:19).

In all of my interviews, I attempted to be ‘engaged but non-obtrusive’ (Eingal in

Bondi 2002:232). All participants signed an informed consent form before the

interview was conducted (see appendix 2), except in the case of the ‘survivors

workshop’ where all the participants were informed that I was there within my

research capacity. I did not record the ‘survivors workshop’ but after I left, noted the

aspects that stood out. Following the workshop, I spoke in more depth with one

                                                                                                                         8 Duncan McLean, Clinical Pyschologist & Psychoanalyst; Zoe Lodrick, Sexualised Trauma Psychotherapist; Nicc Seccombe, Mental Health services manager; Jacqui Campui Peterborough Rape Crisis Centre; Rachel Matheson SARC; L. Grillo respiratory physiotherapist, NHS; and one woman who founded an organisation for ‘survivors’ providing help and counseling for gynecological and sexual problems who has been anonymised because I accessed the survivors workshop through her organization. This anonymisation has been discussed with my supervisor. (See Appendix 1 for details of interviews) 9 The survivors workshop was attended by around 30 people and was a day of discussions and activities where people were encouraged to talk about their experiences in an open and friendly space. I accessed the workshop through an organisation, which will remain anonymous (as discussed with my supervisor) in order to protect the identities of anyone involved who might be quoted in this thesis. I have cited 4 participants from the workshop in this study and have listed them as (survivor(S) 1 workshop), (S2 workshop 2015) etc.

 

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woman (S2) about her experience of the event. She was aware that I would quote her

in my thesis and signed a consent form.

The three ‘survivors’ interviewed for this project had over 10 years time lapse

between the rape and the point of interview and each of them worked in some

capacity, with women who have been raped. In the first instance, I ‘accessed’ these

women through their professional roles so I did not have a ‘gate keeper’ present

during the semi-structured one-to-one interviews. I have anonymised these interviews,

and will not provide details of the organisations, as I want to draw upon the insights

of these women in their ‘survivor’ rather than professional capacity.

To interview people, particularly when dealing with personal experiences such

as the aftermath of a rape, is to ask them to ‘open themselves up to the researchers

questions’, therefore protection of their identities is of utmost importance (Bingley in

Bondi 2002:2009). Interviewing such women afforded me an insight into the

‘narrative voice and the biographical structure’ of people who have personal

experience of rape, but who also work within the therapeutic and research sector and

therefore are doubly positioned ‘between the categories of insider and outsider’

(Eingal in Bondi 2002:232). This allowed for a ‘double hermeneutic’ where they were

able to talk of the aftermath of their experiences with statutory services from their

position as ‘survivor’ and reflect critically upon this from their position ‘within’

service provision (Ibid). This also allowed for richer comparative insight when

looking at the voices of ‘survivors’ within the online forums.

In conducting both the professional interviews and interviews with survivors,

despite differing degrees of critical appraisal of discourses, all responses were to some

extent coded within an already established discourse. Most respondents, to differing

 

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extents constructed rape as always traumatic and used medicalised terminologies or

models to refer to victimhood. As with all narratives, the interviews must be viewed

as ‘meaning-constructing’; spoken accounts must therefore be seen as ‘inscribing’ and

creative of material reality (Stern 2006:184).

CHAPTER TWO: MEDICALISING THE RAPE VICTIM

Medicalisation

Medicalisation denotes a process through which nonmedical problems come to be

defined by, and understood through a medical lens, ‘usually in terms of illness or

disorder’ (Conrad 1992:209). The ‘dominion, influence and supervision’ of the

medical profession (Zola 1983:295) was inaugurated during the 19th century, 10 when

doctors and psychologists began to describe and classify pathologies that had

previously ‘remained below the threshold of the visible and expressible’ (Foucault

1973:xii). Thus, it was within the ‘new epistemological space’ of 19th century medical

science (Ramazanoglu & Holland 2002:26), that the medical gaze fixed, ‘isolated and

animated’ objects of knowledge (Foucault 1973:45).

This ‘mode of revelation’ (Heidegger 1977:13), of bringing-something-into-

existence by defining and rendering knowable, ‘certain behaviours, persons and

things’ (Conrad & Schneider 1980:8), is one of the most ‘committed forms’ of social

control, precisely because categorising humans and human behaviours is productive

of and re-produced by the very subjects under surveillance (Pastor 1978:382). The

subject of ‘the gaze’ is thus effected through its perception (Crossley 1993:411), and

                                                                                                                         10 I use the term ‘19th century’ to refer to the period in which the broad social processes of medicalisation of rape victimhood took place, however it is near impossible to isolate epistemic changes to specific historical dates and the views and constructions of rape at the beginning of the 19th century were radically different from those at the end. However, the period of focus is mostly from around 1860 onwards, although source material ranges from as early as 1814 to as late as the 1930s.

 

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through an ‘infolding of an ‘exterior’ to constitute an ‘inside’’, comes not only to

know itself as an object of knowledge but to re-produce—through the ‘internalised

technologies of the self’ (Martin 2005:56)—the prescribed behaviours, characteristics

and tropes associated with such medicalised identities (Venn 2002:30).

Foucault argued that this ‘informationalisation of bodies’ (Wilcox 2014:3)

forged a new alliance between things and words, ‘enabling one to see and to say’

(Foucault 1973:xii). The medical gaze is an ‘active perceptual system’ (Haraway

1988:582) with the power to isolate and classify the ‘forms’ and ‘deformations’ of

certain bodies, behaviours and characteristics (Foucault 1979:136), by visually

‘proving’ their existence (Fielding 1996:176;Stafford 1991:1). This ‘panoptic power’

is a tool for organising and orienting living matter, with the power to designate some

bodies and some things as marginal, and some as normative (Foucault 1980:144-5).

The gaze is therefore ‘the eye that knows and decides, the eye that governs’ (Foucault

1973:108).

Sex and Medicine in the 19th Century

Foucault argued that by the 19th century, the development of understandings of

‘demography’ transformed the ‘social body’ from a ‘jurido-political metaphor’ into a

‘field for medical intervention’ (Foucault 1978:6-7). This fundamentally transformed

the technologies and rationalities of political power, where the state was increasingly

called upon to ensure the ‘welfare’ and ‘normality’ of its citizenry (Rose 1996:48).

Medicine functioned as a ‘public hygiene’ that promised to eliminate ‘defective

individuals’ and ‘bastardised populations’ not only through surveillance and

disciplining techniques, but also through moral self-regulation imposed upon and

reproduced by individuals (Foucault 1979:54). Here, the doctor and the psychologist

 

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became a technician to heal the societal body, as well as the individual soul (Foucault

1978:7). This moralising arm of medical science was essential to the developing idea

that sexual behaviours (outside of monogamous heterosexuality) were expressions of

disease or pathology (Hart & Welling 2002:897; Cryle & Downing 2009:2).

Rape and medicalisation

In The History of Sexuality (1979), Foucault argues that sexuality became the locus of

identity during the 19th century. During this time, the sexual act came to be seen as a

way of being11. Following Foucault’s theorisation in Discipline and Punish (1975),

one could argue that the rapist and the rape victim are twice defined, once by the act

(done by, or done to them) and second by the identity position this confers upon them

(Taylor 2009b:13). Forging such characters as ‘objects of knowledge’ with the

intrinsic identities of ‘the rapist’ and ‘the rape victim,’ inculcates and imbues such

identity positions with psychological discourses that ‘categorise[s], observe[s] and

refashion[s]’ the very souls of the subjects (Ibid:8,1).

The construction of the ‘rape victim’ is intimately tied to the quest to establish

rape as a sexual deviancy committed by a small minority of men (Porter 1986:235).

Recognition that sexual violence against women was commonplace would have

required society to address the normativity of a rapacious masculine sexuality. During

the 19th century however, it was still a perfectly acceptable idea that a ‘proper’ lady

would not consent ‘without some force’ (Beck 1825:57). Havelock Ellis’ writings

constructed violent male sexuality as a ‘biological necessity’ because female                                                                                                                          11 Though Foucault argues that sexuality is the locus of identity, I would complicate this further. Though sexuality was afforded far more importance during the 19th century, it was certainly not the sole marker of identity. Sexuality and sexual identity were also deeply reliant upon the class formations within the UK—particularly when looking at the typologies of the ‘legitimate’ rape victim (who was mostly a hard working, moralistic, working class woman; rather than a drunk, brawling lewd character.) I will attend to class considerations with more detail in the section of ‘legitimate forms of speech’

 

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resistance to intercourse was a ‘natural’ part of the heterosexual mating-game and

‘functioned to increase male arousal’ (Anderson & Doherty 2008:6)12. Therefore, in

order to distance masculine sexuality from recognising itself as violent, the idea that

rape was committed by a small number of determined perverts meant that character

assessments of both the rapist and the raped woman were needed in order to ascertain

guilt (Whitlock 1999:424). Due to the desire to see rapists as a minority, the legal and

medical institutions systematically favoured the idea that most victims were at least

partially deserving of being raped.

Medical Jurisprudence and Raped Women in the 19th Century

The development of a ‘medico-legal’ understanding of rape in the courtroom

sanctioned public speech about rape and women’s bodies within the masculinised

space of the courtroom (S.Robertson 1998:348). The body on display encompassed a

‘constellation’ of gendered discourses concerning ‘disorderly female sexuality’ and

respectability (D’Cruze 1998:144). The raped body was therefore called upon to bear

witness to the crime and in doing so, the woman’s character, integrity and reputation

were put on trial.

Medical writing of the time delineates the areas of ‘expertise’ that doctors

provided in the courtroom space. Doctors claimed the ability to preside over and give

evidence in three areas deemed constituting of guilt: 1) physical struggle, 2) signs of

rape and 3) character of the rape victim. Out of these discourses women were able to

publically express the effects of rape in terms of ‘physical and economic ruin’

                                                                                                                         12 Such understandings still have bearing on modern constructions of sexuality. Nicola Gavey (2005) argues that this version of heterosexuality, and the idea that women must be, on some level, ‘coaxed’ into sexual submission forms the heterosexual norms that operate as a ‘cultural scaffold for rape’. Furthermore, Lunbeck argues that it is due to this ingrained understanding of male sexual aggressiveness that means that it is ‘sometimes difficult for women to draw a firm line between abuse on the one hand, and consensual sexual activity on the other’ (Lunbeck cited in Showalter 1997:52)

 

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(Bourke 2012:16) which provided ‘sexual scripts’ to articulate legitimated grievances

(S.Jackson 1978:30). Such legitimated types of speech encouraged women to deploy

their bodies as evidence of injury: The Ipswich Journal (4th-Dec-1880) for example,

detailed a case where a mother presented her daughter’s bloodied and torn

undergarments as evidence that the rape had taken place.

In a visually oriented culture, where seeing was believing, it is perhaps unsurprising

that doctors came to the legal system with the perspective that rape was a physical

struggle (S.Robertson 1998:348). Rape was the ‘unlawful and carnal knowledge of a

woman by force and against her will: A ravishment of the body and violent

deflowering’ (Paris & Fontblanque 1832:416 emphasis added). There was great

concern during this period over the probability that a rape could be ‘consummated on

a grown female in good health’ (Beck 1823:8). Though it was understood that rape

could be attempted, the ‘entire coition’ of a respectable woman was deemed

‘impossible’, for a woman ‘always possesses sufficient power, by drawing back her

limbs, and by the force of her hands, to prevent the insertion of the penis’ (Farr

1814:41-2). Furthermore, there were many medical jurists who believed that the

vagina acted like a vibrating sword-scabbard providing an ‘effectual power of

resistance’ against rape13 (Thomson 1936:449). Tied up in this discourse were notions

of chastity, respectability and virginity, which were given visual and anatomical

credence through discussions of ‘pure’ and ‘impure’ gynaecology14.

                                                                                                                         13 The scabbard metaphor depicted the vagina as self-closing at the point of physical attack, as long as the woman did not on some level consent to the sex. 14 For examples see Farr 1814:142; Beck &Beck 1838:147; Paris & Fonblanque 1823:417

 

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The identification and interpretation of the ‘signs’ of rape drew upon the

valorised position of the chaste female in Victorian ideals15. Only an innocent virginal

female could (legitimately) be raped against her will, while women who ‘had known’

a man were tarnished with sexual experience and had less legitimacy to claim sexual

grievance16. The underlying idea was that ‘if a (respectable) man had a ‘right’ to a

woman with an ‘unstained name’, it followed that a name-stain would be utterly

devastating to any women who hoped to occupy a respectable niche in society’

(Friedman 2002:1097).

Vickery argues that 19th century advice books provided ‘chapter and verse’ on

how a respectable woman should behave (1993:383). This constructed a ‘particularly

crippling ideology of virtuous femininity’ from which literature regarding rape

victims could draw (Ibid). A virgin’s vagina, for example, was described as ‘small

and endued with a light rose colour’ with ‘hymen intact’ (Farr 1814:44). Such

sensitive descriptions show the reverence for virginity. The woman ‘who has

accustomed herself to venereal habits’, on the other hand—and thus ‘useless to be

believed upon a deposition for a rape’—has lips which are ‘flaccid and distended’ due

to ‘constant friction’ (Ibid:46). Here, it is not clear whether the ‘hymen is wanting’ or

the woman’s moral stature. Doctors asserted that marks of violence would be visible

on the genitals and body following a rape. Marks such as ‘ an inflamed vulva, a

lacerated or ruptured hymen, vaginal discharge’, bruises, scratches, blood and semen,

were taken as corroborating (though not outright) evidence that a rape had taken place

(S.Robertson 1998:364).                                                                                                                          15 This was actually enshrined in the law as rape was defined as ‘…ravishment of the body and a violent deflowering’ (Paris & Fontblanque:1832:416 emphasis added). This clearly depicts rape in terms of a theft of the euphemistic ‘flower’. 16 Furthermore, the idea that a married woman could be raped is not spoken about at all—the split is instead between undeserving virgin and deserving whore. This bias was so ingrained that it was not until 1991 that the UK made marital rape an offense.

 

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The physician’s statement in the case of 14-year-old Sarah Stevens in 1880,

notes: ‘ I found the front and lower portion of the chimes covered in dried blood and

stains… The internal parts were dilated and bore evidence of having been recently

penetrated…[yet he states that] there was no evidence of violence whatever’ and adds

‘ the girl is as well developed as some women 20 years old would be’ (CRIM

1/11/3)17. What becomes clear here is that ‘signs’ of ‘legitimate’ or ‘illegitimate’

violence were read in accordance with normative value judgements based on

character assessments (Clark 1983:17). The statement that the girl is ‘well developed

enough’ to pass as someone more sexually mature, depicts her as consenting-upon-

the-basis-of-her-appearance. In the margins of the police report taken by the

constable, the girl is reported to have whispered that her assailant ‘fucked’ her, whilst

her own sister describes her as ‘young and idiotic’18. When put together, this amounts

to a character assassination that dismisses her claims of rape by suggesting that she

had consented to the sexual intercourse either on account of her stupidity, her sexual

maturity, or the lack of respectability shown in her coarse language. Thus, it becomes

clear that the visible signs of rape did not ‘go very far towards proving rape, for they

may arise also after consent is given’ (Smith 1908:222).

Wharton and Stilles forcefully argued (1855:336:emphasis added) that each

rape case brought before the court should be judged ‘according to the correspondence

of the injury received with the woman’s narrative, and her character for modesty and

                                                                                                                         17 The idea that a girl is deserving of rapacious masculine attention on account of ‘looking old enough’ is still prevalent in modern society. In 2013, for example, Judge Nigel Peters claimed that he had ‘taken into account’ that the girl ‘looked and behaved’ a ‘little bit older’ than her 13 years. He also claimed that the girl was predatory and had ‘egged’ the 41-year-old perpetrator on. The man therefore only received a suspended sentence for luring the girl to his house, getting her to strip and perform a sex act on him (Doyle 2013). 18 ‘Idiotic’ could be a reference to the girl having learning difficulties or some form of mental retardation as this was the terminology used at the time to refer to such conditions, however, I could find no further information to confirm this in the case file.

 

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veracity’. The assessment of a woman’s character, and thus the ‘veracity’ of her

claims, also intersected with class sensibilities (Bourke 2010:29). Some medical

jurists expected less physical resistance from ‘refined’ middle- and upper-class

women as they were less ‘accustomed to roughness’. The working classes on the

other hand, more attuned to the struggles of hardened life, could ‘give as good as they

got’ and were therefore required to offer more proof of their physical attempts to stop

the attack (Kerr 1935:164).

Legitimate forms of speech

The process of medicalising rape defined and codified the discourses detailing what

rape constituted and whom rape happened to—at least in an institutional setting19.

These hegemonic definitions define and prescribe acceptable discourses and

narratives and are therefore disciplinary. In other words, the authorised discourses are

devices of meaning production that encourage the subject to internalise and embody

‘vocabularies, norms and systems of judgement’ as a way of knowing themselves

(Rose in Hall&Du Gay130-135). Authorised discourses thus form part of the

ontological narratives that allow the individual to access their own self-definition

(Somers 1994:614).

Throughout the 19th century, the meanings of ‘social danger and moral truth’

played out in the courtroom (Mort 2006:108). Ewick & Silbey (1995:209) argue that

the scripted narrative is ‘nowhere more developed’ than in the courtroom where all

participants engage in ‘the telling of tales’ (Donovan 2005:62). Prior to the

popularisation of the ‘psy’ disciplines the local courts and the police ‘were the chief

                                                                                                                         19 ‘ Whom rape happened to’ means the discursively produced position of the ‘legitimate victim of rape’, rather than the woman who may have actually been raped but not believed within the institutional setting. Therefore, it is a mediated social reality, rather than a literal one that is being referring to.

 

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institutional means’ by which women could legitimately speak about their experience

of sexual assault (D’Cruze 1998:13). Thus, rape trials offer insight into the workings

of the criminal justice system and its ‘gender-based moral evaluations’ (Donovan

2005:61), as well as insight into the ways in which women themselves spoke of their

experiences (Conley 1986:519).

Rape in the Courtroom

Rape was rarely prosecuted because ‘giving way to passion’ was seen as the natural

or inevitable activity of bachelors, and the unfortunate (but excusable) vice of married

men (Conley 1986:535; Vigarello 2001:27). The onus for self-preservation thus fell

upon the women (Bryson in Tomaselli & Porter 1986:152-4). If assaulted whilst

outside of ‘proper’ supervision, they would be taken to be a ‘bad woman’ (Walkowitz

1998:1) and therefore considered guilty of provoking the crime.

The Maidstone & Kentish Journal (M&K Jrnl) (26th-Sep-1863) reported that a

man was acquitted despite the jury believing that the rape took place, because ‘she

had acted foolishly in going with the prisoner through the gardens’20. The criminality

of rape was more socially understandable to an all-male jury if the violence involved

was enough to constitute a bodily assault, and often it was due to this that charges of

‘rape’ were reduced to indecent assault in order to secure conviction. Caroline Conley

(1986:521) analysed all cases of rape and assaults in Kent during the 19th century and

                                                                                                                         20 Such sentiments were oft repeated in the sources I examined at the National Archives in Kew: CRIM 1/543; HO/47/75; CRIM 1/25/1, CRIM 1/8/7 and CRIM 1/8/8 in particular all detail cases where the women are obviously having to continually and repeatedly justify why they were in a position at all –i.e. alone—to be attacked. In the case of R. Footer (CRIM 1/25/1), the woman is subject to three written statements where she is repeatedly asked about why she was in a park alone with a gentleman. It is only when the same attacker, accosts a respectable gentleman and his lady-friend that the case is taken forward and the initial testimony believed.

 

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found that the conviction rate of rape trials was 40% in comparison to 85% of other

assault-related felonies21.

The lesser charges of indecent assault and attempted rape tended to be used

when middle-class men were indicted and the evidence too compelling to be

outrightly dismissed (Conley 1986:523). Conley contends that 81% of the cases

examined where the men had a rank above a soldier or labourer were tried under the

lesser charges. A case was dismissed in 1872 because the justice could not be

persuaded to believe that a ‘respectable’ father would rape a domestic servant (M&K

Jrnl 9th-Dec-1872). Conley found that in all but two of the cases involving the rape of

domestic servants by their employers, the employers were ‘off with a fine’

(1986:525). On the other side of this, every case Conley examines where the victim

was identified as a ‘lady’ went to trial and an overwhelming 87% of these cases

returned with convictions for either rape or indecent assault (Conley 1986:530). This

rate dropped to only 10% if the woman was a drunk or prostitute (Ibid). It was not

simply the attackers on trial22. Women thus had to carefully navigate and modify their

characters in the courtroom in order to be seen as legitimate victims of a crime.

Social Scripts in the Courtroom

Social scripts are a means through which ‘values are made coherent’ in particular

contexts and situations (Holquist 1990:137). For the women involved in rape trials in

the 19th century, the very fact of speaking out about sexual and physical assault ‘put                                                                                                                          21 Rape law is still weighted in favour of the perpetrators today, as only 5% of rape cases in the UK end in conviction (Bourke 2007:xii). This is particularly shocking given that only an estimated 12-18% of women actually report to the police (Monk & Jones 2014:55; Stanko 1985:37). 22 The court transcripts and police reports actually paint a picture where it was the woman’s character that was primarily on trial rather than that of the mans. In nearly every police report I read at the National Archives, the women give protracted statements where they are subjected to intense questioning regarding the experience, whereas the statements of the accused tend simply to refute the charge. In one case, the only words the accused says in his official statement is ‘I did not do it. I know nothing of this’ (CRIM 1/11/3).

 

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their character in jeopardy’. They therefore had to ‘mind the story’ and characterise

themselves as one who had been unjustifiably wronged (D’Cruze 1998:160; 154).

Their position in court was thus inherently contradictory and dangerous. On the one

hand, they could ‘draw upon metaphors of pollution’ in order to explicate the violent

loss of reputation, but in so doing, they also brought their bodies into legal, medical

and public purview where it could be represented as over-sexualised, contaminating

and monstrous (Cook 2012:484). It was therefore crucial that the women play into the

socially scripted, and accepted, typologies of sexual assault narratives.

The most commonly accepted narratives were of an outdoor attack by a

stranger, witnessed by another person (in order to corroborate the woman’s

testimony). The women also used similar vocabularies when describing the attacks,

using phrasing like ‘laid on’, ‘had connexion’ and ‘exposed his persons’ (CRIM

1/13/5; HO/47/75 62; CRIM 1/8/8), as well as repeatedly indicating that they ‘did not

lie down on my own will, the prisoner forced me down. I screamed out but no one

was then about’ (CRIM1/25/1).

Narratives that are emplotted within normative discourses, generate ‘cultural

expectations’ of what should follow (Somers 1994:404). For these stories to be

culturally intelligible to the jurors, the women had to follow such codified scripts in

order to be considered legitimately ‘wronged’. Such narratives are therefore examples

of ‘multiple authorships, whose composition resulted out of precisely located

intersections of power relations and purposes’ (D’Cruze 1998:152). Furthermore,

such ontological narratives necessarily shape the language through which the women

came to understand—and thus directly affected the material reality of—their own

experiences.

 

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The effect rape had on women in the 19th century was therefore predicated

upon, and determined by, medicalised, courtroom and wider social narratives around

‘fallen women’. The idea that rape could result in a woman’s life being ‘despaired of’

was framed in moralistic terms over the irreparable damage to her loss of honour

(London & Sporting Chronical 1856:17; Chaddocks in Hamilton & Godkin1861:544).

Recognition of the power of rape to bring about ‘social death’ is indicated through the

fact that women cried out ‘murder!’ rather than ‘rape!’ to get attention (Bourke

2012:14): ‘I endeavoured to cry out murder but… I could not be heard’, ‘he has

murdered me, he has ruined me forever’ (Wakely 1810:5,11).

Competing Discourses

Up until the 1860s, trauma referred to bodily injury (Cardyn in Micale & Lerner

2001:179). Although there was recognition that fear provoked ‘troubling memories’,

there was no formal medical theory of the propensity of terror to cause psychological

wounding (Van der Kolk et al. 1996:47). During the 1860s, Erichsen developed an

understanding of the ‘trauma syndrome’ people developed after being in railway

accidents, and attributed the ‘distress or shock’ they felt to a ‘concussion of the spine’

(Leys 2000:3). Out of this growing body of research it came to be widely accepted

that the ‘emotion of fear alone was sufficient to inflict severe shock on the nervous

system’ (Page 1883:162).

By the 1890s, the meaning of ‘trauma’ had shifted from a physical injury, to

an ‘emotional or psychological factor’ (Prince 1897:614). Bourke argues that

although there was growing understanding that heightened emotional states were

pathogenic across an array of ‘bad events’, this was not applied to rape victims until a

century later in the 1960s (Bourke 2012:1). Certainly at this stage, trauma and

 

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traumatisation had not become the natural or inevitable consequences of sexual abuse,

but if one were to look at gendered disorders of mood, such as extreme melancholy or

hysteria, one could find examples that recognised the propensity of rape to cause

psychological wounding. Freud states that ‘at the bottom of every case of hysteria

there are one or more occurrences of premature sexual experience’ (1962:13).

Hysteria

Sexual assault was seen to produce ‘violent hysterics’ in women (Kentish Express:

20th-Jan-1863). Ogston explicitly links hysteria to rape when he asserts that hysteria

could arise ‘from terror or shame’ associated with sexual assault, though admittedly,

he asserts that the ‘profound hysteric coma’ only lasts ‘some hours’ (1878:119). Such

understandings paved the way for the after-effects of sexual trauma to be categorised

in a taxonomy of disordered mental health (Leys 2000:4).

While a diagnosis of hysteria afforded the women recognition of their

suffering, it also exposed them to challenges against the veracity of their claims. One

of the main ‘proofs’ of hysteria in a woman was ‘a propensity to throw about

accusations of sexual immodesty’ (Bourke2010:33). In a case of a woman ‘found

dying’ after being gang raped, Beck and Beck assert that she was in a ‘paroxysm of

hysteria’ and was therefore an ‘imposter’ (1838:148). It was often the case that when

a patient referenced her rape as the cause of a psychiatric ailment, it was taken as

proof of her insanity rather than proof of what she had experienced (Bourke 2012:4).

Furthermore, many doctors and psychiatrists actually believed that hysteric women,

‘addicted to this delectable vice of pathologic accusation’, were harbouring under a

peculiar sexual perversion (Robinson 1828:307-329). Thus, the medical profession

succeeded in fusing non-normative femininity, rape and ‘madness’ together creating a

 

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pathologised (and gendered) understanding of what rape can and does do to a woman

(Cryle & Downing 2009:24;Theriot 1993:24).

Females were cast as insane when they ‘transcended the norms of their own

sex’ (Houston 2002:320), therefore any woman displaying behaviours outside of the

strictly policed and narrowly defined ‘norms’ were pathologised in terms of mental

disorder (Figlio 1978:176). In this vein, hysteria was a ‘diagnostic gesture’, a social

role ‘uncomfortably inhabited by suffering women’ and a didactic warning about the

dangers of ‘engaging in ‘unfeminine’ behaviour’ (Briggs 2000:247). It is important to

note here, that by virtue of being raped, women also become inculcated within a

taxonomy of sexual perversions that again adds to their overall depiction as

dysfunctional and disordered creatures.

Fallen Women and Corrective Reform

The Victorian convention that a ‘fallen’ woman’s life was irreparably broken

(Auberback 1980:30) and ‘compelled to suffer the pollution her soul abhors’ (Bartley

1815:40) was subject to contestation though religious philanthropy. Attempts to

debunk the myth of ‘the fallen woman’ subverted her identity to that of the victim,

fallen prey to economic and personal hardship (Melosh 1995:1756-7). Though sin

was seen to cause ‘irrevocable’ damage (Sanford 1892:122), it was also propagated

within certain social movements that women could ‘do penance for their past sins and

purge themselves of their moral contagion’ (Walkowitz 1991:221).

Penitentiaries, as well as some Salvation Army workhouses explicitly

accepted women and girls ‘who ha[d] fallen owing to violence’ (Sister Clare 1873:9),

 

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and though to be pitied as victims, they were nevertheless still viewed as ‘sexually

tainted by virtue of the act done to them’ (L. Jackson 2000:107). 23 The need for

repentance combined medical and religious discourses with the institutional policy

that stressed the need for cure and reform (Ruiz 2011:125). The scourge of tainted

sexuality had to be excised through (physical and moral) cleansing, in order to save

the soul (Englehardt 2007:139-142).24 In this way, the penitentiaries offering places to

raped or fallen women can be seen as a nascent therapeutic community, where the

penitents were seen as patients being treated (Mumm 1996:533).

Such institutions attempted to transform the women from morally ruined and

socially dead into respectable and spiritual women (Mumm 1996:527). The women

were therefore encouraged to ‘blot out the memory’ of their abuse so that all

‘remembrance of the iniquity’ may be eliminated (Booth 1916:331). The importance

of ‘forgetting’ for this model of conversion and redemption was twofold: firstly,

forgetting allowed the woman to distance herself from the sexual knowledge that had

marked her initial ruin, and second, it was only through this unburdening from sin that

the women could find a place in heaven (Walker 1991:124).

From this, we can trace the constellation of forces and social processes that came

together during the late 19th and early 20th centuries that are intrinsic to modern day

conceptions of rape victimhood. First, the process of medicalisation privileged

                                                                                                                         23 Though the reform and penitents movements were primarily focused upon prostitution, there are explicit references to them accepting women who had ‘fallen owing to violence’ particularly in the Salvation Army. What I am trying to explain, is not necessarily that the number of women who had been raped were necessarily statistically prevalent in these places (though I am sure they were), it is that tainted sexuality came to be subjected to ‘corrective’, and ‘transformative’ treatments. This bears many resemblances to the modern day stress on personal transformation of an affected sexual identity (i.e. rape victimhood). 24 The idea of needing to ‘wash away’ the stain of sexuality, that sexuality outside of monogamy was ‘contaminating’, could be said to contribute to modern discourses where raped women feel ‘disgust, feelings of dirtiness and urges to wash’ following a traumatic event (Badour et al. 2013:155). This is so pervasive that in one study conducted by Fairbrother & Ranchman (2004), up to 70% of repondents reported immediate desire to wash following a sexual assault.

 

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sexuality as the locus of identity, and encouraged doctors to pathologise deviant

sexualities. By creating the subject position of ‘the rapist’, the rape victim was

inadvertently created in opposition. The rape victim therefore became an object of

knowledge and was subjected to the inspecting gaze of the medical profession which

then created an authorised discourse about what a real rape victim looked like,

shrouding rape victimhood in ‘objective science’.

This medicalisation of victimhood began to see psychological understandings

of trauma gain credibility towards the end of the 19th century, transforming the

understandings of rape from the social (external) to the psychological (internal)

(Bourke 2012:17). This established rape as an attack upon a woman’s sexual identity,

with the power to create a ‘psychic wound’ and violation of ‘self’ which is a

profoundly modern conception. Furthermore, rape victims were afforded legitimised

types of speech within the courtroom, which gave such women the opportunity to

speak about their experiences, albeit through a normative lens. Such discourses

offered didactic models of victimhood with the power to materially alter the way a

woman defined and understood their own identity and experiences.

Contemporaneously, the corrective reform movements subverted the

understanding that a woman’s fall is a kind of social death, by stressing the

transformative and redemptive potential of repentance. Such institutionalised

narratives about personal transformation precede the ‘survivor movement’. Both

movements could be said to promote a therapeutic process where the self is

transformed from abject, corrupted victim into redeemed survivor, though the stress

on remembering, associated with the ‘survivor’ movement is starkly contrasted to the

practice of ‘forgetting’ in the penitents movement (L.Jackson 2000:115).

 

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CHAPTER THREE: SHIFTING EPISTEMES

Certain formulations and wider social processes in the 19th century provided the

‘conditions of possibility’ for modern conceptualisations of rape victimhood

(Foucault 1973:xxi-xxii). Such history has significant resemblance with the modern

‘regimes of truth’ (Foucault 1972: 127). First although different discursive

productions of rape would have produced different material experiences of trauma

(Pollock in Mieke2005:187), both historic and modern constructions involve a

permanent loss that is differentially represented as a kind of ‘social death’

(Taylor2009b:23). Secondly, socially scripted narratives of rape are only seen as

socially legitimate if they prescribe to certain tropes. For example, the legitimacy of a

claim of rape is still predicated upon the assessment of character, behaviour and

‘respectability’25, and stories of rape are still more likely to be ‘acceptable’ if it

involves a physical struggle with a stranger.26 Moreoever, rape is only tangible and

thus authentic when it inflicts a visual or visualisable mark. The veracity of claims of

rape in modern society are predicated upon the wounds—whether visible or

invisible—that the woman are able to lay claim to.

Modern history

During the late 19th and early 20th centuries women had no social discourse or

‘collective narrative’ through which to articulate their personal grievances to wider

                                                                                                                         25 For example, a 2005 Amnesty International survey found that of the 1095 respondents, 22% believed that a woman was wholly or partially responsible for being raped, this increased to 26% if the woman was wearing ‘revealing clothing’, 30% if the woman was drunk, and 37% if the woman had failed to say no clearly enough (cited in Anderson & Doherty 2008:3). 26 The case of Ione Wells is a case in point about this (Evans 2015). Her story of being violently attacked received a huge amount of media attention because she effectively ‘fought off’ her attacker and was not, in the end raped. As an Oxford student coming to her familial home at nighttime she was seen as a ‘respectable’ and ‘undeserving’ victim, rather than a ‘drunk’, ‘immoral’ woman who put herself in a position of danger. In our interview, Zoe Lodrick and I discussed this case and she said ‘it makes me sad when I hear of Ione Wells being so widely spoken about…I’m thinking, how is this narrative going to affect the girls who didn’t fight back’.

 

  34  

society (Richardson 1990:128), unless through the limited—and often mediated—

opportunities offered by the courtroom (Brownmiller 1975:xi-xiii). Emphasis placed

on bodily wounding and ‘fight off’ an assailant meant that only a highly scripted

discourse on rape could be articulated. In stark contrast, due to the increasing

popularisation of psychology throughout the 20th century, by the 1970s, researchers

had moved towards a trauma model of rape that viewed the consequences of sexual

violence in predominantly psychological, rather than physiological terms.

The ‘psy’-doctrine that all human beings have an ‘inner domain’ which is

‘structured by the interaction of biographical experience’—with theorised or

hypothesised laws or processes—changed the ontology of western metaphysics (Rose

in Hall & Du Gay 1996:129). Psychology offered the vocabulary and regulatory

techniques through which the interiorised individual could be accessed and governed

(Rose 1996:103). Here, psychology is a mechanism through which the human

condition is constituted by rendering one’s inner life remarkable (Rose 1996:54). Yet,

this ‘remarkability’ is dependent upon an inducement to speak one’s inner self, as

well as the interpersonal power relations (doctor-patient, questioner-speaker)

necessitated by such confessions of the soul (Davis & Manderson 2014:8). This

‘incitement to discourse’ has radically altered the way in which society conceives of

and speaks about rape and rape victimhood (Taylor 2009a:70).

One of the pitfalls of ‘speaking out’ about one’s experiences of sexual

violence is that confession confers an identity position on that person. ‘Narrated

memories’ are foundational (Brison 2002:30). The past is not ‘simply there’; it is

actively reproduced when articulated: ‘the fissure that opens up between experiencing

an event and remembering it in representation is unavoidable’ (Huyssen 1995:3).

 

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‘Breaking the Silence’

Second-wave feminism precipitated a ‘radical shift’ in the way that rape was

understood by society, including the ideas that: any man could be a rapist, any woman

could be raped and that rape could occur in a variety of forms (including marital or

acquaintance rape) (Chasteen 2010:107; Plummer 1995). It was during this period

that feminists and trauma theorists alike argued that rape produced the same effects in

women as war did in men, providing a powerful narrative of the chronic

psychological distress caused by sexual violence (Freedman 2006:106). 27 The trauma

narrative can be seen as an attempt to validate and authenticate the political claim of

injury relating to the impact that gendered violence had on women’s lives (Donovan

2005:70). Through the distinctly second-wave feminist project of consciousness-

raising, women started speaking publically about their experiences of sexual assault,

creating ‘survivor discourse’.

‘Survivor discourse’ propounded the political message that sexual violence

against women could no longer be institutionally ignored (Bumiller 2008:13). This

discourse formulated the rape victim as a subject of care rather than an object of

knowledge (Haaken in Lamb 1999:16). For example, archival documents of the

Metropolitan Police in the early 1960s detail how, following intense lobbying by the

National Women’s Council, the Police instituted the requirement for women doctors

to conduct the ‘intimate examinations’ of rape victims (MEPO2/10401). These

documents reveal the processes through which the rape victim came to be

institutionally accepted as a traumatised individual, culminating in the creation of

grass-roots rape crisis centres (RCCs) and helplines, and extended into the

                                                                                                                         27 For examples see Burgess & Holmstrom 1974; Kilpatrick et al. 1981; Stanko 1985; Kelly 1988; Katz 1984; Brown 1995.

 

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institutional practices of the medical and legal professions (Zuspan 1974:145; Bourke

2012:5). Such institutionalisation led to the creation of national ‘codes of ethics’, and

frameworks for helping women through their recovery process. This challenged the

most damaging aspects of the social stigmas attached to rape (Caretta 2011:18).

The early grassroots RCCs understood rape as an expression of a violent

gender war against women (Bumiller 2008:3). This model encouraged women to

confess their experiences of abuse ‘in the name of persuading society as to its reality

as a rape culture’ (Herberle 1996:64), leading many feminists to reify and enshrine

the notion that collective space to grieve the wounds of the gender war were not only

useful socially, but therapeutic (Roestone Collective 2014):

‘I wanted to found a national women’s rape museum… a public space where

women who were survivors could come and grieve the collective pain of other

women who were raped’ (Gage 1992:6)

The model of rape associated with second-wave feminism is indebted to the

constitution of the confessing modern subject, whose inner turmoil must be

articulated, not only to heal the self, but also to heal society. According to Davis,

1971 is the ‘watershed year’ in the emergence of rape as a social problem. The first

‘speak outs’, where women told their stories of abuse were held, reclaim the night

marches took place, and Germaine Greer conducted the first television interview with

a rape victim, on ABC-TV (in Patterson 2002:108). The political necessity of

speaking out—or ‘having voice’—has permanently changed the sexual violence

agenda (Lamb 1999:127). The idea that ‘to speak and to be heard’ is to have privilege

and agency over one’s life, while to remain silent or to be silenced, is oppressive and

 

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victimising (Ahrens 2006:263) provided the women’s movement with powerful

justification for the elevation of ‘stories from survivors’ (Lamb 1999:128).

In so doing the ‘new definition of the victim person-category’ was instituted,

providing a collective discourse from which women could speak (Best 1999:95; Davis

in Patterson 2002:121). This model individualised the suffering and encouraged

women to view their experiences in terms of ‘victim’ or ‘survivor’ identities. It also

inadvertently imposed value judgements on speaking (read: voice) and not-speaking

(read: silence) through the articulation of the ‘victim’ and ‘survivor’ labels, where the

‘survivor’ label was valorised for the strength of having ‘the courage-to-heal’

associated with ‘speaking’ out and ‘owning’ ones experiences (Haaken in Lamb

1999:16), while the ‘victim’ was categorised as the silenced, weak and traumatised

other (Naples 2003:163).

In order to collectively politicise rape and suffering, (Cole 2007:12), the

movement required exposing ‘bodies in pain’, as well as ‘dramatising the moral

degradation’ that women suffered (Cole 2007:13) in order to form a politic based

upon the claim of injury (Hanhardt 2013:8). This marks the continuing importance of

‘bodily signs, marks and private parts’ required by wider society to validate women’s

experiences of sexual violence as authentic (S.Robertson 1998:388). It also, through

the ‘language of heightening’28, sensationalised sexual violence by making rape and

the traumatisation of victims ever more visible and imbued with more symbolic

potential to destroy (Scarry 1990:869). Such language of heightening has assigned to

rape and sexual violence a special sign of mental pathology and ‘glorified scandal’

(Foucault 1965:70).                                                                                                                          28 The language of heightening is where ‘the meaning is continually lifted out and made more visible through a continuous sequence of clarifications’ (Scarry 1990:869)

 

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Furthermore, the ascendancy of an increasingly professionalised language to

detail sexual trauma, as well as the increasing co-optation of responses to rape by the

state (Bevacqua 2000:115), meant that eligibility for services was increasingly linked

to the women’s status as traumatised victims of rape and ‘their ability to recognise

their problems in medical or psychological terms’ (Bumiller 2008:13). A politic of

‘sympathy’—where identities are fashioned around suffering and injuries are

converted into ‘cultural capital’—tends to preserve the status quo (Puar 2011:151).

The sensationalisation of rape discourses and prominence afforded to trauma models

has imbued society with a bias: ‘it is the degree of suffering (not the grotesqueness of

the injustice) that speaks of the wrongness of the assault’ (Armstrong 1996:300).

Therefore, attention has shifted from structural inequalities that render women more

susceptible to violent attacks, to that of an individual exercise of self help (Cole

2007:138).

Such collective narratives of traumatisation and survivorship favoured the

trope of recovery and personal transformation by privileging the voices of empowered

survivors. In turn, this created a movement that required ‘recovery’ from pathology

and ‘closed off alternative stories’ and conceptualisations of rape victimhood (Davis

in Patterson 2002:122). Therefore, the survivors movement was complicit in

discourses that oppressively cast victims of rape in monolithic model suffering and,

rather than cure society of its rape culture, came instead to facilitate the growth of an

extensive recovery movement (Naples 2003:167).

By the 1980s, neoliberal politics and the increasing prominence of the medicalised

model of victimhood depoliticised the survivors movement, shifting the focus of anti-

violence campaigns from communal critiques of structural violence to individualised

 

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articulations of personal injury (Duggan 2012:Ch.2). The ascendency of

institutionalised and professional expertise has led to the development of a large

professional apparatus that presents sexual violence as ‘chronic yet treatable problem’

(Bumiller 2008:13). Marcus (in Butler & Scott 1992:387) argues that in conflating the

act of rape with irrevocable personal injury, the second-wave anti-rape movement

accepted rather than rejected a metaphysical status of rape that it can ‘only be feared’

or legally or medically repaired.

Rather than asserting ‘survivors stories’ as the basis of collective organising

against rapacious masculinity, the medicalised model of victimhood instead favoured

individualised and apolitical narratives of ‘recovery’ and personal transformation

(Ovenden 2012:950). The medicalised model of victimhood constitutes victims of rape

as a persistently vulnerable demographic, living in a perpetual state of ‘prognosis (Jain

2007:79). The reification of the trauma model of rape increases the potential of the act

to cause traumatisation in women who have been raped. Contemporaneous to the

construction of rape as always already traumatising, the pervasive culture of wellness

in western ontology has imbued modern society with a tension between capability and

debility, which impacts on the lives of victims of rape (Thackhuk 2011:156).

Modern Discourses

Culture of Wellness

As a result of the 19th century moral reform movements—where the moral imperative

of sanitation, nutrition and family health was promulgated—modern western society

has inherited and extended a ‘culture of wellness’ (Clark et al. 2003:172). The

melding together of the two distinct processes of medicalisation (where the ‘moral

turns into the medical’) and healthicisation (‘where health turns into the moral’)

 

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(Conrad 1992:223), has imbued western ontology with a tension between the removal

of personal responsibility (to medical professionals) on the one hand, and the

imposition of unrelenting responsibility to be ‘better than well’ on the other (Puar

2009:167).

The construction of the body and self as never well enough provides an alibi

‘for the translation of sensation and affect into symptom’ (Puar 2009:167), as well as

ensuring the ‘continual enlargement of the domain of the therapeutic’ (Sunder-Rajan

2006:144). This process produces an increasing aversion to, and fear of, suffering

(May 2011:84)—which becomes increasingly pathologised and subjected to

‘corrective treatment’.

Out of this milieu, health itself can be seen as a ‘side effect of successful

normativity’ (Berlant 2007:765). Yet, these discourses rely upon the ‘spurious

binarisation’ of ‘bodily capability and bodily debility’ (Puar 2011:149) therefore, rape

victims who reside in the ‘zone of uninhabitability’ as abject subjects (Butler 1993:3)

bear the brunt of the two competing discourses of healthicisation and medicalisation.

The first puts the responsibility upon them to be ‘better than well’—to be empowered

survivors—whilst the second takes away their powers of self-definition and

pathologises them as mentally abject, rape victims.

The pathologisation of victims of rape

This idea that victims of rape are mentally wounded implicitly ties social constructions

of rape victimhood with mental illness, where their behaviours and identities are read

as ‘irrational, disordered, impaired and frightening’ (Nicki 2001:87). By pathologising

rape victims, both the state and nongovernmental actors are able to advance an

understanding of sexual violence that subsumes complex, unpredictable and

 

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uncontrollable life experiences into a predictable set of symptoms (Bumiller 2008:74).

This functions to make sexual violence ‘treatable’, because the woman is required to

assume the responsibility of ‘recovery’, rather than socially and politically ‘treating’

the sex offenders and addressing the realities of western societies rape culture

(Herberle 1996:64)29.

The establishment of certainty around identifiable pathologies is not based

upon ‘the completely observed individuality’ of a persons symptomatology, but is

instead based upon the ‘completely scanned multiplicity of individual fact’ (Foucault

1973:124). This privileges convergent symptoms over divergence; it is easier to

‘treat’, ‘rehabilitate’ and cure’ if there is uniformity, universality and neat

categorisation30.

Trauma model

The trauma paradigm of rape which was first depicted by Burgess and Holmstrom

(1974) as ‘Rape Trauma Syndrome’ (RTS)—and bears many similarities to PTSD—

has infused the vernacular lexicon with medicalised understandings of trauma and the

traumatising impact of rape (Eby et al. 1995:564). This model has become so infused

and normalised within social understandings, that assumptions about the hypothetical

                                                                                                                         29 This perpetuates victim support models and does not address the complex realities of why women are raped and how to reduce such sexual violence. Privileging such models also leads to funding deficits in research of treatments and therapies of potential and actual sex offenders. For example, the NSPCC used to have a hotline available for people who were worried they were going to commit a sexual offence against a child, but funding for this and similar projects has been cut. The only available projects now focus on people who have already offended within the carceral system to try to stop them recidivating (Lodrick 2015b). The taboo nature of providing sympathy and preventative therapy for people prior to them committing an act means instead that the ‘corrective machinery’ of the state is wielded only after the offense is committed and with minimal success – because by virtue of being labelled as ‘rapist’, the offenders become bound to the identity and therefore are increasingly likely to reoffend. 30 Not to mention the fact that it is easier to ‘treat’ victims of rape than it is to cure society of its rape culture.

 

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aftermath of rape are indistinguishable from the medicalised model of trauma (Gavey

& Schmidt 2011:451).

Marecek describes this lexicon for speaking about sexual violence and

subsequent ‘narrative framework for explaining’ the ‘problems’ women develop

following an assault, as ‘trauma talk’ (in Lamb 1999:158). In this conceptualisation,

trauma talk ‘refers to the system of terms, metaphors and models of representation’

that are presented as natural fact when speaking about rape victimhood used by

feminist researchers, mental health professionals, the mass media and wider society

alike (Ibid:158-9). Such medicalised and ‘scientific’ approaches to trauma have

‘tremendous appeal’ to those who work with victims of sexual violence because it

provides an ‘objective’ understanding of the harm caused by such victimisation, that

doesn’t hold rape victims responsible, or ‘to blame for… their own victimisation’

(Gilfus 1999:1240).

Rather, the symptoms of trauma are described in biological or biopsychosocial

terms which lifts the effects of rape out of the hands of the victims (and arguably into

the hands of an expert):

‘She gave me the scientific reason behind my anxiety, panic and PTSD. Seemed

a strange thing to talk about, but I felt it was beneficial’ (Sarretta 2015)

If the 1970s saw the institutionalisation and normalisation of the trauma model of

rape, current conceptions have extended the naturalness of such discourses and

extended the unassailability of this model by locating trauma in the physical make up

of the brain. Although the trauma model of rape is intended to help victims feel as

though they are responding ‘normally’ to traumatic stimuli, there are also aspects of

 

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this model that are ‘pathologising, exclusionary and decontextualising’ (Gilfus

1999:1239).

The Neurobiological Trauma model

Modern accounts of psychological trauma are articulated through the physical

componentry of the brain (Corzolino 2002:71). The stress hormones activated in the

amygdala through the traumatic event are seen to ‘alter psychobiology, personal

adjustment and systems of meaning’ (Bloom in Giardiano et al. 2003:405). According

to Lodrick, when a traumatic event occurs ‘terror overwhelms higher brain

functioning’ (2007:4) meaning that the trauma is encoded in the ‘implicit, right hand

side of the brain’ which is fragmentary and emotional rather than in the left hand side

of the brain which is ‘explicit and analytical’ (Lodrick 2015a). Furthermore, during

the assault itself the amygdala regulates the bodies ‘fight, flight, [or] freeze’ response

(Lodrick 2007:4). The freeze response, which is said to occur in somewhere between

37% and 52% of rape victims (Gola et al. 2012:214; Moor et al. 2013:1054) is a

dissociative survival mechanism which enables people to ‘endure experiences that are

at the moment beyond endurable’ (P.Levine 1997:138).

However, such dissociative survival strategies are said to bode badly for

‘future psychological and physical wellbeing,’ as the memories of the trauma are

more likely to be encoded in the emotive right hand side of the brain which is harder

to rationally appraise once the traumatic experience has ended (Giesbrecht &

Merckelbach 2009:338). This encoding in the right hand side of the brain is argued to

be the reason why people experience psychological symptoms post-trauma: ‘traumatic

symptomatology has, at its foundation, a lack of sufficient neural integration’

(Lodrick 2007:9; Herman 1992:28). It is this lack of ‘neural integration’ that is said

 

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to cause ‘traumatised people [to] lead traumatic and traumatising lives’ (Van der Kolk

& McFarlane 1996:11).

The Expansiveness of the Trauma Model

The trauma model of rape creates a psychologised ‘rhetorical commonplace’ where the

notion that rape forecasts a devastating array of damage is ‘recognised, characterised

and then standardised’ (O’Malley in Barry et al. 1996:189). Rape is nearly always

depicted as exceptionally traumatic (Petrak 2002:1; Bargelow 2014:118). It is seen to

damage the women ‘for the rest of their lives’ (Matheson interview), affecting the way

they ‘think, learn and remember’ and well as how they feel about themselves, others

and the world (Bloom in Gardiano et al 2003:405)

‘…when he raped me, part of me died. I can’t get over that. I can’t forget, it’s

not possible. Yes, I have learned to live without that part of me’ (Guest_* 2002d)

The trauma model of rape represents not only a comprehensive neurobiological and

‘biopsychosocial’ account of the effects of rape, but it actually represents an all-

encompassing model that is seen to profoundly alter all facets of human experience

and identity irreparably. Not only is this enshrined in medical and professional

discourses, but is infused in wider social narratives as well.31

In the DSM-IV, traumatic experiences can be anything ranging from ‘violent

personal assault’, ‘natural or manmade disasters’, ‘or being diagnosed with a life

threatening illness’ (APA 1994:424). Grouping such experiences into the ‘same

cognitive category’ is highly problematic (Fine 2007:27), as they will tend to receive

the same ‘treatment’ despite being tangibly different (Degloma 2009:113). This                                                                                                                          31 For example, Chasteen’s (2010:124-5) research found that all female respondents believed that rape involved permanent damage and destruction of the physical and emotional self, with respondents repeatedly asserting that ‘rape takes something away from you that you can never get back’.

 

  45  

creates a culture of ‘abstraction, objectification’, where all victims of rape have

certain attributes, behaviours and identities foisted upon them in a kind of ‘mandated

normativity’ (Stahl 2013:53).

In establishing ‘regimes of truth’ traumatised victimhood is universalised,

abstracted, decontextualized and ultimately, ahistorical. This obscures the socio-

political reality of rape and trauma, as it does not look at ‘the source of the injury or

the social and cultural context of victimisation’ (Gilfus 1999:1242). In universalising

the trauma model, race, gender and class differences are effaced (Daniels 1994:231).

Traumatic injury does not randomly affect people, but is ostensibly more likely to

occur in particular groups: ‘Wounds adhere differently to different people’ (Jain

2006:58). Abstracted models of trauma are said to be gender neutral, yet women are

diagnosed with PTSD at a rate of 2:1 in comparison to men and the length of time they

suffer from symptoms of PTSD is up to four times longer than men (Norris et al. in

Kimerling 2002:3-6). Though it is difficult to extricate pre-trauma gender scripts from

post-trauma memory, it is quite possible that the disparities found in PTSD rates

between men and women are a result of socio-psychological scripts that always

already predispose women to embody and perform post-trauma symptoms that match

diagnostic criteria (Tolin & Foa in Kimerling 2002:349).

Moreover, the idea that rape is not necessarily traumatising tends not to be

asserted for fear of ‘the political dangers of misrepresentation’ (Gavey in Lamb

1999:70). Survivors’ accounts that refute the trauma model are often suppressed and

countered with aspersions to a kind of false-consciousness; that even if rape victims

do not immediately experience psychological symptoms, such symptoms will occur

 

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‘after a latency period of months or years following the trauma’ (Koss et al.

1987:169).

CHAPTER FOUR: THE EFFECT OF DISCOURSES ON THE WOMEN

Incitement to Speak: Confessional Society

In Madness and Civilisation, Foucault argues that Freud ‘abolished silence,’ by

inciting his patients to reveal and describe their madness, as though the very act of

revelation in and of itself could lead to a clinical cure for their ailments (1965:275).

The ‘psy’-disciplines have popularised the idea that ‘bottling things up’ (S1 workshop

2015) is maladaptive, whilst ‘getting things off your chest’ is liberating, despite the

fact that Freud later rejected the efficacy of this ‘talking cure’ realising that it could

‘repeat rather than heal trauma’ (Taylor 2009a:70).

The idea that simply talking about something is necessarily curative is

disciplinary insofar as it compels people to explain themselves in a way that

‘discursively fixes their identities’ to the pathology they wish to be cured of

(Ibid:119). This mechanism extends beyond the therapeutic realm. Modern western

society requires its subjects to realise and become their authentic selves, yet to know

oneself requires ‘self-examination, explanation of oneself, [and] revelation of what

one is’ (Foucault 1978:2) before one can truly bear ‘special witness to the truth of

individual personality’ (Brooks 2001:18). Therefore, confessional subjectivity

encourages people to put themselves into words, even if this is damaging

(Shuttleworth 2012:643).

The compulsion to confess has been internalised as a result of ‘infolding’ the

‘exterior’ compulsion, and has guaranteed confession as an intuition of the modern

 

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soul (Venn in Patterson 2002:30). The normalcy of this intuition is ensured by the

self-perpetuating understanding that we are repressed, and that the only cure to such

repression is to confess. Western society constantly calls for ‘breaking the silence

over sexual assault’, yet we have been officially ‘breaking’ this ‘silence’ for over 45

years.

Taylor argues the belief that we ‘cannot speak about it’ allows us to feel ‘we

are achieving something important both psychologically and politically’ in the

process of speaking out (2009a:74). For Foucault (1979), the claim that confession is

difficult, that it is an achievement to confess provides the very excuse to confess in

the first place.

This mechanism of truth-production anchors identity to the attention received

in, and the pleasure derived from, the telling of oneself. In turn, the subject is ‘fixed

by the gaze, isolated and animated by the attention’ it receives (Foucault 1979:44-5).

Therefore, for Foucault, the issue is that this hermeneutic of the self is an effect of

power, and rather than revealing an essential or authentic self, confession instead

reveals a disciplined self (Taylor 2009a:78). As such, both the supposed ‘resistance’

to confess and the gratification derived from confessing are erroneously experienced

as the achievement of personal freedom (Foucault 1979:60).

Talking as healing

The cyclic ‘lure of the confessional’ produces a social narrative around rape that

firstly assumes that ‘confessing’ is invariably cathartic and secondly perpetually

requires survivors to ‘reveal’ their experiences (Warner 2002:120) on the basis that

‘we don’t tell enough stories of abuse’ (Burrows 2015).

 

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‘I want to be able to say everything I want to say and put it out in the universe in

hopes of healing and bringing closure. I’m not sure where the best place to do

that is. I have come so far but it always seems like there are things that keep me

back’ (Love2013)

The idea that ‘recognition’ in and of itself has curative powers compels acts of self-

disclosure (Joinson 2001:178) and becomes self-perpetuating through the idea that

revelation is a personal achievement:

‘The word [rape] is really hard to get out…Just last week I was telling some

friends of my partner’s and it was really difficult. I got it out though, and I was

proud of myself’ (Guest_* 2001c).

In a psychological case study of how to ‘treat’ rape and trauma, Papaikonomou

(2014:213) encourages therapists to ask their clients to provide a detailed retelling of

the event, asking questions such as ‘‘what was the worst moment for you?’’ As long as

the client remains in their ‘window of tolerance’ (Siegal 1999:523), talking is said to

aid the rape victim assign the trauma to the past, as narrativising the traumatic

experience increases the integration among neural networks (Lodrick 2007:13)32.

Therefore, the need for confession is guaranteed in the presentation of traumatic

memories being coded in the right hand side of the brain and the need for such

memories to be re-encoded in the ‘realm of processed thought’ (Papaikonomou

2014:213).

                                                                                                                         32 Window of tolerance refers to a state where the client is not over-aroused by the emotive content of the interview such that they still possess the ‘integrative brain functioning’ necessary to be able to appropriately consign the trauma from the left to the right hand side of the brain (Lodrick 2007:13). In order to help keep the client in the window of tolerance, Lodrick asserts it is necessary to ‘ensure the cortical and hippocampal functioning remains available to client. If functioning appears to be significantly impaired ask the client simple cortical questions like: ‘how many fingers am I holding up?’, ‘what colour is that lamp?’… keep the questions simple and observable’ (Ibid).

 

  49  

Without re-encoding such memories, victims are thus said to be ‘cut off from

language, deprived of the power of words, trapped in speechless terror’ (Bloom in

Giardiano et al. 2003:422). Therefore, if a woman chooses not to speak of the event,

she is said to ‘bury’ or ‘repress’ her emotions, which is taken to be a maladaptive

coping strategy, pathologised and argued to cause ‘long-term struggles with

depression or PTSD’ (Clarke & Griffin 2008:201). However, the idea that ‘turning off

your emotions’ (Interview 4) is necessarily harmful fails to recognise dissociative

coping strategies as meaningful or natural, let alone as potentially helpful (Warner

2001:30).

‘It happened to me a week ago…when Monday came around (I was expecting to

have nightmares or something and nothing happened) ….I guess what I am trying

to say is that I didn’t feel like a ‘victim’’ (Samealdo 2006)

‘It came as a surprise to me that as time passed I still felt little to nothing about the

rape. I was increasingly bewildered at the odd numbness surrounding the entire

incident. I would check up on it every so often in my mind’ (Survivor cited in

Bargelow 2014:130).

Numbness in the aftermath of trauma is a perfectly logical strategy for self-

preservation, yet both women appear to feel like they should be feeling traumatised.

The disciplinary powers of such discourses culminated in both women actively

seeking to ‘conduct their own conduct’ in accordance with the ideal-type of

victimisation.

In the neurological trauma lexicon, victims of sexual violence ‘protect

themselves against the overwhelming exposure of threatening stimuli by inhibiting

information processing’ (Giesbrecht & Merckelbach 2009:337). However, the trope of

denial is drawn upon to mark rational responses to the rape in pathological terms: she

 

  50  

is either lying or in denial (Gavey & Schmidt 2011:443). Ultimately, in pathologising

women’s survival strategies as inherently self-destructive, women's actual ‘attempts at

self-preservation are discredited’ and their need to utilise narrative strategies to

overcome the trauma are ‘paradoxically reinforced’ (Warner 2001:126).

There is widespread recognition that ‘debriefment’ following trauma

significantly increases the likelihood of a person developing PTSD (Chivers-Wilson

2006:116). Further, it is widely accepted that traumatised individuals tend to

traumatically re-enact and repeat their own traumatisation. That there is a ‘valid’ and

‘invalid’ way of talking to rape victims about their experiences—one that is likely to

‘retraumatise’ and one that is likely to aid the person assign the trauma to the past—

presents a troubling picture, highlighting the difficult terrain that survivors have to

navigate.

Talking as potentially harmful

Many ‘survivors’ welcome opportunities to speak out about their experiences because

they have adopted the oft-repeated mantra that ‘telling is freeing’ (Guest_* 2002b).

However, when this claim is questioned further, a far more complex picture emerges:

‘Talking helps me. Before I go I’m a wreck and sick but after I’ve done it, I feel

strong. In less than two hours, I’m talking with a reporter from a newspaper. I’m

in the mess part right now. But after it’s out, I know I’ll feel wonderful’ (Guest _ *

2002a).

Here, although the aftermath of revelation is seen to invoke feelings of strength, the

act of telling is prefaced by intense emotional discomfort. This indicates that in reality

 

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telling ‘your story’ is not simply about healing the self, but is bound to the validation

or attention received through the act of telling:

‘The telling of the story itself is totally pointless and potentially harmful without

some relational holding of it…in terms of support networks, in how it is received

and responded to’ (Lodrick 2015a).

In revealing their experiences of rape to somebody, the listener is put in a

position of ‘response-ability’ with the potential to alter the relationship between

themselves and the teller at the point of revelation (Davis & Manderson 2014:156).

This situates the listener in a position of power, insofar as they are faced with a choice,

of ‘whether or not, and how to respond’ (Ibid). During our interview, McClean said

that he found the incitement to speak problematic:

‘...it becomes a spectacle…revealing something about yourself that Is very

painful and personal in a public forum…because actually the response you are

expecting from someone when you reveal something like that is somebody who

is really going to pay attention to your pain and is not just for public

consumption’ (McClean 2015)

Therefore, in ‘confessing’ their experiences of rape, rather than simply revealing

something about the self in order to ‘heal’, the rape victims actually enter into a social

relationship where they hand their most personal and vulnerable experiences over to

somebody else who may or may not respond appropriately:

‘I think… after all these years, it’s not to much the fact that I was raped that hurts

me, it’s the fact that people who I loved, like my friends and my parents,

responded in such negligent ways’ (Interview 2 2015).

According to one study, up to three-quarters of rape victims receive negative reactions

from their informal social support network (Campell et al. 2001). When such

 

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validation is lacking this could damage both the victims self-definition and their trust

within their surrounding environment (Bargh et al. 2002:34)

During a group ‘survivor’ session I attended, one woman attempted to hand

out postcards, but was stopped by staff because they thought that the material could

be ‘triggering’ to others in the group. When I spoke to her about it later she said:

‘I felt that there was an invitation to offer something and I thought: here is what I

have to offer. It took courage—every time I put my poems out there, or I put a

tweet out there, or I put my postcards out there… which are basically my naked

soul—it takes a bit of a gasp in and… a leap of faith each time. I mean it takes

something from you. It’s not something I find easy to do, and when [the staff]

took them out, I just went into a place of shame, like there was something wrong

about what I was offering, that it was seen as inappropriate and not to be trusted’

(S2 workshop 2015).

This highlights the extraordinary amount of trust afforded to strangers to sensitively

respond to the outpouring of ‘naked soul’. Particularly within the ‘survivor

movement’ where people group together on the basis of commonality, there is the

‘illusion of support, the illusion that you are surrounded by a whole movement’ who

understand and care for each other (Lodrick 2015a). However, in sharing their most

vulnerable moments, survivors may reassert rather than challenge their vulnerability:

‘The only thing I ever regret when looking back is telling certain people ‘I was

raped’ …I told a teacher at my college about what had happened to me. I don’t

really know why I said anything, I think I just wanted people to know I wasn’t

crazy…and the only remark she made was about the fact that I’d been drinking

that night…as though it was somehow my fault’ (Interview 2 2015).

 

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The propensity of negative responses to cause psychological suffering in rape victims

is becoming an area of increasing interest to researchers. Research into how rape

myth acceptance (Baugher et al. 2010:2039; Frese et al. 2004:156), cognitive

distortions33 (Iverson et al. 2015:49) and counterfactual thinking34 (Branscombe et al

2010:267) increase the likelihood that a rape victim will suffer from PTSD and re-

traumatisation, highlights growing acceptance that meaning ascription can negatively

impact upon the victims sense of wellbeing and long-term prognosis. Therefore, if

responses to sexual violence re-impose harmful thinking, the strategy of speaking out

about suffering does not necessarily achieve healing and can actually ‘enact a

‘secondary victimisation’ where the initial trauma is repeated (Campell & Raja

1999:261).

Repetition Compulsion

Van der Kolk (1989:389) argues that traumatised individuals tend to ‘expose

themselves, seemingly compulsively’ to the traumatic retelling or reliving of their

experiences. Due to this ‘repetition compulsion’ traumatised individuals rarely ‘gain

mastery’ over their life experiences and instead, repeatedly cycle behaviours and

cognitions that accentuate the trauma and traumatic sequelae (Lodrick 2007:10). The

online forums are quite literally, riddled with examples of traumatic re-enactments: ‘I

keep coming back over and over again to where I was molested… I can’t stop talking

about it; I’m never done’ (Setrain 2010).

One survivor, when talking of her ‘obsessive’ compulsion to search for

triggering material commented that it is ‘almost like I want to suffer’ (Minute 2010).                                                                                                                          33 An example of a cognitive distortion is the idea that ‘bad things happen to bad people’ therefore, because a bad thing happened to me, I must have deserved to be raped. 34 An example of counterfactual thinking is imagining alternative outcomes: if I had not drunk so much alcohol, I would have avoided passing out in the bedroom where I was raped.

 

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Another admits: ‘ even though sometimes it hurts I still trigger myself on purpose’

(Anonymouse09 2010). This could be argued to be why so many survivors construct

their lives following their assault as being in a kind of ‘stasis, waiting for life to begin

again’ (Interview 2 2015) or permanently ‘stuck’ in a cycle of depression:

‘When you just keep telling your story over and over… you are just stuck. I cried

and I cried about everything and only felt depression and grief… I was a broken

record’ (Guest_* 2002c).

COMING TO TERMS WITH THE LABELS

In the 21st century, the Internet has become the platform par excellence of self-

expression because, through the ‘intermediation of screens and pseudonyms’

(Reingold in Joinson 2001:178), it offers a kind of liminal space ‘betwixt and

between’ ordinary social interaction, and the ‘hyperpersonal’ interaction afforded by

Internet anonymity (Turner 1967; Walther 1996:3).

It has been shown that people are much more likely to reveal intimate personal

details about themselves to both known and unknown users over the internet (Rice et

al. in Joinson et al. 2007: 10):‘I will be more truthful in my answers here then if I

were to do them alone at home’ (Guest_* 2001a). Internet platforms offer ‘safe’

spaces where rape victims can express their experiences:

‘While I can write those words [‘I was raped’] in a safe space, like here… I don’t

believe I shall ever verbally utter them; not in relation to me’ (Guest_* 2001b).

Furthermore, such online spaces tend to be pools of information, not only providing a

deluge of educational resources and articles about the impact of sexual violence, but

also spaces where symptoms and feelings are discussed and encoded as ‘normal’

(Segal 2009:355-361):

 

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‘I’m still navigating my survivor identity… I repeat my story to myself to better

understand who I am and where I’m going. Beyond self-reflection, some helpful

ways to negotiate this process might be connecting online… Reading educational

resources about sexual violence helped me begin articulating and contextualising

my complex emotions’ (Kuo 2015).

Although such spaces aid victims of violence to ‘understand’, ‘articulate’ and

‘contextualise’ their experiences, inevitably it also encourages the women to inherit

the common ‘themes, structures, characters and images’ associated with the

symptomatology of rape victimhood (Showalter 1997:6).

People are ‘extremely suggestible’ (Scheff 1974:450) and the comparison of

one’s inner self to didactic victim-models leads to a ‘more efficient regulation and

normalisation’ of victim-identity through the production of ‘self policing subjects’

(McNay 1992: 87). Experience and identity are linguistic: ‘all of us come to be who

we are (however ephemeral, multiple, and changing) by being located or locating

ourselves (usually unconsciously) in social narratives rarely of our own making’

(Somers 1994:606).

Language is a ‘social practice’ (Marecek in Lamb 1999:159), an assemblage

or technology through which people can access and understand their sense of self and

of being in the world (Potter in Richardson 1996:126). It follows that rape victimhood

is not only ‘scripted’; it also scripts (Marcus cited in Hersford 1999:195). Elaine

Scarry argues that the very act of naming an ‘interior’ event causes ‘an immediate

mental somersault out of the body [and] into external social circumstances’ (1988:16).

‘By labelling it rape straight away I think I hurt myself more somehow…I feel

more damaged by calling it rape than by calling it something awful that happened’

(Baily 2009).

 

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Therefore not only is the victim of rape subjected through the act of violence, but her

subjectivity ‘continues to acquire validity and sense through fidelity to’ the violent act

(Calcagno 2009:35).

Labelling experience

Disclosing ones experience and labelling it in a narrative is ‘deeply temporalising’

(Davis & Manderson 2014:161). The act of telling, discursively constitutes an identity

prior to the assault, in opposition to an identity post-assault. This dissociates a

person’s present sense of self from their past self in an artificial way, and could be

argued to be a contributing factor in why rape is seen to simultaneously enact an

‘irreparable loss of past- self’ and create ‘a new identity’ (Lodrick 2015a).

‘Rape victim: I’ve had my ups and downs but I’m kind of getting back to normal

now, whatever that is’…

Counsellor: ‘and that really is difficult because it really is a new normal and you

have to adjust your life and everything that you knew before according to who

you are now.’ (White Buffalo Calf Woman Society 2013)

Homi Bhabha wrote that ‘no name is yours until you speak it’ (cited in Sonntag

2011:223). Through the ‘rituals of storytelling’, women who have been raped come

out of the closet and become rape ‘victims’, or ‘survivors’ (Haaken in Lamb 1999:13).

This naming exercise is required if the survivor is to ‘own’ their experiences and

become empowered. One ‘survivor’ I interviewed described herself as ‘just out and

proud’ (Participant 3 survivor workshop).

This naming exercise is not only a kind of ‘linguistic citation of norms’

(Hollywood in Armour & St.Ville 2006:253), but is a signifying act that encourages

the rape victims to express their identities in terms of the regulatory ideals of

 

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traumatised victimhood (Butler 1993:1-2). In this sense, labelling oneself a ‘victim’ or

‘survivor’ is a moment in the ‘dialectic of identity’ (Ronai in Lamb 1999:156) where

self-identity is given value in sense-structures.

‘Victim’ – ‘Survivor’

Labelling yourself or your experiences is not value-neutral. The terms ‘victim’ and

‘survivor’ are already imbued with a priori meanings. A survivor I interviewed said

that she hates the victim-label because people ‘instantly assume you must be weak,

fragile or vulnerable—as though you need to be tiptoed around’. On the other hand,

she disliked ‘survivor’ because it is an ‘inescapable identity—you will always be a

survivor of rape, but victimhood can be transcended’ (Interview 3 2015).

Some women outrightly rejected the labels saying that they don’t ‘walk

around with an S for ‘Survivor’’ on their ‘sleeve’ (Tilted 2003); but some feel that the

‘level of healing’ implied by ‘survival’ isn’t something they will ‘ever accomplish’ or

‘achieve’ (Magdalene 2003; Lora 2003). What becomes clear is that the ‘survivor’

label is very often experienced as being out of reach and reserved for those who have

‘self-consciously redefined their relationship to the experience from one of ‘victim’ to

that of ‘survivor’ (Naples 2003:163).

The values ascribed to each label are continually reinforced in the online

forums where the women list their behaviours against ‘victim’ or ‘survivor’ checklists

(See Appendix 3). For example, Calliehere (2010) was told by her therapist that she

was ‘showing a lot of victim behaviour’. As this behaviour had been ‘diagnosed’ by a

person in a position of (therapeutic) authority, the woman searched the Internet to

educate herself and then compared her character traits to ‘victim’ and ‘survivor’

 

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behaviours. In giving credence to the idea, the material likelihood that her behaviours

would be associated with the normative tropes of victimhood were reinforced.

Marking one’s behaviours and feelings against a checklist—mimics the

diagnostic process for a host of mental health diagnoses, such as PTSD and Anxiety

disorders (See Appendix 4). It is indicative of how the inspecting gaze of the clinician

encourages survivors—through the internalised technologies to the self (Martin

2005:56)—to conduct their own conduct in line with medicalised models.

Furthermore, her choice to disseminate this material to others in the space of the

online forum increased the likelihood that they would then come to construct their

own behaviours through this colonising lens:

‘Thanks for sharing! I am sad to say that I am mostly in the victim category as

wellLLLL’ (Wishinguponastar 2010).

This example is representative of one way in which the act of naming and labelling

self and experience can anchor victims of rape to stigmatised identities that can be

‘more painful and debilitating’ than the act of rape itself (Thackuk 2011:141).

The need to name ones experiences of sexual violence to oneself as a way of

assimilating experience into identity often becomes confused by the array of

discourses that incite the survivors to reveal themselves:

‘…this probably seems tiny, but for me it was huge—I… told the nurse to add

‘CSA’ [Child Sexual Abuse] to my medical history. So it’s there!... Going to trust

the doctor…to help me’(Orangeblossom 2014).

In revealing her history as a matter of clinical relevance, not only will

‘Orangeblossom's’ other ailments and complaints be viewed ‘through the coloured

lens of her diagnosis’ (Harris cited in Morrow 2002:7), but she also assumes the

 

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‘subject position’ of an abuse victim, which elevates this aspect of her identity to one

of centrality and limits the types of ‘truth’ she can reveal in relation to her traumatic

experiences (Weedon1997:116). Truths allowed in such discourse are the ‘therapeutic

truths of harm’, of ‘symptomatology, survivorship, [and] lifelong suffering’ (Lamb

1999:129).

‘When people know you were raped they just see you as a victim like your entire

personality is taken away, as though all you are is a victim and then they expect

you to be really vulnerable and they are surprised if you are not. Its like they can

only see you as fragile’ (Interview 3 2015).

There are many ways to victimise people, one particularly insidious way is to

‘convince them’ and treat them as though they are victims (Gavey in Lamb 1999:62).

Diagnostic Labels

Modern society increasingly constructs the aftereffects of rape through references to

diagnostic labels. PTSD is one of the most prevalent with research indicating that

between 50% and 95% of women will develop PTSD following an attack (Caretta

2011:7). In addition, sexual violence is increasingly linked to acute pathologies such

as DID (Brand 2012) and borderline personality disorder (Becker 1997), as well as to

a range of comorbidities such as recurrent depression (Kilpatrick et al.1985), eating

disorders (Bordo 1993), chronic pain conditions (Barker 2002) and sexual dysfunction

(Berlo & Esink 2010).

Labels can aid ‘survivors’ in understanding the ‘confounding and confusing’

symptoms they experience. Particularly in the most severe cases of DID35, people are

                                                                                                                         35 During our interview, Zoe Lodrick used the example a case where her client had called to take out car insurance but found that whilst in a dissociative state she had insured her car with three separate

 

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able to ‘put words’ to symptoms and situations that make ‘no sense unless they have

some context’ (Lodrick 2015a). A diagnosis, wraps rational understanding and

medical terminology around what can be very overwhelming and frightening

symptoms—this effectively helps the person to contain the symptoms under the

diagnosis rather than psychosomatically experiencing new ones (Duncan Interview)36.

That being said, labels can be extremely damaging:

‘This business with labels is really just bullshit that avoids the point, and causes

endless cycles of distress and stigma for patients. I’ve been through the psychiatric

mill. They didn’t help me—they loaded me down with incorrect diagnoses and a

boatload of inappropriate heavy-duty pscyh meds, while completely missing and

dismissing two physical illnesses’ (Hellothere 2014).

Not only do mental health labels stigmatise an already vulnerable demographic, it

further reinforces the permanence of their victimhood. Once labels are given, they are

not easily transcended and usually require a professional to remove them:

‘I went back to therapy temporarily… to have my diagnosis updated formally.

Well today, after about five months of therapy, my therapist decided that I am

done. So no more PTSD or DID. My new diagnoses are now: major depression in

full remission. DID in full remission, [and] anxiety disorder’ (Buckaroobanzai

2014).

The discursive permanence of formal diagnosis intersects with wider trends in mental

health advocacy groups who campaign for mental ill-health to be recognised as a

                                                                                                                                                                                                                                                                                                                                                           insurers. Furthermore, in an article for Vice Magazine an anonymous writer details the time his girlfriend totally dissociated from her body and couldn’t recognise who he was, believing instead that he was trying to hold her captive (Anonymous 2015). 36 To explain this further, Duncan McClean (2015) told me a story of a client he had worked with, who after smoking very strong marijuana found himself experiencing auditory and visual hallucinations. In receiving a ‘label’—that it was a temporary state of anxiety—he was able to understanding that he was not ‘going mad’ and would not be like this forever. Therefore, the containment of his symptoms within a diagnosis reduced the anxiety experienced regarding the symptoms as well as anxiety over his prognostic future.

 

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physical rather than psychological disease (see appendix 5). ‘Buckaroobanzai’ had to

go back to therapy to ‘remove’ her diagnosis, and understands her mental health

diagnoses to be in ‘remission’. In drawing upon the physiological understanding of

remission—that of a ‘temporary or permanent decrease’ in the manifestations of a

disease, she codifies the diagnosis, not as totally healed but as ever present with latent

potential.

Furthermore, people tend to feel a great deal of anxiety around their

diagnoses; they are not simply value-neutral labels but carry the weight of prognostic

futurity and social stigma (Puar 2009:167):

‘I have fibromyalgia and C-PTSD! Two extremely distressing illnesses!!!!…how

do you explain to someone who’s never experienced it and who doesn’t have

flashbacks and amnesia disease that I have—so how can my significant other

comprehend that even if their mother was dying in a hospital that night I COULD

NOT BE THERE’ (Obliterated 2014)

A formal diagnosis can also make rape victims feel more abnormal or isolated, as

their experience becomes less translatable and out-of-reach to their surrounding

support network who, for example, could perhaps empathise with feelings of

depression, but have no access to understandings of complex traumatic diagnoses.

This is often why people with formal diagnoses turn to the internet.

In a recent study, White and Horvitz (2008:1) found that people who utilised

the Internet to access information about health were highly susceptible to an

‘unfounded escalation of concerns about common symptomatology’. Searches for

symptoms and shared experiences are one of the mainstays of the online survivor

 

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forums. In response to a forum post by ‘Apache’ (2006) on RTS, which explains the

prognosis, the symptoms and ‘stages’ of the syndrome, one woman commented:

‘I was raped seven years ago…and it is still affecting my daily life. If one can

call it ‘life’!! Recently I was diagnosed with Borderline Personality Disorders

and Emotional Attachment Syndrome, both of which are also a result of the

attack, in my view… I would like to hear from anyone who knows anything

about this condition too—Is it something I will get over?’ (Littleme 2007).

This highlights the extent to which online forums act as a conduit through which the

medicalised jargon and symptomatologies are learned and understood. The online

forums are therefore a place where the diagnostic labels are encoded and assimilated

into the identity of the rape victims that concretises the diagnosis as an identity label.

While there is explicit ambiguity over the terms ‘victim’ and ‘survivor’ in the

online forums, there is an absence of ambiguity over formal medical or psychiatric

diagnosis. Instead, the women refer to their diagnoses such as PTSD or DID, in very

certain and often fatalistic ways. The women talk about their diagnostic labels in a

way that ascribes the disease rather than themselves agency over their lives:

‘…because of my multiple personality disorder, I saw a cupcake and cried for

four hours’ (S3 workshop 2015).

‘I’ve been thinking about goals for 2015, but I feel so limited. I have C-PTSD,

recurrent depression so coping emotionally is hard’ (Hiding fox 2015)

‘My attacks of PTSD are fuck horrible’ (Louise 2003)

The ascription of agency to the diagnosis could be seen as a reaction to healthicisation

of identity where the ‘survivor’ mantle increasingly connotes ‘assuming personal

 

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responsibility’ over self-management and contributes to the overall stress the women

feel in the aftermath of the assault (Cole 2007:139):

‘It is really hard to take responsibility for fixing all of the problems that are caused

by being victimised especially because SV and its aftermath makes you feel so

powerless’ (Lis 2003).

On the one hand, a formal diagnosis removes the victim’s culpability in their own

traumatisation, but on the other it places the onus for transformation and self-

management in the hands of the sufferer, by seeing symptomatology as the domain of

individual pathology rather than as a socially determined and culturally bound disease

(Gross & Graham-Bermann 2006:394). However, this also evacuates the victims

control over their own diagnosis:

‘Labels become a way of not having to think about themselves or their difficulties

any further. My patients would say, ‘my doctor says I have manic depressive

illness’ and I would say ‘ok, what does that feel like?’ and they would say, ‘well

you should know, you’re a psychiatrist’…. it becomes a closure and a stop to

dealing with things…’ (McClean 2015).

In this way, a diagnosis of PTSD can represent one of the ‘worst thieves of agency’

because by virtue of its expert nature, this effectively takes the ‘remedy’ out of the

hands of the sufferer (Lamb 1999:111):

‘I have been ‘labelled’ with a disorder… and all my T does is talk about that, I

feel like I’m in a sea drowning yelling ‘help me’ and she is standing on a cliff

near by reading symptoms and asking me ‘on a scale of 1-10…’blah blah’

(Tornpieces 2014).

 

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This is particularly problematic given that the criteria for anxiety disorders and

diagnoses like PTSD tend to be incredibly expansive, vague and therefore, applicable

to many in the general population who have not been ‘traumatised’.37

The trend towards the increasing use of diagnostic categories is particularly

problematic because diagnostic labels are increasingly used not only to capture ‘a

small pathological minority, but almost all of us’ (Rose 2006:466). There is an

increasing multitude of conditions on the borders of normality that are diagnosed as

mental pathology. This ‘diagnostic creep’ of the expansive use of psychiatric

diagnosis means that conditions that encompass a spectrum of severity from normal to

severe become monolithically diagnosed as pathological (Conrad 1992:221).

The vague and elastic nature of rape-related psychiatric diagnoses lends itself

to self-diagnosis as every woman (probably even women who have never been raped)

can see something of her own experience within them’ meaning that an ever-

increasing proportion of rape victims will receive formal diagnosis (Chisler &

Johston-Robeldo in Ballou & Brown 2002:177). Labels therefore ‘concretise’ that

which is not concrete.38 This is especially harmful given the trend towards ascribing

biomedical and physical fixity to psychological disorders.

                                                                                                                         37 See Appendix 3 for example of PTSD and Anxiety Disorder checklist (Carretta 2011: 174). 38 As an aside, this is also particularly problematic when untrained individuals start to deploy diagnostic labels in official settings. Without wanting to give too much credence to a throw away comment – during my interview with Rachel Matheson who worked in a managing position at a SARC as well as a volunteer counsellor, she said: ‘ I love DID, I really do. Its just the most fascinating illness and the people who have it are so lovely’. She then went on to describe a case of a young boy whom she had counselled and she said ‘ I knew it as soon as I saw him that he had it [DID], you could tell because he spoke about being at school and it was his confident persona whilst in the therapy room he was withdrawn and angry’. Though I cannot make comment as to the particulars of this case, I just want to highlight my shock that a person who has some degree of expert authority within the therapeutic setting, but has received no formal training in psychotherapy—and who actively ‘loves’ the diagnosis of DID—is diagnosing people as suffering from this disorder. This shows how easily and the extent to which people come to attribute mental pathology to rape victims. However, who does the diagnosis serve? Is it the expert’s desire and excitement at diagnosing, or, the rape victim being diagnosed?

 

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CHAPTER FIVE: WHO DO SUCH CONSTRUCTIONS SERVE?

The PTSD Brain

In the neurobiological account of personhood, mental pathology is the consequence of

a visually identifiable abnormality (Rose 2007:192). In appealing to the physical

nature of neuro-pathology, the new truth technologies of modern biological

psychology appeals to ‘western culture’s affinity for visual proof’ (Thackuk

2011:149). In visually confirming an abnormality within the brain, the stigma

associated with mental illness (and blame attached to mentally ill people) is said to be

reduced in the sense that it renders behaviours which are often misunderstood by

society as more intelligible (Ibid:151). Illustrating pathologies through their particular

molecular materiality changes ontology; ‘different practices and locales embody and

enjoin different senses of selfhood’ and discursively create qualitatively different

material realities (Rose 2007:222).

For example, from a psychological perspective depression is generally

attributed to negative thought cycles, genetic predisposition and low self-esteem

(Horvitz &Wakefield 2007). However, in the biopsychological or neurobiological

‘style of thought’ (Rose in Ericson 2003:412), depression can be visualised and

evidenced as a ‘deficit in monoamine neurotransmitters’ such as norepinephrine and

serotonin (To, Zepf & Woods 2005:102). Neuroimaging is thus pictorially creative of

‘different kinds of brains’ that in turn produces ‘different kinds of minds’ (Dumit

2003:37), as well as different kinds of ‘treatment’.

Even though such ‘diseases of the mind’ are a matter of representation

(Theriot 1993:3) and given meaning through ‘value-judgements’ (Boyd 2000:10), this

kind of biological psychiatry produces ‘operative’ images that have a ‘reality making

 

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function’ (Layne 2003:41). The biomedical model of the brain establishes what counts

as an explanation and how this can be ‘treated’—fundamentally altering the way that

people perceive their own subjectivity (Rose 2007:192). The idea that it is possible to

advance a ‘value-free’, objective understanding of mental illness that exists prior to,

and independent of power, simply isn’t the case (Thackhuk 2011:149). By locating

trauma in the structures of the brain, the potentiality of rape to cause permanent and

irrecoverable damage to a persons identity is linguistically (as opposed to biologically)

consolidated.

The PTSD brain is a striking example of the ways that neurobiological psychiatry has

changed the ontological status of rape victimhood. Though it is understood by experts

that PTSD does not necessarily permanently affect the brain and that PTSD is

‘treatable’ (Lodrick 2015a), there is a wealth of misinformation on the Internet (Segal

2009:355):

‘I thought of myself as tainted, like I was going to be scarred permanently by what

happened to me. And when I started researching my PTSD diagnosis there was all

of this stuff on the internet about the effects it has on the brain… it was really

scary… like, not only did I feel tainted but that my brain was actually tainted too’

(Interview 2 2015)

Cerebral atrophy, which is associated with the neurological image of the PTSD brain

(see Fig 1) describes the process where brain tissues ‘shrink’. The visceral mental

imagery evoked by such descriptions, particularly for the average layperson, who

would not know whether such changes are permanent or what areas of the brain tend

to be affected by certain diseases, is almost apocalyptic.  

 

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Fig 1: Bremner (Unknown)

The issue with presenting PTSD as having the power to permanently

physically alter the brain, is that it makes recovery much harder to contemplate

(Zeedyk 2007:68). In shrouding mental pathology in the expert discourses of

neuroscience, the brain-based model of PTSD becomes irrefutable as it transcends the

average persons knowledge base. If rape-related psychological sequelae are removed

from the psyche (where the women have agency over their experiences) to the brain

(where the women are removed from their experiences), this discursively limits the

coping strategies available to them (Warner 2001:131). One woman in the forums

stated:

‘There is no effective way to minimise and get past what has happened to me. Did

you know that recent research has shown that sexual assault actually changes the

brain, and that these changes are permanent? I don’t think its possible to get over

that.’ (Guest_sk_Redmond_*2002)

The process whereby neurobiological and biopsychosocial models of rape victimhood

have come to be accepted as the truth of what happens to a person during and

following sexual assault entails a ‘social process of exclusion’ where alternative and

competing paradigms are marginalised and ‘not allowed to enter ‘the true’’ (Rose

 

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1996:55). In likening the mental pathology of a rape victim to a physical disorder, it is

reconceptualised as something that is beyond the ‘individual’s voluntary control’

(Thackuk 2011:149). In so doing, rape victims are discursively encouraged to

understand their emotions through a physical lens, thereby increasing the likelihood

that they develop other physical conditions.

Though I do not seek to challenge the scientific validity of neurobiological

accounts of trauma, the wholesale adoption of such models needs to be questioned and

problematised. Such accounts have acquired a kind of mythic ascendancy where the

synonymity between rape, trauma and irreparable neurological damage becomes a

‘master signifier authorising and reproducing’ a socially constituted world-view of

what rape does to a person, as well as delineating who is professionally capable of

‘curing’ the rape victims of their continuing traumatic distress (McCutcheon

2002:192).

The assumption that professional treatment for rape victims represents an

‘unqualified good’, presumes that the women will be better off when experts can

correctly recognise their symptoms and treat them accordingly (Bumiller 2008:64).

However, the very idea that

‘…you can diagnose people with mental disorders…,and as though by virtue of

that diagnosis, you can instantly access what the treatment should be and deliver

it, and that is all that is needed ‘to get better’’ (McLean Interview).

presents a mechanistic and rigid model of ‘treatment’. Crucially, this model gives the

clinician defining powers over what constitutes ‘successful recovery’ (Garden

2010:72).

 

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Such definitive powers mean that it is the professional who ‘educates’ the

women about their own, subjective, experience of trauma. In this way, therapists

could potentially harm the victims’ self-developed coping strategies (Gavey &

Schmidt 2011:451). Though this is of course not always the case, there is the potential

to do symbolic violence to the victims’ self-assessment. Gavey and Schmidt

(2011:451), contend that given that one of the especially damaging elements of rape is

the ‘forcible taking of control’, a response that on some level ‘mimics that dynamic,

albeit from an ostensibly caring and sympathetic position’ is nonetheless,

problematic.

Procrustean model of therapy

The potential to cause such harm is more pronounced in institutions where services

are tailored specifically for rape victims, such as SARCs or RCCs because they are

more likely to subject the women to an ‘almost colonising interpretative lens’ (Gavey

in Elliot 2008:242):

‘…a lot of organisations that help people with sexual trauma have some sort of

model in their mind before they’ve met them, and so rather than going ‘we have

this individual who is suffering from this, therefore this is how we should treat

it’. They already have a model of what that person might be feeling like and

treat accordingly… people tend to push their ideology’ (McClean 2015).

The integration of institutional care through interagency programmes such as RCCs,

the police, and primary care services does allow for more uniformity in the treatment

of rape victims—and, given that rape myths and victim-blaming is still pervasive,

means that rape victims will generally be received in a sensitive way (Eogan et al

2013:55). However, institutionalisation has also expanded the reach of the normative

 

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models of rape victimhood and associated psychological sequelae (S.Levine

2012:409).

A number of the women I spoke to viewed their experiences of RCCs

negatively, as they felt that ‘they had to be the victim’ in order to access the support

they required (Interview 3 2015). One survivor said this of her experience with a

RCC:

‘I was trying to talk to the therapist about the good things in my life, like what

I’d been doing with friends and she just kept bringing me back to the rape and to

the negative things I was experiencing. I mean, in fairness, at the time I probably

was in need of that therapy because I was convinced I was being followed but at

the same time, she made me fill in all these questionnaires about how anxious I

was and then she told me I had PTSD and anxiety disorder… and I just think at

the time, I just wanted to move on even if that meant pretending that everything

was ok for a while… and then after all of that effort in making me talk about

what had happened to me, my 10 sessions were over and I was just kind of left

on my own to try and put the pieces back together’ (Interview 2 2015).

Here, the ‘survivors’ control over her ‘recovery’ was, at least to some degree, taken

away through the denigration of her coping strategy as being a maladaptive

expression of a psychiatric diagnoses. Through the therapeutic process, the survivor

was thereby inculcated into the mandated normativity of traumatic victimhood, firstly

through the incitement to speak about her experiences negatively and secondly by

encouraging her to define her experiences against the diagnostic criteria of PTSD and

Anxiety disorder. When speaking to another woman of her experiences of such

therapies, she commented that

 

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‘…squashing people into boxes and giving them 6 sessions… It’s the absolute

antithesis of everything I’ve ever found helpful in my recovery—which is that

spaciousness and being met with expression and not necessarily having clear

stories or boxes for things to fit within… not some expectation of how you should

be…not by changing individuals’ (Interview 1 2015).

It follows that institutional and therapeutic experiences can be experienced as a

‘continuation of a process of victimisation’, particularly if victims (and their

resilience, or coping strategies) are ‘muted’ by the professionals they come into

contact with, or if they are forced into a procrustean model of victimhood and therapy

that doesn’t suit their particular needs (Robson 2011:264). As evidenced, the quality

of therapy varies dramatically from therapist to therapist and institution to institution:

there are ‘RCCs and there are RCCs, just like there are SARCs and there are rooms in

hospitals with SARC written above the door’ (Lodrick 2015b).

Whom do labels serve?

Given that diagnostic labels have the propensity to add to the damage done to the rape

victims’ chances of recovery and long-term prognostic future, it is important to

question whom such diagnostic labels serve. Diagnostic labels are not only ‘much

more useful to researchers’ (as they demarcate the demographic who have to be

classified in order to be studied,) but labels also more readily serve the purpose of

mental health managers than they do victims of violence.

‘I don’t like labels and pigeon-holes but the doctors do. It’s a shame they can’t just

listen to people for the individuals they are and not need a label before they decide

to listen on their own terms only… diagnosis, pigeon-holes and labels aren’t what

is important’ (Bronte 2011).

 

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The marketisation of healthcare means that increasing pressure is put upon

service providers to provide quantifiable and measurable outcomes. Particularly

outside of the statutory services, the outcomes of treatment must be costed in order for

the organisations to continue operating (Interview 4). In putting people in arbitrary

boxes, managers can provide ‘effective treatment’, such as 10 therapy sessions for a

rape victim or the prescription of anti-depressants for someone experiencing a

depressive episode. Labelling allows managers and stakeholders to target limited

resources to the most needed areas (Marshall 2012:339).

Market driven model

Nikolas Rose (2007:11) asserts that medicine and medical treatment has been

reshaped by ‘intense capitalisation’. The increasing demands for ‘normalcy’ and the

moralising drive for optimal ‘well-being’ fosters market demand for and consumer

base of ‘products, procedures and drugs’ that will ‘cure’ an increasingly array of

‘abnormalities’ (Farrell & Cacchioni 2012:329). Marketised model of mental health

treats patients a ‘commercial commodity’ where they are measured against pre-set

criteria, and the ‘success’ of the treatment is measured against an abstracted market

model of health (McClean 2015).

The requirement of providing ‘outcomes’ can be particularly damaging. Jacqui

Campui, at the RCC in Peterborough, alluded to the fact that they had had to become

‘more strong’ with state-funding bodies and decided not to provide outcomes such as

‘who has stopped claiming benefits and gone back to work’ because of the treatment

they received at the RCC (Campui interview). In their annual report, the Women and

Girls Network (WGN) (2011:5) actually estimated what violence against women

costs British society each year. Every adult rape is said to cost ‘£96,000 in its

 

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emotional and physical impact on the victims, lost economic output due to

convalescence, treatment costs to health services and costs incurred in the criminal

justice system’, costing society a total of £37.6bn each year.

Furthermore, they go on to provide a breakdown of the ‘total value created by

the WGNs’ therapeutic programme; apparently for every ‘£1 invested in WGN, £5 of

social value is generated to clients, their families, wider society and the state’ (WGN

2011:16). In reducing the ‘outcomes’ of women’s lives to the ‘value-added’

financially to society is revealing of who organisations are increasingly accountable to

(i.e. donors).

The problem with donor-accountability is that services are increasingly drawn

upon to provide detailed reports of their service-users, as well as providing better

outcomes for less. This is arguably why there is an increasing number of mental

illness diagnoses (as it provides information) which are said to be ‘treatable’ in the

provided ’10 sessions of therapy’.

PTSD makes sexual assault treatable insofar as donors or insurance companies

(in the case of the US) are more likely to pay out for diagnosed disorders than they are

for ‘stress’ (Lamb 1999:111). The increasing use of diagnostic categories as a way of

accessing much needed funding, as well as the concomitant need to ‘treat’ disorders

efficiently could perhaps be a contributing factor in why between 1990-2000 there

was a 126% increase in the psychiatric drug market in the European Union and 638%

increase in the US (Rose 2006:470). One survivor comments:

‘My psychiatrist thinks I do not need [my therapist] anymore because she ‘cured’

me with a new anti-depressant’ (Lionesscub 2014a)

 

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In the age of austerity where funding is limited, it often means that people are

unable to access services. Though some people can afford private treatment the

majority cannot

‘…so these women have plucked up the courage to come to us (RCC), and we

have to tell them that there is a big waiting list and we try to accommodate that as

best we can, but they are often left coping alone’ (Campui interview).

Lengthy waiting times encourage triage assessment where rape victims are more

likely to be seen quickly if they present as particularly traumatised. This means that

‘eligibility and priority for services’ is predicated upon and increasingly linked to the

women’s status as abject victims and their ability to articulate their problems in the

institutionally intelligible model of traumatised victimhood (Bumiller 2008:13).

CHAPTER SIX: PERFORMING ILLNESS IDENTITIES

Framing experiences of rape and the aftermath in terms of the lived experience of

symptoms encourages rape victims to self identify with, and disclose as identity, an

illness narrative (Shapiro 2011:68). The requirement of an illness narrative as a means

of validating their experience is a technology of presencing, it renders their emotions

and somatic pains intelligible to wider society (Jain 2007:78). In presenting their

‘condition’ as being physically debilitating and highlighting their suffering and plight,

the women try to explain their unexplainable symptoms (Barker 2002:282):

‘The FOG you speak of is so real. I tell my family that the song ‘I’m not crazy,

I’m just a little unwell’ is for me… when I wake up feeling so ill, I am so afraid it

may continue and I will never get out of bed. On days like this, I can hardly type…

when the memories come again of my pain it adds so much to the discomfort also’

(Patches 2011).

 

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While this may garner support and reduce social stigmas associated with abuse-

related psychological and somatic sequelae, it also encourages the women to

increasingly view all emotions through a physiological lens, which cultivates an

understanding of psychological and physical distress as inextricably linked. Many

‘survivors’ in the online forums recognise that their physical symptoms get worse

when they emotionally relive their abuse:

‘I have fibro that gets worse when my PTSD is acting up so I do believe there is a

link to abuse’ (Darlingluck 2011)

‘That evening I was experiencing an intense pain flare, with the backache, the

headache, feet pain, the dizziness… AND, I was experiencing intense emotional

distress and despair as I’d worked that afternoon with my T, stretching way past

my emotional limits’ (Obliterated 2014)

This physicality is damaging to the long-term prognosis of the women as it marks

transitory emotional stages with discursive permanence that shapes the material

reality these women live out. Furthermore, it has been found that the perceived

severity of the assault is linked to expressions of somatic symptomatology, as the

more life events are perceived as undesirable, the more likely they are to influence

stress levels, thereby influencing somatic distress (Rynd 1988:155-9). They

perennially inhabit their illness identities and ‘perform’ the tropes associated with

traumatised victimhood:

‘The psychiatrist from hell… said that I ‘had been in therapy and sick for so long

that I have no idea what it is to be well’ (Lionnesscub 2014b).

Ultimately, the conversion of emotional turmoil and pain into the

‘camouflaged but culturally acceptable languages of bodily illness’ (Showalter in

 

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Boyd 2000:10) means that rape victims are more likely to attribute their physical

symptoms to the rape:

‘I have cerebral palsy and severe bipolar disorder. Neither of those would have

been what they are without the abuse’ (Silentstar 2008).

That Silentstar attributes cerebral palsy—a neurological condition that can occur ‘if

the brain develops abnormally or is damaged before, during or shortly after birth’

(NHS Choices 2015)—in some way, to the sexual violence she experienced,

highlights the expansive ways in which rape and sexual violence achieve ‘master

status’ and foundational centrality to the lives of the women (Becker in Link et al.

1991:303). Everything comes to be coded as being a result of the abuse.

In their study on sexual violence and incidences of physical pain, Eby et al.

(1995) found that 99% of their respondents who had been raped reported at least one

physical health symptom. The most common symptoms were low energy (88%), sleep

problems (77%) and headaches (77%) (Ibid:569) (see appendix 6 for table). The study

found of the 68% of women who reported chronic fatigue, 65% of the women

attributed such symptomatology to the rapes they had experienced.

In viewing experiences of sexual violence as causally linked to physical

symptoms, victims of rape appeal to wider society to validate their suffering. Physical

symptoms are more intelligible to wider society because they are more likely to be

communal (Thackhuk 2011). For example, I spoke to a respiratory physiotherapist

who reported treating a sizeable number of abuse victims for what had been

diagnosed as ‘chronic asthma’ but that she felt was more likely the result of

misdiagnosed panic attacks or anxiety (Grillo 2014). The women who were being

treated had pushed for physiological diagnosis rather than psychological as they felt

 

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this better explained their symptomatology. One woman I spoke to at a ‘survivors’

workshop explained that she kept going to A&E because she had ‘muscles that were

too tight around her heart’, yet it later transpired that what she was describing was an

anxiety induced panic attack. She had taken what doctors had explained to her about

panic attacks and reformed their explanations to lend physical credence to her

suffering (S4 workshop 2015 ).

Giving physical tangibility to their symptomatology is a ‘tactical and

persuasive’ move where rape victims seek to ‘recruit’ and ‘convince’ the listener of

the ‘truth of their self account’ (Kokanovich & Philip in Davis & Manderson

2014:58). However, any attempt to tell the truth of oneself is limited by ‘speakability’

(Butler 2005:121); the account that the subject gives of its experience is always

already structured by its ‘relationship to culture, language and moral frameworks’

(Kokanovich & Philip in Davis & Manderson 2014:59). Inevitably such disclosure

comes at a cost. Following Foucault (2001) Butler argues that the ‘price of telling is

always the suspension of a critical relation to the truth regime in which one lives’

(2005:131).

Disclosing ones psychological distress through aspersions to physical

tangibility is a form of self-subjection to regulatory regimes and a highly complex

social performance (Butler in Garry & Pearsall 1996:372). Therefore, when validation

of rape-related sequelae is tethered to the physical tangibility of traumatisation, rape

victims are more likely to be statistically prevalent in cases of contested illnesses such

as Fibromyalgia (Barker 2011), CFS (Dickson et al. 2007; Seccombe 2015), chronic

pain conditions (Dumit 2006) and Borderline personality disorder (Koehne et al

2012). This is because the ‘body believes in what it plays at’ (Bourdieu cited in Butler

 

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1997:154). Through the ‘words, acts and gestures’ that link psychological distress to

physiological symptomatology within the ‘affected’ rape-victim identity, the women

are not only discursively constituted by the internalised norms of that psychosomatic

victimhood, but come to ‘perform’ and embody their illness identities. 39

This is not to deny the scientific research that details the way in which stress

hormones impact ‘negatively upon the body’ and immune system, producing short

term and long term physical consequences’ (Bloom in Giardiano et al. 2003:425). A

lot of the women in the forums complain of weakened immune systems:

‘Mybody/brain seems to be breaking down, lately—catching colds frequently,

sleeping way too much (10+ hours a day), poor eating habits, feeling hopeless’

(Blackbird86 2012).

Yet, the difference between ascribing such immune-responses to an innate experience

associated with rape, or whether these physiological symptoms are the result of

feeling victimised, performing—and then becoming—the victim is the difference

between inescapable victimhood, or one that can be transcended. Recognising such

psychosomatic symptoms is not to deny their reality, but recognition of the ‘inherent

duality of mind and body’ and the propensity of language and discourse to construct

reality (Webster in Ballou & Brown 2002:162). The symptoms experienced by the

women undoubtedly have devastating consequences on their self definition and their

                                                                                                                         39 For example, discourses surrounding sexual violence assert that rape has a detrimental affect on women’s sexuality: ‘ rape locates and mortifies the genitals that it violates’ (Grand 2003:322). This inculcates the women through regulatory regimes into believing that they will experience issues sexually and therefore creates subjective experiences of such conditions: Eby et al. (1995:564) reported that two of the most frequently cited issues rape victims experience are that of painful intercourse (72%) and vaginal pain (63%). However, Berlo & Esink (2010:236) in their meta-analysis of all studies researching sexuality after sexual assault found that the victimised and nonvictimised groups of women did not differ in the frequency of ‘oral sex, sexual intercourse, anal intercourse, masturbation or orgasms’, but the victimised group ‘reported less satisfaction’ than the nonvictimised group. This shows that the physiological response during sex remains unaffected by rape but the perception of sexual stimuli as ‘anxiety provoking’.

 

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lives (Showalter 1997:128), but what lies behind such conditions is the very idea of

‘what constitutes a real illness, what doesn’t and what we do to make something real’

(Wessely 1993:338).

I am in no way trying to ‘minimise’ (Sister 2003) or ‘deny the reality’

(Guest_* 2003) of the pain that someone has suffered, nor take away from them what

they view as an essential and foundational aspect to their identity. Self-expression

constructs ‘the durable properties of a character’ (Ricœr 1991:195); it is productive of

material reality. Therefore, even though there is no essential or pre-discursive reality

to the trauma and traumatic sequelae of rape—as it is created in language—this does

not diminish the reality of the trauma and pain produced through discourse and

experienced by the women.

Conclusion

A constellation of forces and devices of meaning production have ‘invented, refined’,

‘stabilised’ (Rose in Hall & Du Gay 1996:130), and disseminated the modern models

of rape and rape victimhood. In providing a critical history of the present, I have

traced the processes of medicalisation in the 19th century that forged both the rapist

and the rape victim as objects of knowledge. This ‘act of seeing’ (Foucault 1963), or

of inspecting bodies, brought-into-being the rape victim, actively creative this identity

in discourse. This social ‘thinkability’ afforded rape victims legitimate types of

speech (within circumscribed settings) to articulate their claim of injury.

Medicalisation has to be set within the complex interplay of competing and

contradictory discourses around rape and rape victimhood, as well as understandings

of gender, madness, trauma, and pathology. Competing discourses at the time

constructed disorderly femininity in terms of mental ill-health and the reform

 

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movement can be seen as a nascent therapeutic community, aiming to transform the

abject, corrupted victim into redeemed survivor. These narratives of transformation

fed into the ‘breaking the silence movement’, the stress on remembering, associated

with the ‘survivor’ movement is starkly contrasted to the practice of ‘forgetting’ in the

penitents movement (L.Jackson 2000:115).

The 1970s model of sexual trauma encouraged women to speak publically of

the ‘inner truth’ of their experiences based upon the psychologised understanding that

confession is cathartic and political, but the movement required exposing ‘bodies in

pain’. This dramatised, sensationalised and depoliticised ‘the moral degradation’ that

the women suffered. Increasing stress on ‘recovery’ required rape victims to be ‘better

than well’, whilst taking away their powers of self-definition by pathologising them

as mentally abject and simultaneously magnifying the discursive construction of rape

as always already traumatising. The model of rape-as-trauma represents an all-

encompassing model that is seen to profoundly alter all facets of human experience

and identity irreparably.

I have argued that people are extremely suggestible and the comparison of one’s inner

self to didactic victim-models (both formal and informal labels, behaviours and

symptoms) leads to a more efficient regulation of victim-identity through the

production of ‘self policing subjects’ (McNay 1992: 87). The women become rape

‘victims’ by ‘telling’ and ‘living’ the story of their experience (Andrews et al

2000:78). By assuming the ‘subject position’ of an abuse victim, this aspect of their

identity is afforded foundational centrality and limits the types of truth the women can

reveal in relation to their traumatic experiences (Weedon1997:116).

 

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Furthermore, by locating trauma in the structures of the brain, the potentiality

of rape to cause permanent and irrecoverable damage to a persons identity is

linguistically (as opposed to biologically) consolidated. Coping strategies are socially

located practices, and if rape-related psychological sequelae are removed from the

psyche to the brain, the coping strategies available to the rape victims are taken out of

their control, instead giving the clinician defining powers over what constitutes

‘healing’ (Garden 2010:72).

Framing experiences of rape in terms of symptoms encourages rape victims to self

identify with, disclose as identity, and perform an illness narrative (Shapiro 2011:68).

Adopting the ‘sick-role’ increases the material likelihood that the women will ‘feel’ a

range of other symptoms. Through the ‘words, acts and gestures’ that link

psychological distress to physiological symptomatology within the ‘affected’ rape-

victim identity, the women are not only discursively constituted by the internalised

norms of that psychosomatic victimhood, but come to ‘perform’ and embody their

illness identities. Modern medical models of rape victimhood therefore represent

assjeuttisment (subjectification) in ‘both senses of the word’ (Foucault 1979:81).

Fundamentally, what I am trying to argue is not that these conditions don’t

objectively exist, or that they are not experienced physically but rather that because

victimhood is always already invested with medical meaning that far out strips any

real medical basis the victims can only understand any psychological or physiological

pain they may feel through this very particular lens. This creates a prognosis for the

future of these women that is particularly grim.

Not only have they been raped, not only have they got to evaluate themselves

in terms of survivor or victim behaviour, or experience complex psychological

 

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trauma; but they also have to cope and navigate scientific and pseudo-scientific

accounts of their diagnoses.

Rape victimhood thus achieves ‘master status’ (Becker in Link et al.

1991:303), where everything comes to be coded as being a result of the abuse, so that

every facet of identity and experience can be read in accordance with and in reaction

to rape victimhood. Furthermore, this is compounded because as a sexual act, rape

victimhood is an identity: one can be traumatised by a violent act and come to terms

with the randomness of violence, but it is incredibly difficult to overcome an identity.

Therefore, ‘before we speak we need to look at where the incitement to speak

originates, what relations of power and domination may exist between those who

incite and those whoa re asked to speak, as well as to whom the disclosure is directed’

(Alcoff & Gray 1993:284).

Through discourse, the ontology of the rape victim is materialised and women become

bound to a ‘spoiled identity’ (Goffman 1986). It is therefore fundamentally important

that we deconstruct rape victimhood to present an understanding of rape victimhood

that neither medicalises, pathologises nor trivialises victimisation, and allows for new

conceptions of rape to be put forward.

 

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APPENDIX ONE: LIST OF INTERVIEWS

Campui, J. (2015) Interivew, interviewed by Constance Flude, 16th May 2015 at Race Crisis Peterborough.

Grillo, L. (2014) Interview, interviewed by Constance Flude, 22nd December 2014 [Phone Interview].

Interview 1 (2015) Anonymised ‘survivor’ interview, interviewed by Constance Flude on 18th May 2015, [Phone Interview]

Interview 2 (2015) Anonymised ‘survivor’ interview, interviewed by Constance Flude on 17th April 2015, at Wellcome Collection, London.

Interview 3 (2015) Anonymised ‘survivor’ interview, Interviewed by Constance Flude on 23rd April at The Breakfast Club, London.

Interview 4 (2015) Anonymised ‘professional’ Interview, interviewed by Constance Flude on 9th May 2015.

Lodrick, Z. (2015a) Interview, interviewed by Constance Flude [Phone Interview] on 19th May 2015.

Mattheson, R. (2015) Interview, interviewed by Constance Flude 16th May 2015 at Rape Crisis Peterborough.

McClean, D. (2015) Interview, Interviewed by Constance Flude on 1st May 2015 at Boulanger Matin (Stroud Green Road, London N4).

Seccombe, N. (2015) Interview, interviewed by Constance Flude on 8th April 2015, [Phone interview].

Survivor 1 (S1) (2015) Anonymised ‘survivor’ cited from ‘Survivors workshop’, recorded by Constance Flude on 9th May 2015.

Survivor 2 (S2) (2015) Anonymised ‘survivor’ cited from ‘Survivors workshop’, recorded by Constance Flude on 9th May 2015.

Survivor 3 (S3) (2015) Anonymised ‘survivor’ cited from ‘Survivors workshop’, recorded by Constance Flude on 9th May 2015.

Survivor 4 (S4) (2015) Anonymised ‘survivor’ cited from ‘Survivors workshop’, recorded by Constance Flude on 9th May 2015.

 

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APPENDIX 2: INFORMED CONSENT FORM

Participant Consent Form and Information Sheet

I am required to give you this information and get your signed consent prior to interviewing you, in order to meet the ethical standards prescribed by the University of Cambridge. Please read this consent document carefully before you decide to whether to participate in this study.

Purpose of the research study: This research project aims to look effects that sexual trauma has on women's lives. Looking specifically at the ways that the medical, psychiatric and social institutions set up to aid women through overcoming such trauma, help these women come to terms with what has happened to them.

Who is conducting the study: My name is Connie. I am currently a research student at the University of Cambridge. I have previously conducted research and interviews with women who have been sexually assaulted in Cambodia and Thailand and have researched and worked with vulnerable children and their families in Uganda.

What you will be asked to do in the study: During the interview, I will ask you questions about your experience of the services on offer to victims of rape and your understanding of the difficulties they face. The interview is, in part, predesigned and in part, based upon the discussion on the day. The predesigned questions have passed an ethics review by the University of Cambridge.

Recording: The interview will be recorded on an audio device. If you wish not to be recorded please let me know at the beginning of the interview and I will take written notes instead. If at any point during the interview you wish the recording equipment to be turned off—either permanently or temporarily—I will do so without hesitation.

Anonymity: All of the information you disclose will remain completely anonymous, unless you choose to waiver this anonymity. I will retain in a protected file, the signed copy of this consent form until such a time as my supervisor agrees it can be deleted. The signed form will then be disposed of safely where no one will see that it is signed.

If you agree to participate in this study please sign below. Thank you.

Agreement: I have read the procedure described above. I voluntarily agree to participate in the interview and I have received a copy of this description. I understand that this interview will be audio recorded and consent to this unless otherwise stated. Furthermore, I understand that what I say during the interview may be quoted in the written thesis produced as a result for this research.

Name (Printed) ___________________________________________

Signature: ________________________________________

Date: _________________

 

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APPENDIX THREE: VICTIM, SURVIVOR THRIVER CHART

(Calliehere 2010)

Victim Survivor Thriver

Doesn’t deserve nice things or trying for the "good life."

Struggling for reasons & chance to heal

Gratitude for everything in life.

Low self esteem/shame/unworthy

Sees self as wounded & healing

Sees self as an overflowing miracle

Hyper vigilant Using tools to learn to relax Gratitude for new life

Alone Seeking help Oneness

Feels Selfish Deserves to seek help Proud of Healthy Self caring

Damaged Naming what happened Was wounded & now healing

Confusion & numbness Learning to grieve, grieving past ungrieved trauma

Grieving at current losses

Overwhelmed by past Naming & grieving what happened

Living in the present

Hopeless Hopeful Faith in self & life

Uses outer world to hide from self

Stays with emotional pain Understands that emotional pain will pass & brings new insights

Hides their story Not afraid to tell their story to safe people.

Beyond telling their story, but always aware they have created their own healing with HP

Believes everyone else is better, stronger, less damaged

Comes out of hiding to hear others & have compassion for them & eventually self

Lives with an open heart for self & others

Often wounded by unsafe others

Learning how to protect self by share, check, share

Protects self from unsafe others

 

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Places own needs last Learning healthy needs (See Healing the Child Within & Gift to Myself)

Places self first realizing that is the only way to function & eventually help others

Creates one drama after another

See patterns Creates peace

Believes suffering is the human condition

Feeling some relief, knows they need to continue in recovery

Finds joy in peace

Serious all the time Beginning to laugh Seeing the humor in life

Uses inappropriate humor, including teasing

Feels associated painful feelings instead

Uses healthy humor

Uncomfortable, numb or angry around toxic people

Increasing awareness of pain & dynamics

Healthy boundaries around toxic people, incl. relatives

Lives in the past Aware of patterns Lives in the Now

Angry at religion Understanding the difference between religion & personal spirituality

Enjoys personal relationship with the God of their understanding

Suspicious of therapists-- projects

Sees therapist as guide during projections

Sees reality as their projection & owns it.

Needs people & chemicals to believe they are all right

Glimpses of self-acceptance & fun without others

Feels authentic & connected, Whole

"Depression" Movement of feelings Aliveness

 

 

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APPENDIX FOUR: EXAMPLES OF DIAGNOSTIC CRITERIA TESTS

(Caretta 2011: 174-184)

 

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PTSD Checklist (PCL) – Civilian Version for DSM-IV

INSTRUCTIONS: Below is a list of problems and complaints that people sometimes have in response to stressful experiences. Please read each one carefully. Circle the response that indicates how much you have been bothered by that problem in the past month.

1. Repeated, disturbing memories, thoughts, or images of a stressful experience?

1. Not at all 2. A little bit 3. Moderately 4. Quite a bit 5. Extremely

2. Repeated, disturbing dreams of a stressful experience?

1. Not at all 2. A little bit 3. Moderately 4. Quite a bit 5. Extremely

3. Suddenly acting or feeling as if a stressful experience were happening again (as if you were reliving it)?

1. Not at all 2. A little bit 3. Moderately 4. Quite a bit 5. Extremely

4. Feeling very upset when something reminded you of a stressful experience?

1. Not at all 2. A little bit 3. Moderately 4. Quite a bit 5. Extremely

5. Having physical reactions (e.g., heart pounding, trouble breathing, sweating) when something reminded you of a stressful experience?

1. Not at all 2. A little bit 3. Moderately 4. Quite a bit 5. Extremely

6. Avoiding thinking about or talking about a stressful experience or avoiding having feelings related to it?

1. Not at all 2. A little bit 3. Moderately 4. Quite a bit 5. Extremely

7. Avoiding activities or situations because they reminded you of a stressful experience?

1. Not at all 2. A little bit 3. Moderately 4. Quite a bit 5. Extremely

8. Trouble remembering important parts of a stressful experience?

1. Not at all 2. A little bit 3. Moderately 4. Quite a bit 5. Extremely

 

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APPENDIX FIVE: EXAMPLE OF PRESENTING PTSD AS A PHYSICAL AILMENT

(www.healingfromcomplextraumaandptsd.wordpress.com 2015)

 

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APPENDIX SIX: EBY ET AL. TABLE OF WOMEN WHO ATTRIBUTE PHYSICAL SYMPTOMS TO SEXUAL ASSAULT.

(Eby et al. 1995:569)