A Phenomenological Understanding of Acquaintance Rape and the Subsequent Trauma As Experienced by Young South African Women

A PHENOMENOLOGICAL UNDERSTANDING OF ACQUAINTANCE RAPE AND THE SUBSEQUENT TRAUMA AS EXPERIENCED BY YOUNG SOUTH AFRICAN WOMEN

LAUREN MOSS

A dissertation submitted in partial fulfilment of the requirements for

the degree of

D. LITT ET PHIL (PSYCHOLOGY)

in the

FACULTY OF HUMANITIES

at the

UNIVERSITY OF JOHANNESBURG

PROMOTER: PROF. C.R. STONES

2011

DECLARATION

I hereby declare that this thesis is my own, unaided work and that recognition has been given to the references used. It has not been submitted for any degree of examination at any other university.

______Lauren Moss Date

ABSTRACT

A PHENOMENOLOGICAL UNDERSTANDING OF ACQUAINTANCE RAPE AND THE SUBSEQUENT TRAUMA AS EXPERIENCED BY YOUNG SOUTH AFRICAN WOMEN

With the prevalence of rape in South Africa being the highest in the world, it is important for there to be a sound understanding of how the rape experience impacts the individual victim. A majority of rapes in the South African context are perpetrated by someone known to the victim, making acquaintance rape the most prevalent of all rape types in this country.

The current understanding of the impact of all types of rape on a victim predominantly emerges from international studies which for the most part, considers the presence of traumatic distress in the victim. These studies are essential to the understanding of the impact of rape, although they are predominatly obtained through quantitative research. A qualitative understanding of the lived experience of the victim after her rape enhances and deepens the already substantive quantitative data regarding rape trauma. The practical implication is that clinicians can have a better understanding of the factors that are present in the rape experience and the complex interaction of those factors with the victim and the resulting rape trauma.

As this study explores the lived experience of acquaintance rape of South African female rape victims, a qualitative methodology is utilised. Phenomenology lends itself best to the exploration of lived experience as it describes the meaning of the lived experience of individuals as that meaning pertains to a particular phenomenon. In this case the study phenomenologically explores the lived experience of being raped by an acquaintance as it applies to two young South African women who were raped by someone that they know. Through various phases of explication, the data, which is obtained through interviews with the participants, is transformed from a holistic description of the lived experience of the i

participants into profiles, which are essential descriptions of the raw data, and then into categories of meaning clusters. These categories are then used to achieve an extended description of the phenomenon of acquaintance rape as experienced by the participants of the study.

The phenomenon of being raped by an acquaintance as experienced by the participants of this study emerge as the following themes: the specific meaning of being raped by someone that you know to those victims, the life changes which occur after the rape, the reactions of others, culpability attributed to the rape incident, the mixed emotional reactions of the victims, dealing with possible HIV infection, disruptions in interpersonal trust, social support received or not received regarding the rape and the meaning that is made of the rape experience. Each of these aspects is relevant when considered in relation to the existing body of knowledge regarding rape experiences. Certain aspects are seen to be specific in the South African context, such as the increased possibility of HIV infection.

Although the small sample size means that the conclusions of the study cannot be generalised to the greater population of South African acquaintance rape victims, the observations do give readers a deeper understanding of the concept that each rape experience is unique and yet at the same time can be understood when considered in relation to the existing body of knowledge.

It is recommended that future South African studies explore the phenomenon of acquaintance rape by interviewing more participants, as well as interviewing them in their mother tongue, as this would allow for an enhancement of the depth of the descriptions obtained. It is also recommended that future research takes into account the prevalence of traumatic experiences in South Africa and explores the impact of previous traumas on the recovery experience of rape victims.

ACKNOWLEDGEMENTS

I would like to take the opportunity to express my heartfelt gratitude to the following people for their support, without which this study would not have been accomplished:

Firstly to my family - Adrian, you have always believed in me and your sacrifices and support were paramount in helping me through this long process. Thank you for always standing by me and supporting me, even when the road seemed long and full of obstacles. To Aaron, thank you for your smile and laughter, this always made the long hours spent working feel worthwhile. To Richard, you have endured so many hours of me having to focus on this study, and yet you are still so full of life and love.

To my parents - I am so blessed to have four parents who have supported me unconditionally. I always knew I could turn to any of you and you would be there to encourage or empathise. Thank you Mom, Dad, Beverley and Peter.

To Professor Chris Stones – I will be forever indebted to your willingness to see the opportunity for my work to become what it is today. Thank you for your kindness and your time. I truly feel that you have gone beyond what is expected in your support and encouragement.

My final thank you is extended to the participants of this study. The courage to share an experience that is traumatic and very personal will not be forgotten. The understanding that I have gained from your experience will be of benefit to many others who have endured the pain of rape, them and I will be forever grateful.

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TABLE OF CONTENTS

Chapter 1: Motivation, aims and terminology

• Introduction 1 § Global view of rape 1 § Rape in South Africa 2 § The impact of rape on the individual 3 • Motivation for the present study 4 • Aims and objectives 6 • Understanding the terms used 7 § The Victim and the Survivor 7 § Theoretical understandings of the term rape, acquaintance rape and lived experience 9 • Overview of the present study 12

Chapter 2: Understanding the experience of rape trauma as presented in existing literature

• Introduction 15 • The nature of Trauma – What it is and how it is experienced 16 § The experience of trauma in general 16 § Understanding Post Traumatic Stress Disorder 17 § The presence of PTSD in rape victims 18 § Rape Trauma Syndrome 20 § The trauma of acquaintance rape 22 • Factors influencing the extent of rape trauma 23 § Who the victim is 24 § Who the perpetrator is 25 § Pre-rape experiences 26 § The level of violence experienced during the assault 28 § Possible HIV infection 29 § Secondary victimisation 31 § Choosing to disclose the incident 32 § The reactions of others 34 iv

§ Victim credibility and precipitation 35 § Coping strategies employed after the rape 37 § Cognitive appraisals of culpability and self-blame 38 § Social support 40 • The experiences that could be seen to be part of rape trauma 41 § Fear 42 § Anxiety 43 § Anger 44 § Shame and guilt 45 § Depression 47 § Disruptions in self-esteem 49 § Disturbances in interpersonal interactions 50 • The process of recovering from rape trauma 51 § Understanding the process of recovery from three perspectives 52 • Harvey’s ecological model of recovery 52 • Herman’s understanding of recovering from trauma 54 • Smith and Kelly’s three staged process of recovery 56 § Factors affecting the duration of recovery processes 56 • Conclusion 57

Chapter 3: Methodology

• Introduction 59 • Explication of selection of the methodology 59 § Qualitative approach 60 • Phenomenology - “to the things themselves” 61 § Defining phenomenology 61 § Phenomenological concepts 62 • Phenomenology as a research method 67 § The focus on lived experience of having been acquaintance raped 68 § The influence of the researcher 69 • Research procedure 70 § Selection of participants 70

• Selection of participants in phenomenological research 71 • Criteria for selection of participants in the study 72 § Data collection 73 • Interview 73 § Analysis 74 • The scientific explication of the data 74 § An intuitive holistic grasp of the data 74 § Spontaneous emergence of natural meaning units 75 § Constituent profile descriptions 75 § Second order profiles 75 § Hierarchical categorisation 76 § Extended descriptions 76 • Ethical considerations 77 • Summary 78

Chapter 4: Results and discussion

• Introduction 79 • Introducing the participants 79 § Participant One 79 § Participant Two 81 • The extended description of the data 83 • Themes emerging from the data analysis 86 § Being raped by someone you know 86 § Changes in life after the rape 88 § Reactions of others to the disclosure of the rape 90 § Considering culpability 93 § Mixed emotional reactions 95 § Dealing with possible HIV infection 100 § Interpersonal trust 102 § Social support 105 § Making meaning – perspectives on the meaning of being raped 107 • Conclusion 108

Chapter 5: Evaluation, recommendations and conclusion

• Introduction 110 • Summary of findings 110 • Personal reflections 111 • Strengths and limitations of the study 114 • Recommendations for future research 116 • Finale 117

References 118 Appendices

• Appendix A – Information letter 152 • Appendix B – Informed Consent 153 • Appendix C – Interview transcript and NMUs of Participant One 154 • Appendix D – First Order Profile and Constituent Profile of Participant One 166 • Appendix E – Second Order Profile of Participant One 169 • Appendix F – Interview transcript and NMUs of Participant Two 170 • Appendix G – First Order Profile and Constituent Profile of Participant Two 184 • Appendix H – Second Order Profile of Participant Two 187 • Appendix I – Categories 188 • Appendix J – The extended description 190

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CHAPTER 1: MOTIVATION, AIMS AND TERMINOLOGY

INTRODUCTION

In giving language to my experience, I hope I can make rape less 'unspeakable.' I hope to dispel at least some part of the fear and shame that has made victims mute.

Nancy Raine, After Silence: Rape and My Journey Back, 1998

The experience of rape and its subsequent trauma, although unique to each victim (Brownmiller, 1975; Cahill, 2001; Resick, 1993), is understood to be one of the most destructive traumas a person can experience (Lindorfer, 2007). Being raped by someone that is known to you, be it an acquaintance, family member or intimate partner can be overwhelming and confusing, as the horror of the experience may go unnamed and unacknowledged (Kahn & Mathie, 2000). Rape and acquaintance rape is a phenomenon which is too prevalent and atrocious to ignore.

The thought that children, women and men are being raped is one that most people in society would like to avoid. It was once said that rape is seen to be a rare event perpetrated by unknown assailants who are unbalanced or who lose control of themselves in the face of female enticement (Koss, Heise & Russo, 1994). For many, rape is something that happens to other people. In spite of this perception, the prevalence of rape and sexual violence in the world undermines this belief, and forces society to take notice of this crime. It is estimated by various sources that one in three women worldwide have experienced rape or sexual assault (Coetzer, 2005). When one considers the likelihood of being raped in one’s lifetime, the presence of this phenomenon becomes real and threatening.

• Global view of rape The global view of rape reflects society’s views and perspectives. In many countries the legitimacy of rape accusations depends on the status that women are given in that society. For example in the 1990s in Latin American countries, certain laws only recognise the rape of honest and chaste women (Heise, Pitanguy & Germain, 1993). In Pakistan around the same period, the testimony of a woman is weighed on her

virtue, which is measured by the accommodation of her vagina to a finger test (Jahangi & Jalani, 1990).

Rape not only features as a form of interpersonal violence, it is also used as a weapon of war. In 1993, the United Nations Commission on Human Rights passed a resolution identifying rape as a war crime (United Nations, 1993). Rape is used during war as a method of destroying the bonds of family and society and demoralising the enemy (Koss et al., 1994).

Rape can also be considered in terms of the economic cost that it bears on a society. Women who have been physically and sexually assaulted are likely to receive more medical care than non-victimised women. According to Koss et al. (1994), the cost of providing health care to victimised women is two and a half times greater than that of non-victimised women.

Much can be written and discussed about rape in the global setting; however it is the presence of rape in South Africa that is of particular interest to this study.

• Rape in South Africa South Africa has been labelled as the “rape capital of the world” (Coetzer, 2005; Morse, 2000), with statistics showing that the recorded prevalence of rape in South Africa is 138.5 in 100 000 people (South African Police Services [SAPS], 2010) compared to a county like the United States of America where the recorded prevalence of rape is approximately 30 in 100 000 (Harrendorf, Heiskanen, & Malby, 2010). The latest police statistics reveal that there were 68 332 sexual offences committed in the period of 2009/2010. Of the rapes that were reported to the police, 75% were perpetrated by someone known to them (SAPS, 2010). This statistic reflects that in South Africa, where rape is more prevalent than in any country, being raped by someone that you know is very likely for a relatively large portion of the population. Although the statistics of sexual offences provided by the South African Police services are concerning enough, when one considers that it is thought that 20%-70% of rapes go unreported (Coetzer, 2005) the prevalence of sexual violence in South Africa is disturbing.

According to Newham (Coetzer, 2005), most violent crimes are committed by young men who are uneducated and have little hope of finding meaningful employment and as a result feel excluded from society. These are circumstances that are rife in South Africa. Compounding those circumstances is a history of oppression, which can contribute to the need for these males to assert their masculinity and “avoid the emasculation of their social world” (Coetzer, 2005, p. 177). Sexual conquest and control may possibly become the method in which they are able to do so. High levels of poverty have also been cited as playing a major role in the reasons for the high prevalence of rape (Coetzer, 2005), although this observation looses ground when South Africa’s rape prevalence is compared to other highly impoverished counties.

As rape continues to be a social problem in South Africa, the need to understand the act of rape becomes more urgent. Government, policy makers and the upholders of the policies need to ensure that more is done to understand the nature of this problem.

• The impact of rape on the individual It is acknowledged that rape is perpetrated to both males and females, although females are more likely to be sexually assaulted than males. For the purposes of this study the focus is on female rape victims.

Although it is important to consider the impact that rape has on society, it is equally important to consider the impact that rape has on the individual rape victim. When an individual is raped, their physical, sexual, social, emotional and often even spiritual world is disrupted. The very nature of the crime invades a victim and leaves her with a complex set of emotional, behavioural and cognitive reactions. The rape also impacts on those people involved in the victim’s life, such as partners, family members, friends and even employers. In order to assist victims of rape with the arduous task of reconstructing their lives after rape, health professionals, law enforcement and social support agencies need to be sufficiently equipped to assist where needed.

It has been observed that rape victims are likely to seek assistance from general medical professionals or religious figures regarding emotional problems related to their rape (Amstadter, McCauley, Ruggiero, Resnick, & Kilpatrick, 2008) and not necessarily mental health practitioners. When presenting to mental health practitioners, rape victims are more likely to present with psychological issues that may not be seen to be a part of the rape trauma or Post Traumatic Stress Disorder (PTSD), such as depression, eating disorders, substance abuse, anxiety disorders and dysfunctional relationships (Breslau, 1988; Creamer, McFarlane, & Burgess, 2005; Shalev et al., 1998). If these presenting problems are treated exclusively and no intervention is received regarding possible rape trauma, it is likely that these victims will continue to experience psychological distress. Most rape related interventions are aimed at treating PTSD, a disorder that is found to be prevalent in more than half of rape victims (Kilpatrick, Saunders, Veronen, Best & Von, 1987). Treating PTSD in rape victims is effective at reducing symptomology (Foa & Rothbaum, 1998). However, if a victim’s experience of rape trauma includes experiences that are not necessarily a part of the diagnostic picture of PTSD, are practitioners equipped to recognise these sequale as a part of the rape trauma and treat accordingly?

MOTIVATION FOR THE PRESENT STUDY

When considering the prevalence of rape in South Africa, it is important that there be a sound understanding of the phenomenon. Although there is ample international research on rape and the impact that it has on the victim, there is a distinct shortage with regards to South African literature. Much of the research emerging from South Africa regarding rape largely concerns itself with the prevalence of rape (Burke, 2003; Gilchrist & Butchart, 1988; Jewkes & Abrahams, 2002); HIV/AIDS and rape (Caesar, 2001; Jewkes, Sikweyiya, Morrell, Dunkle, 2009; Lunt, 1995; Meel, 2003; Ncayiyana, 1999); understanding rape perpetration (Jewkes, Sikweyiya, Morrell, Dunkle, 2010); convictions of rape offenders (Terblanche, 2006; Webster, 1997) and service provision to rape victims (Collings, 2010; Payne & Edwards, 2009; Wulfsohn, 2001). There is little consideration of the lived experience of the South African rape victim. When one considers the unique social situation in South Africa and its high

rate of rape, it seems even more crucial that South African practices of victim support be based on South African specific knowledge.

The South African context has very specific social and cultural aspects that are likely to influence the nature of rape and the lived experience that may be a result of the rape. These factors include concepts such as the culture of violence, the perceived sexual rights of men, the fear of contracting HIV/AIDS and the unique political climate of South Africa (Lewis, 1994; Vogelman & Lewis, 1993). If social and cultural factors influence the way in which rape victims’ experience their rape trauma, then one may assume that the different and unique social aspects of South Africa could possibly result in a diverse experience for South African victims when compared to the experiences of victims’ from another society or culture.

Knowledge gained from previous international studies has contributed to the understanding of how rape trauma develops and is experienced by rape victims. The conceptualisation of rape as a traumatic event has allowed for the development of theoretical understandings of concepts such as Rape Trauma Syndrome, rape and PTSD, the co-morbidity of rape trauma with various psychopathologies and theoretical models of the recovery process. All such knowledge is crucial to the clinicians understanding of the experiences that a rape victim may be expected to go through. This knowledge needs to be on hand and utilised in the development of treatment models as well as policies and preventative plans. The appreciation of the need to have a sound understanding of the experience of rape from the perspective of the victim is pertinent to the author, who has worked with rape victims in various contexts. While much of the work with this population requires general counselling skills, there is a need to have additional skills and understanding which would better equip a practitioner to deal with the specific aspects of this psychological trauma. Having first hand experience of the need for additional skills and understanding, the author is motivated both academically and practically to explore the experience of rape from the perspective of the victim.

It is imperative that there be an awareness that each rape victim’s experience is unique and that an appreciation for this uniqueness needs to be balanced with a well developed theoretical understanding of what is known about rape victim’s

experiences of their trauma. If health care professionals are able to find this balance and use their understanding of rape trauma to better meet the victim and explore their unique lived experience, then treating rape victims is more likely to allow for the resolution of their trauma in an effective and respectful way.

Acquaintance rape is three times more likely to occur in South Africa than stranger rape (Burger, Gould & Newham, 2010; SAPS, 2010). This means that in order to gain a relevant and practical understanding of rape trauma in South Africa, focusing on acquaintance rape experiences is likely to be more beneficial than focusing on stranger rape or a mixture of rape types.

AIMS AND OBJECTIVES

This study aims to acquire a description of the unique lived experience of two young South African women who were raped by an acquaintance. Through this description, the study hopes to be able to better understand the experience and compare it to the known theoretical understandings of rape and its subsequent trauma. In doing so, the study intends to have some insight into the lived experience of acquaintance rape in the South African context and reflect on this insight with regards to established knowledge on the topic. It is anticipated that the understanding of the lived experience presented by the participants of the study will become enriched when balanced with what is known through empirical studies about rape trauma and how it is experienced.

The study shall present and critically evaluate the existing body of knowledge regarding PTSD and rape, rape specific trauma and where possible acquaintance rape. This presentation shall include considering factors that are presented in the literature as influencing the development and experience of rape trauma. These factors would include amongst others, aspects such as the nature of the assault, possible HIV infection, secondary victimisation, the reactions of others and social support. Although it is widely accepted that rape trauma would be considered as a form of PTSD, there are certain aspects of the lived experience of rape trauma that may be distinctive to the rape victim’s experience. These aspects are presented as they appear in the literature and would include the experience of fear, anxiety,

shame, guilt, depression, disruptions in self-esteem and interpersonal disturbances. The recovery process as it pertains to trauma victims and specifically rape victims is also considered by the study.

Through the use of qualitative phenomenological interviews, two South African female rape victims are given the opportunity to explore their own unique lived experience of their rape and subsequent trauma. Phenomenological enquiry allows for a phenomenon to be explored from the perspective of the individual having experienced the phenomenon in question. As the study intends to understand the unique lived experience of acquaintance rape and its subsequent trauma, a phenomenological methodology is well suited. Through the phenomenological data analysis certain themes will emerge to represent the phenomenon of acquaintance rape experiences as presented by the participants of this study. These themes will be presented and considered in relation to existing knowledge regarding rape trauma and experiences.

UNDERSTANDING THE TERMS USED

• The Victim and the Survivor There is a trend of late is to refer to people who have been abused or assaulted as survivors rather than the traditional term of victim. It seems that academics and researchers are using both terms interchangeably in studies of those who have been raped.

A victim is defined as: “a person killed or made to suffer by cruelty or oppression; one who suffers injury or hardship” (Swannell, 1986, p. 629). A Survivor is defined as: “a person who has continued to live or exist; live or exist longer than; or someone who has come alive through or continue to exist in spite of (danger, accident)” (Swannell, 1986, p. 564). The simplistic understanding that one can conclude from these two definitions is that in order to be a victim something has to happen to you and then in order to become a survivor you have to continue to live in spite of an event.

It is interesting to note that researchers, counsellors and lay people have turned away from the term ‘victim’ and embraced the term ‘survivor’. This could stem from the commonly held view that the rape victim can be blamed for her assault (Lamb, 1999; White & Sorenson, 1992). It may be possible that we are trying to avoid the victim ideology because of the way it downgrades women’s sexual identity and autonomy (Burr, 2001). In using the label ‘survivor’, perhaps we are dis- empowering the raped women even more by denying her the opportunity to be able to feel helpless and abused.

Herman (1997) states that it is only when the truth is finally recognised that survivors can begin their journey. The truth, in this case, is the pain and atrocity of what the raped women has gone through. The experience of rape is described as one of helplessness and a loss of control (Donat & D’Emilio, 1992). It can only be when we can recognise the sheer trauma of what being a victim means that we can begin to acknowledge the strength the raped women has to survive the ordeal and begin her recovery. If we call a raped woman a survivor before she has had the opportunity to be a victim, she will be forced to deny the pain and embrace “being ok”. The question can then be asked whether the denial had an influence on her recovery.

Muehlenhard, Powch, Phelps and Giusti (1992) clarify this argument better:

We use victim to refer to someone who is sexually coerced and perpetrator to refer to someone who is sexually coercive. We realize that the term victim connotes powerlessness; thus, by using this term, we are implying that a person is powerless while being coerced. Subsequently, however she or he could be called a survivor.

(Muehlenhard et al., 1992, p. 24)

It can be argued that the evolution of the term used for raped women can be attributed to social factors. Donant and D’Emilio (1992) discuss the view of the victim over the centuries; each view or description/understanding of the victim is in relation to societal views of women at the time. In the colonial era, a raped woman

was not respectable enough to be married, and was therefore a financial burden to her father. The raped woman was also punished if she could not prove non- consent, thus depicting the women as a perpetrator to the event. In the 19th century a raped woman was seen as ‘fallen’ and depraved, she was blamed for the man’s crime. It was only in the 20th century that the rape was conceptualised from the point of view of the perpetrator and not from the role the women played in the assault. As a result of this view, the victim became marginalized. The victim became a helpless target of the male dominated society in which she could only be passive, weak, and helpless. In Brownmiller’s classic contribution entitled “Against out will: Men, women and rape” (1975), she reflects numerous times on the dis- empowering of the victim by the male ideology of society. Perhaps it is the empowering nature of the word survivor in comparison of the dis-empowering connotation of the word victim that has caused the current shift in terminology.

For the purposes of this study, those who have been assaulted will be referred to as victims, both for clarity as well as in recognition of the ordeal in which they have gone. While their potential to be a survivor is respected and honoured.

• Theoretical understandings of the term rape, acquaintance rape and lived experience Theoretical definitions of rape are predominantly based on the theorist’s view on the dynamics perceived to be involved in the act of rape.

Thornhill and Palmer (2000) advocate that rape is an evolutionary phenomenon. Their claim is that rape is a natural, biological phenomenon that is a product of the human evolutionary heritage. From this evolutionary perspective, rape is seen as a conditional reproductive strategy in which low status males are able to be reproductively successful (Archer & Vaughan, 2001), otherwise referred to as the mate deprivation hypothesis, (Thornhill & Palmer, 2000). Males need to be able to reproduce with as many women as possible, and are not restricted to time in between insemination (unlike the female who must wait at least nine months before being able to reproduce again). Therefore, if a man cannot achieve sexual access to a woman by appealing to her choice, or through deception, he must use force

(Archer & Vaughan, 2001). This conceptualisation of rape is shortsighted and seems to not capture or respect the ordeal that a victim goes through while experiencing such a “reproductive strategy”.

Paglia (1995) claims that rape is an act of sex, not violence. She defines rape as “a ritual enactment of natural aggression latent in all sexuality, which is primary mating behaviour” (Paglia, 1995, p. 34). Paglia enhances this definition by saying that rape is an attack of the powerless (men) against the powerful (women). In her view, the rapist is sickened by the conflict between his humiliating neediness and his masculine rage for autonomy (Paglia, 1995). Once again this view does not acknowledge the helplessness and horror of the ordeal of rape on the victim.

How one defines rape is of particular importance when one is considering research. Rozée (1993) notes that narrow definitions of rape have the effect of masking the true incidence of rape. Koss (1993) also ratifies this notion by maintaining that the differences in prevalence estimates from rape studies are due to the “definition of the measured phenomena”. In other words, how the participants of research on rape define their experience could influence the results obtained. In many of the prevalence studies considered by Koss (1993), no explicit definition is presented. Ellis (1989) also notes that the criteria used to identify rape accounts for the variance in reported prevalence.

White and Sorenson (1992) consider the defining of rape in research and assert that the definition, assessment and study of sexual assault are guided by cultural attitudes. Not only does cultural understanding influence the way a researcher will define rape, it also affects the likelihood that an assault will occur, that the victim will recognise it as a crime and will report it or seek help (White & Sorenson, 1992). The acceptance of rape myths also have an influence on the definition used (Burt & Albin, 1981; White & Sorenson, 1992). More restrictive definitions of rape may be indicative of the acceptance of rape myths (Burt & Albin, 1981). Therefore the researcher’s attitudes towards rape myths as well as research participants’ views would have a profound impact on the understanding of the word rape and its subjective meaning.

The way one depicts the components of rape may furthermore influence its definition. The concept of consent, the nature of the violence used, the sexual behaviours specified, the view of the victim, the intention of the perpetrator and the perceived relationship between the two (Muehlenhard et al., 1992; White & Sorenson, 1992) all impact on how rape is defined.

Consent is a concept that is important in the understanding of rape, and requires clarification. When considering rape and sexual assault, consent does not include submission under the use of pressure, coercion, force or threats. Holmstrom and Burgess (1975) reinforce the significance of consent in their definition of rape. They define rape as the “forced, violent sexual penetration against the victim’s will and without the victim’s consent” (Holmstrom & Burgess, 1975, p. 1288).

Moreover, rape has been defined in terms of the intention of the act. Herman (1997) describes rape as the physical, psychological, and moral violation of the person. She declares that the rapist’s intention is to terrorise, dominate and humiliate the victim, to render her utterly helpless. When the intention is to physically force sexual intimacy when one of the individuals involved chooses not to become sexually intimate, Ellis (1989) would call this rape.

Rape can also be deconstructed into different forms or types. Lewis (1994) mentions statutory rape, date rape, gang rape and attempted rape. Ellis (1989) differentiates rape by using the term date rape to describe assaults that occur among persons who are acquainted and classic and predatory rape to describe rape in which the attacker is a stranger.

In the Encyclopaedia of Rape, rape types are distinguished as stranger rapes, in which the assailant is a stranger to the victim and acquaintance rape (Smith, 2004). Acquaintance rape is defined as “any situation in which the requisite elements of the crime of rape are satisfied (i.e. to force a women to engage in intercourse against her will and without her consent) and the victim and the rapist know each

other” (Smith, 2004, p. 54). The varying degrees of familiarity would include work or schoolmates, friends, family members and romantic partners. As mentioned previously as much as 75% of rapes reported in South African are by perpetrators known to the victim (SAPS, 2010). Smith (2004) and Miller (2008) both conceptualise date rape as a subset of acquaintance rape, where the relationship between the victim and perpetrator is has a romantic element to it.

Although acquaintance rape is more prevalent than stranger rape, the likelihood of victims of acquaintance rape to report their assault is considerably less than in instances of stranger rape (Kennedy Bergen, 1998; Koss, Dinero, Siebel & Cox, 1988). It is possible that the low reporting of this particular kind of sexual crime has meant that the large populations of acquaintance rape victims are not known or accessible to researchers or support agencies. Another consequence of the low reporting rate of acquaintance rape is that most rape research is either on mixed samples of acquaintance and stranger rape victims or samples where the rape type is not specified, meaning that there is little comprehensive theoretical knowledge of the experiences of acquaintance rape victims as a specific group of victims.

OVERVIEW OF THE PRESENT STUDY

The present study explores the lived experience of acquaintance rape and its subsequent trauma, from the perspective of two young South African women. Through investigating the phenomenon of acquaintance rape trauma, the study hopes to gain understanding and insight into the unique lived experience of acquaintance rape victims as it is understood through the what is theoretically known about rape trauma in general.

The present chapter introduces the phenomenon of rape as it is experienced on a global level and then specifically in the South African context. The high prevalence of rape in South Africa is considered as the motivation and aims of the study are presented. The chapter also explores the terms used within the study, considering the use of the term victim rather than survivor and the complexities of defining rape and acquaintance rape.

Chapter two examines the literature pertaining to the phenomenon under investigation, that being acquaintance rape and its subsequent trauma. As acquaintance rape is predominantly understood as a part of the general understandings of rape, most of the literature reviewed considers rape and rape trauma. The literature review chapter begins by presenting the nature of trauma, that being what trauma is and how it is experienced. This review reflects on the experience of trauma, PTSD, PTSD in rape victims, Rape Trauma Syndrome (RTS) and the trauma of acquaintance rape. The review then moves onto understanding the factors that are seen to influence the lived experience of rape. These factors include who the victims and perpetrators are, pre-rape experiences, the level of violence used, possible HIV infection, secondary victimisation, experiences around disclosure, the reactions of others, victim precipitation, coping strategies employed, cognitive appraisals and social support. Experiences that can occur after a rape incident could include fear, anxiety, anger, shame, guilt, depression, disruptions in self-esteem and disturbance in social interactions. These experiences are all considered as they are seen to be a part of the rape trauma experience. Finally the literature review chapter considers the process of the recovery after a trauma such as rape. Three theoretical models of recovery are presented and explored.

The third chapter presents the methodological aspects of the study. This includes a review of the theoretical concepts of phenomenology, which are considered important in relation to the study. Phenomenology as a research method is presented, which includes characteristics of the research perspective, such as the influence of the researcher as well as procedural aspects such as the selection of participants, criteria of the study, data collection and data analysis. The chapter concludes with some reflection on the ethical components of the study that are considered.

Chapter four introduces the participants of the study and presents the themes that emerged from the findings of the data analysis and discusses these themes in relation to the literature presented in chapter two. The themes include: being raped by someone you know, changes in life after the rape, the reactions of others to the disclosure of the rape, considering culpability, mixed emotional reactions, dealing

with possible HIV infection, interpersonal trust, social support and perspective on the meaning of the ordeal

Finally, chapter five provides an overview and evaluation of the study, highlighting the strengths and limitations of the study. The researcher reflects on her personal experience of having been involved in the study of the lived experience of acquaintance rape and its subsequent trauma. The chapter concludes with recommendations for future research.

CHAPTER 2: UNDERSTANDING THE EXPERIENCE OF RAPE TRAUMA AS PRESENTED IN EXISTING LITERATURE

INTRODUCTION

This chapter shall examine the literature pertaining to the understanding of the experience of being raped and its subsequent trauma. The review begins by presenting the nature of trauma, that being what trauma is and how it is experienced. The discussion reflects on the experience of trauma in general, the clinical understanding of PTSD, PTSD as it is experienced in rape victims, the development of the ground breaking theory of Rape Trauma Syndrome and the trauma of acquaintance rape.

In coming to understand the development and experience of rape trauma, knowledge regarding the factors that are known to influence rape trauma is a key component. The chapter then moves onto understanding the factors that are seen to influence the lived experience of rape. These factors include who the victim and the perpetrator are, pre-rape experiences, the level of violence of the assault, possible HIV infection, secondary victimisation, choosing to disclose the incident, the reactions of others to disclosure, victim credibility and precipitation, coping strategies employed after the rape, blame for the rape and cognitive appraisals of culpability and finally, social support.

Although rape is often thought to be a traumatic experience much like a motor vehicle accident or exposure to a natural disaster, rape trauma can have specific experiences that may be seen as diverse from other kinds of trauma. The experiences that are reported by researchers as being as a result of a rape experience include fear, anxiety, anger, shame, guilt, depression, disruptions in self- esteem and disturbance in social interactions.

Integral to the experience of rape and rape trauma is the process that the victim undergoes in order to recover from her ordeal. The final section of this chapter considers the process of the recovery after a trauma such as rape. Three theoretical models of recovery are presented and explored, namely Harvey’s ecological model

of recovery (Harvey, 1996), Herman’s understanding of trauma recovery (Herman, 1997) and Smith and Kelly’s three-staged process of recovery from rape (Smith & Kelly, 2001).

As far as the existing literature differentiates acquaintance rape from other forms of rape, the review shall focus on acquaintance rape. However most studies reviewed do not differentiate and include all forms of rape, and will refer to the rape victim as such without distinguishing if a stranger or some one that was known to her raped her. Where the distinction is made, the review will highlight this as a study focusing on acquaintance rape.

THE NATURE OF TRAUMA – WHAT IT IS AND HOW IT IS EXPERIENCED

• The experience of trauma in general According to Reyes, Elhai and Ford (2008), psychological trauma is an important concept, although it is difficult to define. For them, the official definition of trauma is provided in Criterion A of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) criteria for Post Traumatic Stress Disorder (PTSD). That being:

(A) That a person has been exposed to a traumatic event in which both of the following were present: (1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others (2) the person’s response involved intense fear, helplessness or horror (American Psychiatric Association [APA], 2000, p. 467)

Herman (1997) describes psychological trauma as the affliction of the powerless. In most circumstances the person who is a victim of trauma is powerless in controlling the event, be it an accident a sudden death or victimisation. She notes that traumatic events overwhelm the ordinary system of care that gives people a sense of control, connection and meaning. Harvey (1996) encapsulates Herman’s thoughts regarding the systems involved in trauma, in her ecological view of trauma. This ecological

analogy understands violence and traumatic events as ecological threats not only to the adaptive capacities of the individuals involved but also to the ability of human communities to foster health and resilience among community members.

In order to gain a better understanding of trauma, one would need to examine the usual responses to trauma. Carlson (1997) explains that although individuals respond differently to trauma, there are two basic categories into which most responses fit. These categories are re-experiencing and avoidance. Herman (1997) describes this as the dialectical nature of trauma. She sees trauma as an alteration between the intrusive symptoms and the numbing symptoms. For Herman, the process is an attempt to find a satisfactory balance between the two. Some researchers (Foa, Zinbarg & Rothbaum, 1992; Horowitz, 1986; Van der Kolk, 1987) have suggested that it is the alteration between intrusive re-experiencing of the trauma and denial or numbing of emotional response (or avoidance) that characterise PTSD.

• Understanding Post Traumatic Stress Disorder PTSD is the conceptualisation of the experience of trauma responses in terms of the medical model of psychology. As mentioned above, the DSM-IV-TR defines PTSD as a disorder in which a person experienced, witnessed, or was confronted with an event of events that included "actual or threatened death or serious injury, or threat to the physical integrity of self or others," and "the person's response involved intense fear, helplessness or horror" (APA, 2000). The symptomatic sequelae of the event or events include more than one month of persistent re-experiencing in thoughts, images, and dreams; behaving or feeling the event is recurring; and intense psychological or physiological reactivity to cues that are reminders of the event. Avoidance of stimuli associated with the trauma and numbing of general responsivity are also included in the description. Symptoms of increased arousal are also present and can include sleep disturbance, irritability, poor concentration, and exaggerated startle reflex (APA, 2000).

Foa, Riggs and Gershuny (1995) investigated the symptoms of PTSD in rape victims. Their study revealed that there were three factors present in the responses of the participants of their study. They found that along with intrusion (re-

experiencing) and avoidance factors, the numbing factor was also present as a factor on its own and not as a part of the effortful avoidance factor. The re- experiencing of a trauma can be characterised by the following symptoms: Intrusive thoughts, nightmares, flashbacks and sleep disturbances (Foa et al., 1995). The avoidance characteristics are: emotional reactivity, avoiding thoughts of trauma, avoiding situational reminders, hypervigilance, excessive startle reactions and physiological reactivity (Foa et al., 1995). The third factor, numbing, is characterised by symptoms such as: loss of interest, detachment, restricted affect, sense of foreshortened future, increased irritability and difficulty concentrating (Foa et al., 1995). Shipherd and Beck (1999) linked intrusive thoughts and PTSD in rape victims. In their study of 36 women who had been sexually assaulted, they found that the respondents who met the criteria for PTSD were less able to suppress rape- related thoughts (intrusive thoughts) than victims who did not meet the PTSD criteria. This study is able to give one the ability to conceptualise the relationship between rape and PTSD by relating the responses of the rape victim and the symptoms of PTSD.

• The presence of PTSD in rape victims The prevalence of PTSD as a disorder is significantly found in populations of rape victims. A recent study of 3001 American women indicated that 36% of the women interviewed with a history of rape presented with PTSD at the time of the study (Zinzow et al., 2011). Studies from as far back as 1987 investigated the presence of PTSD in rape victims. In that year, Kilpatrick and associates embarked on a study of a large population of rape victims. They found that 57% of the sample met lifetime diagnostic criteria for PTSD, and 16.5% had PTSD an average of 17 years post rape. (Kilpatrick et al., 1987). This result became more noteworthy as other studies looked at the existence of PTSD criteria observed at closer intervals to the time of the rape. Results of a longitudinal assessment of 64 rape victims interviewed at weekly intervals post rape indicated that at one week post rape 94% of respondents met the PTSD criteria (Rothbaum, Foa, Riggs, Murdock & Walsh, 1992). At four weeks post rape 75% still exhibited the symptoms of PTSD, and by 12 weeks post rape the number had dropped to 47%. The significance of this study is that it reveals that although most victims of rape may display PTSD initially, almost half of them are

likely to improve in terms of the PTSD symptoms by three months post rape (Resnick, Schnicke & Markway, 1991; Rothbaum et al., 1992).

Further studies compare the responses of sexual assault victims to non-sexual assault victims. Out of a sample of sexual assault victims and non sexual assault victims, the highest rates of PTSD, even after controlling for the presence of life threat and injury during the assault, were with the victims of sexual assault (Kilpatrick & Resnick, 1993). Gilboa-Schechtman and Foa (2001) compared the assessment measures of PTSD and other levels of pathology (anxiety and depression) of sexual assault victims to those of non-sexual assault victims. They found that rape had a greater impact on the magnitude of initial and peak reactions (peak reactions were operationally defined as the highest severity of PTSD, depression and anxiety) than non sexual assault.

More recently, Elklit and Christiansen (2010) studied the prevalence of Acute Stress Disorder (ASD) and PTSD in a population of rape victims. ASD is a diagnosis introduced in the DSM-IV to identify people who, shortly after trauma exposure, are high risk for subsequent development of PTSD (Bryant, 2006). They found that 59% of their sample of 148 rape victims met the criteria for a full ASD diagnosis and after three months 45% of the sample met the criteria for PTSD (Elklit & Christiansen, 2010). When compared to other types of trauma, such as motor vehicle accidents (Harvey & Bryant, 2002) and other physical assaults (Elklit & Brink, 2004) this number is significantly higher.

The various studies exploring the prevalence of PTSD in rape victims seem to all indicate that rape victims are more likely than other trauma populations to experience PTSD, if not long term, then at the very least in the three month period following the assault. The compelling question is why do rape victims display such high incidences of PTSD when compared to other traumatised populations? According to Herman (1997) a traumatic event like rape calls into question basic human relationships:

They [rapists/rape] breach the attachments of family, friendship, love and community. They shatter the construction of the self that is

formed and sustained in relation to others. They undermine the belief systems that give meaning to human experience. They violate the victim’s faith in a natural or divine order and cast the victim into a state of existential crisis. (Herman, 1997, p. 51)

• Rape Trauma Syndrome When considering the significant prevalence of PTSD symptoms in rape victims, it is not unlikely that a particular syndrome describing rape trauma developed. In 1974, Burgess and Holmstrom published their renowned article entitled Rape Trauma Syndrome. Rape Trauma Syndrome (RTS) is defined as an acute stress reaction to a life-threatening situation, namely forcible or attempted rape (Burgess & Holmstrom, 1974a). This response to trauma is a syndrome composing of behavioural, somatic and psychological responses.

In their study of 146 participants, Burgess and Holmstrom identified the acute reaction phase and the reorganisation phase, as characteristic responses of the victim to rape. The acute phase is marked by disorganisation and is short term. The initial impact of the rape usually evokes severe feelings of shock or disbelief. These feelings are shown either in the expressed style or the controlled style. During the acute phase the victim may display various somatic symptoms (Burgess & Holmstrom, 1974a). The emotional reactions of the victim range from fear, humiliation, embarrassment, anger, revenge and self-blame (Burgess & Holmstrom, 1974a).

During the re-organisation phase, which can start to takes place about two-three weeks after the assault; the victim can display responses that can be characterised into motor activity, nightmares and traumatophobia. Traumatophobia is defined as the phobic reaction to traumatic situations (Burgess & Holmstrom, 1974a). Holmstrom and Burgess (1975) noted that the diagnosis of RTS is usually made when symptoms such as increased anxiety, abrupt changes in relationships with men, marked changes in sexual behaviour, sudden onset of phobic reactions or increases in nightmares are present.

Amanat (1984) also studied RTS and explored possible developmental variations. He found that his sample of 54 rape victims showed the following symptoms during the acute or alarm phase: hyperawareness, revival of other crisis emotions, hyper- emotionalism, specific physical symptoms, sleep disorders, blocking of thoughts, poor concentration, multiple fears of injury or death and sexual behavioural changes (Amanat, 1984). Amanat (1984) found that three distinct reaction patterns were observed in the reorganisation phase. These patterns are dependent on personality structures of the victims and psychological development of the victim prior to the rape. The first response pattern is the pre-symbiotic personalities; these victims reveal a great level of isolation, withdrawal, mistrust and disengagement. These characteristics are intensified during the reorganisation phase with a high frequency of reliving experiences, somatisation, hypoactivity, conservation depression, preoccupation and fantasy (Amanat, 1984). The symbiotic personalities are basically trusting but dependent people. During the reorganization phase these people tend to become more clingy and dependent. They show regressive tendencies and intense phobic reactions (Amanat, 1984). Finally the Post-symbiotic personalities are a group of autonomous, independent, outgoing and assertive people. The reorganisation phase is marked by a greater level of hyperactivity, life-style changes, irritability, reliving experiences, intellectualisation, agitation, compulsive behaviour, depression, self-reproach guilt, shame, and eventually repression (Amanat, 1984).

The responses to rape are not just associated to those responses identified in RTS theory. Many other researchers have documented other responses to rape, such as those listed below (Carlson, 1997; Cohen & Roth, 1987; Mechanic, Resick & Griffin, 1998; Meyer & Taylor, 1986; Resick, 1993; Shipherd & Beck, 1999). Much of the research covers similar responses and even describes the symptoms that are described by RTS. Most of the research reviewed indicates the following to be responses by the victim of rape: intrusive thoughts, which include flashbacks (Cohen & Roth, 1987; Carlson, 1997; Resick 1993); nightmares (Cohen & Roth, 1987); disruptions in close relationships (Carlson, 1997; Cohen & Roth, 1987); fear (Carlson, 1997, Herman, 1997, Kilpatrick, Resick & Veronen, 1981; Resick, 1993); problems with social and work adjustments (Cohen & Roth; 1987; Resick, 1993; Resick, Calhoun, Atkeson & Ellis, 1981); problems in sexual satisfaction and functioning (Burgess & Holmstrom, 1979; Cohen & Roth, 1987; Meyer & Taylor,

1986; Resick, 1993); anxiety (Carlson, 1997; Resick, 1993); deficits in reported memory (Mechanic et al., 1988); depression (Meyer & Taylor, 1986; Resick, 1993); family related problems (Ellis, Atkeson & Calhoun, 1981) and PTSD (Foa et al., 1995; Gilboa-Schechtman & Foa, 2001; Resick, 1993; Resnick et al., 1991; Rothbaum et al., 1992; Shipherd & Beck, 1999).

• The trauma of acquaintance rape Acquaintance rape is vastly under-reported by victims and occurs more frequently than stranger rape. In South Africa, it is reported that more than 75% of reported rapes have been perpetrated by someone known to the victim (Burger, Gould & Newham, 2010). It would therefore be logical to assume that no perspective of rape trauma would be complete without considering acquaintance rape trauma.

In making sense of what makes an experience traumatic, Green (1993) describes seven dimensions to trauma. These include: threats to life and limb; severe physical harm or injury; receipt of intentional injury or harm; exposure to the grotesque; violent or sudden loss of a loved one; learning of exposure to a noxious agent and causing death or severe harm to another. She considers these to cover most of the experiences that are considered potentially traumatic to humans. However, this understanding does not necessarily account for an experience where none of those factors occur, such as in acquaintance rape incidents. In light of this possibility, Carlson (1997) proposes that there are three elements to an event that can potentially make it traumatic. These three elements are the perception of the event as negative, sudden, and with a lack of controllability. If one takes these three elements into account, as well as the fact that date rape could be perceived as intentional injury and harm, then the trauma of acquaintance rape can be conceptualised.

In reviewing the existing literature on the experience of rape trauma of acquaintance rape victims and stranger rape victims, there seems to be little distinction in their experience of trauma. When considering levels of psychological symptoms post- rape, acquaintance rape and stranger rape victims showed very little to no variance in the much of the literature (Ellis et al., 1981; Frank, Turner, & Stewart, 1980; Kilpatrick et al., 1981; Ruch & Chandler, 1983). Various studies have endeavoured

to determine what factors could be different in the experiences of these two kinds of rape (Amir, 1971; Bart & O’Brien, 1981; Bart & O’Brien, 1985, Katz & Burt, 1986). Factors that did seem to be differentiated were disclosing the incident or being more psychologically prepared for the assault (Bart & O’Brien, 1981; Bart & O’Brien, 1985).

Koss and associates (1988) explored the differences in the experiences of stranger rape victims and acquaintance rape victims in their study of 489 rape victims, they found that in aspects such as the victim’s perceptions of the clarity that they communicated non-consent, the degree of resistance exerted, feelings of anger and depression and the extent that they felt responsible for the assault there were no significant differences between to the two types of rape victims (Koss et al., 1988). The significant differences supported previously mentioned factors of disclosing the rape to others and psychological preparedness for the assault.

Bearing in mind Carlson’s view that an incident is traumatic when it is negative, sudden and presents with a lack of controllability, then the results of research that is not able to distinguish significant differences in the traumatic experiences of stranger rape to acquaintance rape is understandable.

In even the earliest contributions of our understanding of rape trauma, it has been noted that a rape experience is unique (Brownmiller, 1975). This uniqueness could be contributing to the deficiency in the literature of a distinguishable account of acquaintance rape trauma from rape trauma in general. It seems apparent that rather than trying to generalise the experience in order to understand it, it would perhaps be more prudent to dissect what is known about the factors which are influential in the development and experience of rape trauma. In doing so, the ability to understand a rape victims experience as it pertains to the factors which are pertinent to her, would help in understanding her unique experience, and how traumatic that experience is.

FACTORS INFLUENCING THE EXTENT OF RAPE TRAUMA

When one considers the development of trauma responses to rape, there are various aspects that are thought to influence this development. Some of the aspects

mentioned in the literature are present pre-rape, such as pre-rape stressors and certain variables, such as victim demographics. There are aspects which are influential in the development of rape trauma that are present in the actual incident, such as relationship with the perpetrator, the level of violence experienced and possible exposure to HIV. A majority of the factors that are highlighted by existing research occur after the rape incident, these factors include secondary victimisation, choosing to disclose the incident, the reactions of others, victim credibility, coping strategies employed after the rape, culpability issues and social support.

Each of these factors will now be considered as they are presented in the literature:

• Who the victim is Resick (1993) comments that the role of demographic variables is somewhat equivocal at the time of the writing of her article. She reports that some researchers found that demographic variables have little effect on victims’ responses and do not play a role in the experience. However, other research has produced different results.

Ruch and Chandler (1983) reported that, although any woman can be a victim of rape, regardless of employment status or age, there is evidence that the victim’s demographic variables are related to trauma. According to their study, older, non- Caucasian, married women are especially at risk for severe trauma reaction. However, they do not delineate exactly which ages fell within the “older” range, but rather that in their sample the ages were from 14-72 with a mean age of 25. Sales, Baum and Shore (1984) also found that older women had more difficulty adjusting psychologically after an assault. From these results, one could envisage that older woman who have been raped are more likely to have a more severe reaction to the rape and therefore a slower or more complicated recovery than younger women.

When reporting on studies they carried out in the 1990s, Thornhill and Palmer (2000) found that reproductive-aged women suffer greater distress after a rape than did children or women who were past reproductive age. Therefore, in this particular study, age was operationalised according to pre-reproductive, reproductive and post-reproductive women (Resick, 1993).

Foley and Davis (1983) describe older women’s reluctance to tell others about their trauma, because of their fear of how others will respond, as the reason for the phenomenon of older women being less able to get the social support needed for recovery.

Cohen and Roth (1987) convey, in their study of 72-raped women, that age and socioeconomic status are variables that relate to psychological functioning up to eight years after the rape. The older the women in the study, although not necessarily older at the time of the rape, showed fewer overall symptoms than the younger participants. They also found that lower socioeconomic status was correlated significantly with worse outcomes. Burgess and Holmstrom (1978) also found that less economically advantaged rape victims also had more symptoms, and therefore were less recovered than others.

Harvey (1997) elucidates trauma in the ecological view discussed previously. She understands the ecology of trauma and recovery as interplay of person, event and environmental factors, and therefore cites, among other things, that the age, developmental stage, intelligence, and personality of the victim are personal variables influencing traumatic response and recovery. She also notes that there are other factors that are usually excluded in the clinical assessment that are influential in the recovery process. These factors include the individual’s culturally based understanding of the experience of victimisation and her comfort and familiarity with various kinds of care (Harvey, 1997).

• Who the perpetrator is Groth, Burgess and Holmstrom (1977) proclaim that the aetiology of the victim’s trauma is the perpetrator’s pathology. The focus of this dissertation is not on the rapist as a construct on its own, so although the perpetrator can be considered in terms of how the factors motivating the rape can have an influence on the victim’s experience, the focus remains of the relationship between the victim and assailant as it would contribute to the rape type.

Rapes are often distinguished from each other in terms of the relationship between the assailant and the victim. Date rape and stranger rapes are examples of these

instances. It can therefore be hypothesised that the relationship between the assailant and the victim could have an effect on the extent of the trauma experienced.

Herman (1997) explains that often the victim may remain in jeopardy after the attack, particularly if she knows the offender. This may mean that she is forced to withdraw, in part, from her social world.

Hassell (1981) compared victims of stranger and non-stranger rape and found that after three months post-rape there were no differences in reactions or recovery. Kilpatrick et al. (1987) also found no differences in mental health between groups of stranger, marital and date rapes. Koss et al., (1988) found similar results. They found that there was no difference between victims raped by strangers, non- romantic acquaintances, casual dates, steady relationships or spouse or family members in depression, state anxiety or sexual satisfaction.

Ullman and Siegel (1993) explored the effect of the victim-offender relationship on the psychological symptomology and found that women who were attacked by intimates experienced more sexual stress, those attacked by strangers experienced more fear and anxiety and the experience of depression was not influenced by the victim-offender relationship.

Sawtell (2008) confirms that being raped by someone that is known is not in any way more or less detrimental to a victim’s well being than being raped by a stranger. She states that regardless of whether the perpetrator is known to the victim, the experience is traumatic (Sawtell, 2008). Her study goes on to explore if there are any differences on well being within the category of acquaintance rapes. She found that the experience of partner rape can be more violent than other kinds of acquaintance rapes and that date rape is seen to be the least detrimental of all the acquaintance rape types (Sawtell, 2008).

• Pre-rape experiences Experiences of life stressors prior to the rape incident can be said to have an influence on how the victim can experience the current rape ordeal. Stressors such

as prior victimisations as well as persistent life stressors are mentioned in relation to how they could influence the experience of rape trauma.

Burgess and Holmstrom (1978) studied prior victimisation with the intent of finding out if there was a correlation between previous victimisation and length of recovery from rape trauma. They found this to be the case. They established that with prior victimisation only 20% of their sample recovered within months, compared to 47% that had not been previously victimized. 47% of previously victimized participants were not yet recovered at the four-six year follow up sessions, compared to only 14% of the non –previously victimized sample.

In response to various studies (Burgess & Holmstrom, 1978; Frank et al., 1980; Frank & Anderson, 1987; Marhoefer-Dvorak, Resick, Hutter & Girelli, 1988; McCahill, Meyer & Fisherman, 1979) Resick conducted research in 1988, in which she extensively studies prior victimisation (Resick, 1988). She concluded that although it appeared that the victimisation factors were related to recovery, there were no obvious and consistent factors. More recently, Elklit and Christiansen (2009) while investigating the prediction of Acute Stress Disorder (ASD) in rape victims found that in their sample of 150 rape victims previous sexual assault did not influence the development of ASD after the rape.

Although previous victimisation is not strongly related to the person’s experience of a current rape, previous exposure to trauma (not necessarily victimisation) is linked with a significant risk of the development of PTSD in subsequent traumas (Breslau, Chilcoat, Kessler, & Davis, 1999).

Life stressors as defined by Burgess and Holmstrom (1978) are stressors that have persisted over time, from which there is no relief and over which the person has little control. They describe these factors as: economic stress, lack of social support and pre-existing biological, psychological, and/or social problems. They found that chronic stress is related to a longer recovery time. In their sample, they found that 37% of the participants who had chronic life stress were not recovered in the four-six years follow up. This is in comparison of 16% who had not recovered but did not have chronic life stress.

Atkeson and colleagues (1982) found that in terms of long-term recovery from rape trauma, depression, suicidal history, and sexual adjustment prior to the rape significantly predicted depression at four months after the rape. Prior anxiety attacks and prior obsessive-compulsive behaviours predicted depression at eight and twelve months after the rape and psychiatric treatment history predicted depression at one year after the rape (Atekeson, Calhoun, Resick & Ellis, 1982).

• The level of violence experienced during the assault Sales, Baum and Shore (1984) observed that neither the presence of violence nor the extent of violence per se was strongly associated with victim reactions. However, further studies found there to be certain relationships with factors relating to levels of violence and initial responses. Sales et al. (1984) found that threats to the victim’s life predicted symptomology within the first three months, but not in a follow up assessment six months later. Kilpatrick and associates found that victims who developed PTSD were more likely to have been seriously injured than those who did not (Kilpatrick et al., 1987).

As Resick (1993) concluded, the assault variables do not predict the responses of the victim after the assault, but the extent of the threats do have an influence on the predictability of global severity of symptoms.

The level of violence used, as well as the threat of violence, is an indicator of the assailant’s behaviour during the assault. There is an insufficient body of literature discussing the victim’s behaviour during the rape. One study that does discuss these responses is that of Carter, Prentky and Burgess (1988). They developed the following typology of response strategies: escape, verbally confrontative resistance, physical confrontative resistance, non-confrontative verbal response, non- confrontative physical resistance and acquiescence. Escaping would obviously involve the victim fleeing from the potential rape scene and if successful would be the optimum response. Verbally confrontative resistance includes screaming or yelling as a means of attracting attention or asserting oneself against the assailant. Physical confrontative resistance strategies can range from moderate responses such as fighting, struggling or kicking to violent responses such as attacking with

lethal intention. Non-confrontative verbal responses include responses in which the victim may try to dissuade the attacker (e.g. “I have my period”). Non-confrontative physical resistance would include responses that do not actually confront the attacker and may be feigned or real and uncontrollable, such as fainting, gagging, sickness or seizure. Acquiescence implies no counteractive response and is often the result a fear and terror or a belief that such a response is necessary to save one’s life. Although these responses are listed by Carter and colleagues (1988), no supporting literature as to the effectiveness of these strategies was found.

• Possible HIV infection The threat of rape is coupled, especially in South Africa, with the threat of becoming infected with HIV or another Sexually Transmitted Disease (STD). Zeelie (2002) notes, that rape has become the most serious health risk in South Africa, as the incidence of rape is so high in this country and leads to the infection of so many South Africans with HIV as many rapists are HIV positive. Charlene Smith, a rape survivor and journalist comments that there is 40% risk of becoming HIV infected after a rape (De Capua, 2003). A more recent study by Bello and Pather (2008), show that the likelihood of being infected with a STI post rape is 24.6%. Of the rape victims presenting in their study, 12.1% were HIV positive at the time of presentation, although not all cases knew their HIV status prior to the rape (Bello & Pather, 2008). When considering the interplay of HIV and sexual violence, Jewkes and associates (2009) found that there was no difference of HIV status between men who had perpetrated rapes and those that did not. This is to say that being raped is likely to be as risky for exposure to HIV than unprotected consensual intercourse. However, when their study accounted for intimate partner violence, of which acquaintance rape could feature, it was found that men who had been physically violent to their partners on more than one occasion were more likely to be HIV positive (Jewkes et al., 2009). This could suggest that with regards to acquaintance rape perpetrated by an intimate partner, the risk of HIV infection could be higher, compounding the already stated observation that intimate partner rapes are known to be more violent than other types of acquaintance rapes.

Becoming HIV positive after a rape could have significant effects on the rape victim. The response to the rape may be shadowed by the response of finding out that

one’s HIV status is positive, or the fear of an unknown status. This may influence the recovery process significantly.

When interviewing victims of sexual assault three months post rape, 26% of those interviewed responded that they were concerned about HIV and AIDS (Baker, Burgess, Brickman & Davis, 1990). In another more recent study, that sampled 62 recent rape victims, Resnick and colleagues found that 91.9% of the women reported some degree of initial fear or concern about possible risk of HIV infection (Resnick et al., 2002). 72.6% of the women related that they were extremely fearful of contracting HIV. Substantiating Resnick and colleagues’ findings, Kraegel (2002) found in her study of rape experiences of 52 Ugandan rape victims, that fear of infection featured as a significant experience (Kraegel, 2002).

It has been noted that the reported fear or concern of contracting HIV or another STD following a rape incident is a significant additional stressor and not just a part of the reactions to the possible post-traumatic stress of the rape incident and can add to the psychological impact of the rape (Gostin, Lazzarini, Alexander, Brandt, Mayer & Silverman, 1995; Resnick et al., 2002).

Taking into account the extremely high prevalence of HIV infection in South Africa, the likelihood of South African rape victims to have elevated levels of fear and concern surrounding their possible HIV infection post rape is also high. Issues such as suicide idealation and depression are areas that need to be researched and taken into account as a part of the treatment of rape victims who are at risk of HIV infection. Research in South Africa tends to focus more on the PEP treatment of victims than on the psychological component of the risk of infection (Kim, Martin & Denny, 2003; Ncayiyana, 1999). Although Abrahams and Jewkes (2010) did explore barriers to PEP treatment completion in rape victims and found that the perceived stigma of rape and fear of HIV played very powerful roles in debilitating women's ability to take medication to prevent HIV infection. The study also mentions the impact of being blamed for the rape and lack of social support as having a profound impact on the victim (Abrahams & Jewkes, 2010).

• Secondary victimisation Secondary victimisation refers to the negative experiences which involve behaviours and attitudes of social service providers that are “victim blaming” and insensitive and which traumatise victims of violence who are being served by these agencies (Campbell & Raja, 1999; Campbell, Sefl, Barnes, Ahrens, Wasco & Zaragoza- Diesfeld, 1999). Although it is acknowledged that some rape victims have positive and helpful experiences, for many victims seeking help after the assault can feel like a ‘second rape’ (Campbell, 2008). This happens when providers subjugate the needs and psychological boundaries of rape victims to agency’s needs, which leave the victim feeling violated. The violation occurs when the disregard for the victim closely mimics the victim’s experience at the hands of her assailant (Campbell & Raja, 1999). The victim may feel that this treatment “hurts as much as the rape itself” (Campbell et al., 1999). The most common encounter of secondary victimisation occurs when the victim interacts with social, medical, police and the legal systems that hold negative or judgemental attitudes (Campbell et al., 1999; Moore, 1998; Vetten, 1997), these responses from agencies that are expected to assist can lead to psychological distress over and above the distress experienced as a result of the rape (Campbell et al., 1999).

Cluss, Boughton, Frank, Stewart and West (1983) found that women who wished to prosecute their rapist reported greater self-esteem than those who did not. They also found that those who wished to take legal action but were unable to do so due to lack of arrest or insufficient evidence, showed better work adjustment and more rapid improvement in self-esteem than those who were proceeding with the prosecution. From those results it can be concluded that wanting to prosecute, but not actually going through with the process, is the optimum conditions for improvement of self-esteem after a rape. The differences between those who want to proceed but do not and those that do proceed is that the process of testifying can be even more traumatic for the victim. This was confirmed in the Sales et al., (1984) study. They found that victims who began the process of reporting the case and whose charges held showed fewer symptoms of traumatic stress at the initial interview and six month follow-up. However, there were indications that further progress toward the trial left victims with more symptoms. It is thought that the legal process may inflict additional demands on the victims, which in turn can keep them

in the victimised role (Sales et al., 1984). This factor contributes to many victims not wanting to report their rape in fear of experiencing secondary victimisation (Sales et al., 1984). In South Africa the belief that the crime of rape will go unpunished also contributes to lack of reporting and participating in the justice system (Jewkes & Abrahams, 2002).

The medical system is also reported to be contributing to a traumatising experience (Campbell et al., 1999). Campbell (2008) explores the contributions of rape crisis centres, restorative justice programs, and sexual assault nurse examiner programs in America with the view of improving the services to rape victims seeking assistance. The possible impact of seeking help for rape victims in South Africa needs to be explored and considered in issues such as policy making and training of service providers.

• Choosing to disclose the incident After a rape assault the victim of rape is faced with many behavioural options. The first response a victim has is making sense of what has just happened to her. This process is crucial in determining the victim’s behaviours from then on. The victim will need to decide if the assault was rape and if she recognises it as a crime. If she does so then she may decide if she will report the crime and seek assistance or not disclose the assault. The main factor that will influence this decision is culture (White & Sorenson, 1992). Vetten (1997) explains that in South Africa, the likelihood of not reporting a rape is dominated by socio-cultural beliefs, which outweigh the need to report the incident. As Koss (1993) points out, in the United States of America, rape is more likely to be kept a secret than any other form of victimisation. The question that comes to mind is why do women not disclose their rapes. According to Kilpatrick (1983) there are several reasons why victims of rape do not disclose. The primary reason is that victims have significant fears about the types of response that will follow disclosure. They fear retribution, disbelief, or blame for the rape. The second reason for non-disclosure is that often victims do not perceive their psychological problems as being related to the rape. When seeking assistance, they are often not asked about rape or other victimisation by clinicians (Kilpatrick, 1983). Finally they may not identify their experience as rape. Moore (1998) also cites fear of an unsympathetic response from the police and little faith in the judicial system as

reasons for a victim not reporting the crime. She also notes that the ordeal of the medical examination is enough to deter many women from reporting the crime. Jewkes and Abrahams (2002) also point out several factors that may influence a victim’s choice to disclose the rape. They list the range of barriers to include problems like physical access to the police and other resources, fear of retaliation by the perpetrator and fear of the legal process. It is likely that all the factors mentioned above contribute to the finding that 70% of rape victims initially disclose to friends, partners and family members (Ahrens, Campbell, Ternier-Thames, Wasco & Sefl, 2007)

Understanding how disclosure experiences impact the victim, Ahrens and colleagues (2007) explored 102 rape victims’ experiences regarding their first disclosure post-rape. They found that in general over half of the survivors received positive reactions and less than one third felt the disclosure had a detrimental impact on their recovery (Ahrens et al., 2007). It was noted that when victims actively sought assistance from formal support providers that their experience was more likely to be negative; however, when support providers initiated the assistance the experience was perceived as positive (Ahrens et al., 2007).

With regards to acquaintance rape victims, Koss et al. (1988) refer to the lower likelihood of victims who are raped by someone that is know to them to disclosure the rape. It seems, according to their research, that the closer the relationship between the victims and perpetrator, the less likely the victim will disclose the rape (Koss et al., 1988). When exploring the disclosures of date and acquaintance rape victims, Rickert and associates (2005) found that of their sample of 71 victims’, 60 % disclosed the incident to one or more individuals. It was also found that factors such as the perpetrators alcohol use and a shorter dating history were associated with more rapid disclosure (Rickert, Wiemann & Vaughan, 2005).

When considering the issue of disclosure of a rape, two issues emerge as pertinent for victims in the process of deciding to disclose, these being the reactions of others and whether or not they will be believed. Both issues will be discussed below.

• The reactions of others When considering disclosing a rape incident, the victim is likely to consider the reactions that she will receive from others (Kilpatrick, 1983). Reactions of others can be seen as positive or negative. Positive social reactions include emotional support and tangible aid, whereas negative social reactions include blaming or doubting victims (Davis, Brickman, & Baker, 1991; Ullman, 2000)

Ullman (2000) proposes seven distinct types of social reactions to sexual assault victims. These include: emotional support, tangible aid, blame, taking control, distraction, treating the victim differently and egocentric reactions (Ullman, 2000). Emotional support would include supportive reactions such as listening, believing, or telling victims’ it wasn’t their fault. Tangible aid includes providing information or actual assistance. Telling victims that they are at fault or accusing them of not being cautious enough would describe blame reactions. Taking control includes making decisions for the victim or treating the victim like a child. Distraction would include trying to get the victim to stop thinking or talking about the assault. Pulling away from the victim or acting like the victims is ”damaged goods” would describe treating differently and finally, egocentric reactions would include those support providers who focus on their own needs or become so emotionally upset that they cannot support the victim (Ullman, 2000).

The reaction of others to a victim’s disclosure of rape has been documented to have an affect on the victim’s recovery (Filipas & Ullman, 2001). However, there seems to be some inconsistency in the results of studies investigating the phenomenon of positive and negative reactions of others to rape disclosure (Ahrens, Cabral & Abeling, 2009).

In their study of 323 victims of rape, Filipas and Ullman (2001) found that when victims sought help from formal support sources, that they were more likely to face negative reactions such as victim blame, stigmatising responses, and controlling reactions from others (Filipas & Ullman, 2001). When considering the impact of positive reactions, Filipas and Ullman (2001) found that positive reactions from formal support sources did not have as much of a significant impact as positive

reactions from friends. Although negative reactions regardless of the source, was seen as harmful (Filiaps & Ullman, 2001).

Borja, Callahan and Long (2006) found that both positive reactions from friends and family as well as from formal support services were seen as beneficial. With regards to negative reactions, they found that only negative reactions from friends and family were associated with more distress (Borja et al., 2006).

Despite the inconsistency in the two studies presented, there seems to be consensus that negative reactions from others is likely to complicate and delay recovery from a rape experience (Davis et al., 1991; Frank et al., 1988; Ullman, 1996a, 1996b, 1996c). It also seems apparent that victims are most likely to be best served by disclosing to friends and counsellors who are seen to provide the highest levels of emotional support, tangible aid, and lower levels of negative reactions (Ahrens et al., 2009).

When negative reactions were experienced, rape victims are more likely to become silent regarding their rape experience. According to Ahrens (2006) negative reactions from others are likely to cause rape victims’ to question if future disclosures would be effective, to have their possible feelings of self-blame reinforced and to question if their experience did in fact qualify as a rape (Ahrens, 2006). All of these doubts are likely to lead to the victim not seeking support after the rape and hence more likely to experience ongoing distress as a result of rape trauma

• Victim credibility and precipitation Stanton (1993) talks about the fact that the fear of not being believed is the reason why many women will not report most incidents of sexual assault. He goes on to say that these fears are confirmed by police assertions that many women lie about being raped. The believability of the victim is associated the belief that the victim in some way precipitated the rape. There is no other crime – murder, burglary, assault and battery – in which the victim is routinely blamed for the crime, except for rape (White & Sorenson, 1992).

The victim’s role in the rape or her precipitation tends to come into play when the circumstances surrounding the assault are ambivalent (Roth, Wayland & Woolsey, 1990) or when there seems to be an existing relationship between the victim and the assailant (Brownmiller, 1975). Brownmiller (1975) describes the victim precipitation as “each word, act and gesture on the part of the potential victim” that serves to “either strengthen or lessen the resolve of the potential rapist, and hinder or help him commit his crime” (Brownmiller, 1975, p. 353). In her book, Brownmiller describes how the National Commission on the Causes and Prevention of Violence defined victim precipitation as when the victim agreed to sexual relations but retracted before the act or when she clearly invited sexual relations through language, gestures etc. Behaviours such as provocativeness (Best & Demmin, 1982) and the “hot pants” analogy (Burt & Albin, 1981) are mentioned in research as possible behaviours that would influence a bystander in believing that the victim precipitated the crime. What is it about victim precipitation that allows it to even be considered in research? We seek an explanation for the perpetrator’s crimes in the character of the victim (Burt & Albin, 1981).

Amnant (1984) admits that he is interested in focusing on which personality characteristics might create the illusion of the “set up” for assault behaviour in the minds of victims, their friends, close relatives or even clinician. Herman (1997) suggests a hypothesis as to why “we” participate in giving the victim responsibility in the crime. She believes that if we were to absolve the victim of all responsibility we would have to engage with the victim in the “lacerating moral complexities” of the situation. As a bystander one is faced with a choice, to choose the side of the perpetrator the observer is asked to do nothing. To take the side of the victim, the observer shares the burden of the pain (Herman, 1997).

When considering victim precipitation in acquaintance rape situations, victims of acquaintance rape are attributed more responsibility for the assault compared to victims of stranger rape (Bridges & McGrail, 1989). This notion is supported by Viki, Abrams and Masser (2004) who found that perpetrators in acquaintance rape scenarios were found to be less responsible than perpetrators of stranger rapes.

• Coping strategies employed after the rape Coping strategies generally refer to behavioural and psychological efforts that are used to deal with stress (Lemaire & Wallace, 2010). The coping strategies a rape victim chooses to exercise post rape can play an influential role in her recovery (Arata, 1999; Frazier & Burnett, 1994; Gibson & Leitenberg, 2001; Santello & Leitenberg, 1993; Ullman, 1996c; Valentiner, Foa, Riggs, & Gershuny, 1996).

Snyder and Pulvers (2001) mention two primary coping strategies: approach coping and avoidance coping. Approach coping is chosen when the individual appraises the stressor as one for which she has sufficient coping resources and then uses active strategies that are either focused on the problem at hand or the emotional reaction to the stressor. In contrast, when an individual appraises a stressor as one for which she does not have sufficient coping resources, she is likely to employ avoidance strategies, such as denying that the stressor exists, avoiding thinking about the stressor, and fantasising (Snyder & Pulvers, 2001).

In research that considers the efficacy of avoidant or nonavoidant copying strategies for a general population (i.e. not specifically rape victims), it has been shown that avoidance coping can lead to more positive adaptation in the short run, but that attention or approach strategies are more beneficial in dealing with stressful incidents in the long run (Suls & Fletcher, 1985). A more recent study by Little and Breitkopf (2006) investigated the different coping strategies utilised by rape victims and the efficacy of those strategies on the development and persistence of psychological symptoms post rape. They found that feelings of self-blame and negative reactions received from others were potentially important predictors of avoidance coping strategies that could contribute to difficulties in recovery from a rape experience (Littleton & Breitkopf, 2006).

When considering previous experiences of trauma, that are not necessarily related to sexual assault, it is possible that a victim may develop adaptive coping strategies towards her current rape trauma due to the knowledge that previous strategies used were effective in reducing stress. This means that the victim may have learned from a prior trauma that adaptive strategies, such as reaching out for emotional or

instrumental support, helped to alleviate her experience of the trauma (Najdowski & Ullman, 2009), and thus can be utilised in her current rape trauma.

• Cognitive appraisals of culpability and self-blame Cognitive appraisals can be described as consisting of two factors, the individual's initial interpretations about what is at stake for the individual, and whether the environment is stressful or relevant to the person's well-being (Dewe, 1993). Personal (e.g., perceived intensity and controllability) and situational factors (e.g., source of stress, novelty and predictability of the situation, feedback from the environment) jointly influence the person's appraisal of a stressful event. How a rape victim appraises her ordeal can have an influence on how she will feel, which will in turn influence how she will react. Research has shown that women who were able to make sense of their experience reported less psychological stress, better social adjustment, greater self-esteem and greater resolution (Resick, 1993).

It would be relevant to consider what kinds of cognitive appraisals or attributions victims can make, and which of these hinder or improve the way a victim reacts to rape. The process of the victim attempting to make sense of her assault can be motivated by the need to try to regain the illusion of predictability, controllability and meaning. By attempting to discover which aspects of the ordeal could be controlled, it is possible the victim may feel she would be better prepared in the future. The development of an understanding of how a victim may appraise her ordeal, as well as her own contributions to the incident has created opposing results in the literature over time.

In 1979, Janoff-Bulman hypothesised that victims may gain this meaning by turning to themselves to try and find an answer. In other words, by finding what aspects they could blame on themselves, they could have more control in the future. She claimed that certain types of self-blame could serve as an adaptive function. She identified behavioural self-blame (when the victim ascribes responsibility of the rape to her own modifiable behaviours) as enhancing the victim’s sense of control, thereby decreasing the fear of being raped again (Janoff-Bulman, 1979). If the victim assigns characterological self-blame (making the attributions for the rape to stable aspects of the victims themselves, such as “I am too trusting”) this implies inevitability and a

feeling that the attack was deserved. Accordingly, Janoff-Bulman claims that behavioural self-blame should be associated with more effective post rape adjustment than characterological self-blame (Janoff-Bulman, 1979).

Meyer and Taylor (1986) tested this hypothesis in their own study of 58 women who had been raped. They found that particular attributions and coping patterns that follow a sexual assault are predictably associated with the severity of the psychological consequences of the event (Meyer & Taylor, 1986). In response to Janoff-Bulman’s hypothesis that behavioural self-blame would be an adaptive strategy, they found that no form of self-blame was an adaptive response for rape victims. Behavioural self-blame was related to sexual dysfunction and symptoms of depression whereas characterological self-blame was associated with high levels of fear and symptoms of depression. Only societal blame was not associated with the severity of negative outcomes after a rape (Meyer & Taylor, 1986). Characterological self-blame was also found to be negatively related to adjustment (Arata & Burkhart, 1988; Fetchenhauer, Jacobs & Belschak, 2005).

Frazier (1990) also explored the attributions that victims make. In her study of 67 women who had experienced sexual assault (defined in her study as oral, anal or vaginal penetration), Frazier found that some victims do engage in self-blame but that the mean responses on her measures indicated that most victims did not blame their behaviour, their character, or themselves in general. Most victims rate the causes of their rape as generally external (Frazier, 1990). Frazier and Schauben (1994) too investigated self-blame and its relation to adaptation and recovery after rape. They found that those who blamed themselves reported more anxiety and hostility and greater disruption in basic beliefs about themselves and the world.

In Nadon’s 2003 study, she investigated the possible link between self-blame, psychological symptomology and acquaintance rape victims. Existing literature has explored the perception others will tend to blame the victim of acquaintance rapes more than victims of stranger rapes for their contribution to the assault (Bell, Kuriloff, & Lottes, 1994; Frese, Moya, & Megias, 2004; Johnson & Russ, 1989; L'Armand & Pepitone, 1982; Quackenbush, 1989; Whatley, 1996). It can be assumed that acquaintance rape victims themselves are more likely to have more self-blaming

behaviour than victims of stranger rape. Nadon’s results were unexpected as she found that acquaintance rape victims were less likely to indulge in self-blame than stranger rape victims. However, the experience of exhibiting lower resistance during the assault did lead to higher levels of self-blame. Those acquaintance rape victims who felt that they could have resisted more did report self-blaming behaviour and were found to report more psychological symptoms than victims of stranger rape (Nadon, 2003).

In more recent research Breitenbecher (2006) found that characterological self- blame and not behaviour self-blame was associated with psychological distress after sexual assault.

• Social support Social support consists of interpersonal connections and exchanges that are perceived as helpful (Rudkin, 2003).

Social support and especially the support of family, romantic partners or friends can have a strong influence on the recovery from a traumatic experience (Littleton, 2010; Resick, 1993; Herman, 1997). As previously discussed, social support has been found to be associated with better adjustment after rape (Burgess & Holmstrom, 1978; Frazier & Burnett, 1994; Frazier, Tashiro, Berman, Steger & Long, 2004; Ozer, Best, Lipsey, & Weiss, 2003 ).

Social support is a problematic construct to research, as different people can perceive the same behaviour as being social support or not. To operationalise social support for empirical purposes is not an easy task. It is difficult to measure and interpret levels of social support after a rape (Resick, 1993) as it is confounded by the quality and quantity of support prior to the assault. Ullman, Townsend, Filipas and Starzynski (2007) examined the relationships between factors such as assault severity, global social support, negative social reactions, avoidance coping, self- blame, traumatic life experiences, and PTSD symptoms. With regards to social support, they found that it was related to coping strategies as well as self-blame, however the direction of this relation is not clear (Ullman et al., 2007). In order to have a better understanding of the role that social support can play in understanding

victims’ responses to assault future research such as longitudinal studies would be needed (Ullman, et al. 2007).

Other studies found a more direct relationship between social support and enhanced recovery from rape experiences. Burgess and Holmstrom (1978) reported that social support is related to the length of recovery. They found that of those victims in their sample who had social support, 45% of them recovered within months, whereas of the victims without social support, 53% had not recovered after several years. Sales et al. (1984) found a correlation between the violence of an assault and the level of family closeness post assault. They also found that victims reporting greater closeness to their families had fewer symptoms. Ruch and Chandler (1980) also found that victims with supportive families experienced lower levels of trauma fairly soon after the assault. Moss, Frank and Anderson (1987) reported that poor spousal support was associated with more symptoms post rape, particularly when the lack of support was unexpected.

Ozer, Best, Lipsey and Weiss (2003) comment that prior characteristics such as trauma, psychological adjustment, and family history of psychopathology are less predictive of adjustment following trauma than post trauma variables such as social support. The following year, Frazier and colleagues concluded that social support was a significant predictor of positive sequelae after sexual assault (Frazier et al., 2004).

THE EXPERIENCES THAT COULD BE SEEN TO BE PART OF RAPE TRAUMA

In the understanding of rape trauma, as well as trauma in general, one works with the assumption that the experience will differ from one victim to another (Resick, 2003). Keeping in mind that each rape experience is unique and the psychological consequences of the rape will develop differently for each victim, the literature regarding rape trauma does present certain factors that are more likely to be present in a rape experience. These factors include the experience of fear, anxiety, anger, shame, guilt, depression, disruptions in self-esteem and disturbances in social interactions. The following sections will discuss each of these experiences as they have been documented in existing literature.

• Fear According to the literature, fear is by far the most prominent psychological reaction to rape, and trauma in general. Herman (1997) refers to the most common denominator of psychological trauma as the “feeling of intense fear, helplessness, loss of control and threat of annihilation”. Burgess and Holmstrom found in their 1973 study on rape victims in the emergency ward that the “primary reaction of all women was fear” (Burgess & Holmstrom, 1973, p. 1743). They also reported in 1975, "again and again victims stressed how fearful they were” (Holmstrom & Burgess, 1975, p. 1290). Fear and anxiety, in many of the initial studies of rape, were reported to be prominent symptoms experienced after a rape (Burgess & Holmstrom, 1974a; Burgess & Holmstrom, 1974b; Notman & Nadelson, 1976; Sutherland & Scherl, 1970).

Lewis (1994) describes feeling frightened as a very normal reaction after being raped. The fear can range from fear of being raped again, that the rapist may kill the victim or hurt her family. She may also be afraid of being left alone, leaving loved ones or breaking down emotionally. Longitudinal studies have shown that the intense fear of being in rape related situations have been reported up to 16 years after the assault (Calhoun, Atkeson & Resick, 1982; Ellis et al., 1981; Kilpatrick et al., 1981;). Rothbaum and associates also found that intense fear of rape related situations was among the most persistent rape related symptom (Rothbaum et al., 1992). Neville and Heppner (1999) describe other fears which may emerge after rape, these include fear related to: talking to the police, tough-looking people, being awake at night, being alone, blind dates, going out with new people and making mistakes.

Fears can become extreme and may even turn into phobias. Burgess and Holmstrom (1974a) reported such phobias as: fear of indoors, outdoors, of being alone, of crowds, of people coming up behind them and of sexual fears as being experienced by rape victims. In a study conducted that compared rape victims to victims of robbery, Resick (1988) found that rape victims reported significantly more sexual fears than robbery victims.

The experience of fear after a rape incident is not only related to rape, Culbertson, Vik, and Kooiman (2001) and Smith (1988) indicate that women who have experienced sexual assault are more fearful of crime than women who have never been assaulted.

Rizvi and colleagues (2008) found that fear responses experienced during the trauma were not necessarily related to subsequent PTSD and depression symptomology after the assault. They suggested that fear may not be a good discriminator for adjustment in the period following interpersonal violence (Rizvi, Kaysen, Gunter, Griffen & Resick, 2008). Resick and Miller (2009) also comment that fear as well as anxiety are neither exclusive nor predominant emotions associated with PTSD. This is to say that the experience of fear or anxiety (discussed below) can be said to be independent experiences and not exclusively a part of the PTSD picture.

• Anxiety Along with fear, anxiety is one of the most frequently observed symptoms following a rape (Atkeson et al., 1982; Foa et al., 1995; Resick, 1993; Rothbaum et al., 1992). Anxiety is defined as a mood state characterised by marked negative affect and somatic symptoms of tension in which a person apprehensively anticipates future danger or misfortune (Barlow & Durand, 1995).

Stein and colleagues (2004) investigated the relationship between sexual assault history and somatic symptoms and health anxiety. Health anxiety is understood to be the worry or fear of illness. They found that there was a significant increase in health anxiety in women with sexual assault history (Stein et al., 2004).

According to Kilpatrick and associates, anxiety was found to be a more significant long-term problem in rape victims than in any other group of crime victims (Kilpatrick et al., 1987). Burnam and associates found similar results in a survey of 3 132 households. They found that of the 13.2% of the sample of victims of sexual abuse, these victims reported a significantly greater onset of phobias and panic disorders after the assault (Burnam et al., 1988). As Kilpatrick and Veronen (1984) point out there are significant differences between the levels of anxiety experienced by rape

victims versus non-rape victims 12 months post rape, the difference usually dissipates after a period of 18 months post rape, indicating that although anxiety is a commonly experienced reaction to rape, it tends to not be pervasive.

• Anger Anger is an understandable reaction to rape. Although this is a commonly expressed reaction, there has been surprisingly little research into the presence of anger as an emotional reaction to crime and in particular rape (Riggs, Dancu, Gershuny, Greenberg & Foa, 1992). What has emerged from research is that victims of crime and in particular, rape victims, experience intense anger following the incident (Lee & Rosenthal, 1983; Yassen & Glass, 1984). This intense anger may be as a result of the victim resenting the unfairness, senseless, shame and humiliation of the assault (Lewis, 1994). Riggs et al. (1992) found that victims who are initially very angry, and who hold in their anger, have more severe PTSD symptoms during the month following the assault. Their study also revealed that assault characteristics such as the use of a weapon, level of forces used active or passive reactions during the assault impacted on the experience of anger.

It is hypothesised by Riggs et al. (1992) that anger is another way that anger allows the victim to avoid feelings of anxiety. A victim may attempt to reduce anxiety by activating an anger response as opposed to experiencing the anxiety provoking reactions such as intrusive thoughts or images.

The anger may not necessarily be directed towards the assault or the perpetrator, but may be expressed in other areas of her life. In general victims of sexual violence showed higher levels of anger and hostility than non-victims (Kilpatrick & Veronen, 1984).

Anger can manifest itself in several behaviours, including aggression. Carlson (1997) talks of aggression being both a core and secondary response to trauma. Aggression could be seen as a re-experiencing symptom or it could be considered as a behaviour resulting from the anger over inability to modulate the anxiety felt after a trauma.

Orth, Cahill, Foa, and Maercker (2008) support the claim that there is a link between anger and PTSD following an assault. However, their study indicated that the presence of PTSD predicted subsequent levels of anger, and that anger did not predict the presence of PTSD (Orth et al., 2008)

• Shame and Guilt Guilt and shame are closely related emotions that can be powerful reactions to trauma (Carlson, 1997). According to Tangney and Dearing (2002), shame and guilt are “self-conscious and moral” emotions. Meaning that they involve the self evaluating the self and they presumably play a role in fostering moral behaviour. However, clear distinctions have been made between the two responses (Ferguson & Stegge, 1995; Ferguson, Stegge & Damhuis, 1991; Lee, Scragg & Turner, 2001; Lindsay-Hartz, 1984; Lindsay-Hartz, de Rivera & Mascolo, 1995; Niedenthal, Tangney & Gavanski, 1994; Tangney, 1993; Tangney & Dearing, 2002; Wicker, Payne, & Morgan, 1983). Lewis (1971) eloquently describes the differences as follows:

The experience of shame is directly about the self, which is the focus of the evaluation. In guilt, the self is not the central object of negative evaluation, but rather the thing done or undone is the focus. In guilt, the self is negatively evaluated in connection with something but is not itself the focus of the experience (Lewis, 1971, p. 30.)

It is therefore not the objective nature of the transgression that determines the emotional reaction, but rather the individual’s subjective interpretation of the event (Tangney, 1993). The event can be judged with the emphasis on a “bad self” or on “bad behaviour”. The feeling of shame emerges when the entire self is painfully scrutinised and negatively evaluated (Tangney, 1993). It is understandable that this form of self-evaluation would have an impact on the person’s self-esteem and overall adjustment.

Shame-prone individuals appear relatively more likely to blame others (as well as themselves) for negative events, more prone to seething, bitter, resentful kind of

anger and hostility, and less able to empathise with others in general (Tangney & Dearing, 2002). Shame can be experienced externally, where the individual relates to the experience with one’s social presentation, with feelings such as being unattractive or devalued (Lee, Scragg & Turner, 2001); or internally where the individual sees aspects of themselves as undesirable even though there is not an audience to judge these aspects (Gilbert, 1998).

Guilt on the other hand involves a focus on a specific behaviour that is negatively evaluated (Tangney, 1993). Guilt is seen to not be as bad as shame as guilt prone individuals are better able to empathise and accept responsibility for negative interpersonal events. Guilt is less likely than shame to elicit anger (Tangney & Dearing, 2002). Shame prone individuals are also less likely to seek treatment for their trauma as they are inclined to avoid thoughts and reminders of the shaming event (Blum, 2008). When considering the possible elevated anger and avoidance of seeking help, the experience of shame as a reaction to rape can more harmful than guilt.

The dynamic of shame, guilt and trauma is not well documented, and in some cases can produce conflicting results. Some studies showing that guilt is strongly associated with PTSD (Beckham, Feldman, & Kirby, 1998; Henning & Frueh, 1997; Kubany et al., 1995; Kubany et al., 1996; Nishith, Nixon, & Resick, 2005), while other studies, discussed below, show that shame is more significantly represented with PTSD. Although these contradictions in the presence of shame or guilt with regards to PTSD experience could be more related to poor discrimination between the two emotional responses by respondents or researchers.

In 2002, Lesekela, Dieperink, and Thuras reported in their study of guilt, shame and PTSD that those respondents with PTSD presented significantly with shame and not guilt. They hypothesised that this could indicate that a proneness to shame could be a risk factor for the development of PTSD (Lesekela et al., 2002). Street and Arias (2001) also found that in victims of intimate partner violence (which could include acquaintance rape), shame but not guilt was a powerful predictor of PTSD.

In Herman’s landmark contribution “Trauma and Recovery”, she claims that feelings of guilt and inferiority are practically universal to trauma survivors (Herman, 1997). Eagle (1998) also implies that guilt is a predominant reaction in her account of counselling with trauma victims. She states that if a therapist is observant for the presence of self-blame or guilt, that it is “almost always present” (Eagle, 1998, p. 140.)

It seems apparent from the literature reviewed that a deeper understanding of the presence of shame and guilt in rape victims needs to be developed, as well as exploring the interplay between these two emotions and trauma. • Depression Depressive symptoms are frequently reported by rape victims (Katz & Mazur, 1979), with approximately 30% of victims experiencing a major depressive episode post- rape (Kilpatrick et al., 1992). As Rothbaum and associates (1992) note it is a common reaction to rape, but not as persistent as fear and anxiety (Rothbaum et al., 1992). Although, as Frank and Stewart (1984) point out, the consequence of depression, in attempted or completed suicide, may be more serious than fear and anxiety.

Depression can be marked by feelings of worthlessness, sadness, hopelessness and frustration. These feelings can develop out of the victim’s experience of loss and anger (Lewis, 1994). Carlson (1997) comments that a traumatised person may express their depression cognitively, emotionally, behaviourally or physiologically. The depression could take the form of inactivity, lethargy, negative thinking, problems concentrating, depressed mood, feelings of apathy, sleep disturbances, or loss of appetite. Suicidal thoughts or behaviour can also manifest.

Frank, Turner and Duffy (1979) found that 44% of their sample of 34 rape victims, scored in the moderately or severely depressed range on the Beck’s Depression Inventory (BDI). A later study by Frank & Stewart (1984) found that 56% of their sample fell into the moderately or severely depressed range on the BDI. They also found that 43% of the women were diagnosed as suffering from major depression based on a semi-structured interview.

Atkeson and associates (1982) investigated depressive symptoms in rape victims one year after their assault. They established that rape victims do exhibit depressive symptoms after the assault and that these symptoms are significantly greater than those reported in non-victims (Atekeson et al., 1982). They also found that the average duration of symptoms is similar to that of outpatient reactive depressions. It can be presumed that the depression experienced by rape victims is comparable to that experienced by non-victims in reaction to an event.

Existing with the experience of depression is the significant reporting of suicidal thoughts and attempts among rape victims (Ellis et al., 1981; Kilpatrick et al, 1984). Kilpatrick and associates report that in a population of rape victims, 33% of rape victims have contemplated and 13% have attempted suicide in their national sample (Kilpatrick, Edmunds & Seymour, 1992).

Mayer and Taylor (1986) bring to attention the point that in order to conclusively address reactions like depression after a rape or traumatic event, one needs to be able to understand pre-existing patterns. This is obviously a difficult task to achieve empirically; however within the therapeutic context exploring pre-existing patterns is not only possible but also crucial.

Zinzow and associates (2010) explored the possible differences between types of rapes and the development of PTSD and depression. They sampled rape victims who had experienced forced rape, rape while incapacitated (when the victims voluntarily induces substances and is intoxicated) and drug or alcohol facilitated rape (when the perpetrator deliberately intoxicates the victim). They found that forcible rape victims were over three times more likely to meet the criteria of PTSD and depression than non-victims (Zinzow et al, 2010). They also found that the type of rape strategy used showed significantly different relationships with the experience of PTSD and depression after the assault. Victims who were incapacitated at the time of their rape did not present with PTSD or depression (Zinzow et al., 2010). It is thought that this is related to the perceived controllability of the event, meaning that the victims who had actively used substances prior to the rape where able to feel that they had some control. Bolstad and Zinbarg (1997) have demonstrated that the diminished perception of control is associated with greater distress following assault.

When discussing acquaintance rape, intimate partner violence (IPV) becomes one of the related concepts, as it is in this form of violence that some acquaintance rapes are perpetrated. IPV is defined by the American Centres for Disease Control (CDC) as “intimate partner violence describes physical, sexual, or psychological harm by a current or former partner or spouse (CDC; 2008). The body of research regarding intimate partner violence and depression is vast and would be valuable to our understanding that rapes perpetrated by an intimate partner is very likely to result in depressive experiences and possible diagnosis of depressive disorders. Women who experience IPV are at risk for a range of poor mental health outcomes, particularly depression (Coker et al., 2002a; Coker et al., 2002b; Nicolaidis, Curry, McFarland, & Gerrity, 2004; Sato-DiLorenzo & Sharps, 2007; World Health Organization, 2000). Recent population-based, (Carbone-Lopez, Kruttschnitt, & Macmillan, 2006; Coker et al., 2002a; Zlotnick, Johnson, & Kohn, 2006) and clinic- based (Carlson, McNutt, Choi, & Rose, 2002; Coker et al., 2002b; Dienemann et al., 2000; Mitchell et al., 2006; Pico-Alfonso et al., 2006; Zlotnick et al., 2006) studies demonstrate a strong relationship between IPV and depression, and the severity of depression is significantly related to the severity and duration of IPV (Bonomi et al., 2006; Dienemann et al., 2000; Golding, 1999; Houry, Kemball, Rhodes, & Kaslow, 2006; Kessler, Chiu, Demler, Merikangas, & Walters, 2005; Zlotnick et al., 2006).

• Disruptions in self-esteem Self-esteem is the evaluative component of an individual’s self-concept and implies personal assessment of worth or competence (Burgess & Holmstrom, 1979). Many traumatic experiences indirectly impair self-esteem (Carlson, 1997). Low self-esteem would be experienced subjectively as a lack of self-confidence, poor self-image, or negative evaluations of oneself and one’s accomplishments (Carlson, 1997). Rape survivors may experience a loss of self-respect and self-confidence (Lewis, 1994); they evaluate themselves as worth less than others. This evaluation is incorporated into their self-esteem.

Burgess and Holmstrom (1979) found that victims who gave positive statements (an indication of high self-esteem) had a higher rate of recovery than those who gave negative statements (an indication of low self-esteem). They acknowledge the

influence of a previously high or low self-esteem that could influence the rate of recovery and also that the way a victim has dealt with the rape could produce a high or low self-esteem.

As self-blame is a prominent theme in the reactions of rape victims, it is expected that self-esteem (an evaluation of one’s self) could be affected by being raped. Murphy and associates (1988) found that victims reported significantly lower self- esteem than non-victims on most subscales of the Self-Report Inventory, up to one year after the assault. At that time the self, others and parents were sources of lower esteem. At 18 months after the rape, only the self-scale was a source of low esteem (Murphy et al, 1988). Murphy (2010) also found in her sample of 280 college women, that those who indicated a history of sexual assault also reported poorer self-esteem.

In the exploration of rape victims seeking treatment, Resick and associates found that on average rape victims scored lower than normal on the Tennessee Self- Concept Scale (TSCS) (Resick, Jordan, Girelli, Hutter & Marhoefer-Dvorak, 1988). Schnicke and Resick (1990) found that attributions of self-blame in treatment – seeking rape victims predicted higher self-criticism scores on the TSCS, showing a relationship between self-blame and self-esteem.

• Disturbances in interpersonal interactions The rape victim is not only faced with the possible physical and psychological trauma after a rape, but she also has to face social implications of her trauma. Changes in a victim’s day-to-day life after a rape are expected (Hanson, Sawyer, Begle & Hubel, 2010). These changes are seen to impact her social interactions as well as sexual functioning.

Herman (1997) talks of the oscillation that occurs regarding intimacy after a traumatic experience such as rape. Trauma impels people both to withdraw from close relationships and to seek them desperately. The rape causes a profound disruption in basic trust. Along with that is the need of the victim to avoid reminders of the trauma, to avoid the shame, guilt and inferiority that they are experiencing after the rape. All of these feelings foster social withdrawal (Herman, 1997).

Burgess and Holmstrom (1974a) include behaviour such as taking trips, changing telephone numbers and changing residence as motor activity symptoms evident in RTS. These can be described by social acquaintances of the victim as a form of social withdrawal.

Although rape can be described as an act of violence, sex is the weapon of choice. It is understandable that the victim’s sexuality will possibly be influenced by her assault. It is possible that a rape victim finds that she does not enjoy or have an interest in sex anymore (Lewis, 1994). Resick (1993) notes that sexual dysfunction is among the longest-lasting problems experienced by rape victims. Sexual dysfunction can include sexual aversion, flashbacks, vaginismus and orgasmic dysfunction (Burgess & Holmstrom, 1979). Researchers have found that the most immediate reaction was an avoidance of sex followed by decline in the frequency of sexual activity (Burgess & Holmstrom, 1979; Ellis, Calhoun & Atkeson, 1980). However, most women who had frequent or somewhat frequent sexual activity before the rape were able to return to normal levels after about one year after the rape (Ellis et al., 1980). In 1981, Ellis reported that for most of the rape victim’s interviewed, sexual activity returned to normal four to six months after the rape, although there was a small group of 10-20% who had sexual difficulties which persisted over a longer period of time (Ellis, 1981).

Wyatt, Gunthri and Notgarss (1992) and Wyatt, Notgrass and Gordon (1995) found that being raped increased some victim’s participation in high-risk sexual behaviour, such as not using contraception or a condom. This behaviour can be linked to the fear of possible HIV infection or pregnancy post rape, and the victims’ sense of lack of control over these possibilities.

THE PROCESS OF RECOVERING FROM RAPE TRAUMA

Rape is an experience that challenges or can even alter a woman’s identity, assumptions about the world and how one operates in it. Along with the disruption there is also the possibility that these shattered elements will be put back together in new ways as the woman recovers (Burt & Katz, 1987). If one can isolate the

elements of a victim’s life that are shattered, then one is closer to identifying the outcomes of her journey to recovery and becoming a survivor.

Burgess and Holmstrom (1978) define recovery in terms of the psychological work that is required by the victim. It includes “freeing oneself from the fears caused by the rape, acknowledging and bearing the pain caused by the rape, redefining the feelings of vulnerability and helplessness, and gaining control of one’s life again” (Burgess & Holmstrom, 1978, p. 166). Gilboa-Schectman and Foa (2001) explain that emotional engagement with the traumatic experience is a necessary condition for successful processing of the trauma. They also indicated that early reactions, which are associated with emotional engagement is associated with more rapid recovery. However, it must be noted that Gilboa-Schectman and Foa (2001) do not clearly describe what exactly is required for emotional engagement, and how they would measure this occurrence.

The following sections will explore the how the process of recovery from rape trauma is defined from three different perspectives, namely the ecological model of recovery as presented by Harvey (1996), Herman’s (1997) understanding of recovering from trauma and Smith and Kelly’s (2001) three staged process of recovery.

• Understanding the process of recovery from three perspectives

• Harvey’s ecological model of recovery Harvey (1996) notes that in the literature recovery is generally poorly defined and criteria indicative of trauma recovery are seldom specified. She points out that generally clinicians speak of recovery from trauma in global terms, equating trauma recovery to the abatement of symptoms (Harvey, 1996). One example is the absence of flashbacks or nightmares. In support of this criticism, Harvey (1996) has presented a multidimensional definition of recovery. According to this ecological model, recovery is hallmarked by the following outcome criteria: symptom mastery, affect tolerance, authority over the remembering process, integration of memory and affect, self-esteem and self-cohesion, safe attachment and meaning making. Each of the criteria will be discussed.

Symptom mastery – This stage ensures that the physiological symptoms of the traumatic response are brought within manageable limits. The recovered survivor may continue to experience symptomatic arousal, but she has mastered and practices helpful coping routines to reduce arousal and manage stress. Avoiding an area of known triggers is an example of symptom mastery.

Affect tolerance - The individual can now experience affects associated with the traumatic incident, without feeling overwhelmed or the threat of becoming overwhelmed. In this aspect of recovery feelings can be named and endured.

Authority over the remembering process - This criterion is achieved when the recovered individual can choose to recall events of the trauma as well as decide to put the memory aside. Meaning that memories of the incident no longer intrude uninvited into awareness.

Integration of memory and affect - The incident can be remembered in a coherent narrative and can be remembered with feeling.

Self-esteem and self-cohesion - Self-esteem that can be damaged as a result of the trauma is restored. In recovery, self-injurious behaviours and impulses are replaced by healthy, self-caring routines, and a more coherent and consistent experience of the self.

Safe attachment - Recovery from trauma entails the development, repair and restoration of a victim’s relational capacity. This means that important relationships that could have been damaged are restored. Traumatic experiences often leave the victim isolated and withdrawn from others, the recovery process replaces this with the new or renewed capacity for trust and attachment.

Meaning making - The victim must assign new meaning to the trauma, herself as a survivor and the world in which the traumatic event occurred. Her new coherent system of meaning and belief should encompass the story of the trauma and how it has impacted her life.

In practice, the processes mentioned by Harvey (1996) are interconnected and are addressed throughout recovery. From this framework, recovery is apparent whenever a change from a poor outcome to a desired one is realised in any domain affected by traumatic exposure (Harvey, 1996). Relating this definition to rape trauma, perhaps the desired outcome is the victim’s wishes to be able to re-establish intimate relationships. Recovery, according to this model, would therefore be achieved when the victim realises that she can pursue and possibly maintain an intimate relationship.

• Herman’s understanding of recovering from trauma Herman (1997) describes psychological trauma as the core experience of disempowerment and disconnection from others. Based on that description, recovery can be seen as the empowerment of the survivor and the creation of new connections. In order to empower and reconnect a victim, recovery cannot take place in isolation; it requires a context of relationships.

According to Herman (1997) recovery from trauma takes place over three stages. The first stage of the process requires the victim of trauma to establish safety. Establishing safety begins by focusing on controlling the victims body, this would include attention to basic health needs, possible medical needs, regulating bodily functions such as sleep, eating and exercise, management of post-traumatic symptoms and controlling self-destructive behaviours (Herman, 1997). Once bodily integrity is established, the attention moves towards control of the environment, which includes establishing a safe living situation and a plan for self-protection in the victim’s daily life. Completion of this stage is often marked by the victim experiencing some confidence that she is able to protect herself to some degree and regulate her most disturbing symptoms (Herman, 1997).

The second stage involves reconstructing the trauma story. The most important tasks of this stage are to remember and mourn. These tasks are achieved by the retelling of the story, transforming traumatic memories and mourning the traumatic loss the person had gone through (Herman, 1997). While the victim is recounting the memories of the incident, the need to preserve the safety established in the first phase must be balanced by the need to face the past (Herman, 1997).

Reconstructing the story not only includes describing details of the event but also expressing affects experienced as well as reflection on meaning made since the event, which can include values and beliefs that were destroyed by the trauma (Herman, 1997). Mourning traumatic loss is inevitable, according to Herman (1997), as trauma will certainly bring loss. Experiencing grief can be an overwhelming experience for many victims, and often the victim feels that experiencing the grief would mean giving power to the perpetrator. However, Herman (1997) describes the mourning process as the victim grieving what was lost in order to “discover her indestructible inner life” (Herman, 1997, p. 188).

The final stage of this process involves the restoration of the connection between the survivor and the community. Much like some of the tasks in Harvey’s model, the survivor needs to develop a new sense of self, and new sense of relating and a new way of viewing the world. Some of the issues of the first stage are readdressed, such as caring for her body, immediate environment, material needs and relationships with others. However, unlike the first stage these tasks are carried out with an active engagement with the world (Herman, 1997). The victim is now ready to incorporate the lessons learnt from the trauma. This stage includes learning to fight, reconciling with oneself, reconnecting with others, finding a survivor mission and resolving the trauma (Herman, 1997). Learning to fight could include active learning to fight as in taking self-defence classes or a more symbolic way as in developing coping strategies in response to dealing with situations that are potentially hostile or coercive (Herman, 1997). Reconciling with oneself would entail the notion that the victim is herself, rather than a result of her traumatic past (Herman, 1997). By this stage of recovery the victim has regained some capacity for appropriate trust, and hence would deepen her significant relationships. “Finding a survivor mission” would describe the tendency for victims to engage in social action as a part of their recovery (Herman, 1997). Participating in social action allows the survivor to draw on her own initiative, energy and resourceful, all aspects which she could have had taken away from her during her trauma.

Herman (1997) notes that the trauma is never fully resolved and issues that have been resolved in one stage of recovery can be reawakened as the victim experiences a new developmental period. However, when a victim is able to turn her

attention away from the tasks of dealing with her trauma towards the tasks of ordinary life, she can be said to have achieved resolution.

• Smith and Kelly’s three staged process of recovery Smith and Kelly (2001) describe a three-staged process of recovery in their research. Firstly, they recognise that the woman must first be willing to risk “coming out of her cocoon” before the recovery process can begin. The journey of recovery is comprised of three interrelated and interdependent themes: reaching out, reframing the rape and redefining the self.

Smith and Kelly (2001) describe the journey as a spiralling movement, from a larger circle inwards. They acknowledge that during this spiralling process, the survivor has to often revisit feelings, such as fear and anger. Theme one entails reaching out to others. This period focuses on external needs and desires. By reaching out to others the woman accomplishes the following tasks: getting back into normal routines, talking without crying, being in control of obsessive thoughts and gaining the ability to move about freely in her environment.

The second theme involves the survivor reframing what happened to her. In this stage she challenges herself to see the positives of recovering from the trauma, to gain a new perspective on life and to no longer need people to believe what she is saying regarding her rape experience. The tasks of this theme are very similar to those achievements attained in the seventh criteria of Harvey’s model (1996), i.e. that of meaning making. The survivor is able to use the reframes to provide and integrate new meaning of the trauma with herself, and her view of the world.

The final phase involves the survivor redefining herself. This allows for internal understanding. This process involves self-love, forgiveness of self and rapist and inner peace. These ideas are reflected in the fifth criteria of Harvey’s ecological model (1996), namely self-esteem and self-cohesion.

• Factors affecting the duration of recovery processes One cannot predict how long or if a person will be able to recover from a traumatic experience. It therefore makes sense that Smith and Kelly (2001) depict rape

recovery as being an “arduous journey”. They do not describe the period of time that it could take for recovery. Other research has been able to give empirical evidence and estimates of how long recovery from rape is observed to take.

Burgess and Holmstrom (1979) divided their sample of rape victims into three groups, based on the time they reported their recovery to be complete: 37% felt that they had recovered within months, another 37% felt that it had taken years to recover, and 26% did not feel that they had recovered by the time of the study’s follow up (four-six years later). Therefore on follow-up, four to six years later, these researchers found that a majority of the victims felt that they had recovered.

Gilboa-Schectman and Foa (2001) report that recovery from rape is a slower process than recovery from non-sexual assaults. Apart from commenting that rape gives rise to more severe reactions than non-sexual assaults, they are unable to give a reason for why sexual assault recovery is slower than non-sexual assault recovery.

Rothbaum et al. (1992) established that from their sample of rape victims, those that did not show evidence of substantial recovery within 1 month post rape were likely to continue to suffer from PTSD. Their research did not reveal how long the predicted PTSD symptoms would persist and how substantial recovery would be operationalised.

In Resick’s (1992) review of rape studies she found that, in general, by three months post rape, much of the initial turmoil had decreased and stabilised. Some victims continued to experience problems for indefinite periods of time. It must be mentioned that this view on recovery is very much based on the assessment of symptom abatement and not on the testimony of the survivors themselves or the criteria discussed previously as outlined by Harvey (1996), Herman (1997), Smith and Kelly (2001).

CONCLUSION

The literature presented in this review covers many different contributions to what is known about rape trauma and how it is experienced. By considering all these contribution, one is able to come to the realisation that the experience of rape and its

subsequent trauma can be complicated and dynamic. The factors influencing rape trauma presented assist the reader to grasp that it is not likely that any two rape experiences would be the same, as so many aspects can mould and shape that experience. However, the body of knowledge presented is able to give the reader a sound grasp of what elements could be considered when understanding a rape victim’s unique experience.

CHAPTER 3: METHODOLOGY

INTRODUCTION

The purpose the this chapter is to introduce phenomenology as the methodological framework chosen for this study, as well as to introduce the research strategy and data analysis applied to the study. The chapter will define phenomenology and phenomenological concepts and then describe phenomenology as a research method. By describing the research procedure, one will understand the way in which participants for this study were selected and how data was collected in the form of an interview and analysed through phenomenological explication.

As the study aims to acquire a description of the unique lived experience of young South African women who have been raped by an acquaintance in order to enhance or deepen understanding of the experience of acquaintance rape and its subsequent trauma in the South African context, a qualitative research design would be most suitable. Qualitative research attempts to describe and interpret human phenomena, in this case the lived experience of acquaintance rape. The resulting descriptions will be of the participant’s subjective experience rather than measurements and statistical results.

By obtaining clarification into how an acquaintance rape victim experiences her rape it is hoped that what is already known regarding rape experiences and rape trauma will be enhanced. By getting to know the experience of acquaintance rape trauma from the perspective of a South African victim, the study aims to have a deeper sense of what is known regarding rape trauma in the South African context. The knowledge gained from this study may also assist in understanding the contribution of the unique social aspects of South Africa to the experiences of the rape victim.

EXPLICATION OF SELECTION OF THE METHODOLOGY

As Giorgi (1985) points out, many important aspects of phenomena that are lived and experienced are overlooked or distorted by quantitative methods, as quantitative approaches deal primarily with phenomena and not experienced phenomena. His

argument is supported by the view that many philosophers and psychologists find the positivist model too objective, reductionistic and mechanistic (Byrne, 2001).

Specifically with regards to studies of rape trauma, quantitative research predominates, meaning that the body of knowledge regarding an intensely subjective experience, such as rape, is largely obtained through objective research methodologies. These quantitative studies have contributed greatly to our understanding of the prevalence of traumatic responses in rape victims (Kilpatrick et al., 1987; Rothbaum et al., 1992) as well as information regarding expected duration of distress (Resick, 1992) and possible time lines regarding recovery (Gilboa- Schectman & Foa, 2001); however, these studies do not always reflect the actual experiences that are a part of the ordeal of rape (Mukamana & Brysiewicz, 2008; Smith & Kelly, 2001). Although there are some studies that explore the lived experience of rape, there still exists a need to enhance the already established knowledge with studies exploring the lived experience of rape.

• Qualitative approach The qualitative approach to research involves the studied use and collection of empirical material that describes routine and problematic moments and meanings in individuals’ lives (Denzin & Lincoln, 2000). This approach places the observer in the world to “study things in their natural settings, attempting to makes sense of, or to interpret, phenomena in terms of the meanings people bring to them” (Denzin & Lincoln, 2000, p. 3).

The aim of qualitative research is to seek answers to the questions that stress how social experience is created and given meaning (Denzin & Lincoln, 2000). This is achieved by documenting and interpreting the whole of what is being studied from the frame of reference of the subjects involved (Duffy, 1987).

Qualitative methods of research are often employed in the hope of generating richer and more finely nuanced accounts of human action and experience. As Gergen and Gergen (2000) point out, a crucial ingredient of human understanding, namely, the private lived experience of the individual was left out by the empiricist emphasis on quantifiable behaviour.

Qualitative research methods are not aimed at discovering data that is reliable, valid, objective and generalisable, but rather data that is trustworthy. Trustworthy data encompasses concepts such as credibility, dependability, transferability and confirmability (Lincoln & Guba, 1985; Shenton, 2004; Sinkovics, Penz & Ghauri, 2008). If the research findings represent a convincing conceptual understanding of the data drawn from the participants’ original data, they are said to be credible (Lincoln & Guba, 1985, p.296). An assessment of the quality of the integrated processes of data collection, data analysis, and theory generation relates to the dependability. Transferability is the degree to which the findings of this inquiry can apply or transfer beyond the bounds of the research process. Confirmability is a measure of how well the findings are supported by the data collected. (Lincoln & Guba, 1985). These aspects of qualitative research are employed as guiding principles thoughout the research undertaken.

PHENOMENOLOGY - “To The Things Themselves”

• Defining Phenomenology In its simplest form, phenomenology can be understood as the study of phenomenon. The word phenomenon comes from the Greek phainesthai, meaning, “to appear”. Phenomenon therefore means to bring to light, to show itself in itself (Heidegger, 1977). According to Moustakas (1994), “phenomena are the building blocks of human science and the basis for all knowledge” (Moustakas, 1994, p. 26). As Husserl, the Founder of phenomenology (Moran, 2005) describes it, phenomenology implies the rigorous and unbiased study of things as they appear so that one might come to an essential understanding of human consciousness and experience (Valle, King & Halling, 1989). Hence, the aim of phenomenology is to allow one to contact phenomena as we actually live them out and experience them (Husserl, 1970).

According to Kockelmans (1967), the term phenomenology has been used from as early as 1765. It was Hegel, however, who gave the philosophy a well-defined meaning. Hegel’s definition states that “phenomenology referred to knowledge as it appears to consciousness, the science of describing what one perceives, senses

and knows in one’s immediate awareness and experience” (in Moustakas, 1994, p. 26).

Phenomenology can be distinguished into various fields such as Phenomenological Philosophy, Phenomenological Psychology and Sociological Phenomenology to mention a few. According to Polkinghorne (1989), Phenomenological Philosophy deals with the provision of descriptions of the general characteristics of experience. Phenomenological Psychology, on the other hand, acknowledges the reality of the realm of meaningful experience as the fundamental locus of knowledge (Polkinghorne, 1989). Sociological Phenomenology considers the notion of “meaning structures”, which refers to the concept that meanings come in structures and are given meaning in relation to other meanings (Aspers, 2009). Thus the process of constructing meaning can occur at the level of the individual and at the social level where it can be studied empirically.

According to Aspers (2009), Empirical Phenomenology is the approach that takes into consideration the core insights of social sciences and the philosophical tradition of Phenomenology. The premise of Empirical Phenomenology is that an “explanation in the social sciences should be connected to the meaning structure of real people” (Aspers, 2009, p. 5).

• Phenomenological Concepts When considering the philosophical and empirical aspects of phenomenology, there are certain concepts or constructs that are fundamental. Having a deeper understanding of some of these concepts would allow one to engage with the approach of phenomenology and better comprehend the aspects as they are utilised in phenomenological research. The following section introduces certain phenomenological concepts in order to have a sense of how they relate to the selected methodology of this study.

If phenomenology is the study of things as they appear, then Lebenswelt would describe the world in which the ‘things’ appear. Lebenswelt or “life world” represents the world as we live and experience it (Daniels, 2005). The focus on phenomenology is not on the world as interpreted as scientifically factual, but is rather on the world of

everyday experience. It is the domain of the phenomena – “pure phenomena independent of and prior to any reflective interpretation, scientific or otherwise” (Valle et al., 1989). Lebenswelt is therefore the beginning or starting point for phenomenological enquiry.

Phenomenological enquiry is an activity that thematises the phenomenon of consciousness (Giorgi, 1995; 1997). Consciousness, according to Giorgi (1995), consists of all the objects, events, process that we are aware of. It can be seen to encompass the totality of our lived experience. As Gurwitsch (1974, in Giorgi, 1995, p.13) states, consciousness has privilege and primacy, “not only because of its indubitability but also because it is the universal medium of access to whatever we may be dealing with”.

Objects or phenomena are held and sustained by the constituting power of consciousness (Valle et al., 1989). Phenomenologists consider that without a consciousness to perceive the world, there is no world, and interdependently, without a world to be conscious of there is no consciousness (Valle et al., 1989). Therefore, consciousness is the forum in which the world is revealed.

Within phenomenology, consciousness is inextricably connected to intentionality. According to Valle et al. (1989), consciousness is one’s implicit or explicit referral to an intended object. Kelly (2008) describes consciousness as an intentional activity. By having an interest in the world, consciousness transcends itself and attends to the world by a myriad of intentional acts, such as perceiving, remembering, imagining, willing, judging. Hence Husserl’s claim that intentional consciousness is correlated (that is, co-related) to the world (Kelly, 2008).

It is prudent to keep in mind that an object has reality in consciousness but that this reality exists for the person experiencing the object, as long as they can confirm it (Moustakas, 1994). As Husserl (1975) describes “…I must be able to provide useful procedures and other evidences which lead me to the object itself and through which I realise the object as truly there “(Husserl, 1975, p. 23). This helps one to understand that objects of consciousness are different to objects that are the focus logical-empirical methods (Osborne, 1994). As Helminiak (1984) explains,

consciousness is not amenable to methods of study, or accessible to public observation. Rather, it is subjectivity itself and is only accessible to the conscious subject.

Intention indicates the orientation of the mind to its objects; the objects exist in the mind in an intentional way (Kockelmans, 1967). Intentionality is the process in which consciousness actively reaches out toward phenomena in a directed way. It is the essential feature of consciousness (Giorgi, 1997). According to phenomenology, our experiences are directed towards that which is being represented or intended through particular concepts, thoughts, images, ideas, etc. (Woodruff Smith, 2003). Directedness is intrinsic to intentionality. The mind is directed to some phenomenon whether the phenomenon exists or not (Moustakas, 1994). Giorgi (1997) notes several classical ways of stating intentional relation, such as “to know means that one knows something, or that to be emotional signifies that one is emotional about some situation or person”.

As stated previously, consciousness is intrinsically related to intention. This interrelation is made apparent by Zaner (1970) who explains that it is through consciousness that objects are made present (are intended) and it is by objects that consciousness is revealed or elucidated.

Phenomenological enquiry endeavours to investigate a phenomenon as it appears in consciousness. The process of bracketing and phenomenological reduction allows the researcher to engage with consciousness as it is made present by those experiencing the phenomenon.

The process of bracketing is conceptualised in phenomenology by the term Epoche. Epoche is the Greek word meaning to “refrain from judgment, to abstain from or stay way from everyday, ordinary way of perceiving things” (Moustakas, 1994, p. 33). Descartes influenced Husserl in the development of the concept of Epoche (Moustakas, 1994). For Husserl, knowledge is based on intuition and essence, and these precede empirical knowledge (Moustakas, 1994). One must therefore have a new way of looking at things, a way that requires that we learn to see what is before us.

For some, this notion was seen as the rejecting of all concepts and forms of knowledge that may open doubt (Ashworth, 1996). However, rather than reject knowledge, which would be impossible, one should set aside this knowledge or bracket it. According to Giorgi (1997), bracketing is the setting aside or rendering as “non-influential” all previous knowledge associated with the phenomenon in question, so that it may have the opportunity to present itself in its fullness. Schmitt (1967) used the terms “invalidate”, “inhibit” and “disqualify” in his description of Epoche. However, it is not an elimination of everything or a denial of reality. The purpose of Epoche allows one to grasp the structural principles of an experience rather than the specific instances (Polkinghorne, 1989). To achieve this purpose one needs to first “lay out” ones assumptions, to make explicit and then bracket ones attitudes, frame of references and preconceived thoughts (Hycner, 1985; Moustakas, 1994; Valle et al., 1989). When conducting phenomenological research, Ashworth (1996) explicitly describes that one should bracket science and any judgments on the “correctness or falsity of claims which are implicitly made by the research participants” (Ashworth, 1996, p. 6).

Achieving Epoche is both challenging and limited, as complete Epoche is impossible (Osborne, 1994). According to Moustakas (1994), the challenge is in being “transparent to ourselves, to allow whatever is before us in consciousness to disclose itself so that we may see with new eyes in a naïve and completely open manner. Thus, in the process of being transparent in the viewing of things, we also become transparent to ourselves” (Moustakas, 1994, p. 86).

A fundamental limitation to the practical achievement of Epoche is that when a research topic is chosen and participants selected, there needs to be some former knowledge of the phenomenon under investigation in order to select and introduce the participants to a discussion that would give descriptions direction (Ashworth, 1996). However, the key is to allow these descriptions to be received in a way that is as undistorted as possible.

The method utilised in the process of achieving Epoche or bracketing is reduction. The phenomenological sense of the term reduction is not the same as the

philosophical term “reductionism”, the notion of reducing a phenomenon by explaining it on a “lower level” or reducing it to its primitive parts (Karlsson, 1993; Polkinghorne, 1989). Rather phenomenological reduction is a way of reducing descriptions to their fundamental structures or most invariant elements of experience (Polkinghorne, 1989) by listening with a conscious and deliberate intention of opening ourselves to phenomena as phenomena (Moustakas, 1994).

Karlsson (1993) presents three types of reductions that appear in phenomenological thought: Eidetic Reduction, Phenomenological Psychological Reduction and Phenomenological Transcendental Reduction.

Eidetic Reduction is the intention of discovering the essence or meaning-structure of that which we study (Karlsson, 1993). This is carried out by imaginative variation. Eidetic reduction moves from the particular fact to the principal structure, that which makes the phenomena what it is (Karlsson, 1993).

Phenomenological Psychological Reduction describes the bracketing of the world but not the empirical subject (Giorgi, 1997). In other words, the external world is bracketed but the empirical world is untouched, “its existence is taken for granted” (Karlsson, 1993, p. 49).

Phenomenological Transcendental Reduction is more far reaching as it brackets everything, the empirical subject and the world. As Schmitt (1967) explains, “it is called transcendental because it moves beyond the everyday to the pure ego in which everything is perceived freshly, as if for the first time. It is called phenomenological because it transforms the world into mere phenomena. It is called reduction because it leads us back to the source of the meaning and existence of the experienced world” (Schmitt, 1976, p. 61).

Many contributors to phenomenological thought refer to Phenomenological Transcendental Reduction as Phenomenological Reduction, taking it for granted that reduction will mean the bracketing of the world as well as empirical knowledge (Giorgi, 1997; Karlsson, 1993; Moustakas, 1994; Polkinghorne, 1989;). In reaching Phenomenological Reduction, “the task is that of describing in textural language just

what one sees, not only in terms of the external object but also the internal act of consciousness, the experience as such, the rhythm and relationship between the phenomenon and self” (Moustakas, 1994).

Reduction is a reflective activity where the phenomenologist reflects back on their stream of consciousness, with the focus being on that which has just been experienced (Karlsson, 1993). According to Husserl, reflection should not change anything; rather it should bring to light that which was concealed in the experience.

The process of reduction can be attained using imaginative variation. According to Hermberg (2006), imaginative variation brackets the subject and any individualising characteristics of a phenomenon and thereby moves one to the necessary and general essence of the phenomenon.

One example of imaginative variation can be illustrated in the considering of the essence of a chair. By imaginatively varying the perception of the chair, we are able to grasp what is constant and therefore essential and what are “accidental qualities” (Hermberg, 2006). For example, if we are experiencing a red, wooden chair in front of us, and we can imagine it is blue, and it would still be a chair, therefore colour is not an essential aspect of chair. If we were to imagine it as metal it would remain a chair, and so wood is not essential. However, if we imagined it as liquid, it would no longer be a chair, and we can assume that solidness is an essential quality of chair. This process would continue until its limit has been reached and the phenomenologist is able to arrive at a complete structural analysis of the phenomenon (Karlsson, 1993). Alternatively, Husserl (1977) describes it as being able “to arrive at a structural differentiation among the infinite multiplicities of actual and possible cognitiones, that relate to the object in question and thus can somehow go together to make up the unity of an identifying synthesis” (Husserl, 1977, p. 63)

PHENOMENOLOGY AS A RESEARCH METHOD

Phenomenological research is concerned with the study of experience from the perspective of the individual. As an epistemology, phenomenological research

approaches are based in the realm of personal knowledge and subjectivity, with the emphasis on personal perspective and interpretation (Lester, 1999).

The phenomenological researcher uses descriptions of experience as they occur in everyday life as the basis for enquiry. These descriptions are systematically or methodically analysed so that the implicit or explicit meaning contained in them can be made clear and the organised to reveal the underlying structure of meaning (Giorgi, 1995), or the essence.

As an approach to research, phenomenologists are not focused too much on specific methodology (Hycner, 1985). As Keen (1975) so eloquently put it: …”unlike other methodologies, phenomenology cannot be reduced to a ‘cookbook’ set of instructions. It is more an approach, an attitude, an investigation posture with a certain set of goals.” (Keen, 1975, p. 41).

The following section will touch on certain concepts that are of particular relevance to the phenomenological researcher.

• The focus on lived experience of having been acquaintance raped Both narrative and phenomenological research focus on the lived experience of individuals; however, a phenomenological study will describe the meaning of the lived experience of the individuals as it pertains to a particular phenomenon (Miller & Salkind, 2002).

The aim of phenomenological research is to elicit naïve descriptions of experience as it is lived, rather than to collect embellished or narrative accounts that could be based on what the participant believes the researcher expects (Osborne, 1994).

By employing a phenomenological stance, characterised by the use of Epoche and phenomenological reduction, the researcher is able to connect with the Lebenswelt of the participant and from there identify the life experiences that pertain to the phenomenon under investigation.

• The influence of the researcher According to Jurema, Correia Pimentel, Corderio and Austregēsilo Nepomuceno (2006), phenomenological research is not only a methodological choice on the part of the inquisitive researcher, but it must be a choice that is adopted by someone who is invested in the fundamentals of phenomenology.

The role of the researcher in phenomenological research is therefore guided by the principles of phenomenological philosophy. As Husserl (1970) puts it, “the psychologist as such in his inquiry must…take and have no position: he must neither concur nor refuse, nor remain in problematic suspense, as if he has some say in the validities of the persons who are his subjects. So long as he has not acquired this posture as a serious and consciously established one, he has not arrived at his true subject matter” (Husserl, 1973, p. 240).

The challenges of phenomenological research transpires, as the researcher has to silence directing voices and remove himself from manipulating or predisposing influences in order to become completely attuned to what appears (Moustakas, 1994).

During the analysis stage of phenomenological research, there are opportunities for certain ‘judgment calls’ on the part of the researcher to be made (Hycner, 1985); these are particularly present during the delimitation of meaning units. However, if the researcher has been able to adopt a ‘transcendental attitude’ and bracket presuppositions, it seems that there is a minimal chance of subjective judgments creeping in (Hycner, 1985).

Finlay (2009) explores the relational approach to phenomenology and comments that phenomenological research data does not speak for itself but is rather “born within the between of the researcher/co researcher encounter” (Finlay, 2009, p. 2). The researcher is not a passive receiver of information as described by a participant, but is rather an active participant. Evans and Gilbert (2005) suggest that the researcher builds a bridge to the participant through the use of their own special awareness, skills, experience and knowledge. Although pure relational phenomenological research would entail the researcher to engage in active

reflexivity of their own experience, this is usually more appropriate for case study research of psychotherapy (Finlay, 2009). The concept of relational phenomenology has been mentioned here as it allows the researcher the opportunity to reflect on her own contribution to the study.

Working with rape victims for many years in a counselling setting has afforded the researcher the exposure to the concept that each rape victims comes with a unique and in some cases vastly different experience of her rape. Although each experience is different, theory regarding the psychological impact of rape tends to lead us to believe that there is a fairly generalised expectation of how a victim will experience her rape. The researcher is brining to the research relationship an awareness of the theoretical explanations of how a rape victim is expected to react as well as an acute awareness that each victim’s reaction is unique. It is believed that this awareness will facilitate an interview process where the participant is able to unfold her experience of her rape without prejudice. As the researcher usually encounters rape victims in her role as a therapist, it is also noted that her inclination towards empathic reflection in the encounters with the participants is a part of what the researcher brings to the relationship of the research interview. Rather than this constraining the neutrality of the researcher, relational phenomenology allows us to understand that this “open presence” is the researchers capacity to be emotionally and bodily present and actively listening to the participant (Finlay, 2009) and thus facilitating an intersubjective experience in which the research data can emerge.

RESEARCH PROCEDURE

The following section will address certain research procedure issues, such as the selection of participants, data collection, data analysis and finally ethical considerations.

• Selection of Participants Firstly, the selection of participants in phenomenological research will be explored, followed by the criteria for participant selection for this study and finally ethical considerations pertinent to participant selection will be addressed.

§ Selection of participants in phenomenological research Research participants in phenomenological research can also be referred to as co- researchers or research partners (Polkinghorne, 1989), these titles emphasise the interactive nature of phenomenological research. Participants are not treated as experimental objects; rather it is their role to share experiences with the researcher (Polkinghorne, 1989). However, for the purposes of this study, the term participants will be used.

Moustakas (1994) explains that there are no ‘in-advance’ criteria for locating and selecting research participants. Statistical sampling techniques, such as random sampling are not necessary for phenomenological research. Participant selection is usually carried out with the certain criteria in mind. Participants must have had the particular experience under investigation (Hycner, 1985; Moustakas, 1994; Polkinghorne, 1989). Participants also need to have the capacity to provide “full and sensitive descriptions” of their experience (Hycner, 1985). Van Kaam (1969) expands the notion of capacity by describing six important skills that are related to the participants’ ability to partake in the research:

1. The ability to express themselves linguistically. 2. The ability to sense and express inner feelings and emotions. 3. The ability to sense and express the experiences that accompany these inner feelings and emotions. 4. Have experienced the situation under investigation recently. 5. A relative interest in their experience. 6. The ability to report on what they have experienced.

The last criterion can be related to the atmosphere provided by the researcher in allowing the participant to feel necessarily relaxed and contained.

As phenomenological research focuses on qualitative and not quantitative issues, the number of participants is not a crucial aspect of the study. As Polkinghorne (1989) describes, the number of participants selected for phenomenological studies vary considerably. This variation can be attributed to the vast amount of relevant data that may emerge from just one interview (Hycner, 1985). However, the more

participants involved would lead to even more variation of the experienced being described, which can in turn lead to even more impactful insights about the invariant structure under investigation (Giorgi, 1995).

§ Criteria for selection of participants in the study As the aim of this study is to explore the lived experience of young female South African rape victims who have been raped by an acquaintance. The participants of this study are two South African female students, aged 18 who have by their own definition been acquaintance raped. Participants were recruited through the University of Johannesburg’s Student Counselling and Career Development division. Participants were informed of the study when they approached this facility for service (see appendix A for the information letter that was distributed). If they expressed interest in the study they were given the researchers contact details in order to discuss participation further. Participants were selected on the following criteria: • They are voluntarily joining the research, and are willing to partake in the interview process. • The participants are over the age of 18 years old (this is to exclude any possible confusion around child abuse and statutory rape in terms of the defining characteristics of the study). The researcher acknowledges that males are also victims of rape. However, 1 in 6 women compared to 1 in 33 men report having experienced an attempt or completed rape in their lifetime (Hensley, 2002). Therefore, due to the prevalence of female rape victims as well as for research clarification, only female participants were interviewed. • Be South African. In order to obtain a better sense of the South African rape victim, only South Africans were included in the study. • The occurrence of the rape was to have been reasonably recent, meaning that it could not have occurred too recently (less than three months to the time of the interview), and not too long ago. This criterion is stipulated in an attempt to ensure against deterioration of memories of the experience of the phenomenon under investigation if too much time has past since the rape and the interview, as well as against residual trauma symptoms that could be present and contribute strongly to the lived experience but are likely to dissipate three months post the rape incident (Rothbaum et al., 1992; Resnick, Kilpatrick & Lipovsky, 1991). The

participants selected had both experienced their rape incidents 4 months prior to the interview.

• Data collection § Interview As Moustakas (1994) describes, the phenomenological interview is an informal, interactive process that makes use of open-ended comments and questions. Questions used are aimed at evoking a comprehensive account of the participant’s experience of the phenomenon, and as each story or experience is shared, the questions may be varied, altered or not used (Moustakas, 1994).

The focus of the interview is on the life-world or experience of the participant and is theme-orientated and not person-orientated (Kvale, 1983). The interview is intended to discover descriptions of the experience itself without interpretation and theoretical explanations (Polkinghorne, 1989). Rather than interpret ambiguous statements, the researcher should aim to clarify these statements through further open-ended questions.

Each participant was interviewed in a manner that allowed for clarification and repeated opportunities for the participant to expand on what had been said. Once the participant was confident that all information relating to the research question had been answered and clarified the interview was terminated. With the participants consent interviews were audio taped. The interviews were conducted separately, were unstructured and began with the following question:

“As someone who has been raped, it is likely that you had certain feelings and reactions to this experience. Please can you describe as accurately and concretely as possible your psychological, emotional or personal reactions to your rape experience?”

During the interview, open-ended questions were asked based on the emerging data, in order to attain clarification or elaboration and to ensure that the participant has sufficient opportunity to express her viewpoint extensively (Giorgi, 1997). It is acknowledged by the author that it would be prudent to conduct a follow up interview in order to obtain further clarity on the research data. However, due to the sensitive

nature of the phenomenon under investigation, both respondents indicated that they would prefer only one interview session. As mentioned, clarifying questions were asked specifically keeping in mind that there would not be an opportunity for further interviewing.

• Analysis § The Scientific explication of the data A scientific explication of the data as described by Stones (1988) is outlined below. As Stones notes the phases of explication described are based on an understanding of phenomenological research presented by Colaizzi (1978), Giorgi (1975), Stevick (1971) and Van Kaam (1959).

The phases include the following stages that are not seen as operating independently but rather that they are likely to overlap with one another.

1. An intuitive holistic grasp of the data 2. Spontaneous emergence of Natural Meaning Units (NMUs) 3. Constituent Profile Descriptions 4. Second Order profiles 5. Hierarchical Categorization 6. Extended descriptions Each of the stages shall now be discussed:

1. An intuitive holistic grasp of the data

This stage incorporates the researches initial reading of the data, in this case, being the transcribed interviews from each of the participants. Keeping in mind the phenomenological concept of epoche, the researcher engages with the data while bracketing his or her own preconceptions and judgments, particularly regarding the phenomenon under investigation.

The transcripts are read again with a more reflective attitude in preparation of the subsequent stages. Essentially it is important that the researcher retains a sense of the wholeness of the data (Stones, 1988).

2. Spontaneous emergence of Natural Meaning Units (NMUs)

A Natural Meaning Unit (NMU) is defined as “...a statement made by [the subject] which is self-definable and self-delimiting in the expression of a single, recognised aspects of [the subject's] experience” (Cloonan, 1971, p. 117). In other words, a unit of text that expresses a self-contained meaning (Polkinghorne, 1989). When delineating the NMUs, Polkinghorne warns that “care must be taken to treat the text as a naïve and non-theoretical presentation of the subjects experience and to seek those divisions that are part of the subject's own experience” (Polkinghorne, 1989, p. 54).

A copy of the transcribed interview of each participant as well as the delineation of the NMUs is attached in appendix C and F.

3. Constituent Profile Descriptions

This stage of analysis involves the elimination of those NMUs that are repeated. According to Stones (1988), these would be the eliminating of the units that convey an identical intention or meaning. Once recurring units have been eliminated, attention is turned to those units that are irrelevant to the research question. Those that are obviously irrelevant are also eliminated. The remaining units are considered to be the First Order Profile as they are made up of non-repetitive and relevant statements concerning the phenomenon under investigation. The First Order Profile is then converted into a Constituent Profile Description, which is understood to be a condensed summary of the original data, containing the essence of what the participant expressed (Stones, 1988). The First Order Profile and Constituent Profile of each participant is found in appendix D and G.

4. Second Order Profiles

The Second Order Profile is an essential description of the raw data, which is obtained by repeating stages one through three on the Constituent Profile Description (Stones, 1988). This involves the listing and numbering of the elements

that emerge from these steps. As in the previous stage the elimination procedure ensures that any redundant constituents are removed.

The intention of obtaining the Second Order Profile is to develop an Essential Description of the raw data. This is achieved by making explicit that which is implicit in the data and containing all the essential elements relating to the phenomenon under investigation.

The Second Order Profiles of each of the participants is found in appendix E and H.

5. Hierarchical Categorisation

When the study includes more than one participant, as this study does, the fifth stage is included. This stage entails gathering the descriptive statements from all participants with similar meaning into clusters called Categories (Stones, 1988). Although the statements chosen to be grouped together in a category are similar, they are not necessarily identical. Categories can contain statements from just one participant or more than one.

Once the Categories are established, they are arranged in a hierarchy in order to facilitate the next stage of explication. The Categories are found in appendix I.

6. Extended descriptions

An extended description of the Categories is now developed. This entails describing what the first few clusters of Categories tell the researcher of the phenomenon under investigation (Stones, 1988). The description is then added to by considering the next category in the description, which could either extend the description or modify it. This procedure is repeated until all the Categories are considered. Once the essence of the data is obtained all the remaining Categories are systematically checked to ensure that they are compatible to the Extended Description (Stones, 1988). The thematic elements that are not comparable to Extended Description at this time are described and when possible shown that they are only “apparently incompatible” (Stones, 1988, p. 131) to the already described elements.

The Extended Description is found in appendix J and is discussed in the following chapter.

§ Validity of the Essential Description In the case of phenomenological research, validity is not indicated as another researcher using exactly the same words to describe the themes emerging from the data, but rather that the Extended Description are seen to be intersubjectively understood by a panel of judges to reflect an identical meaning or similar essential theme to the data that has been explicated by the original researcher (Stones, 1988).

ETHICAL CONSIDERATIONS

In order to ensure that the study meets required ethical standards, the study was proposed to and approved by the University of Johannesburg ethics committee.

Owing to the sensitive nature of sexual abuse and rape and the fact that phenomenological research requires that the participant connect with the essence of her experience, the researcher is acutely aware that the possibility of the participants experiencing uncomfortable and painful memories and emotions during the interview process. Participants were made aware of this possibility and should discomfort or distress arise as a result of the interview, the participant would be offered debriefing and therapeutic intervention as necessary.

Participants were made aware of the nature of the study and were given the opportunity to ask questions and gain clarity around their role in the study and their rights as participants. Each participant only participated in the study after receiving informed consent (see appendix B for copy of informed consent form).

None of the participants’ real names were used; rather numbers were used for ease of referral. When during their interviews participants made any referrals to names or places that may identify them, these were excluded or altered to be less specific, with the consent of the participant.

SUMMARY

This chapter endeavoured to provide an overview of the phenomenological framework as the overall research design employed in this study. The operational aspects of the study were explained and the aims of the study were stated. The research procedure was specified with regards to the selection of participants, collection and analysis of data. Certain ethical considerations were also discussed.

CHAPTER 4: RESULTS AND DISCUSSION

INTRODUCTION

The following chapter will present the results and conclusions obtained from the data analysis explained in the previous chapter. The phenomenological analyses lead to a description of the lived experiences of acquaintance rape of the participants involved in the study. Each of the participants is introduced and the narrative of their lived experience is presented. This introduction is followed by the extended description of the lived experience of the participants as it was explicated using the processes explained in the previous chapter. The description is broken down into relevant themes. Those themes include: being raped by someone you know, changes in life after the rape, the reactions of others to the disclosure of the rape, considering culpability, mixed emotional reactions, dealing with possible HIV infection, interpersonal trust, social support and perspective on the meaning of the ordeal. Each of themes are discussed and presented in relation to how they were expressed by each participant and how the relate to what is empirically known with regards to that theme, as reviewed in chapter two of the study.

INTRODUCING THE PARTICIPANTS

The following section introduces each of the participants and then aims to investigate and reflect on the description of the lived experience of two acquaintance rape victims as derived through a phenomenological explication of the interviews with the two participants of this study

• Participant One Participant One is an eighteen-year-old Zulu speaking black South African female. She has grown up in a well-educated family and is the last born in a family of four daughters. Participant One is currently studying a business related degree at an urban university.

She was raped by an acquaintance four months prior to the interview. She did not have a significant relationship with the perpetrator and the incident took the form of a

date rape. She did not report the rape to the police and did not need any medical intervention, as there were no physical injuries. Although she did not go for Post Exposure Prophylaxis treatment (PEP), she did test for HIV infection after the rape, and so far has tested negative. Participant One did seek psychological counselling relating to the rape.

The predominant reaction that Participant One expressed from her account of her experience was anger. Her feelings of anger were directed at others and had a significant impact on her interactions with others. She explains this in the following extract:

…it kind of came up by itself…it came with wanting to be alone… I felt angry at my whole life so I took it out on other people.

As she explains, her anger was connected with wanting to be alone, which manifested in social withdrawal. Although these reactions appeared to provide temporary relief and a sense of strength, she also found herself experiencing feelings of isolation as a result of pushing those around her away. Emanating from the feelings of isolation was a strong sense of loneliness.

She also experienced feelings of shame. Participant One describes feeling shame from the moment the rape ended. These feelings are also strongly related to the sense that she is in some way to blame for her rape. She perceives that others are judging her for any part she may have played in the rape, which in turn intensifies the shame that she experiences.

Although the feelings of shame decreased in the months since the rape, she still experiences shame intermittently. For Participant One, relying on people she can trust with her story and talking about it has helped. It is understandable that these two processes are important to her own sense of recovery, as she had expressed feeling misunderstood by others.

Reflecting on Participant One’s story, the most difficult aspects of her experience were related fundamentally to the feeling of shame. As she was raped by an

acquaintance, she blamed herself for her own actions that could have, in her mind, contributed to the assault. Fearing judgment by others as consenting to or possibly encouraging her perpetrator, she withdrew from those around her. Being isolated from the people that could provide support and perspective intensified feelings of loneliness, and increased the shame. As Participant One reflected on her feelings following the rape, she articulated how alone she felt in the following extract:

Because the people around me didn’t really fully understand what I had been through, and people around you when they haven’t gone through the same thing, they just carry on with life just normally, laughing and whatever, and I found it hard to be just around that when deep inside I was just hurt…

It seems that the emotion that was initially the most accessible for Participant One was anger. When she was expressing anger overtly, she felt less vulnerable. However, her anger was mostly directed at herself and the sense that she was to blame for what happened. Through counselling sessions and her own reflections, Participant One is in the process of letting go of the anger; and although she feels that she is moving on, she still finds it difficult to trust others. In her own understanding of the process, she has learnt a “negative lesson”.

{it’s} made me learn something about myself, and really made me stand up and think about certain things in my life and what I need to change…maybe not be as friendly and open to everyone…as some people are not as how they appear.”

• Participant Two Participant Two is an eighteen-year-old Tsonga speaking black South African female. She grew up in a rural town and is the fourth born of five children. She has two sisters and two brothers. Participant Two is currently studying towards a degree in Social Work at an urban university.

She was raped by her brother-in-law. She did not report the incident to the police and did not receive any medical interventions, and in particular did not receive any PEP

treatment, although she has tested negative for HIV infection since the rape. Participant Two had an existing relationship with her perpetrator, and experienced her rape as unexpected and forceful.

Participant Two’s reactions to her rape seem to be related, in the most part, to her interpersonal relationships. Her perpetrator was a family member and although this was the cause for much anger, in terms of not understanding how he came to do this to her, it was also the cause of much emotional conflict as she had to consider the impact of the rape on her family system. In the period shortly after the rape, she expressed feeling very concerned for her family. Her worry was directed toward her niece who may also be at risk of being a victim of the perpetrator’s actions. In addition, she was worried that if she disclosed the rape to her family members that it would cause a rift in the family for which she would be responsible. Her reaction towards the perpetrator is also conflicted. She is angry for the rape and yet has continued to maintain a relationship with him.

In terms of her experience of her psychological reaction to the rape, Participant Two expressed feeling angry and sad. However, her predominant reaction was a sense of avoidance. Behaviourally, Participant Two avoided her feelings by spending time with friends who did not know about the rape and was involved in drinking and going out often in an attempt to avoid the feelings that may be felt in reaction to the incident. In time she has developed insight that this behaviour was not helpful:

one can drink and drink and the problem can still be there and I felt as if I wasted my time and energy for that … the problem is still very much around, as a way I was trying to get rid of it by drinking and partying. I am proud to say that I am no longer doing it

Participant Two also found it difficult to concentrate on her studies and was not focused on her schoolwork, although she expresses a strong motivation to be successful in her life plan. Although Participant Two was wishing to forget about what had happened, her behaviour after the rape indicated that it had impacted on her functioning, particularly her academic functioning.

In terms of Participant Two’s coping strategies, she had prior to the rape developed an understanding that suffering had meaning and was a part of life, she felt that this helped her to gain perspective on what happened and to realise that she was in a healing process and needed to talk about what had happened. She has even expressed an interest in starting a support group for other victims of sexual abuse to further her own healing process and help others.

Although Participant Two articulated a story that implied that she had adjusted well after her rape there were still aspects that she seemed to have difficulty adjusting to. The most significant being the possibility of being HIV positive. Participant Two expressed a deep fear that she may have been infected in the rape and although she has tested negative frequently since the rape, she is still concerned. It was with regards to the possibility of being HIV positive that she was able to express various emotional reactions. She felt fearful and suicidal when she considered her possible infection. Although she had managed to develop coping skills with regards to the rape, she expressed that being HIV positive was not something she could cope with, as the following extract explains:

I was very worried. Many things would come into my mind. What if I am HIV positive? By that time I was thinking of committing suicide, if I find that if I am HIV positive I am done with this living.

When she considered the possibility of being HIV positive, Participant Two reflected on her part in the rape and felt guilty that she had not fought back. Although she reported feeling no guilt for the rape, if she was HIV positive, she felt that she would have felt guilty for ‘freezing’ and not fighting back during the rape. Although by her own admittance, she was terrified during the rape that any resistance would have resulted in a threat to her life.

THE EXTENDED DESCRIPTION OF THE DATA

The lived experience of participant one and two of having been raped by an acquaintance, as explicated in the previous chapter is described in the following paragraphs. The extended description contains themes that are related to the

experience of having been acquaintance raped. Each theme is further discussed as it pertains to each of the participants and the existing knowledge regarding that theme.

The extended description is as follows:

Being raped by someone you know is so unexpected and while the rape is happening the reactions of freezing and feeling vulnerable and helpless exists1. In the time after the rape life loses meaning and can lead to various reactions such as lack of energy, suicide idealation, social withdraw and changes in every day behaviour2.

As the victim considers culpability regarding the rape, the reactions of others is a predominate factor, others are thought of to be judging the victim and hence resulting in the victim feeling misunderstood or pitied3. When the victim considers her own culpability, blame is associated with behaviours that may have contributed to the rape happening or a lack of action to prevent it4.

The emotional reactions are described as being mixed. These include feeling shame, guilt, anger and sadness5.

Dealing with the possibility of HIV infection can intensify the emotional reaction of guilt and lead to suicide idealation should infection have occurred6.

Knowing the rapist can lead to either an extreme response of losing trust in males at large or to having to isolate the incident and continue a relationship with the perpetrator7.

1 Being raped by someone you know – discussed on p. 86. 2 Changes in life after the rape –discussed on p. 88. 3 Reactions of others to the disclosure of the rape – discussed on pg. 90. 4 Considering culpability – discussed on pg. 93. 5 Mixed emotional reactions – discussed on pg. 95. 6 Dealing with possible HIV infection – discussed on pg. 100. 7 Interpersonal trust – discussed on pg. 102.

Talking to others and feeling understood and supported is beneficial and aids recovering from rape. Having a future perspective of wanting to help and support others who have experienced a similar ordeal can also be beneficial8.

Perspectives on what the rape means can have both a damaging or uplifting result9.

It is important to keep in mind that although the above description expands on the lived experience of both participants of this study, there are some aspects of the lived experience that are shared and others that are unique to each participant. This is acknowledged by the researcher to embody the phenomenon of rape experience, as there are aspects of being raped that are seen time and time again to be shared by many victims, as research discussed in previous chapters of this study have shown. Yet at the same time, each rape experience is unique and one cannot assume that each victim of rape, be it acquaintance or stranger rape, shall go through the same lived experience.

The following themes have been identified to represent the description of the lived experience as explicated from the data:

1. Being raped by someone you know 2. Changes in life after the rape 3. The Reactions of others to the disclosure of the rape 4. Considering culpability 5. Mixed emotional reactions 6. Dealing with possible HIV infection 7. Interpersonal trust 8. Social support 9. Perspective on the meaning of the ordeal

8 Social support – discussed on pg. 105. 9 Perspectives on the meaning of the ordeal – discussed on pg. 107.

THEMES EMERGING FROM THE DATA ANALYSIS

1. Being raped by someone you know

Being raped by someone you know is so unexpected and while the rape is happening the reactions of freezing and feeling vulnerable and helpless exists

It is known that more rapes are perpetrated by someone known to the victim than strangers (Burger, Gould & Newham, 2010), the idea of being raped by someone that you know, and hence someone that you trust in some way, can be so unexpected. Stranger rape victims are often involved in a criminal incident as a lead up to the rape, such as house burglary or abduction, this can be said to prepare them in some way to the possibility of being assaulted sexually. However, in an acquaintance rape scenario one is not likely to be considering a possible sexual assault and therefore may not be prepared. Studies have suggested that women who were being assaulted by someone that they knew hesitated or were less prepared psychologically to use active avoidance than women who were assaulted by strangers (Bart & O’Brien, 1985; Levine-MacCombie & Koss, 1986).

The realisation that one is now being assaulted by someone that you know is described by one of the participants as leaving her feeling vulnerable and helpless. This can understood in light of a sense of control that a person may believe that they have. If a person believes that they could have avoided the rape in some way, their sense of power, realistic or not, is kept in tact (Janoff-Bulman, 1979). However, in the case of an acquaintance rape, the sense of control or power over ones’ “safe” environments, such as home or a friend’s house is lost, as these are possible places where the rapes can occur.

Rape victims often describe, “freezing” as one of the reactions they experience. In this study Participant One described this reaction as follows:

I froze, I froze and I was for that moment, I was never thinking about anything. I just froze…I didn’t even move, I didn’t even fight, I guess, I just remained constant as the way I was.

When a person is faced with a terrifying or traumatic event they are likely to experience an acute stress reaction. This being the physiological response to an event wherein the sympathetic nervous system responds in order to prepare the person to react to the incident. It is commonly referred to as the “Fight or Flight” response as first coined by Cannon in 1929. In recent years there has been a drive to expand our simple understanding of just a fight or flight response to include other acute stress reactions such as freeze and fright (Bracha, Ralston, Matsukawa, Williams & Bracha, 2004). According to Bracha et al., (2004), the freezing response is what clinicians typically refer to as hypervigilance – an initial freezing in order to “Stop, look and listen”. The term “Fright” refers to the tonic immobility that occurs once a person or animal chooses to “play dead” rather than flee or fight. Tonic immobility and the term freeze have been used interchangeably and can hence explain the tendency for “freeze” to describe a “play dead” reaction rather than a “stop, look and listen” one (Bracha et al., 2004).

When a person is being raped by someone they know it is likely that they may not experience the situation as potentially life threatening as a violent stranger rape. However, an acquaintance rape is still a traumatic event and the stress reaction of fright (or commonly called freezing) is understandable as the victims makes the survival choice to be immobile rather than to risk harm by fighting back or fleeing (Marx, Forsyth, Gallup, Fusé & Lexington, 2008). Studies exploring the presence of tonic immobility in rape victims found that 41%-52% of rape victims experience tonic immobility during their assault (Fusé, Forsyth, Marx, Gallup, & Weaver, 2007; Heidt,

Marx, & Forsyth, 2005)

The link between tonic immobility experienced during sexual assault and the subsequent development of PTSD has been explored (Bovin, Jager-Hyman, Gold, Marx & Sloan, 2008). The fright response is said to be confusing for rape victims as they may not understand their lack of active resistance (Bovin et al., 2008).

One of the participants in this study reflected that she felt guilty that she had not done anything to attempt to stop the rape. Her comment is as follows:

I can say that at this time I was feeling guilty… because I never fought back while he was raping I should have prevented that at the time. So I blame myself for that.

If through counselling, the victim is able to understand that her response can be an automatic reaction in which her survival instincts choose between fighting, fleeing, hyper vigilance or immobility, she may be better equipped to deal with the feelings of guilt and shame which are reported to be common reactions to a rape (Marx et al., 2008).

2. Changes in life after the rape

In the time after the rape life loses meaning and can lead to various reactions such as lack of energy, suicide idealation, social withdraw and changes in every day behaviour.

Victims regularly describe rape as an event that disrupts their life (Hanson et al., 2010; Nadelson, Notman, Zackson, & Gornick, 1982; Resick et al., 1981). In the period after a rape, the victim is faced with having to recover from the physical as well as emotional consequences of the rape. If the victim has chosen to not disclose the rape, she is often forced to deal with these consequences on her own.

Physiological consequences include possible injuries, possible pregnancy and the possible infection of sexually transmitted diseases. These consequences can lead to the victim now having to face life-changing decisions. The ordeal of now having to deal with these possibilities while the victim is still trying to make sense of her rape can exasperate the feelings of being overwhelmed experienced after the rape. How each victim deals with the emotional and physical experiences after the rape can depend on her previously used coping strategies or ones that are developed as a direct result of the rape.

The participants of this study reported social withdraw and behaviour changes as the initial coping strategies utilised after each of their rapes. The first participant described her social withdraw as follows:

I just kept to myself more, I was less talkative, less outgoing I just didn’t have energy, no energy for anything, and that is all I can remember. I just wanted to be alone a lot more.

Social withdraw can be understood as the victim’s need to withdraw from close relationships and yet to also seek them out for support (Herman, 1997); as described with comments like “I was feeling lonely, that no-one really cares about me, that I am all alone in this world” (Participant Two) and “I just wanted to be alone a lot more” (Participant One) as well as comments of needing social connection such as “it made me feel very lonely because I didn’t have anyone who can help me, and anyone I could talk to” (Participant One).

Participant One reports changes to be more general, such the general loss of meaning. She lists school, going out with friends and even eating as all losing their meaning. Participant Two describes in more detail activities as having changed due to experience of the rape. She describes some of these activities as follows:

I will bunk classes, I will not do my homework because I didn’t do my homework as a result. So, I never wanted to come into contact with people as a result

I would not concentrate during a lecture class and a lecturer would be teaching and I would be doing other things to distract myself. I would distract myself as far as possible.

…go to parties, drink a lot, bunk classes…

I was trying to get rid of it by drinking and partying.

According to Nadelson et al., (1982) major life changing decisions after a rape can include moving home or cities or changing jobs. Neither of the participants of this study reported such changes at the time of the interview. This could be due to their age, as both are 18 years old and studying at tertiary level. Major decisions such as

moving home or changing jobs are not likely to be viable or possible at this age. It is possible that these changes could emerge later in life, possibly if there were any additional victimisations. As Fischer and Wertz (1979) point out in their study of criminal victimisation, being victimised disrupts daily routine. Their study can be drawn upon as a source of reflection as it employed the same qualitative phenomenological research design as this study, although they investigated the loved experience of being criminally victimised, their study did exclude completed rape victims.

3. Reactions of others to the disclosure of the rape

How others react to a victim’s disclosure of her rape is seen by the two participants of this study to be of great concern. It is understandable that how others react will also influence how the victim attributes blame for the incident as well as how much social support is gained after the rape. The dynamic of blame and the impact of social support will be discussed in following sections.

The reaction of others to a victim’s disclosure of rape has been documented to have an affect on the victim’s recovery (Filipas & Ullman, 2001). Certain research indicates that a negative reaction from others will delay and complicate the victim’s recovery (Davis et al., 1991; Frank et al., 1988; Ullman, 1996a, 1996b, 1996c) while other studies report that positive or supportive reactions will enhance recovery (Borja et al., 2006).

The participants of this study both indicated that they were concerned about how others would react. Participant One describes her concern as:

I didn’t have anyone who can help me, and anyone I could talk to cos if I talked to my friend who has been my friend since we were in grade one, and she didn’t know how to answer me and it made me feel lonely, and

like maybe I’m just being crazy, maybe I’m overreacting to certain things, that’s what it made me feel.

Participant Two

…people will react in a way that one will never want that reaction to come out…

Being concerned about how others will react can be understood to be connected to the victim’s own pre-rape beliefs regarding rape myths. If a rape victim felt before her rape that victims of rape have in some way contributed to the rape, then they may be more likely to think that others will have the same belief and hence will respond in a negative and judgemental way. Participant Two may have a pre-rape belief that rape victims are to be pitied as seen in her comment:

People will say “Agg, shame man”, what kind of a thing, some people will even say, those who are cruel, I wanted it and deserved it.

… I will tell people but they were not in that good stage of telling me what I wanted to hear in that time. Some people would say “Agg shame” and that was not the thing I wanted to hear from them because I did not want them to feel sorry for me.

Participant One on the other hand seemed to be experiencing more concern that people would judge the rape as being her fault.

I still feel like now like people who know about it judge me in a way about it, I feel like maybe they think it is my fault and they’re judging me and I feel even they can see certain things and that’s why I wanted to just keep myself, keep it to myself to the point that I just wish I’d not even told my friends and just kept it to myself

I told her that I feel like you all judge me and she told me we don’t judge you, your just being paranoid but I just cant help feeling like that.

It is interesting to note that in both participants’ experiences, neither of them actually experienced a negative reaction from close friends or family, and yet their concern for how others would react was not influenced by actual reactions. This notion seems to reinforce the idea that the victims own preconceived ideas about rape victims holds strong, even in the light of actual reactions of others. Borja and colleagues explored the link between reactions of others to a rape disclosure and subsequent adjustment, and found that negative reactions from informal support structures (such as friends or family) were associated with difficulties in adjustment (Broja et al., 2006); meaning that the participants of this studys concern regarding the possible reactions of others was founded, but fortunately for each of them, did not materialise in negative responses.

Participant Two mentions her culture’s possible response to people who have been raped. She describes:

Sometimes, because in our culture there are many people who will say that she wanted it. That’s why we should not feel sorry for her, she deserves it. That’s why sometimes I was feeling guilty as a result of my culture.

The rape myths that are adopted by a cultural can be said to influence how the victim is seen to be accountable for the incident (Miller, Amacker & King, 2010). Although Participant Two mentions her culture influencing her feelings of guilt, in that she is thought to have “wanted it”; she also accounts that she does not feel guilt or responsible for the rape:

No, I never felt any guilt. Because I know what…I am not ashamed of what had happened to me, I never wanted it to happen, I never applied for that kind of behaviour, the behaviour for him to invade my rights

It would seem apparent that in the case of Participant Two, she was able formulate her own unique appraisal of her rape without allowing her culture’s acceptance of rape myths to influence her. Perhaps this phenomenon helps us to understand how

the research mentioned at the beginning of this section can be so contradictory. Meaning that although victims of rape are concerned about the reactions of others to their rape, the impact that this reaction has is not necessarily effective in influencing their own recovery (Borja et al., 2006).

4. Considering culpability

When the victim considers her own culpability, blame is associated with behaviours that may have contributed to the rape happening or a lack of action to prevent it.

It has been discussed that victims of acquaintance rape are more likely to experience self-blame for the incident than victims of stranger rape (Nadon, 2003). Furthermore, self-blame has been associated in the literature with poorer adjustment (Frazier, 1990) and the experience of shame and guilt (Tangney, 1996). In Eagle’s approach to counselling rape victims, the focus is put on reframing the blame from self to perpetrator, implying that blaming one’s self is an expected reaction of rape victims (Eagle, 1998).

Participant One of this study found herself questioning her own actions with regard to culpability of the rape. She can comprehend that it was not her fault, and yet wonders if she had done things differently, as seen in the following comments:

…I know deep down it wasn’t my fault, I didn’t know something like that would happen, and I said, had I said, I don’t want certain things to happen and he agreed, but then again I think maybe if I just didn’t leave, maybe it would have been differen.t

…I should be angry at myself more because I let it happen.

The argument for the presence of self-blame as a reaction to rape is that if the victim blames herself for the rape, she can attribute the rape to certain factors which are in some way in her control, such as her behaviours or her character; and then by not displaying those behaviours or characteristics in the future it would mean that the victim could have control over her life and possible future assaults. This notion of self-blame as a mechanism to regain a sense of mastery over events was first

thought to enhance recovery from rape (Janoff-Bulman, 1979). As discussed previously, the relationship between self-blame and post rape adjustment is well researched (Breitenbecher, 2006; Katz & Burt, 1988; Meyer & Taylor, 1986; Ullman et al., 2007) and although different conclusions are presented, it seems that self- blame, in whatever form, does not contribute to positive adjustment post-rape. Fishcer and Wertz (1979) also mention that victims of criminalisation (excluding completed rape victims) are also likely to consider their role in the crime.

Within the South African context, where the possibility of experiencing a rape incident is so high, with estimates being that one in three South African women would be raped in their lifetime (Coetzer, 2005), it may be illogical for the victim to attribute rape to internal factors. It is possible that many South African females are of the belief that they are likely to be victims of crime at some stage in their lives, and therefore would not feel that by changing their behaviour they are in control of that possibility. This may account for the lack of guilt or little self-blame in the experiences of Participant Two. She comments of suffering being a part of life and hence she feels no shame:

we are born to suffer, that woman are born to suffer. That I had to endure the pain that I was going through.

I am not ashamed of what had happened to me, I never wanted it to happen, I never applied for that kind of behaviour, the behaviour for him to invade my rights.

When working with rape victims, establishing if a victim of rape is experiencing self- blame needs to occur before any assumptions are made regarding the nature of that self-blame and the impact that it has on the victim. If a victim of rape is experiencing a sense of self-blame it can be indicative of the presence of feelings of guilt or shame, but this must not be assumed and must be explored and validated with the victim.

5. Mixed emotional reactions

The emotional reactions are described as being mixed. These include feeling shame, guilt, anger and sadness.

The two participants of this study describe a mixture of emotions when recounting their experience of having been raped. Not only do their accounts vary with regards to each other, they are also mixed in their own experiences. Participant One describes feeling shame and anger, as seen in the following comments:

…I don’t know maybe shame, in a way for me, cos its, I feel if I blame myself about something I just feel shame on me…

[Anger] kind of came up by itself, I …it came with wanting to be alone, so if somebody wanted come into my circle I just want to push them away and if some body is begging me for something, then its like can’t you see I am not in a good space so stay away so I could explain it that way. I felt angry at my whole

life so I took it out on other people.

Participant Two describes feeling angry, sad and guilty towards the possibility of having been raped and possibly infected with HIV. She also reports having mixed feelings towards the perpetrator and feelings of denial, as seen in the following comments:

I was angry, at times I was sad. And I will break some things around me, ja.

It was only the option because I can say that at this time I was feeling guilty, maybe I was the cause of the HIV positive result, because I never fought back while he was raping I should have prevented that at the time. So I blame myself for that.

I would not concentrate during a lecture class and a lecturer would be teaching and I would be doing other things to distract myself. I would distract myself as far as possible. I was in denial for that time. I was in denial.

He told me he was sorry but…I still have these mixed feelings that, this person is not sorry. But now I can see that he is sorry but being drunk does not give him the right to go into people lives and raped them the way he has.

The following sections will discuss each of the emotions experienced by the participants of this study, namely anger, sadness, shame and guilt.

Anger is reported in the literature as a common and understandable reaction to rape (Lee & Rosenthal, 1983; Riggs et al., 1992; Yassen & Glass, 1984) it is also linked with the experience of PTSD. According to Riggs et al. (1992), victims who are initially very angry, and who hold in their anger, have more severe PTSD symptoms during the month following the assault. Orth et al. (2008) support the claim that there is a link between anger and PTSD following an assault but describe this link as PTSD predicting levels of anger and not anger predicting PTSD. When this understanding is applied to the participants of this study, it could be interpreted that Participant One was experiencing possible PTSD as she seems to struggle with anger towards herself, the perpetrator and others following the assault. She also reports the anger subsiding over the period following the rape, which is consistent with reports that PTSD in rape victims tends to subside by three months post rape (Resnick et al., 1991; Rothbaum et al., 1992).

Participant One, describes her anger towards those around her as:

[It] feels like nobody understands me and everyone’s out to get me so I have to be angry just to show them that I am also strong in a way.

The following comments from Participant One indicates how she experiences her anger changing over time:

… I wouldn’t really say it helped me, it was like a quick fix, but it wasn’t healthy to be angry all the time.

I feel so much better actually now, I just feel, because like I said, the anger is gone, I am more at peace. I have talked to someone else whose has made me see it in the right perspective so I am not as angry at myself anymore, and I am no longer angry at him, because when I shifted the anger from me it went to him, and now I’m no longer angry at him, because it just doesn’t help to be angry forever.

The idea that anger may present as a form of anxiety avoidance is discussed by Riggs et al. (1992), as they conceptualised that when a victim experiences intrusive thoughts or flashbacks after the trauma, their level of anxiety increases as they are unable to control these thoughts and reactions and escape from them is impossible. Rather than deal with the fear that accompanies such anxiety, the victim may attempt to reduce the anxiety through focusing on other reactions, such anger. By focusing their emotions and thoughts on how angry they feel towards the perpetrator, legal system, lack of safety etc., the victim is able to avoid the anxiety and fear she is experiencing. Anger may also increase a victim’s sense of control, as they may feel that if they are angry and they direct their anger towards something, that they may be able to control circumstances and thus regain some sense of control after the rape.

There is a distinct lack of sources that reflect on the presence of sadness as it pertains to the experience of rape. The existing literature rather considers sadness as a symptom of depression as it pertains to PTSD and rape victims. Although depression is a significant reaction to a rape experience, it is important to note that ruminating in feelings of sadness after a rape incident does not necessarily indicate depression (Conway, Mendelson, Giannopoulos, Csank & Holm, 2004). Although Participant Two mentions feeling sad, she does not describe this feeling in any further detail. She also does not describe feeling depressed.

Guilt and shame are two emotional responses to trauma that can be described as closely related (Carlson, 2007). According to Tangney and Dearing (2002), shame and guilt are “self-conscious and moral” emotions. Meaning that they involve the self-evaluating the self and they presumably play a role in fostering moral behaviour. However, clear distinctions have been made between the two responses (Lee et al., 2001; Tangney & Dearing, 2002).

Shame is defined as “an extremely ugly and painful feeling that has a negative impact on interpersonal behaviour. Shame-prone individuals appear relatively more likely to blame others (as well as themselves) for negative events, more prone to seething, bitter, resentful kind of anger and hostility, and less able to empathise with others in general” (Tangney & Dearing, 2002, p. 3.). Shame can be experienced externally, where the individual relates to the experience with one’s social presentation, with feelings such as being unattractive or devalued (Lee et al., 2001); or internally where the individual sees aspects of themselves as undesirable even though there is not an audience to judge these aspects (Gilbert, 1998).

Guilt is seen to not be as bad as shame as guilt prone individuals are better able to empathise and accept responsibility for negative interpersonal events. Guilt is less likely than shame to elicit anger (Tangney & Dearing, 2002). Shame prone individuals are also less likely to seek treatment for their trauma as they are inclined to avoid thoughts and reminders of the shaming event (Blum, 2008). When considering the possible elevated anger and avoidance of seeking help, the experience of shame as a reaction to rape can more harmful than guilt.

The participants of this study seem to encapsulate the contradictions that can be found in the literature. Participant One reports significant experiences of shame and related anger. Participant Two on the other hand does not describe shame as a part of her lived experience. She does mention guilt, but relates it to the possibility of being infected with HIV.

It is interesting to note Lesekela and colleagues’ point regarding proneness to shame as a predisposing risk factor for PTSD (Lesekela et al., 2002) as it could relate to Participant One. Participant One does recount a previous experience that seems to describe shame. Take note of the internal and external shame as described by Lee et al. (2001) in her comments:

I’d say I had a lot of self esteem issues in my life to the point that I almost took my own life, so when this one also happened it kind of put me in the same position that I was before that I just didn’t want to keep on living as I felt before.

…before I had kept it all inside of me, and same as before, no one understood me, and if I did try to talk about it people would be like you are crazy and that just kind of made you just feel like I should keep it to my self and that got more lonely, I don’t know how I got through it all but I did, and this time I thought ok, I don’t think I can handle this for a second time again but I talked to a counsellor and I felt a lot better.

Participant Two on the other hand expresses confidence in her experience of not having experienced shame. Rather than relating her rape as impacting her internal evaluation of herself, she explains that this can happen to anyone and she did nothing to invite it. The following comments illustrate these points:

… we are born to suffer, that woman are born to suffer. That I had to endure the pain that I was going through.

Understanding whether a rape victim is experiencing guilt or shame, or neither needs to be an essential component of treatment. Realising what the victim is experiencing emotionally will help practitioners to understand the interplay of

emotional experiences with PTSD (Lesekela et al., 2002) as well assist in the decision of which treatment modality would best serve the distinctive experience each victim is going through (Bransen, Elklit & Nielsen, 2009; Campbell, 2008; Nishith et al., 2005; Vickerman & Margolin, 2009).

6. Dealing with possible HIV infection

Dealing with the possibility of HIV infection can intensify the emotional reaction of guilt and lead to suicide idealation should infection have occurred.

According to the 2009 United Nations Programme for HIV/AIDS (UNAIDS) and the World Health Organisation (WHO) report on the AIDS epidemic South Africa’s rate of infection amongst adults was the 4th highest in the world (UNIADS & WHO, 2009). This statistic indicates the high probability of being exposed to HIV infections that sexually active South Africans face. In the case of rape, the threat of exposure to HIV and the lack of control around safety measures, such as condom use, are high. This means that in most rape cases, even acquaintance rapes, the victim has to not only face the fact that she has just been raped, but also have to deal with the possibility of being infected with HIV.

Both participants of this study were exposed to risk of infection and although they both did test for HIV infection after the rape, neither took Post Exposure Prophylaxis medication. In Participant One’s account of her lived experience of having been raped, she did not relate to the experience of being at risk for HIV infection. However, Participant Two did relate to this experience, which she described in ways that appeared more emotionally intense that her experience of the rape itself. She comments on how the thought of being at risk to HIV lead to her to contemplate suicide, as this following comments show:

I was very worried. Many things would come into my mind. What if I am HIV positive? By that time I was thinking of committing suicide, if I find that if I am HIV positive I am done with this living. I can forget

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about this home based care and living. I am done with that. But when the results came back negative I was so happy

If you find that you are HIV positive “commit suicide, commit suicide, commit suicide”. Like that I was no longer focusing on myself.

There is a sense that Participant Two splits her reactions toward possibly being infected with HIV as separate to having been raped. She is able to make use of various coping strategies to make sense of her rape and yet these do not seem to be utilised with regards to her experience of the threat of HIV infection. She very clearly described feeling no guilt or self-blame for the rape, yet describes feeling guilty that she was not able to prevent the possible exposure to HIV. She describes that if she was HIV positive that it would be her fault for not fighting back harder during the rape, as the following extract shows:

I was feeling guilty, maybe I was the cause of the HIV positive result, because I never fought back while he was raping I should have prevented that at the time. So I blame myself for that.

As there is a three month “window period” period between the possible infection of HIV and the conclusive testing for the presence of antibodies, it is likely that during that period the rape victim is more focused on dealing with her possible HIV infection and not on the processing of the experience of having been raped. In her lived experience of the ordeal, all the feelings experienced in the first three months post rape could easily be associated to the possible HIV infection and not to the rape itself. It is possible that with regards to Participant Two, that her feelings of guilt and self-blame which she was experiencing after the rape in relation to possibly being HIV positive, could also have been associated with feeling guilt and self-blame about the rape. However, as she associated those feelings with the possible HIV infection, once she was tested negative after the window period, she was able to abandon those feelings and not associate them to the experience. As she describes in the following comment, she was only able to be happy once the results were negative:

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This hypothesis can be supported by the knowledge that three months post rape approximately 50% of rape victim’s show a significant drop in the experiencing of post traumatic stress (Resnick et al., 1991; Rothbaum et al., 1992). It is likely that Participant Two did experience more post traumatic stress than she describes, however she has associated these experiences more facing the possible HIV infection rather than the rape experience itself. . In the South African context the probability of possible HIV infection after a rape is too vast to ignore, and yet most research emerging on the topic does not address the impact that this possibility has on victims, but rather discusses PEP treatment issues (Abrahams et al., 2010; Abrahams, & Jewkes, 2010; Kim et al., 2009; McQuoid-Mason, Dhai & Moodley, 2003) intimate partner violence and the presence of HIV infection (Jewkes, Dunkle, Nduna & Jama Shai, 2010) and gender inequalities (Jewkes, 2010) meaning that there is a need to explore the impact of HIV exposure to the lived experience of rape for the South African victim.

7. Interpersonal trust

Knowing the rapist can lead to either an extreme response of losing trust in males at large or to having to isolate the incident and continue a relationship with the perpetrator.

Trust in others is significantly disrupted after rape (Resick et al., 1991). In particular, when the rape is perpetrated by someone that the victim knows, these victims are more likely to experience disruptions in their trust of others than those who are raped by strangers (Guerette & Caron, 2007; McCann & Pearlman, 1990). When a victim seeks help after a rape, it is important that she is able to rebuild her ability to trust others, although this ability can be adjusted to include the realisation that not all people are good and their intentions honourable.

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For Participant One, her trust in others, particularly males, was damaged as she describes in the following comments:

I had trust, so that trust been broken, I just I know deep down it wasn’t my fault, I didn’t know something like that would happen, and I said, had I said, I don’t want certain things to happen and he agreed.

About trust, mostly trust in guys, it just went to zero, dropped to zero, I just felt I couldn’t trust anyone, um, cos everyone was out there just to use me.

Yeah any guy, maybe in my family I could feel like I still have that trust but someone whose not my family, friends and anyone I meet that day, I just I had no trust at all.

When she reflects on her experience of having been raped, she also reflects on the lesson that she has learnt, that not all people are trust worthy. To her this is a negative lesson, as prior to the rape she had a belief that she could trust people openly. Her comments regarding this are as follows:

[It] made me learn something about myself and really made me stand up and think about certain things in my life and what I need to change in my life perhaps and maybe not being as friendly and open to every one as I have always been as some people aren’t as how the appear.

[It was a] negative [lesson] because it effected my life negatively more than positively, ja, I’d say it has a lot of negative implications and positive not much, just learning not to trust as much as I did before.

Participant Two does not describe disruptions to trust in her account of her lived experience. She mentions in the follow comment how she trusted her perpetrator and that she still has a relationship with him:

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... I never expected him to do this kind of a thing especially to me, because we were really close, we were really close. I was shocked at the same time, still surprised. How can he do this to me, I trusted him. But still I don’t have those bad feelings towards him, I don’t have bad feelings.

Rather than generalise her rape incident to all males, Participant Two rather chooses to isolate the incident and hence does not experience disruptions in trust. She not only isolates the incident from attributing blame to all males, but even isolates the event from her brother-in-law’s character by focusing on his behaviour in her comments that he was drunk and hence the rape. Doing so allows her to be able to continue a relationship with her perpetrator as her need to keep her family system intact dominates, as seen in the following comments:

I am trying my level best to maintain that standard, that he is still my brother in law and I still respect him the way I did the last time. We have to move on both of us, especially myself I have to move on. I still maintain the same standards that we used to have in the relationship we used to have before. I understand that people can make mistakes and when I wanted to report him, it will have resulted in a conflict within my family structure.

…I am also feeling sorry for the guy because he is from Nigeria, an outsider but it doesn’t give him the right to do what he did. So I am feeling sorry for him. Because an outsider will get harsh treatment especially from my family. So I want to keep that family still functioning together like we used to do.

Understanding the way in which a rape incident has disrupted trust is an important aspect for clinicians to consider. Vaile-Wright and colleagues (2010) suggest that it is important for therapists to pay attention to the cognitive restructuring of schemas

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which have been disrupted as a result of sexual trauma, of which trust is one of them (Vaile Wright, Collinsworth & Fitzgerald, 2010).

8. Social Support

Social support and especially the support of family, romantic partners or friends can have a strong influence on the recovery from a traumatic experience (Herman, 1997; Littleton, 2010; Resick, 1993). As previously discussed, social support has been found to be associated with better adjustment after rape (Burgess & Holmstrom, 1978; Frazier & Burnett, 1994; Frazier et al., 2004; Ozer et al., 2003)

When considering the lived experience of the participants of this study, there were inferences made by both regarding social support and the impact that it had. For Participant One, she felt alone and misunderstood while she was withdrawn from her social networks; however, once she began to talk about what had happened she was able to resolve some of her anger and begin to move towards recovery, as seen in her comments:

Now I feel so much better actually now, I just feel cos like I said the anger is gone I am more at peace I have talked to someone else whose has made me see it in the right perspective so I am not as angry at myself anymore, and I am no longer angry at him, cos when I shifted the anger from me it went to him, and now I’m no longer angry at him, cos it just doesn’t help to be angry forever.

This time um talking about it, talking about it was the best way, cos before I had kept it all inside of me, and same as before, no one understood me, and if I did try to talk about it people would be like you

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are crazy and that just kind of made you just feel like I should keep it to my self and that got more lonely, I don’t know how I got through it all but I did, and this time I thought ok, I don’t think I can handle this for a second time again but I talked to a counsellor and I felt a lot better.

Participant Two also expressed that talking to those who supported her helped her to feel better and move on from the rape. She speaks of wanting to begin a support group as a result of her realisation that social support has such a positive impact on her recovery. She comments as follows:

Talking helped me to get rid of these feelings

So talking to my friends and boyfriend helped me, because he understood me, better than anyone else. Also consulting Miss XXX helped me a lot.

My boyfriend offered me support that I needed; he told me the right words that lead to here…He told me “you are not the cause of your rape. You are not the cause of your rape. No one will ever wish of that kind of thing, even your worst enemy you won’t wish for him or her to be raped. So don’t blame yourself for being raped be strong and look at life in a positive light.

When one considers the obvious impact that social support has had on the participants as well as the results discussed in the literature, it is important that when one is dealing with a victim after their rape, that connecting them with a social support network and encouraging them to rely on the network will likely have a significant impact on their recovery.

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9. Making meaning – perspectives on the meaning of being raped

Perspectives on what the rape means can have both a damaging or uplifting result.

How a victim makes sense of her rape can be thought to be closely linked to how she adjusts to the incident. Positive adjustments can include aspects such as improved relationships, development of new possibilities, a greater appreciation for life, a greater sense of personal strength, and spiritual development (Linley, Joseph, Cooper, Harris, & Meyer, 2003; Tedeschi & Calhoun 1995). Negative adjustments would include persistent posttraumatic stress, inability to resume meaningful relationships and psychopathology, such as mood or anxiety disorders (Borja et al., 2006).

Research tends to focus on negative outcomes of rape trauma, although some studies have reported on the presence of positive sequelae. Growth or positive change has been reported to be present in survivors of trauma and sexual assault (Burt & Katz, 1987; Frazier, Conlon, & Glaser, 2001; Frazier et al., 2004; Tedeschi & Calhoun, 1995; Thompson, 2000). Linley and Joseph (2004) report that most positive gains experienced by individuals after trauma are maintained over time. Borja and colleagues (2006) comment that growth and distress are not mutually exclusive, meaning that in their study victims reported both growth and distress following sexual victimization (Borja et al., 2006).

Participant One reported that the rape was a negative lesson for her. She describes it as an instance where she needed to learn something about life. As the following extract shows:

…I feel like in most my life I haven’t really gone through really tough things and this was just one of them that’s kind of made me learn something about myself and really made me stand up and think about certain things in my life and what I need to change in my life perhaps and maybe not being as friendly and open to every one as i have always been as some people aren’t as how the appear.

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To me it feels like a lesson…In the negative, because negative because it effected my life negatively more than positively, ja, I’d say it has a lot of negative implications and positive not much, just learning not to trust as much as I did before.

Although Participant One has been able to talk about her rape and gain support from others, she continues to see the rape as damaging.

Participant Two describes going through her ordeal as something that others also go through, and that she is capable of dealing with it. She also refers to her intention to help others going through a similar thing, as shown below:

A lot of people are going through it. Through that thing which happened to me. I must learn and it is involvement with the person I am. Ja, because I am seeing things in a much broader, way big pictures. Just as I am thinking of starting a support group but not only for the rape victims for also for other people as well as orphans.

I came with the mentality that I am capable of doing this, I know I can do this because I want to make a difference in people’s life.

It seems from the experiences of the two participants of this study that how they make meaning of their ordeal is in some way connected to how they experience their rape incident. Participant One describes feelings of shame and anger and appears from her account to have struggled with recovering from her ordeal. Although Participant Two experienced mixed feelings towards her ordeal, she seems to present to be better adjusted after her rape than the first participant.

CONCLUSION

Being raped by an acquaintance can be said to produce certain reactions in the victim. These reactions are recorded in various studies, many of which have been discussed in previous chapters of this study. The analysis of the lived

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experience of two young South African women has shown that there are certain aspects that describe their lived experience. These aspects include being raped by someone you know, the life changes which occur after the rape, the reactions of others, culpability, emotional reactions, dealing with possible HIV infection, disruptions in interpersonal trust, social support regarding the rape and the meaning that is made of the rape experience.

Although each of the aspects of their lived experience can be understood and reflected on with reference to existing literature, the lived experience of acquaintance rape is unique and can not be thought to be understood through knowing the existing body of knowledge regarding rape. Aspects such as blame, social support and meaning can be unique and unpredictable. It is the conclusion of this study that understanding the lived experience of an acquaintance rape victim needs to be particular to each victim and time needs to be taken to ensure that a victims story is given the opportunity to be told and understood from their own perspective.

Having a better understanding of the lived experience of acquaintance rape, will allow clinicians dealing with such rape victims the opportunity to adequately explore all aspects of the experience. In most cases the focus of the practitioner has been on the diagnosis and treatment of posttraumatic stress. By noting that each victim’s experience is uniquely developed from the interplay of many factors, both pre-, peri- and post-incident, practitioners are able to realise that victim interventions need to be based on models that allow for unique experiences to be taken into account and respond accordingly. Having a sound understanding of the existing body of knowledge regarding rape victims that has grown from empirical research is crucial in understanding and hence treating rape victims. This study hopes to point out that the unique lived experience of an acquaintance rape victim can not be predicted from existing knowledge, but rather that the knowledge applied to the unique experience gives one a deeper understanding of the rape experience.

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CHAPTER 5 – EVALUATION, RECOMMENDATIONS AND CONCLUSION

INTRODUCTION

As the final chapter of the study, this chapter will present a summary of the findings of the data analysis as well as the conclusions that were made based on those findings. The study was a phenomenological study meaning that it explored the lived experience of the participants. In the same light, the researcher takes the opportunity to describe her lived experience of having worked with rape victims and studied the experience of rape trauma. Strengths and limitations of the study are presented and recommendations for future research are suggested. The chapter ends with concluding remarks and final reflections.

SUMMARY OF FINDINGS

Through phenomenological deduction, this study has allowed for the understanding and exploration of the lived experience of two female South African acquaintance rape victims. The telling of their unique experiences was recorded and analysed using the methodology of phenomenology as it most appropriately lends itself to the understanding of a phenomenon as those participating in the study have experienced it.

Certain aspects of the lived experience of acquaintance rape, as experienced by the participants of this study, were explicated from the interviews of the rape victims. Although these aspects are not expected to be conclusions which can be applied to a general population of acquaintance raped South African women, considering these aspects as possible components of the experience of acquaintance rape allows one to have a deeper understanding of how the many factors involved in experiencing a rape can contribute to the unique lived experience which each rape victims endures.

The aspects of the experiencing an acquaintance rape as derived from the lived experience of the participants of this study include the following:

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• Acquaintance rape is unexpected • The acute stress response of freezing can be experienced • Changes in everyday life occur in the time after the rape • Culpability is an important aspect of the experience and can lead to feelings of shame or guilt • The reactions of others can impeded or enhance recovery • Self-blame is associated with behaviours that could have been avoided or actions that could have been taken to change the outcome of the incident. • There are a various emotional reactions to the incident • Possible HIV infection can be as or more overwhelming as the rape incident • Trust in others can be disrupted after acquaintance rape • Talking to others who are empathic aids recovery • Gaining some perspective from the incident can allow for growth and development

The empirical understanding of rape trauma and the impact that rape and acquaintance rape has on the victims life is explored in the earlier chapters of this study. When the empirical understanding is applied to lived experience the complex dynamic of pre, during and after rape factors begins to take the form of an actual unique lived experience and not a theoretical combination of factors and outcomes. When a rape victim can be seen as having gone through a unique ordeal and the time is taken to have a deep understanding of how her particular set of circumstances and experiences unfold to create the phenomenon that is her rape trauma, then practitioners who can reflect on this unique experience with the understanding of what has been theoretically written about and scientifically observed, are able to treat the rape victim with the empathy and understanding that is so needed in helping a victim become a survivor.

PERSONAL REFLECTIONS

Gaining a deep understanding of the journey from rape victim to survivor has been a task that has been a part of my professional and academic life for many years. I have worked with rape victims in many different contexts and in many different ways. I have been a part of action campaigns, psycho-educational tours, a participant in

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policy-making processes and counselled many victims, as well as family and friends of victims. I was privileged enough to be a founding member of a rape counselling centre which meant experiencing first hand the occurrence of rape in our country.

While working with rape victims in the different settings I was exposed to I was taken back by each story of rape and by how significant an ordeal of rape can be. No two rape stories were the same. No two experiences of how the rape impacted the victim’s life was the same and no astonishing journey to recovery was the same. There were cases where the victim found herself unable to even begin the journey to recovery. These could be instances where the violence was ongoing, or there were other distresses that needed to be addressed before the rape could even be acknowledged. It was difficult to have resources on offer to assist a rape victim with her ordeal and not be able to impart with those resources. And yet in many cases there was the opportunity to help. I witnessed in so many of the victim’s stories a drive to stay alive and overcome the tragedy of the rape and be someone who had grown from the experience. Even in situations of severe hardships, growth is possible. Bearing witness to that growth is encouraging, as a practitioner as well as a fellow South African women.

As a professional, I turned to the established intervention models I was trained in to be better equipped to help the rape victim with her recovery. With these models, I was able to feel I had tools to help the victims’ I worked with cope with the trauma that was their rape. The intervention models were developed to assist victims of trauma and not necessarily victims of rape trauma. Although these tools were valuable most of the time, it was my experience that they were sometimes not sufficient to truly help me understand and assist with the unique experience of rape. I often felt that I was trying a ‘one-size-fits-all’ approach. This meant working on assumptions that each rape victim is likely to be experiencing certain things, things that was supposedly ‘universal’ to all trauma sufferers.

Through my academic journey, I aimed to discover as much as I could about what is known about rape trauma and how victims experience it and then to understand the experience of rape from the subjective viewpoint of the victim. This would mean exploring the lived experience of rape from the perspective of the rape victim.

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Phenomenology allowed me to approach understanding the rape victims’ experiences without any assumptions (or at least with assumptions bracketed). Although the methodology was empowering in its respectful stance, to bracket what I had already discovered and experienced regarding rape victims and their trauma was challenging. I found myself as a researcher struggling to put aside myself as a therapist. I hope that through the research procedure and the use of clarifying questions during the interview process that I was able to achieve the bracketed stance of a phenomenological researcher.

This study has given me the opportunity to explore and critique relevant research on the subject of rape and acquaintance rape and the impact that this has on a victim. The knowledge gained in that process has equipped me with a sound grasp of rape and rape trauma, which has no doubt become a part of my own lived experience as a practitioner.

The study has also given me the opportunity to come to know the unique experience of two victims who were courageous enough to share their experience and allow me to dissect those experiences. Both the participants, although nervous to be vulnerable in such a way, were extremely brave to allow someone so close to an experience that is so personal. I feel honoured and hope that I have done each of their stories justice.

By combining both the theoretical knowledge and the realisation that each rape is unique and can be experienced in a complex and dynamic way, I feel that I am able to approach working with rape victims in a way that is empowered through knowledge and respectful in awareness.

As with most academic journeys the researcher becomes intimately involved with their topic of study. In this case, the involvement meant thinking about, reading up on and witnessing rape stories. To me, rape is a crime so horrendous and shocking and something that no one should have to cope with. There were occasions when the topic of this study brought on experiences of sadness for the victims involved, anger towards perpetrators and shame for a society that could be doing more to prevent and care for victims. I can also say that when one is graciously able to

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witness the story of a survivor of sexual abuse, one is able to appreciate the true spirit of being human and struggling to over come and survive. The gift that each survivor who has recovered from a rape ordeal gives the world is the testament that the human spirit is courageous and stronger than most would suppose. As difficult as this topic has been to study, I do believe that is has been a privilege to do so.

STRENGTHS AND LIMITATIONS OF THE STUDY

As with each and every research study there are certain strengths and limitations. The methodology can often be a source of both strengths and limitations.

• Strengths

§ The strengths of conducting this study using the phenomenological framework, allows for there to be a generation of descriptions of a phenomenon, in this case acquaintance rape experiences, which are more than just a list of factors or attributes.

§ This approach lends itself to the opportunity for the understanding of the unique and textured quality of the lived experience of acquaintance rape.

§ Using extracts from the participants interview data adds validity to the study. These extracts are presented in conjunction with the analysis of the data, which adds to the richness of the reported experience.

§ These supporting quotations also reduce possible researcher bias.

§ As the study aims to discover the lived experience of acquaintance rape victims, the open-ended interview style of the study allowed for the participants to describe their experiences. There was also opportunity for clarification and expansion on descriptions. In both instances, the participants of the study expressed at the end of the interview that they had an opportunity to describe all the aspects of their lived experience. Participants also expressed that they had felt adequately understood.

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§ It has been mentioned previously in this study that the body of literature emanating from South African regarding rape research is predominantly focused on the prevalence of rape (Burke, 2003; Gilchrist & Butchart, 1988; Jewkes & Abrahams, 2002); HIV/AIDS and rape (Caesar, 2001; Lunt, 1995; Meel, 2003; Ncayiyana, 1999); convictions of rape offenders (Webster, 1997) and PTSD and rape (Bollen, 1996). There is little consideration of the lived experience of rape and even less on the lived experience of acquaintance rape victims. The scarcity of relevant local knowledge means that when the lived experience of the participants is explicated and considered with regards to existing knowledge, that knowledge is more likely to be based on research conducted outside of South Africa, making it even more challenging to compare with confidence the experiences of the participants with what is known through existing literature.

• Limitations

§ The nature of phenomenological research and many qualitative studies in general, is that with such a small sample size, the findings are not generalisable. The findings therefore cannot be seen to represent the population of South African acquaintance rape victims as reliable findings that are shared by a significant portion of the population. However, it was not the aim of the study to generalise the findings.

§ Although the small sample size is suitable for phenomenological inquiry, the researcher hoped to interview more participates in the quest of richer data. The small sample size is an indication of the reluctance of this population to come forward and speak of their ordeal. Most rape victims encounter mental health support soon after a rape incident when they either report the crime or seek medical intervention. This is usually the period in which participants for most rape research are recruited, as researchers have access to victims through these services. As mentioned previously, when the rape is perpetrated by someone the victims knows, the incident is less likely to be reported to the police or yield injuries which

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may require medical intervention (Koss et al., 1988). Campbell, Sefl, Wasco and Ahrens (2004) had a similar experience when recruiting rape victims in their research and reflected on the challenge in researching rape victims as they represent a community that remains hidden and reluctant to speak about their experiences.

§ The study relied on recruiting acquaintance rape victims who were ready and willing to discuss their rape experience and who were eligible to participate in the research. Meaning that they were fluent enough in the language of the research project and had the ability to express their experiences and reflect on the inner feelings and emotions that accompanied their experiences.

§ An additional limitation to phenomenological research emerges when one considers the possibility of researcher bias. Although all measures were taken to bracket all previous knowledge associated with the phenomenon, a well developed interest and knowledge of the phenomenon of rape experience existed prior to this study, and was the impetus of conducting the study in the first place. The researcher acknowledges that previous knowledge and understanding must have been influential in some of the questions asked during the interview. However, it is believed that these biases were presented in a way that allowed the questions to be perceived as undistorted as was possible.

RECOMMENDATIONS FOR FUTURE RESEARCH

In order to gain a rich understanding of the lived experience of acquaintance rape victims in the South African context, it is suggested that future research in this phenomenon be conducted. As the majority of the South African population do not speak English as their mother tongue, it is highly recommended that future phenomenological research be conducted in the first languages of the participants. Although many South Africans are fluent in English, and hence would meet the requirement to be able to participate in phenomenological research, being able to describe their lived experience in their mother tongue would greatly enhance the depth of descriptions and hence improve the quality of the data obtained.

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In 1988, Koss and colleagues compared the experiences of acquaintance rape victims to stranger rape victims through the analysis of self-report questionnaires. This study noted similarities and differences in aspects such as levels of violence, number of offenders and frequency of assaults, disclosure of rape to others, the seeking of assistance and experience of psychological symptoms post-rape (Koss et al., 1988). It is recommended that research in a similar vein be conducted in South Africa where the experiences of acquaintance rape and stranger rape are explored. Comparing the lived experiences of stranger rape victims’ to acquaintance rape victims’ would be beneficial in assisting health care professionals in being aware as to how these two groups of victims would differ in their experiences and such how best to treat them as an homogenous group of rape victims or by distinguishing between rape type and recognising the distinctiveness of the assault.

As South Africa is a country where the possibility of being a victim of crime is likely, it would be interesting to explore the impact that previous trauma has on the recovery of rape for the victim. Exploring whether previous exposure to crime equips the South African victim with effective coping strategies that can then be applied to the rape incident would contribute to local understandings of the recovery process.

FINALE

Considering the experience of acquaintance rape and its subsequent trauma allows one to grasp the intricacies of a traumatic crime that is often perpetrated by trusted people, be it friends, family members or even romantic partners. Through the knowledge reviewed in this study, it is recognised that certain aspects of the acquaintance rape victim’s trauma is similar to that of victims of stranger rape, and that there are certain aspects that are unique to acquaintance rape experiences. It is also accepted that a rape experience is unique and a dynamic construct that can be influenced by many different factors. The conclusion is then that regardless of how a rape takes place, no matter who perpetrates the crime, the victim is likely to experience an ordeal that can impact her life in many different ways. If she is able to identify her assault as rape and seek support, she is more likely to fully experience the journey from a rape victim to a rape survivor.

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REFERENCES

Abrahams, N., & Jewkes, R. (2010). Barriers to post exposure prophylaxis (PEP) completion after rape: a South African qualitative study. Culture, health and sexuality. 12(5), 471-84.

Abrahams, N., Jewkes, R., Lombard, C., Mathews, S., Campbell, J. & Meel, B. (2010). Impact of telephonic psycho-social support on adherence to post- exposure prophylaxis (PEP) after rape. AIDS care: Psychological and socio- medical aspects of AIDS/HIV, 22(10), 1173-1181.

Ahrens, C.E. (2006) Being silenced: The impact of negative social reactions on the disclosure of rape. The American Journal of Community Psychology. 38, 263– 274.

Ahrens, C., Cabral, G., & Abeling, S. (2009). Healing or hurtful: Sexual assault survivors’ interpretations of social reactions from different support providers. Psychology of Women Quarterly, 33(1), 81-94.

Ahrens, C.E, Campbell, R., Ternier-Thames, N.K., Wasco S.M. & Sefl. T. (2007) Deciding whom to tell: Expectations and outcomes of rape survivors’ first disclosures. Psychology of Women Quarterly, 31, 38–49.

Amanat, E. (1984). Rape Trauma Syndrome: Developmental Variations. In I.R. Stuart & J.G. Greer (Eds). Victims of sexual aggression: treatment of children, women and men. New York: Van Nostrand Reinhold Company.

American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th edition, Text Revision) (DSM-IV-TR). Washington, DC: American Psychiatric Association; 2000.

Amir, M. (1971). Patterns of forcible rape. Chicago: University of Chicago Press.

Amstadter, A.B., mccauley, J.L., Ruggiero, K.J., Resnick, H.S. & Kilpatrick, D.G. Service Utilization and Help Seeking in a National Sample of Female Rape Victims. Psychiatric Services, 59, 1450 - 1457.

118

Arata, C.M. (1999). Coping with rape: The roles of prior sexual abuse and attributions of blame. Journal of Interpersonal Violence, 14, 62–78.

Arata, C.M., & Burkhart, B.R. (1998). Coping appraisals and adjustment to nonstranger sexual assault. Violence Against Women, 4, 224-239.

Archer, J., & Vaughan, A.E. (2001). Evolutionary theories of rape. Psychology, Evolution and Gender, 3(1), 95-101.

Ashworth, P. (1996). Presuppose Nothing! The Suspension of assumptions in phenomenological psychological methodology. Journal of Phenomenological Psychology, 27(1), 1-25.

Aspers, P. (2009). Empirical Phenomenology: A qualitative research approach (The Cologne seminars). The Indo-Pacific Journal of Phenomenology, 9(2), 1-12.

Atkeson, B.M., Calhoun, K.S., Resick, P.A., & Ellis, E.M. (1982). Victims of rape: Repeated assessment of depressive symptoms. Journal of Consulting and Clinical Psychology, 50(1), 96-102.

Baker, T.C., Burgess, A.W., Brickman, E., & Davis, R.C. (1990). Rape victim's concerns about possible exposure to HIV infection. Journal of Interpersonal Violence, 5(1), 49-60.

Barlow, D.H., & Durand, V.M. (1995). Abnormal psychology: An integrative approach. Pacific Grove: Brooks/Cole Publishing Company.

Bart, P.B., & O’Brien, P.H. (1981). Stopping rape: Effective avoidance strategies. Signs: Journal of Women in Culture and Society, 10, 83-101.

Bart, P.B., & O’Brien, P.H. (1985). Stopping rape: Successful survival strategies. New York: Pergamon.

119

Beckham, J.C., Feldman, M.E., & Kirby, A.C. (1998). Atrocities exposure in Vietnam combat veterans with chronic posttraumatic stress disorder: Relationship to combat exposure, symptom severity, guilt, and interpersonal violence. Journal of Traumatic Stress, 11, 777–785.

Bell, S.T., Kuriloff, P.J., & Lottes, I. (1994). Understanding attributions of blame in stranger rape and date rape situations: An examination of gender, race, identification, and students' social perceptions of rape victims. Journal of Applied Social Psychology, 24, 1719-1734.

Bello, M., & Pather, M. (2008). Profile of rape victims attending the Karl Bremer Hospital Rape Centre, Tygerberg, Cape Town: original research. South African Family Practice, 50(6), 46-46e

Best, J.B., & Demmin, H.S. (1982). Victim's provocativeness and victim's attractiveness as determinants of blame in rape. Psychological Reports, 51, 255-258.

Blum, A. (2008). Shame and guilt, misconceptions and controversies: A critical review of the literature. Traumatology, 14(3), 91-102.

Bollen, S. (1996). Rape victims, posttraumatic stress disorder and social support: negative reactions as a mediating factor. MA Dissertation: University of Natal

Bolstad, B., & Zinbarg, R. (1997). Sexual victimization, generalized perception of control, and posttraumatic stress disorder symptom severity. Journal of Anxiety Disorders, 11, 523-540.

Bonomi, A.E., Thompson, R.S., Anderson, M., Reid, R.J., Carrell, D., Dimer, J.A., et al. (2006). Intimate partner violence and women’s physical, mental, and social functioning. American Journal of Preventive Medicine, 30, 458-466.

120

Borja, S.E., Callahan, J.L., & Long, P.J. (2006). Positive and Negative Adjustment and Social Support of Sexual Assault Survivors. Journal of Traumatic Stress, 19(6), 905–914.

Bovin, M.J., Jager-Hyman, S., Gold, S.D., Marx, B.P., & Sloan, D.M. (2008). Tonic immobility mediates the influence of peritraumatic fear and perceived inescapability on posttraumatic stress symptom severity among sexual assault survivors. Journal of Traumatic Stress, 21, 402–409.

Bracha, H.S., Ralston, T.C., Matsukawa, J.M., Williams, A.E., Bracha, A.S. (2004). "Does "Fight or Flight" Need Updating?". Psychosomatics, 45(5), 448–9.

Bransen, R.H., Elklit, A. & Nielsen, L.H. (2009). A Danish Model for Treating Victims of Rape and Sexual Assault: The Multidisciplinary Public Approach. Journal of Aggression, Maltreatment & Trauma, 18, 886–905.

Breitenbecher, K.H. (2006). The relationships among self-blame, psychological distress, and sexual victimization. Journal of Interpersonal Violence, 21(5), 597- 611.

Breslau, N., (1998). Epidemiology of trauma and posttraumatic stress disorder. In R. Yehuda (Ed.), Psychological Trauma, (pp. 1-29). Washington, DC: American Psychiatric Press.

Breslau, N., Chilcoat, H.D., Kessler, R.C., & Davis, G.C. (1999). Previous exposure to trauma and PTSD effects of subsequent trauma: Results from the Detroit Area Survey of Trauma. American Journal of Psychiatry, 156, 902–907.

Bridges, J.S., & mcgrail, C.A. (1989). Attributions of responsibility for date and stranger rape. Sex Roles, 21, 273–286.

Brownmiller, S. (1975). Against our will: Men, women and rape. England: Penguin Books.

121

Bryant, R.A. (2006). Acute stress disorder. Psychiatry, 5(7), 238-239.

Burger, J., Gould, C. & Newham, G. (2010). The state of crime in South Africa - an analysis of the SAPS crime statistics for 2009/10. SA Crime Quarterly, 34, 3-12

Burgess, A.W., & Holmstrom, L.L. (1973). The rape victim in the emergency ward. American Journal of Nursing, 73(10), 1741-1745.

Burgess, A.W., & Holmstrom, L.L. (1974a). Rape Trauma Syndrome. American Journal of Psychiatry, 131, 981-986.

Burgess, A.W., & Holmstrom, L.L. (1974b). Crisis and counselling requests of rape victims. Nursing Research, 23(3), 196-202.

Burgess, A.W., & Holmstrom, L.L. (1978). Recovery from rape and prior life stress. Research in Nursing & Health, 1(4), 165-174.

Burgess, A.W., & Holmstrom, L.L. (1979). Adaptive Strategies and Recovery from Rape. American Journal of Psychiatry, 136(10), 1278-1282.

Burke, L. (2003). The consequences of truth: PTSD in South Africa. Retrieved May 24, 2003, from http://www.journalism.berkerly.edu/projects/southafrica/news/traumapart2.html

Burnam, M.A., Stein, J.A., Golding, J.M., Siegel, J.M., Sorenson, S.B., Forsyth, A.B., & Telles, C.A. (1988). Sexual assault and mental disorders in a community population. Journal of Consulting and Clinical Psychology, 56, 843-850.

Burr, J. (2001). Women have it. Men want it. What is it?: Constructions of sexuality in rape discourse. Psychology, Evolution & Gender, 3(1), 103-105.

Burt, M.R., & Albin, R.S. (1981). Rape Myths, Rape definitions, and probability of conviction. Journal of Applied Social Psychology, 11(3), 212-230.

122

Burt, M. R., & Katz, B. L. (1987). Dimensions of recovery from rape: focus on growth outcomes. Journal of interpersonal violence, 2(1), 57-81.

Byrne, M.M. (2001). Understanding life experiences through a phenomenological approach to research. Association of operating room nurses, AORN Journal, 73(4), 8. Caesar, M. (2001). Rape and HIV: a policy on the management of survivors of rape. Aids legal quarterly, March, 8-9.

Cahill, A.J. (2001). Rethinking rape. New York: Cornell University Press

Calhoun, K.S., Atkeson, B.M., & Resick, P.A. (1982). A longitudinal examination of fear reactions in victims of rape. Journal of Counselling Psychology, 29, 655- 661.

Campbell, R. (2008). The psychological impact of rape victims. American Psychologist, 63(8), 702-717.

Campbell, R., & Raja, S. (1999). Secondary Victimisation of rape victims: Insights from Mental Health Professionals who treat survivors of violence. Violence and Victims, 14(3), 261-275

Campbell, R., Sefl, T., Wasco, S.M., & Ahrens, C.E. (2004). Doing community research without a community: Creating a safe space for rape survivors. American Journal of Community Psychology, 33, 253-261.

Campbell, R., Self, T., Barnes, H.E., Ahrens, C.E., Wasco, S.M., & Zaragoza- Diesfeld, Y. (1999). Community Services for rape survivors: enhancing psychological well-being or increasing trauma? Journal of Consulting and Clinical Psychology, 67(6), 847-858.

Cannon, W. B. (1929). Bodily changes in pain, hunger, fear, and rage. New York: Appleton-Century-Crofts.

123

Carbone-Lopez, K., Kruttschnitt, C., & Macmillan, R. (2006). Patterns of intimate partner violence and their associations with physical health, psychological distress, and substance use. Public Health Reports, 121, 382-392.

Carlson, E.B. (1997). Trauma assessments: a clinician’s guide. New York: The Guilford Press.

Carlson, B.E., mcnutt, L.A., Choi, D.Y., & Rose, I.M. (2002). Intimate partner abuse and mental health: The role of social support and other protective factors. Violence Against Women, 8, 720-745.

Carter, D.L., Prentky, R.A., & Burgess, A.W. (1988). Victim response strategies in sexual assault. In A.W. Burgess (Ed.). Rape and sexual assault II. New York: Garland Publishing.

Centers for Disease Control (CDC). (2008). Intimate partner violence: Definitions. Retrieved October 16, 2009, from http://www.cdc.gov/violenceprevention/ intimatepartnerviolence/definitions.html

Cloonan, T.F. (1971). Experiential and behavioural aspects of decision - making. In A. Giorigi, W. Fischer & R. Von Eckartsberg (Eds.), Duquesne studies in phenomenological psychology, Vol. 1, (112 - 131). Pittsburgh, Duquesne University Press

Cluss, P.A., Boughton, J., Frank, L.E., Stewart, B.D., & West, D. (1983). The rape victims: psychological correlates of participation in the legal process. Criminal Justice and Behavior, 10, 342-357.

Coetzer, P. W. (2005). Rape in contemporary South Africa- More vexing and vicious than ever. Journal for Contemporary History, 30(3), 169-182.

Cohen, L.J., & Roth, S. (1987). The psychological aftermath of rape: Long-term effects and individual differences in recovery. Journal of Social and Clinical Psychology, 5(4), 525-534.

124

Coker, A.L., Davis, K.E., Arias, I., Desai, S., Sanderson, M., Brandt, H.M., et al. (2002a). Physical and mental health effects of intimate partner violence for men and women. American Journal of Preventive Medicine, 23, 260-268.

Coker, A.L., Smith, P.H., Thompson, M.P., mckeown, R.E., Bethea, L., & Davis, K.E. (2002b). Social support protects against the negative effects of partner violence on mental health. Journal of Women’s Health and Gender Based Medicine, 11(5), 465-476.

Colaizzi, P.F. (1978). Psychological research as the phenomenologist views it. In R.S. Valle and M. King (Eds.), Existential phenomenological alternatives for psychology. Oxford University Press, New York.

Collings, S.J. (2010). Provision of health care and social services for child rape survivors : factors predicting the extent of service provision. Acta Criminologica, 23(3), 115-121.

Conway, M., Mendelson, M., Giannopoulos, C., Csank, P.A.R., & Holm, S.L. (2004). Childhood and adult sexual abuse, rumination on sadness and dysphoria. Child Abuse & Neglect, 28(4), 393-410.

Creamer, M., mcfarlane, A.C. & Burgess, P. (2005). Psychopathology following trauma: The role of subjective experience. Journal of Affective Disorders, 86, 175–182.

Culbertson, C.A., Vik, P.W., & Kooiman, B.J. (2001). The impact of sexual assault, sexual assault perpetrator type, and location of sexual assault on ratings of perceived safety. Violence Against Women, 7, 858-875.

Daniels, V. (2005). Phenomenology glossary. Sonoma University. Retrieved April, 2008, from http://sonoma.edu/users/d/daniels/phenomenology.html

125

Davis, R.C., Brickman, E., & Baker, T. (1991). Supportive and unsupportive responses of others to rape victims: Effects on concurrent victim adjustment. American Journal of Community Psychology, 19, 443–451.

De Capua, J. (2003). South Africa: Rape & HIV/AIDS – part one. Retrieved November 12, 2003, from http://www.voanews.com/englishtoafrica/article.cfm

Denzin, N.K., & Lincoln, Y.S. (2000). Introduction: The discipline and practice of Qualitative research. In N.K. Denzin & Y.S. Lincoln (Eds.), Handbook of qualitative research (2nd edn., ch. 1). Thousand Oaks: Sage.

Dewe, P. (1993). Measuring primary appraisal: Scale construction and directions for future research. Journal of Social Behavior and Personality, 8, 673-685.

Dienemann, J., Boyle, E., Baker, D., Resnick, W., Wiederhorn, N., & Campbell, J. (2000). Intimate partner abuse among women diagnosed with depression. Issues in Mental Health Nursing, 21, 499-513.

Donat, P.L., & D’Emilio, J. (1992). A Feminist Redefinition of Rape and Sexual assault: historical foundations and change. Journal of Social Issues, 48(1), 9- 22.

Duffy, M.E. (1987). Methodological Triangulation: A vehicle for merging Quantitative and Qualitative Research Methods. IMAGE: Journal of Nursing Scholarship, 19(3), 130-133.

Eagle, G.T. (1998). An integrative model for brief term intervention in the treatment of psychological trauma. International Journal of Psychotherapy. 3(2), 135-146.

Elklit A, & Christiansen, D.M. (2010) ASD and PTSD in rape victims. Journal of Interpersonal Violence, 25(8), 1470-88.

Elklit, A.D.L. & Christiansen, D.M. (2009). Predictors of Acute Stress Symptoms in Rape Victims. Traumatology, 15: 38-45.

126

Elklit, A.D.L., & Brink, O. (2004). Acute stress disorder as a predictor of posttraumatic stress disorder in physical assault victims. Journal of Interpersonal Violence, 19, 709-726.

Ellis, E.M. (1981). Sexual dysfunction in victims of rape. Women & Health, 5(4), 39- 48.

Ellis, E.M., Atkeson, B.M., & Calhoun, K.S. (1981). An assessment of long-term reaction to rape. Journal of Abnormal Psychology, 90, 263-266.

Ellis, E.M., Calhoun, K.S., & Atkeson, B.M. (1980). Sexual dysfunction in victims of rape: Victims may experience a loss of sexual arousal and frightening flashbacks even one year after the assault. Women and Health, 5, 39-47.

Ellis, L. (1989). Theories of Rape: Inquiries into the Causes of sexual Aggression, New York: Hemisphere Publishing.

Evans, K.R., & Gilbert, M.C. (2005). An introduction to integrative psychotherapy. Basingstoke, UK: Palgrave Macmillan.

Ferguson, T.J., & Stegge, H. (1995). Emotional states and traits in children: the case of guilt and shame. In J.P. Tangney, Self-Conscious Emotions: Shame, Guilt, Embarrassment and Pride (pp. 174-197). New York: Guilford Press.

Ferguson, T.J., Stegge, H., & Damhuis, I. (1991). Children's understanding of guilt and shame. Child Development , 62, 827-839.

Fetchenhauer, D., Jacobs, G., & Belschak, F. (2005). Belief in a just world, causal attributions and adjustment to sexual violence. Social Justice Research, 18(1), 25-42.

127

Filipas, H.H., & Ullman, S.E. (2001) Social reactions to sexual assault victims from various support sources. Violence and Victims, 16(6), 673-92.

Finlay, L. (2009). Ambiguous encounters: A relational approach to phenomenological research. The Indo-Pacific Journal of Phenomenology, 9(1), 1-17.

Fischer, C.T., & Wertz, F.J. (1979). Empirical phenomenological analyses of being criminally victimized. In A. Giorgi, R. Knowles, & D.L. Smith (Eds.), Duquesne studies in phenomenological psychology, Vol. 3, (pp. 135-158). Pittsburgh, PA: Duquesne University Press.

Foa, E.B., Riggs, D.S., & Gershuny, B.S. (1995). Arousal, Numbing, and Intrusion: Symptom structure of PTSD following assault. American Journal of Psychiatry, 152(1), 116-120.

Foa, E.B. & Rothbaum, B.O. (1998). Treating the trauma of rape: cognitive- behavioral therapy for PTSD. New York: The Guilford Press.

Foa, E.B., Zinbarg, R., & Rothbaum, B.O. (1992). Uncontrollability and unpredictability in post-traumatic stress disorder: an animal model. Psychological Bulletin, 112, 218-238.

Foley, T.S., & Davies, N.A. (1983). Rape/nursing care of victims. New York: C.V. Mosby

Frank, E., & Anderson, B.P. (1987). Psychiatric disorders in rape victims: Past history and current symptomatology. Comprehensive Psychiatry, 28, 77-82.

Frank, E., Anderson, B., Stewart, B.D., Dancu, C., Hughes, C., & West, D. (1988). Immediate and delayed treatment of rape victims. In R. A. Prentky & V. L. Qunsey (Eds.), Human sexual aggression: Current perspectives (pp. 296–309). New York: New York Academy of Sciences.

128

Frank, E., & Stewart, B.D. (1984). Depressive symptoms in rape victims: A revisit. Journal of Affective Disorders, 7, 77-85.

Frank, E., Turner, S.M., & Duffy, B. (1979). Depressive symptoms in rape victims. Journal of Affective Disorders, 269-277.

Frank, E., Turner, S.M., & Stewart, B.D. (1980). Initial response to rape: the impact of factors within the rape situations. Journal of Behavioural Assessment, 2, 39- 53.

Frazier, P.A. (1990). Victim attributions and post-rape trauma. Journal of Personality and Social Psychology, 59(2), 298-304.

Frazier, P.A., & Burnett, J.W. (1994). Immediate coping strategies among rape victims. Journal of Counselling and Development, 72, 633-639.

Frazier, P., Conlon, A., & Glaser, T. (2001). Positive and negative life changes following sexual assault. Journal of Consulting and Clinical Psychology, 69, 1048–1055.

Frazier, P.A., & Schauben, L. (1994). Causal attributions and recovery from rape and other stressful life events. Journal of Social and Clinical Psychology, 13(1), 1-14.

Frazier, P.A., Tashiro, T., Berman, M., Steger, M., & Long, J. (2004). Correlates of levels and patterns of posttraumatic growth among sexual assault survivors. Journal of Consulting and Clinical Psychology, 72, 19-30.

Frese, B., Moya, M., & Megias, J.L. (2004). Social Perception of Rape: How Rape Myth Acceptance Modulates the Influence of Situational Factors. Journal of Interpersonal Violence, 19(2), 143-161

129

Fusé, T., Forsyth, J.P., Marx, B., Gallup, G.G., & Weaver, S. (2007). Factor structure of the Tonic Immobility Scale in female sexual assault survivors: An exploratory and confirmatory factor analysis. Journal of Anxiety Disorders, 21, 265–283.

Gergen, M.M., & Gergen, K.J. (2000). Qualitative Inquiry: Tensions and Transformations. In N.K. Denzin & Y.S. Lincoln (Eds.), Handbook of qualitative research (2nd edn., ch. 40). Thousand Oaks: Sage.

Gibson, L.E., & Leitenberg, H. (2001). The impact of child sexual abuse and stigma on methods of coping with sexual assault among undergraduate women. Child Abuse and Neglect, 25, 1343–1361.

Gilbert, P. (1998). What is shame? Some core issues and controversies. In P. Gilbert, & B. Andrews (Eds.), Shame: interpersonal behaviour, psychopathology and culture (pp. 3–38). New York: Oxford University Press.

Gilboa-Schectman, E., & Foa, E.B. (2001). Patterns of recovery from Trauma: the use of intra-individual analysis. Journal of Abnormal Psychology, 110(3), 392- 400.

Gilchrist, A. & Butchart, A. (1998). Monitoring Rape: Preliminary Findings of a rape Surveillance Project. Crime and Conflict, 11.

Giorgi , A. (1975). Convergences and divergences between phenomenological psychology and behaviorsim: A beginning dialogue. Behvaiorsim, 3(2), 200- 212.

Giorgi, A. (1985). Sketch of a Psychological Phenomenological Method. In A. Giorgi (Ed.), Phenomenology and psychological research (ch.1). Pittsburg: Dusquesne University Press.

Giorgi, A. (1995). Phenomenological Psychology. In J.A. Smith, R. Harré & L. Van Langenhove (Eds.), Rethinking psychology (ch. 3). London: Sage

130

Giorgi, A. (1997). The theory, practice and evaluation of the phenomenological method as a qualitative research procedure. Journal of Phenomenological Psychology, 28(2), 235. Retrieved March, 3, 2008, from Academic Search Premier database.

Golding, J.M. (1999). Intimate partner violence as a risk factor for mental disorders: A meta-analysis. Journal of Family Violence, 14(2), 99-132.

Gostin, L.O., Lazzarini, Z., Alexander, D., Brandt, A.M., Mayer, K.H., & Silverman, D.C. (1994). HIV testing, counselling, and prophylaxis after sexual assault. Journal of the American Medical Association, 271(18), 1436–1444.

Green, B.L. (1993). Identifying survivors at risk: Trauma and stressors across events. In J.P. Wilson and B. Raphael (Eds). International handbook of traumatic stress syndromes. New York: Plenum Press.

Guerette, S.M. & Caron, S.L. (2007). Assessing the Impact of Acquaintance Rape: Interviews with Women Who Are Victims/Survivors of Sexual Assault While in College. Journal of College Student Psychotherapy, 22(2).

Hanson, R.F., Sawyer, G.K., Begle, A.M., & Hubel, G.S. (2010). The impact of crime victimization on quality of life. Journal of Traumatic Stress, 23, 189–197.

Harrendorf, S., Heiskanen, M. & Malby, S. (Eds.). (2010). International Statistics of Crime and Justice. HEUNI Publication Series No. 64. European Institute for United Nations Office on Drugs and Crime (UNODC): Helsinki.

Harvey, M.R. (1996). An ecological view of psychological trauma and trauma recovery. Journal of Traumatic Stress, 9(1), 3-23.

Harvey, A.G., & Bryant, R. A. (2002). Acute stress disorder: A synthesis and critique. Psychological Bulletin, 128, 886-902.

131

Hassell, R.A. (1981). The impact of stranger versus nonstranger rape: A longitudinal study. Paper presented at the 8th Annual Conference of the Association for Women in Psychology, Boston, MA.

Heidegger, M. (1977). Basic writings (D. Krell, Ed.). New York: Harper & Row.

Heidt, J.M., Marx, B.P., & Forsyth, J.P. (2005). Tonic immobility and childhood sexual abuse: A preliminary report evaluating the sequela of rape-induced paralysis. Behaviour Research and Therapy, 43, 1157–1171.

Heise, L., Pitanguy, J., & Germain, A. (1993). Violence against women: The hidden health burden. Washington, DC: The World Bank.

Helminiak, D.A. (1984). Consciousness as subject matter. Journal of the Theory of Social Behavior, 14, 21-230.

Henning, K.R., & Frueh, B.C. (1997). Combat guilt and its relationship to PTSD symptoms. Journal of Clinical Psychology, 53, 801–808.

Hensley, L.G. (2002). Treatment for survivors of rape: Issues and Interventions. Journal of Mental Health Counselling, 24(4). Retrieved December 11, 2003, from EBSCO Host database.

Herman, J. L. (1997). Trauma and recovery. New York: Basic Books

Hermberg, K. (2006). Husserl's Phenomenology: knowledge, objectivity and others. London: Continuum.

Holmstrom, L.L., & Burgess, A.W. (1975). Assessing trauma in the rape victim. American Journal of Nursing, 75(8), 1288-1291.

Horowitz, M.J. (1986). Stress-response syndromes (2nd edn.). New Jersey: Jason Aronson.

132

Houry, D., Kemball, R., Rhodes, K.V., & Kaslow, N.J. (2006). Intimate partner violence and mental health symptoms in African American female ED patients. American Journal of Emergency Medicine, 24, 444-450.

Husserl, E. (1970). The crisis of European sciences and transcendental Phenomenology (D. Carr, Trans.). Evanston: North-western University Press.

Husserl, E. (1975). The Paris Lectures (P. Koestenbaum, Trans.) (2nd edn.). The Hague: Martinus Nijhoff.

Husserl, E. (1977). Cartesian meditations: An introduction to metaphysics (D. Cairns, Trans.). The Hague: Martinus Nijhoff.

Hycner, R.H. (1985). Some Guidelines for the Phenomenological Analysis of Interview Data. Human Studies, 8, 279-303.

Jahangi, A., & Jalani, H. (1990). The Hudood Ordinances: A divine seduction? Lahore, Pakistan: Rhotas Books.

Janoff-Bulman, R. (1979). Characterological versus behavioural self-blame: Inquiries into depression and rape. Journal of Personality and Social Psychology, 37, 1798-1809.

Jewkes, R. (2010). Gender Inequities Must Be Addressed in HIV Prevention. Science: 329 (5988), 145-147.

Jewkes, R., & Abrahams, N. (2002). The epidemiology of rape and sexual coercion in South Africa: an overview. Social Science and Medicine, 55(7), 1231-1244.

Jewkes R., Dunkle K., Nduna M., & Jama Shai N. (2010). Intimate partner violence, relationship power inequity, and incidence of HIV infection in young women in South Africa: a cohort study. Lancet, 376(9734), 41–48.

133

Jewkes R., Sikweyiya, Y., Morrell, R., & Dunkle, K. (2009). Understanding men’s health and use of violence: interface of rape and HIV in South Africa. Technical Report. Pretoria: Medical Research Council

Jewkes R., Sikweyiya Y., Morrell R. & Dunkle K. (2010). Why, when and how men rape - understanding rape perpetration in South Africa. SA Crime Quarterly, 34, 23-31.

Johnson, J.D., & Russ, I. (1989). Effects of salience of consciousness-raising information on perceptions of acquaintance versus stranger rape. Journal of Applied Social Psychology, 19, 1182-1197.

Jurema, A.C.L.A., Correia Pimentel, M.L., Corderio, T.S., &, Austregésilo Nepomuceno, A.G. (2006). Disclosing the making of phenomenological research: Setting free the meanings of discourse. Forum: Qualitative Social Research, 7 (4), Art. 7. Retrieved February, 2008, from http://www.qualitative- research.net/fqs-texte/4-06/06-4-7-e.htm

Kahn, A. S., & Mathie, V. A. (2000). Understanding the unacknowledged rape victim. In C. B. Travis, C.B. & J. W. White (Eds.), Sexuality, society, and feminism: Psychological perspectives on women. Washington, DC: American Psychological Association.

Karlsson, G. (1993). Psychological qualitative research from a phenomenological perspective. Stockholm: Almqvist & Wiksell.

Katz, B., & Burt, M. (1988). Self-Blame: Help or hindrance in recovery from Rape? In A.W. Burgess (Ed). Rape and sexual assault II. New York: Garland Publishing.

Katz, S., & Mazur, M.A. (1979). Understanding the rape victim –A synthesis of research findings. New Jersey: John Wiley and Sons

134

Keen, E. (1975). A primer in phenomenological psychology. New York: Reinhart and Winston.

Kelly, M.R. (2008). Phenomenology and time-consciousness. Retrieved June, 6, 2011, from http://www.iep.utm.edu/phe-time/

Kennedy Bergen, R. (Ed.). (1998). Issues in intimate violence. California: Sage.

Kessler, R.C., Chiu, W.T., Demler, O., Merikangas, K.R., & Walters, E.E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617-627.

Kilpatrick, D. G., Edmunds, C. N., & Seymour, A. K. (1992). Rape in America: A report to the nation. Arlington, VA: National Victim Center and Medical University of South Carolina.

Kilpatrick D.G., Resick, P.A., & Veronen, L.J. (1981). Effects of a rape experience: A longitudinal study. Journal of Social Issues, 37, 105-122.

Kilpatrick, D.G. (1983). Rape Victims: detection, assessment, and treatment. The Clinical Psychologist, 36, 92-95.

Kilpatrick, D.G., & Resnick, P.A. (1993). Posttraumatic stress disorder associated with exposure to criminal victimisation in clinical and community populations. In J. R. T. Davidson & E. B. Foa (Eds.), Posttraumatic stress disorder: DSM-IV and beyond (pp. 113-143). Washington, DC: American Psychiatric Press.

Kilpatrick, D.G., & Veronen, L.J. (1984). Treatment of fear and anxiety in victims of rape. Washington, DC: National Institute of Mental Health.

Kilpatrick, D.G., Saunders, B.E., Veronen, L.J., Best, C.L., & Von, J.M. (1987). Criminal victimisation: Lifetime prevalence, reporting to police, and psychological impact. Crime Dealing, 33, 479-489.

135

Kilpatrick, D. G., Veronen, L. J., Saunders, B. E., Best, C. L., Amick-mcmullen, A., & Paduhovich, J. (1987). The Psychological impact of crime: A Study of randomly surveyed crime victims. Washington, DC: National Institute of Justice.

Kim, J.C., Askew, I., Muvhango, L., Dwane, N., Abramsky, T., Jan, S., et al., (2009). Comprehensive care and HIV prophylaxis after sexual assault in rural South Africa: the Refentse intervention study. BMJ, 338, 515

Kim, J.C., Martin, L.J., & Denny, L. (2003). Rape and HIV post-exposure prophylaxis: addressing the dual epidemics in South Africa. Reproductive Health Matters, 11(22), 101-112.

Kockelmans, J.J. (1967). Phenomenology: The philosophy of Edmund Husserl and its interpretation. Garden City, NY: Doubleday.

Koss, M.P. (1993). Detecting the scope of rape: A review of prevalence research methods. Journal of Interpersonal Violence, 8(2), 198-222.

Koss, M.P., Dinero, T.E., Seibel, C.A. and Cox, S.L. (1988). Stranger and Acquaintance Rape: Are There Differences In the Victim's experience? Psychology of Women Quarterly, 12(1), 1-24.

Koss, M. P., Heise, L., & Russo, N. F. (1994). The global health burden of rape. Psychology of Women Quarterly, 18, 509-537.

Kraegel, I.B. (2002). Owners of the secret: The impact of rape trauma on Ugandan women in the Rakai District. (Doctoral Dissertation, The Chicago School of Professional Psychology) Retrieved May 28, 2011, from Dissertations & Theses: Full Text.(Publication No. AAT 3093600).

Kubany, E.S., Abueg, F.R., Owens, J.A., Brennan, J.M., Kaplan, A.S., & Watson, S.B. (1995). Initial examination of a multidimensional model of trauma-related

136

guilt: Applications to combat veterans and battered women. Journal of Psychopathology and Behavioral Assessment, 17, 353–376.

Kubany, E.S., Haynes, S.N., Abueg, F.R., Manke, F.P., Brennan, J.M., & Stahura, C. (1996). Development and validation of the Trauma-Related Guilt Inventory (TRGI). Psychological Assessment, 8, 428–444.

Kvale, S. (1983). The qualitative research interview: A phenomenological and a hermeneutical mode of understanding. Journal of Phenomenological Psychology, 14(2), 171-196.

L'Armand, K., & Pepitone, A. (1982). Judgments of rape: A study of victim-rapist relationship and victim sexual history. Personality and Social Psychology Bulletin, 8(1), 134-139.

Lamb, S. (1999). New versions of victims: feminists struggle with the concept. New York: New York University Press

Lee, J.A.B., & Rosenthal, S.J. (1983). Working with victims of violent assaults. Journal of Contemporary Social Work, December, 593-601.

Lee, D. A., Scragg, P., & Turner, S. (2001). The role of shame and guilt in traumatic events: A clinical model of shame-based and guilt-based PTSD. British Journal of Medical Psychology, 74: 451–466.

Lemaire, J.B., Wallace, J.E. (2010). Not all coping strategies are created equal: a mixed methods study exploring physicians self reported coping strategies. BMC Health Services Research, 10, 208-217.

Leskela, J., Dieperink, M. & Thuras, P. (2002). Shame and posttraumatic stress disorder. Journal of Traumatic Stress. 15 (3), 223-226.

Lester, S. (1999). An Introduction to phenomenological research. Retrieved February, 2008 from, http://www.devmts.demon.co.uk/resmethy.htm

137

Levine-maccombie, J., & Koss, M.P. (1986). Acquaintance rape: Effective avoidance strategies. Psychology of Women Quarterly, 10, 311-320

Lewis, H.B. (1971). Shame and guilt in neurosis. New York: International Universities Press.

Lewis, S. (1994). Dealing with rape. Johannesburg: Sached Books.

Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Beverly Hills, CA: Sage Publications, Inc.

Lindorfer, S. (2007). Sharing the pain of bitter hearts. New Brunswick: Transaction Publishers.

Lindsay-Hartz, J. (1984). Contrasting experiences of Shame and Guilt. American Behavioral Scientist , 27, 689-704.

Lindsay-Hartz, J., de Rivera, J.H. & Mascolo, M.F. (1995). Differentiating guilt and shame and their effects on motivation. In J. Tangney & K.W. Fischer (Eds.) Self-Conscious emotions: The psychology of shame, guilt, embarrassment, and pride. New York: Guilford.

Linley, A.P., & Joseph, S. (2004). Positive change following trauma and adversity: A review. Journal of Traumatic Stress, 17(1), 11-21.

Linley, P.A., Joseph, S., Cooper, R., Harris, S., & Meyer, C. (2003) Positive and negative changes following vicarious exposure to September 11 terrorist attacks. Journal of Traumatic Stress, 16, 481-485.

Littleton, H. (2010). The impact of social support and negative disclosure reactions on sexual assault victims: a cross-sectional and longitudinal investigation. Journal of Trauma and Dissociation, 11(2), 210-27.

138

Littleton, H., & Breitkopf, C.R. (2006). Coping with the experience of rape. Psychology of Women Quarterly, 30, 106–116.

Lunt, R.W.R. (1995). HIV and the rape victim – allaying the feeling of ‘deadly uncleanness for life’. SA family practice, 16(12), 782-785.

Marhoefer-Dvorak, S., Resick, P.A., Hutter, C.K., & Girelli, S.A. (1988). Single versus multiple incident rape victims: A comparison of psychological reactions to rape. Journal of Interpersonal Violence, 3, 145-160.

Marx, B.P., Forsyth, J.P., Gallup, G.G., Fusé, T., & Lexington, J.M. (2008). Tonic Immobility as an Evolved Predator Defence: Implications for Sexual Assault Survivors. Clinical Psychology: Science and Practice, 15, 74–90.

Mccahill, T.W., Meyer, L.C., & Fishman, A.M. (1979). The aftermath of rape. Lexington, MA: D. C. Health.

Mccann, I.L., & Pearlman, L.A. (1990). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress, 3, 131-149.

Mcquoid-Mason, D., Dhai, A. & Moodley, J (2003). Rape survivors and the right to emergency medical treatment to prevent HIV infection. South African Medical Journal, 93, 1.

Mechanic, M.B., Resick, P.A., & Griffin, M.G. (1998). A comparison of normal forgetting, psychopathology, and information-processing models of reported amnesia for recent sexual trauma. Journal of Consulting and Clinical Psychology, 66(6), 948-957.

Meel, B.L. (2003). A study on the prevalence of HIV – seropositivity among rape survivors in Transkei, South Africa. Journal of Clinical Forensic Medicine, 10(2), 65-70.

139

Meyer, C.B. & Taylor, S.E. (1986). Adjustment to rape. Journal of Personality and Social Psychology, 50(6), 1226-1234.

Miller, A.K., Amacker, A.M. & King, A.R. (2010). Sexual Victimization History and Perceived Similarity to a Sexual Assault Victim: A Path Model of Perceiver Variables Predicting Victim Culpability Attributions. Sex Roles, 64(5-6), 372- 381.

Miller, D.C., & Salkind, N.J. (2002). Handbook of research design and social measurement (6th ed.). Thousand Oaks: Sage.

Miller, T.W. (Ed.). (2008). School violence and primary prevention. New York: Springer Science + Business Media.

Mitchell, M.D., Hargrove, G.L., Collins, M.H., Thompson, M.P., Reddick, T.L., & Kaslow, N.J. (2006). Coping variables that mediate the relation between intimate partner violence and mental health outcomes among low-income, African American women. Journal of Clinical Psychology, 62, 1503-1520.

Moore, L. (1998). The experience of rape. Nursing Standard, 12(48), 49-56.

Morse, J. (2000). From Economic Powerhouse to Rape Capital. Spearhead, Feb 2000. Moran, D. (2005). Edmund Husserl. Founder of phenomenology. Key contemporary thinkers series. Oxford: Blackwell/Polity Press.

Moss, M., Frank, E., & Anderson, B. (1987). The effects of marital status and partner support on emotional response to trauma: The example of the rape. Unpublished manuscript: University of Pittsburgh. PA

Moustakas, C. (1994). Phenomenological research methods. Thousand Oaks: Sage.

Muehlenhard, C. L., Powch, I. G., Phelps, J. L., & Giusti, L. M. (1992). Definitions of Rape: Scientific and Political implications. Journal of Social Issues, 48(1), 23- 44.

140

Mukamana, D., & Brysiewicz, P. (2008). The Lived Experience of Genocide Rape Survivors in Rwanda. Journal of Nursing Scholarship, 40: 379–384.

Murphy, M.J. (2010). Post-sexual assault functioning: A prospective examination of the moderating effects of healthy lifestyle variables. Dissertation: Master of Science (MS), Ohio University, Psychology (Arts and Sciences)

Murphy, S.M., Amick-mcmullan, A.E., Kilpatrick, D.G., Haskett, M.E., Veronen, L.J., Best, C.L. & Saunders, B.E. (1988). Rape Victims' Self-Esteem: A Longitudinal Analysis. Journal of Interpersonal Violence, 3, 355-370.

Nadelson, C.C., Notman, M.T., Zackson, H., & Gornick, J. (1982). A follow up study of rape victims. The American Journal of Psychiatry, 139, 1266-1270.

Nadon, S. (2003). The relationship between blame and symptomatology among female victims of acquaintance rape. Dissertation Abstracts International Section A, 64.

Najdowski, C.J., & Ullman, S.E. (2009). PTSD symptoms and self-rated recovery among adult sexual assault survivors: The effects of traumatic life events and psychosocial variables. Psychology of Women Quarterly, 33, 43–53.

Ncayiyana, D.J. (1999). HIV prophylaxis after rape- an unaffordable gamble? South African Medical Journal, 89(8), 803.

Neville, H.A., & Heppner, M.J. (1999). Contextualising rape: Reviewing sequelae and proposing a culturally inclusive ecological model of sexual assault recovery. Applied and Preventative Psychology, 8, 41-62.

Nicolaidis, C., Curry, M., mcfarland, B., & Gerrity, M. (2004). Violence, mental health, and physical symptoms in an academic internal medicine practice. Journal of General Internal Medicine, 19, 819-827.

141

Niedenthal, P., Tangney, J.P., & Gavanski, I. (1994). "If only I weren't" versus "If only I hadn't": Distinguishing shame and guilt in counterfactual thinking. Journal of Personality and Social Psychology, 67, 585-595.

Nishith, P., Nixon, R.D.V., & Resick, P.A. (2005). Resolution of trauma-related guilt following treatment of PTSD in female rape victims: A result of cognitive processing therapy targeting comorbid depression? Journal of Affective Disorders, 86(2-3): 259-265

Notman, M.T., & Nadelson, C.C. (1976). The rape victim: psychodynamic considerations. American Journal of Psychology, 133, 408-413.

Orth, U., Cahill, S.P., Foa, E.B., & Maercker, A. (2008). Anger and posttraumatic stress disorder symptoms in crime victims: A longitudinal analysis. Journal of Consulting and Clinical Psychology, 76(2), 208-218. Osborn, J.W. (1994). Some similarities and differences among phenomenological and other methods of psychological qualitative research. Canadian Psychology, 35 (4), 167-189.

Ozer, E.J., Best, S.R., Lipsey, T.L., & Weiss, D.S. (2003). Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis. Psychological Bulletin, 129, 52–71.

Paglia, C. (1995) Vamps and tramps, London: Viking.

Payne, C., & Edwards, D. (2009). What services and supports are needed to enable trauma survivors to rebuild their lives? Implications of a systematic case study of cognitive therapy with a township adolescent girl with PTSD following rape. Child Abuse Research in South Africa, 10(1), 27-40.

Polkinghorne, D.E. (1989). Phenomenological research methods. In R.S. Valle & S. Halling (Eds.), Existential-phenomenological perspectives in psychology: exploring the breadth of human experience. New York: Plenum.

142

Pico-Alfonso, M.A., Garcia-Linares, M.I., Celda-Navarro, N., Blasco-Ros, C., Echeburua, E., & Martinez, M. (2006). The impact of physical, psychological, and sexual intimate male partner violence on women’s mental health: Depressive symptoms, posttraumatic stress disorder, state anxiety, and suicide. Journal of Women’s Health, 15, 599-611.

Quackenbush, R. L. (1989). A comparison of androgynous, masculine sex-typed, And undifferentiated males on dimensions of attitudes toward rape. Journal of Research in Personality, 23, 318-342.

Raine, N. V. (1998). After silence: Rape and my journey back. New York: Crown Publishers.

Resick, P. A. (1988). Reactions of female and male victims of rape or robbery. In E. B. Foa and B. O. Rothbaum (1998). Treating the trauma of rape: Cognitive behavioural therapy for PTSD. (pp. 29). New York: Guilford Press.

Resick, P. A. (1993). The psychological impact of rape. Journal of Interpersonal Violence, 8(2), 223-255.

Resick, P.A., Calhoun, K.S., Atkeson, B.M., & Ellis, E.M. (1981). Social adjustment in victims of sexual assault. Journal of Clinical and Consulting Psychology, 49, 705-712.

Resick, P.A., Jordan, C.G., Girelli, S.A., Hutter, C.K., & Marhoefer-Dvorak, S. (1988). A comparative outcome study of behavioural group therapy for sexual assault victims. Behaviour Therapy, 19, 385-401.

Resick, P.A. & Miller, M.W. (2009) Posttraumatic stress disorder: Anxiety or traumatic stress disorder? Journal of Traumatic Stress, 22(5), 384–390.

Resick, P.A., Schnicke, M.K., & Markway, B.G. (1991). Cognitive content and posttraumatic stress disorder. Paper presented to the International Society of Traumatic Stress Studies conference. Washington, D.C.

143

Resnick, H.S., Kilpatrick, D.G., & Lipovsky, J.A. (1991). Assessment of rape-related posttraumatic stress disorder: Stressor and symptom dimensions. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 3(4), 561-572.

Resnick, H., Monnier, J., Seals, B., Holmes, M., Nayak, M., Walsh, J., & Kilpatrick, D.G. (2002). Rape-related HIV risk concerns among recent rape victims. Journal of Interpersonal Violence, 17(7), 746-759.

Reyes, G., Elhai, J., & Ford, J. (2008). The Encyclopaedia of psychological trauma. Hoboken, NJ: John Wiley and Sons.

Rickert, V.I., Wiemann, C.M. & Vaughan, R.D. (2005) Disclosure of date/acquaintance rape: Who reports and when. Journal of Paediatric and Adolescent Gynaecology. 18:17–24

Riggs, D., Dancu, C., Gershuny, B., & Greenberg, D. & Foa, E.B. (1992). Anger and Post-Traumatic Stress Disorder. Journal of Traumatic Stress , 5 (4), 613-625.

Rizvi, S.L., Kaysen, D., Gutner, C.A., Griffin, M.G., & Resick, P.A. (2008). Beyond fear: The role of peritraumatic responses in posttraumatic stress and depressive symptoms among female crime victims. Journal of Interpersonal Violence, 23, 853.

Roth, S., Wayland, K., & Woosley, M. (1990). Victimisation History and Victim- Assailant Relationship as Factors in Recovery from Sexual Assault. Journal of Traumatic Stress, 3(1), 169-180.

Rothbaum, B.O., Foa, E.B., Riggs, D.S., Murdock, T., & Walsh, W. (1992). A prospective examination of Post-traumatic Stress Disorder in rape victims. Journal of Traumatic Stress, 5(3), 455-475.

144

Rozée, P.D. (1993). Forbidden or Forgiven: Rape in Cross-Cultural Perspective. Psychology of Women Quarterly, 17, 499-514.

Ruch, L.O., & Chandler, S.M. (1980). The impact of sexual assault on three victim groups receiving crisis intervention services in a rape treatment centre: Adult rape victims, child rape victims and incest victims. Paper presented at the American Sociological Meetings, New York.

Ruch, L.O., & Chandler, S.M. (1983). Sexual assault trauma during the acute phase: an exploratory model and multivariate analysis. Journal of Health and Social Behaviour, 24, 174-185.

Rudkin, J.K. (2003). Community psychology: Guiding principles and orienting concepts. New York: Prentice-Hall.

Sales, E., Baum, M., & Shore, B. (1984). Victim readjustment following assault. Journal of Social Issues, 40, 117-136.

Santello, M.D., & Leitenberg, H. (1993). Sexual aggression by an acquaintance: Methods of coping and later psychological adjustment. Violence and Victims, 8, 91–104.

Sato-dilorenzo, A., & Sharps, P.W. (2007). Dangerous intimate partner relationships and women’s mental health and health behaviors. Issues in Mental Health Nursing, 28, 837-848.

Sawtell, C. (2008) The victim-perpetrator relationship in the crime of rape: Victims' mental well-being. (Ph.D. Dissertation, The Florida State University) Retrieved May 26, 2011, from Dissertations & Theses: Full Text.(Publication No. AAT 3348540).

Schmitt, R. (1967). Husserl's transcendental-phenomenological reduction. In J.J. Kockelmans (Ed.), Phenomenology: The Philosophy of Edmund Husserl and its interpretation. Garden City, NY: Doubleday.

145

Schnicke, M.K., & Resick, P.A. (1990). Self-blame in rape victims. Paper presented at the 6th Annual Meeting of Society for Traumatic stress Studies, New Orleans LA.

Shalev, A.Y., Freedman, A., Peri, T., Brandes, D., Sahara, T., Orr, S., et al. (1998). Prospective study of posttraumatic stress disorder and depression following trauma. American. Journal of Psychiatry, 155, 630– 637.

Shenton, A. K. (2004). Strategies for ensuring trustworthiness in quantitative research projects, Education for Information, 22, 63-75.

Shipherd, J.C., & Beck, J.G. (1999). The effects of suppressing trauma-related thoughts on women with rape-related posttraumatic stress disorder. Behaviour Research and Therapy, 37, 99-112.

Sinkovics, R., Penz, E., & Ghauri, P. (2008). Enhancing the trustworthiness of qualitative research in international business. Management International Review (MIR) 48 (6): 689-714.

Smith, M.D. (1988). Women's fear of violent crime: An exploratory test of a feminist hypothesis. Journal of Family Violence, 3(1), 29-38.

Smith, M.D. (Ed.). (2004). Encyclopaedia of rape. Westport: Greenwood Press.

Smith, M.E. & Kelly, L.M. (2001). The Journey of recovery after a rape experience. Issues in Mental Health Nursing, 22, 337-352.

Snyder, C.R., & Pulvers, K.M. (2001). Dr. Seuss, the coping machine, and “Oh, the Places You’ll Go.” In C. R. Snyder (Ed.), Coping with stress: Effective people and processes (pp. 3–29). Oxford, UK: Oxford University Press.

South African Police Services, Annual Report of the South African Police Service 2009/10, Pretoria, 2010, pp.1–35.

146

Stanton, S. (1993). A qualitative and quantitative analysis of empirical data on violence against women in greater Cape Town from 1989 to 1991. Institute of Criminology. University of Cape Town.

Stein, M.B., Lang, A.J., Laffaye, C., Satz, L.E., Lenox, R.J., & Dresselhaus, T.R. (2004). Relationship of sexual assault history to somatic symptoms and health anxiety in women. General Hospital Psychiatry, 26, 178–183.

Street, A.E., & Arias, I. (2001). Psychological abuse and posttraumatic stress disorder in battered women: Examining the roles of shame and guilt. Violence and Victims, 16, 65–78.

Stevick, E.(1971). An empirical investigation of the experience of anger. In A. Goirgi, W. Fischer, & R. Von Eckartsberg (Eds.), Duquesne studies in phenomenology psychology Pittsburgh: Duquesne University Press.

Stones, C.R. (1988). Research: Toward a phenomenological praxis. In D. Kruger (Ed.), An introduction to phenomenological psychology (2nd edn., pp. 141-156). Cape Town, South Africa: Juta.

Suls, J., & Fletcher, B. (1985) The relative efficacy of avoidant and nonavoidant coping strategies: A meta-analysis. Health Psychology, 4(3), 249-288.

Sutherland, S., & Scherl, D.J. (1970). Patterns of responses among victims of rape. American Journal of Orthopsychiatry, 80, 503-511.

Swannell, J. (Ed.). (1986). The little oxford dictionary of current english (6th ed.). Oxford: Oxford University Press.

Tangney, J.P. (1993). Shame and Guilt. In C.G. Costello (Ed.), Symptoms of depression (pp. 161-180). New York: Wiley.

147

Tangney, J.P. (1996). Conceptual and methodological issues in the assessment of shame and guilt. Behaviour Research and Therapy, 34(9), 741-754.

Tangney, J.P., & Dearing, R. (2002). Shame and guilt. New York: Giulford.

Tedeschi, R. G., & Calhoun, L.G. (1995). Trauma and transformation: Growing in the aftermath of suffering. Thousand Oaks, CA: Sage.

Thompson, S. (1985). Finding positive meaning in a stressful event and coping. Basic and Applied Social Psychology, 6, 279-295.

Thornhill, R., & Palmer, C.T. (2000). Why men rape. The Sciences. January/February 2000.

Terblanche, S.S. (2006). Rape sentencing with the aid of sentencing guidelines. Comparative and International Law Journal of Southern Africa, 39 (1), 1-38.

Ullman, S.E. (1996a). Correlates and consequences of adult sexual assault disclosure. Journal of Interpersonal Violence, 11, 554– 571.

Ullman, S.E. (1996b). Do social reactions to sexual assault victims vary by support provider? Violence & Victims, 11, 143– 157.

Ullman, S.E. (1996c). Social reactions, coping strategies, and self blame attributions in adjustment to sexual assault. Psychology of Women Quarterly, 20, 505–526.

Ullman, S.E. (2000). Psychometric characteristics of the Social Reactions Questionnaire: A measure of reactions to sexual assault victims. Psychology of Women Quarterly, 24, 257– 271.

Ullman, S.E., & Siegel, J.M. (1993). Victim-offender relationship and sexual assault. Violence and Victims, 8(2), 121-134.

148

Ullman, S.E., Townsend, S.M., Filipas, H.H., & Starzynski, L.L. (2007). Structural models of the relations of assault severity, social support, avoidance coping, self-blame, and PTSD among sexual assault survivors. Psychology of Women Quarterly, 31, 23–37.

United Nations. (1993). Rape and the abuse of women in the territory of former Yugoslavia (UN document E/CN.4/1993/L.21). Geneva, Switzerland: Author

United Nations Programme on HIV/AIDS and World Health Organisation (2009) AIDS epidemic update. Retrieved April 19, 2011, from http://data.unaids.org/ pub/Report/2009/jc1700_epi_update_2009_en.pdf

Vaile Wright, C., Collinsworth, L.L. & Fitzgerald, L.F. (2010). Why Did This Happen to Me? Cognitive Schema Disruption and Posttraumatic Stress Disorder in Victims of Sexual Trauma. Journal of Interpersonal Violence, 25, 1801.

Valentiner, D.P., Foa, E.B., Riggs, D.S., & Gershuny, B.S. (1996). Coping strategies and posttraumatic stress disorder in female victims of sexual and nonsexual assault. Journal of Abnormal Psychology, 105, 455–458.

Valle, R.S., King, M., & Halling, S. (1989). An introduction to Existential- Phenomenological thought in Psychology. In R.S. Valle, M. King, & S, Halling (Eds.), Existential-Phenomenological perspectives in psychology (chap. 1). New York: Plenum Press.

Van der Kolk, B.A. (1987). Psychological trauma. Washington, DC: American Psychiatric Press.

Van Kaam, A. (1959). Phenomenal analysis: Exemplified by a study of the experience of "really feeling understood". Journal of Individual Psychology, 15, 66-72.

Van Kaam, A. (1969). Existential foundation of psychology. New York: Image Books. (Original work published 1966).

149

Vetten, L. (1997). Roots of a rape crisis. Crime and Conflict, 8, 9-13.

Vickerman, K.A. & Margolin, G. (2009). Rape Treatment Outcome Research: Empirical Findings and State of the Literature. Clinical Psychology Review, July, 29(5), 431-448.

Viki, G.T., Abrams, D., & Masser, B. (2004). Evaluating stranger and acquaintance rape: The role of benevolent sexism in perpetrator blame and recommended sentence length. Law and Human Behavior, 28, 295-303.

Vogalman, L., & Lewis, S. (1993). Gang rape and the Culture of Violence in South Africa. Published in German under the title, Illusion der Stärke: Jugenbanden vergewaltigung und kultuur der gewalt Südarika, in Derliberblick, No. 2, pp. 39- 42. Retrieved on May 7, 2002 from http://www.csvr.org.za/papers/paplv&sl.htm

Webster, N. (1997). Rape Sentencing. Crime and Conflict, 8, 14-17.

Whatley, M.A. (1996). Victim characteristics influencing attributions of responsibility to rape victims: A meta-analysis. Aggression and Violent Behavior, 1, 81-95.

White, J.W., & Sorenson, S.B. (1992). A sociocultural view of sexual assault: from discrepancy to diversity. Journal of Social Issues, 48(1), 187-195.

Wicker, F.W., Payne, G.C., & Morgan, R.D. (1983). Participant descriptions of guilt and shame. Motivation and Emotion , 7, 25-39.

World Health Organisation. (2000). Women’s mental health: An evidence based review. Retrieved September 20, 2007, from http://whqlibdoc.who.int/hq/2000/ WHO_MSD_MDP_00.1.pdf

Woodruff Smith, D. (2003). Stanford encyclopaedia of philosophy. Retrieved March 2008, from http://plato.stanford.edu/entries/phenomenology

150

Wulfsohn, A.H. (2001). Overview of medical management of victims of sexual abuse prevention. Southern African Journal of HIV Medicine, 2(1), 37-40.

Wyatt, G.E., Notgrass, C.M., & Gordon, G. (1995). The effects of African American women's sexual revictimisation: strategies for prevention. In C. F. Swift (Ed.), Sexual assault and abuse: Sociocultural context of prevention (pp. 111-134). New York: Hawthorn Press.

Wyatt, G., Gunthrie, D., & Notgrass, C. (1992). Differential effects of women's child sexual abuse and subsequent sexual revictimisation. Journal of Cclinical and Consulting Psychology, 60, 167-173.

Yassen, J., & Glass, L. (1984). Sexual assault survivors groups: A feminist practice perspective. Social Work, May-June, 252-257.

Zaner, R.M. (1970). The way of phenomenology. New York: Pegasus.

Zeelie, C. (2002). Newsletter HIV-AIDS and rape. Retrieved November 12, 2003, from http://www.petech.ac.za/aids Zinzow, H.M., Resnick, H.S., Amstadter, A.B., mccauley, J.L. Ruggiero, K.J. & Kilpatrick, D.G. (2010). Relationship to mental health among a national sample of women. Journal of Interpersonal Violence, 25, 2217

Zinzow, H.M., Resnick, H.S., mccauley, J.L., Amstadter, A.B., Ruggiero, K.J. & Kilpatrick, D.G. (2011). Prevalence and risk of psychiatric disorders as a function of variant rape histories: results from a national survey of women. Social Psychiatry and Psychiatric Epidemiology, Online 20 May 2011. Retrieved August 16th, 2011, from Http://0-www.springerlink.com.ujlink.uj.ac.za/content/0933-7954/?K=Zinzow

Zlotnick, C., Johnson, D.M., & Kohn, R. (2006). Intimate partner violence and long term psychosocial functioning in a national sample of American women. Journal of Interpersonal Violence, 21, 262-275.

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APPENDICES

APPENDIX A – INFORMATION LETTER

My name is Lauren Moss; I am a Counselling Psychologist, who is currently completing a doctorate in Psychology.

As part of my doctorate, I am researching the topic of rape. In particular, I am exploring the psychological impact that rape has on a victim. I would like to gain a deeper understanding of the lived experience of the victim. In order to gain this understanding, I will be conducting an interview that seeks to explore the experiences that the victim had as a response to the rape.

The intention of the research is to give mental health professionals a better understanding of the impact that rape has on a victim. With this understanding, professionals may be better equipped to help victims on their journey toward becoming survivors.

Participation in this research will involve an audiotaped face-to-face or telephonic interview, which will likely last about an hour. Participant’s anonymity will be strictly maintained and all information will be treated confidentially.

If you are interesting in participating in the research, please contact me and I will be willing to answer any further questions you may have about the research.

Thank you for your time and consideration.

Sincerely,

Lauren Moss MA (Psych) Counselling Psychologist

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APPENDIX B – INFORMED CONSENT

Dear Participant,

Thank you for agreeing to participate in this research; your willingness is greatly appreciated. In order for you to have a greater understanding of your participation, I would like to give you an awareness of the research process as well as clarifying your rights. Should there be anything you do not fully understand, please do not hesitate to ask any questions.

Purpose and Function of the research An in-depth interview will be conducted for the purpose of identifying themes and insights into the lived experience of the psychological impact of a rape incident, especially in the South African context. The entire session should last about an hour. The interview session will be audio recorded with your consent The information collected will be used to conduct research as part of the completion of a Doctorate Thesis for the completion of a D. Litt et Phil (Psychology) degree at the University of Johannesburg. Risks involved The interview may bring up disturbing or painful issues. The researcher will be available to offer necessary debriefing or psychotherapy in her capacity as a Counselling Psychologist. Right to participate As an individual, you have the right to not participate. There will be no ramifications should you decide not to participate. You have the right to request that the interview be terminated and that content of the interview be erased both during and after the interview. Anonymity As a participant, your identity will remain anonymous in the published research. A pseudonym will be used instead of your name and any identifying details will be erased or hidden. Dissemination The information gained during the course of the interview and from the questionnaire will be transcribed and published as part of Doctoral research at the University of Johannesburg. Once published, it will be available at the University of Johannesburg library and available on request at other academic institutions. No monetary award will be gained by you as a participant as a result of this research.

Once again, your co-operation is greatly appreciated. It is hoped that your participation in this project will enhance the understanding of the impact that rape and sexual violence has on its victims.

Yours Sincerely,

Lauren Moss MA (Psych) Counselling Psychologist

I, ______hereby understand what is required of me and hereby give consent to participate in the above described research. I agree to participating in an interview and to completing a questionnaire.

All questions I have regarding participation in the research have been satisfactorily explained by the researcher.

Signed at ______on the ____ of ______20___

______Participant Researcher

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APPENDIX C – INTERVIEW TRANSCRIPT AND NMUs OF PARTICIPANT ONE (Explicated as described on pg. 75.)

Discriminating Meaning Units focusing on phenomenon of being raped by an acquaintance

My name is Nono; I am 18 years old, 1. 18 years old studying BCom Accounting. 2. Accounting Student

As someone who has been raped, it is more than likely that you had certain feelings and reactions to this experience. Please can you describe for me as accurately as you can the possible you’re psychological, emotional or personal reactions to your rape experience?”

Um, I’d say after it happened, I felt very 1. Felt vulnerable vulnerable, vulnerable, used and I felt 2. Felt used ruined in a way. Um, I couldn’t trust 3. Felt ruined again and I just felt very ashamed of 4. I couldn’t trust again myself and I felt like it was my fault and 5. Very ashamed of myself I just kept to myself more, I was less 6. It was my fault talkative, less outgoing I just didn’t have 7. Kept to myself more, was less energy, no energy for anything, and talkative, less outgoing that is all I can remember. I just wanted 8. Had no energy to be alone lot more. Yes 9. Wanted to be alone more

And why do you think you wanted to be alone?

Because around me people didn’t really 10. People didn’t understand what I fully understand what I had been had been through through, and people around you when 11. They carry on with life as normal they haven’t gone through the same 12. Hard to be normal when hurting thing, they carry on with life just inside normally, laughing and whatever, and I found it hard to be just around that when deep inside I was just hurt, ja.

So like your life had hit a very big … rock...

A very big rock… it just felt like you go 13. Something stops your life through life and the something just 14. Everything seems so meaningless stops you right there and everything that was going on just seemed so meaningless,

Ja, So it just lost its meaning for you? 15. Meaning was lost Yeah it lost its meaning

Is that studying, going out with friends, what lost it’s meaning in that way?

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Um, School, going out with my friends, 16. Normal things, like school, friends even things like eating, I could just say and eating and life in general felt so life in general. It just all felt so meaningless meaningless

Um, you mentioned lots of feelings, lots of stuff. You mentioned like feeling vulnerable, being used, you also said you felt shame, you felt like it was your fault. That is a lot of stuff going on...

All at once 17. Many things happening all at once

All at once and then next to it is this meaningless, its almost a lot of stuff happening inside you and then you almost wanted nothing to be happening around you

Yes

You said you withdrew a bit?

Yes, I did 18. I withdrew

Ja, what kind of impact did that have on your life?

Umm, I’d say that I was more irritable I 19. I was irritable got angry very easily, I just didn’t… I 20. I got angry easily don’t know how I can explain it but 21. I pushed people away people who are in your life that love you 22. I was irritable like your friends and whatever, I kind of 23. I was vulnerable felt like I pushed then away a bit, cos I 24. Others didn’t understand was more irritable and vulnerable and 25. Others withdrew from me because I they didn’t really understand so they was blowing up often might have kind have kind of stepped away from me because I was just blowing up the whole time.

So were they stepping away from you because you were blowing up or because they didn’t understand what you needed?

I think both, yes both

How did that make you feel?

It made me feel very lonely because I 26. I felt lonely didn’t have anyone who can help me, 27. I didn’t have anyone to talk to, even and anyone I could talk to cos if I talked close friend didn’t know what to say to my friend who has been my friend since we were in grade one, and she didn’t know how to answer me and it 28. Feel like I am just overreacting made me feel lonely, and like maybe 29. I am being crazy

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I’m just being crazy, maybe I’m overreacting to certain things, that’s what it made me feel.

You said earlier that you felt like it was your fault,

Yes 30. It felt like my fault And then now your are telling me how your friend almost made you feel like you were overreacting

Yes 31. Felt like you were overreacting

Those two together, how did that …

Um, she kept saying it wasn’t my fault, 32. Despite what she said, I felt it was but I just felt it was because of the way my fault it happened, that it was my fault, and then I felt like I was overreacting as it 33. I was overeating, because it was was really my fault, I’m just blowing my fault things up, maybe it was really my fault, that’s why she can’t say anything to me, ‘cos maybe she thinks it was my fault 34. Maybe she couldn’t say anything too, even though she might say it isn’t because she thinks it was my fault that but it might not be what she is too thinking.

So in a way what you are saying is that the way that she was reacting to you was a way to tell you that she was also confirming that she did maybe think it was your fault but that she didn’t want to tell you that. And then you felt more alone

Very alone 35. I felt very alone

Um, do you think if you think about what happened and I know that you don’t have to tell me everything, but was there things that were your fault in the situation?

I don’t know, I kind of…Ja I do think it is 36. I do think it is my fault my fault, but I don’t and then again 37. Sometimes I don’t think its my fault think it is my fault, Um… well maybe, maybe there is one or two things I 38. I shouldn’t have done one or two thought maybe I shouldn’t have done things that would have not made it that would have not made it possible, possible yes there are.

So something’s that you did, so maybe some behaviours, that you feel could have been your fault

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Yes 39. Some behaviours were my fault

Would it be ok, if I could ask what kind of behaviours you think?

Um, the one thing is I well I’m not 40. I agreed to be alone with him recounting but, we’re in a place where 41. I knew him we were all together and then I agreed to move away from that place to be alone with the person, I knew the person so to me it didn’t seem like a 42. If I had stayed where others were problem, so I felt that maybe if I didn’t maybe it would not have happened agree to move away and strayed where everyone was, maybe it would have been different

So did it feel like that was the thing that got the ball rolling?

Yes like I just let it happened in a way 43. I let it happen

Ok, um, was there… you’ve told me a part of you feels like it was your fault, and it seems like another part knows that it wasn’t your fault, what do you think that you did that kind of supports the argument that it wasn’t your fault,

Like I said leaving with him and being 44. Leaving with him is my fault alone, and just kind of entertaining 45. Being alone with him is my fault certain things that he said and he did 46. I entertained certain things he said and not really reading much into it, cos 47. I didn’t read into what he said like I said I knew the person, I had trust, 48. I had trust so that trust been broken, I just I know 49. My trust is broken deep down it wasn’t my fault, I didn’t 50. I know it wasn’t my fault know something like that would 51. I didn’t know something would happen, and I said, had I said, I don’t happen want certain things to happen and he 52. I told him I didn’t want certain agreed, but then again I things to happen think maybe if I just didn’t leave maybe 53. He agreed not to do certain things it would have been different. 54. Maybe I shouldn’t have left it

So it almost feels like if you could find the moment

Yes the moment where I left the flat 55. Leaving the flat was the moment it maybe everything would be alright would have been different

But now I know we are talking about it and if you get uncomfortable, just let me know, but I think you can help me to understand how you were feeling, when you realised that things were going… what did you do then, did you tell him?

I told him um, I could say when we left 56. We went for a walk in the flat the flat we just went on... it’s a flat complex

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complex we, so we just went for a walk 57. I told him I wasn’t ready for certain and I told him I’m not ready for certain things. things and we weren’t dating anyway I 58. We weren’t dating told him I wasn’t ready for it and even 59. He said that was fine. when it started …certain things I told 60. It happened so fast him I wasn’t ready for something like 61. I didn’t expect it that and he said its fine that’s not want 62. I told him I didn’t want it to happen he wants, so when it happened it just 63. I let my guard down happened, it was just happened so fast 64. He just did it that I hadn’t expected certain ...I told him I don’t want it to happen, I kind of let my guard down and then I just he just did it right there and I… well

But you had told him that

I had 65. I had told him quite a few times

You didn’t want him…

Quite a few times

Ja, Ok, Um, so it feels like some things were your fault and something’s weren’t your fault

Yes

Ok, what emotion do you have when you talk about fault, what feeling if you had to put a feeling word

With fault...Um …I don’t know… I don’t 66. I feel shame when I blame myself know maybe shame, in a way for me, cos its, I feel if I blame myself about something I just feel shame on me, sort of... ja

And then is that something that you mentioned was a feeling,

Yes, I felt it a lot, 67. I felt a lot of shame

Did the shame…How early did it start, the shame

It started the moment it ended 68. The shame started the moment it ended And do you still feel it now

I do sometimes, I everyday, maybe not 69. I feel some shame everyday the whole day but I have moments, everyday, when it comes back and I feel shame

And how does it feel, the shame, how would you

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describe it?

It feels bad, cos I can’t really talk about 70. Shame feels bad it or make it better, I just feel for that 71. I feel lonely moment I feel so lonely and vulnerable 72. I feel vulnerable because of the because of it shame

And you say you can’t change it, do you feel helpless

Ja, I feel helpless 73. I feel helpless

Ok, Alright, you used the word vulnerable quite a few times; can you tell more about that?

Um, vulnerable say towards to him 74. I felt vulnerable towards him mostly, I just feel like certain power or 75. Certain power or strength had been strength I had has just been ripped off ripped off me. me. And when he is around I just feel 76. I can’t protect myself from him like he is more bigger than me and I can’t really protect myself from him in a way.

And I suppose that feeling if you think about what you have told me, that you had said that you didn’t want anything to happened and then it did

Yes

So, No matter what you had said that might had been the end result

Yes

Ok, Um, you are doing very well 77. I am nervous Alright, still nervous though

I know, I want to talk, have you told me everything you feel you need to tell me about that shame

Yes

So you felt it almost immediately afterwards

Yes

And it’s been ongoing and not all the time, but when…

I … with the shame it is kinds of 78. I hope that shame will go away by wearing down I am hoping it will go itself. away by itself , cos at first I felt it the 79. When I feel the shame I want to be

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whole day, that’s why I wanted to be alone. alone. Cos I felt so bad and now I am 80. It (Shame) feels bad kind of trying to push it out but it still 81. I try to push the shame away but it comes back but it is better than before. comes back. 82. The shame is getting better than When you say you want to be alone, did it feel before. like people could see the change?

Yes, I felt like I still feel like now like 83. Feel judged by people who know people who know about it judge me in a 84. Maybe they think it is my fault way about it, I feel like maybe they think 85. They judge me and can see certain it is my fault and they’re judging me and things. I feel even they can see certain things 86. I wanted to keep it to myself; I wish and that’s why I wanted to just keep I didn’t tell anyone. myself, keep it to myself to the point that I just wish I’d not even told my friends and just kept it to myself

Ja, So the shame feels like it gets intensified when people know what’s happened

Yes… because my friend it was actually 87. I told my friend when we came her cousin so I told her when we came back back now that I really feel like you, she, 88. Now she doesn’t think it was my well now I know that she doesn’t think fault that of me she know that it wasn’t my fault, but I told her that I feel like you all judge me and she told me we don’t judge you, your just being paranoid but 89. I told her I felt judged by everyone I just cant help feeling like that 90. She said I was feeling paranoid 91. I can’t help feeling like everyone I take it paranoid is her word, and your word judged me would be shame

Yes

Um, but there’s a definite link what you telling me, between feeling shame and feeling judged

Yes 92. Feeling shame and judged are linked Which also then means to know whose fault it is

Yes

Um, you also spoke a bit about being irritable and angry, do you want to tell me a bit more about how did that come up afterwards,

Um, it kind of came up by itself, I …it 93. Irritation and anger came up by came with wanting to be alone, so if itself somebody wanted come into my circle I 94. I wanted to be alone just want to push them away and if 95. If someone came close, I pushed some body is begging me for them away something, then its like can’t you see I 96. I wanted them to see I was not in a

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am not in a good space so stay away good space. so I could explain it that way. I felt 97. I felt angry with my life angry at my whole life so I took it out on 98. I took it out on others other people.

Did it taking it out on other people also keep them away?

To a certain extend not completely 99. Being angry kept others not as away but they kind of weren’t as close close as usual. as they usually are

Tell me, I’m thinking was there anyway where you used the anger as a weapon to protect the shame because if people were close you felt you felt like they were judging you. But if you kind of protected your self with a bit of anger

Like maybe using the anger to kind of, 100. Feeling angry felt like I had made me seem like I still had some strength strength in inside me I think yes maybe

So like a weapon in a way, and describe how anger feels to you

How Anger feels to me, um… um, I don’t know how I can explain it. Isn’t there another way you can ask me?

What does it feel like to be angry?

Its frustrating, um, its frustrating and I 101. Anger feels frustrating could say it is in a way lonely, and feels 102. Anger feels lonely like nobody understands me and 103. Anger feels like nobody everyone’s out to get me so I have to understands me be angry just to show them that I am 104. Anger feels like everyone is out also strong in a way. to get me 105. Showing anger makes me Ok, so you mentioned lonely and you have also seem strong mentioned feeling strong which is the opposite of feeling vulnerable, so the anger helped you with both those things?

Yes, but I wouldn’t really say it helped 106. Being angry didn’t help, it was me, it was like a quick fix, but it wasn’t only a quick fix healthy to be angry all the time 107. It’s not healthy to be angry all the time And now has that anger slowed down a bit

It has it has it helped talking about it 108. It has helped to talk about the cos I had so many questions I asked anger myself and answered myself and 109. You can be angry at something sometimes you might not see things the you really shouldn’t be angry right way and you keep being angry about over something you really shouldn’t be

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angry about the whole time

What was that for you, the thing you shouldn’t be angry about?

Being angry, I’d say most of all I was 110. I was angry at myself because angry at myself because I felt it was my it felt like it was my fault fault I was angry at myself, I felt like 111. I was more angry at myself know when there like two people in you than angry at him like constantly breaking myself down, because why did you do this type of thing, I was angry at myself more than I was angry at him

It Sounds like it

Cos I felt like, when I was angry at him I 112. I was more angry at myself felt, it was my fault I let him do it to me because I let it happen so I should be angry at myself more because I let it happen.

Mm, I can understand that that’s what you felt at the time. And now?

Now I feel so much better actually now, 113. I am more at peace since I I just feel cos like I said the anger is talked to someone gone I am more at peace I have talked 114. I am not so angry at myself or to someone else whose has made me him anymore. see it in the right perspective so I am 115. My anger shifted from me to not as angry at myself anymore, and I him am no longer angry at him, cos when I 116. It doesn’t help to angry forever shifted the anger from me it went to him, and now I’m no longer angry at him, cos it just doesn’t help to be angry forever,

Because it keeps you lonely?

It keeps you lonely, and the more I get 117. Being angry keeps you lonely angry I’ll just keep, the more I push the 118. Staying angry pushed people people close to me further and further who are close to me away away and I can’t have that. 119. I can’t have close people pushed away Um, I want to talk a little, you mentioned trust, how do feel about, how did you feel after the incident about trust

About trust, mostly trust in guys, it just 120. My trust in guys dropped to went to zero, dropped to zero, I just felt zero I couldn’t trust anyone, um, cos 121. I couldn’t trust anyone everyone was out there just to use me. 122. Everyone was out to use me

So any guy in any situation

In any situation 123. I couldn’t trust any guy

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You didn’t feel like you could trust him

Yeah any guy, maybe in my family I 124. I could trust my family and could feel like I still have that trust but friends but not some one I meet someone whose not my family, friends that day. and anyone I meet that day, I just I had 125. I had no trust at all no trust at all.

I wonder did it feel like, that’s how you feel for the rest of your life?

I felt like actually I wanted to just stay 126. I wanted to stay way for the rest of away for the rest of my life, really my life

So it didn’t feel like it was just a specific thing that at the time it felt like it was goanna be your life forever

I felt like I just couldn’t trust forever. 127. I couldn’t trust forever

Any other feelings now that we have spoken quite a bit that have come into your mind about what you felt or experienced afterwards,

I can’t think of one now, I think I have 128. I have mentioned most of the mentioned most of them, the main ones feelings ‘cos some come probably come up one day; those are the main everyday going through it everyday.

Ok, Is there any that I’ve, that you've mentioned that I haven’t touched on?

Um, I think you touch on everyone; you 129. I felt loneliness touched on loneliness, trust, anger 130. I felt lack of trust vulnerable, yes most of them yes 131. I felt angry 132. I felt vulnerable

Alright I wanted to just ask now, um, how how do you make sense now that some time has past and you have made, and you have spoken to someone and you have made quite a lot of realisations, um, especially you tell me how the anger has gone from you to him to hopefully gone now, how do you make sense of what happened to you?

In what way

Almost in a philosophical way

I felt like it was just like you said a rock 133. I haven’t gone through really tough in your life you go through certain things in my life things and I feel like in most my life I

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haven’t really gone through really tough things and this was just one of them 134. I learnt something about myself that’s kind of made me learn something 135. It made me stand up and think about myself and really made me stand about my life and what I need to up and think about certain things in my change life and what I need to change in my life 136. Maybe I should not be as open and perhaps and maybe not being as friendly. friendly and open to every one as I 137. People are not as they appear. have always been as some people aren’t as how the appear,

So was it like a lesson for you

To me it feels like a lesson 138. What happened feels like a lesson

How do you feel having to have learnt that lesson?

Well I still have trust issues, well I have 139. I still have trust issues its getting there but I still have trust 140. I learnt that people aren’t always as issues, I feel like that is what I learnt the they seem. most, that people aren’t always as what 141. Some one can be your friend and they seem someone can be your friend then do something else and they can just totally do something else.

So of we had to talk about this lesson, and if we had to put in on a continuum on being a positive lesson or a negative lesson, where would it be?

Negative or positive?

Let me ask it differently, of the stuff that you have learnt from the lesson in other words what you have gained from the lesson, is that stuff sitting on the positive side or negative side

In the negative, because negative 142. It was a negative lesson because it effected my life negatively 143. Leant an important lesson of not more than positively, ja, I’d say it has a trusting people as much as before lot of negative implications and positive not much, just learning not to trust as much as I did before. But otherwise I’d say,

But that is an important lesson to learn

I feel that maybe it is, cos it has 144. It changed the way I think about changed the way I think about people people. drastically.

Ja, Ok, you said when I asked you about the meaning you said that um, like up until now nothing, I used the rock and you used the same metaphor, did it feel like this is the first rock that

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you really have hit and had to climb over?

Um, well to be honest, well maybe it 145. This is the second time I have been wasn’t the first rock, maybe the second, in the same position and more or less both of both of it put me in the same position. Yes

Was the other one also related to some kind of sexual violence?

No, it was just I’d say I had a lot of self 146. I had self-esteem issues esteem issues in my life to the point 147. I almost took my own life that I almost took my own life, so when 148. This put me in the same position this one also happened it kind of put me that I just didn’t want to keep on in the same position that I was before living. that I just didn’t want to keep on living as I felt before.

Hmm and how did you deal with that this time?

This time um talking about it, talking 149. Talking about it helped about it was the best way, cos before I 150. No-one understood me if I kept it all had kept it all inside of me, and same inside as before, no one understood me, and 151. People would judge me as crazy if I did try to talk about it people would 152. It felt lonely be like you are crazy and that just kind 153. Not sure how I got through the first of made you just feel like I should keep time it to my self and that got more lonely, I 154. I didn’t think I could handle it again don’t know how I got through it all but I on my own did, and this time I thought ok, I don’t 155. Talked to a counsellor think I can handle this for a second time 156. I felt a lot better again but I talked to a counsellor and I felt a lot better.

Um, you just reminded of me something you did say earlier around not being understood,

Yes, it has been, still is a major problem 157. Other than my friend, no –one with me, I just feel like no one, well my understands me friend does understand me to a certain extent but no, no-one really does. 158. No-one can help me with certain Certain issues I have that no-one can issues really help me with

Ok, Um, and if people could understand that you think you’d feel a lot better,

It would feel a lot better 159. I would feel better if people understood me. I think that you have answered the question very well an nicely, you have given me a good idea of how, of the things you have felt and experience over the period um, I’m going to stop that tape now and once I have typed everything up, if there is anything I am unsure then I might call

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you to get a chance to get you to say something cos I don’t want you to feel after this that you have been misunderstood, I want you to feel like I have understood what you said. Ok.

APPENDIX D – FIRST ORDER PROFILE AND CONSTITUENT PROFILE OF PARTICIPANT ONE (Explicated as described on pg. 75.)

First Order Profile Constituent Profile Description Felt vulnerable. I was vulnerable. I feel Felt vulnerable towards him vulnerable because of the shame. I felt vulnerable towards him Felt used Felt used Felt ruined Felt ruined I couldn’t trust again, I had trust, it was Although I could still trust family and friends, broken, My trust in guys dropped to zero, I my trust in others was broken, especially in couldn't trust anyone as everyone was out guys. to get me. I could trust my family and friends but not someone I meet that day. I felt a lack of trust. I had no trust at all

Very ashamed of myself Very ashamed of myself It was my fault. It felt like my fault, despite Despite what others said, it felt like it was what friends said. Some behaviours were my fault as I had let it happen by doing my fault. I let it happen, by doing certain certain things things, entertaining certain things and not reading into what he said. I let my guard down.

Kept to myself more, was less talkative, Feeling shame and anger made me want to less outgoing. I wanted to be alone more. be alone, so I became less talkative and I withdrew and pushed people away. I felt less outgoing, I withdrew and pushed lonely. When I feel shame I want to be people away alone. Being angry keeps you lonely.

Had no energy Had no energy People didn’t understand what I had been Others did not understand what I had been through. I didn't have anyone to talk to. through, Although I did not talk to them as I Others didn't know what to say. If I kept felt they would not know what to say things inside then no one understands me. I would feel better if people understood. Hard to be normal when hurting inside Hard to be normal when hurting inside Something stops your life Something stops your life Meaning was lost. Everything seems so Normal everyday things seemed meaningless. Normal things like school, meaningless friends and eating felt meaningless Many things happening all at once Many things happened all at once

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I was irritable, I got angry easily. Others Feeling angry and irritable allowed me to withdrew from me because I was blowing keep others away as well as make me feel up often. Irritation and anger came up by strong, but it also made me feel frustrated itself. I felt angry with my life. Being angry and lonely. kept others away. Feeling angry felt like I had strength. It also feels frustrating and lonely; it feels like no one understands me. Showing anger made me feel strong

Feel like I am just overreacting, I am I was overreacting because it felt like it was being crazy. I was overreacting because it my fault and this was making feel crazy was my fault Sometimes I don’t think it’s my fault. I I know it wasn't my fault. I didn't want this to know it wasn't my fault. I told him I didn't happen and I told him no. want certain things to happen. I didn't know something would happen.

I shouldn’t have done one or two things I shouldn't have done certain things; I that would have not made it possible. I agreed to be alone with him. agreed to be alone with him I didn’t expect it I didn’t expect it I felt a lot of shame; I feel shame when I I felt shame immediately afterwards and it blame myself. The shame started still continues. The shame makes me want immediately and continues everyday. I to be alone as I feel judged hope it will go away by itself. Shame makes me want to be alone. It feels bad. I try to push the shame away. It is getting better than before. Feeling shame and judged are linked.

I feel helpless. Certain power or strength I feel helpless as I could not protect myself had been ripped off me. I can't protect from him myself from him Feel judged by people who know. Maybe I feel judged by people I know they think it is my fault. I wanted to keep it to myself; I wish I didn’t I wish I didn't tell anyone tell anyone. I wanted them to see I was not in a good I wanted others to see I wasn't in a good space. place. Being angry didn’t help; it was only a Being angry doesn't help. It is a quick fix quick fix. It's not healthy to be angry all and it not healthy the time. You can be angry at something you really shouldn't be angry about

It has helped to talk about the anger. I am I helps to talk, it can lessen the anger more at peace since I talked to someone. I am not so angry with him or myself anymore. Talking about it helped.

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I was angry with myself because it felt like I was angry at myself for letting it happen it was my fault. I was more angry at myself than at him because I let it happen I learnt something about myself. It made I have learnt to think about my life me stand up and think about my life and what I need to change. It feels like a lesson. I learnt that people aren’t always as they I leant that people are not as trustworthy as seem. Learnt an important lesson of not they seem trusting people as much as before This put me in the same position that I just I felt like I didn't want to keep on living didn’t want to keep on living. Talking about it helped. I don't think I Talking about it helped could handle it again on my own. Talked to a counsellor. I felt a lot better Other than my friend, no –one No one understands me. I would feel better understands me. No one can help me with if people understood me. certain issues. I would feel better if people understood me

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APPENDIX E – SECOND ORDER PROFILE OF PARTICIPANT ONE (Explicated as described on pg. 75)

1. It was so unexpected 2. Normality ceases and becomes meaningless 3. I did not want to keep on living 4. No energy 5. Feeling vulnerable and helpless towards the perpetrator 6. Felt used 7. Felt ruined 8. Shame 9. It was my fault as my actions let it happen 10. Feel judged by others 11. Angry at myself for letting it happen 12. Feeling angry keeps others away 13. Feeling angry gives a sense of strength 14. Anger not healthy 15. Feel misunderstood 16. It wasn't my fault 17. Guys are not always trustworthy 18. Talking helps

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APPENDIX F - INTERVIEW TRANSCRIPT AND NMUs OF PARTICIPANT TWO (Explicated as described on pg. 75.)

Discriminating Meaning Units focusing on phenomenon of being raped by an acquaintance

As someone who has been raped, it is more than likely that you had certain feelings and reactions to this experience. Please can you describe as accurately and concretely as possible your psychological, emotional or personal reactions to your rape experience?”

Ok, well that question… Since I’m a 1. As a student, I bunked class and Social Work student, I will bunk classes, didn’t do homework I will not do my homework because I 2. I didn’t want to come into contact didn’t do my homework as a result. So, I with people never wanted to come in to contact with 3. People in African culture react in a people as a result. As when I want I will certain way to hearing you were tell someone that I was raped. I know raped, and I did not want that people in our African culture, people will reaction to come out. react in a way that one will never want that reaction to come out.

What kind of reaction were your worried about?

People will say “Agg, shame man”, what 4. Some would react with saying “ag kind of a thing, some people will even shame” say, those who are cruel, I wanted it and 5. Cruel people would say that I deserved it, so that’s the thing I never wanted it want that. Until this time, so 6. People would say that I deserved it So you found yourself withdrawing?

Ja withdrawing, ja.

Ok. And that was out of a worry of how people would react? 7. I withdrew from people out of Ja, would react concern as to how they would react Tell me a little bit about the feelings that you were having at that time, you told me about the behaviour…

Um, sometimes, I will blame my friend 8. I would blame other people for the for my big mistakes, because I was things that were going wrong due failing, so I would say that “you are to my behaviour cause of my failing”, that’s why, so I will 9. I blamed others for negative blame people for my negative events. events

Would you say that you were angry with people?

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I was angry, at times I was sad. And I 10. I was angry will break some things around me, ja. 11. I was sad 12. I would be aggressive and break Did you understand that this was a reaction to things your rape?

Yes, I did, because through it I was 13. I knew that these feelings were a healing. Ja, it was a healing process for part of my healing process me.

Tell me about that healing process, how did it unfold for you?

It unfolded in this manner, because 14. Talking to my niece and later a when talking to the first person I told lecturer (adult mentor) about the about the rape, is my niece. She is 14 rape helped me to get rid of these years old, I told her about my rape. feelings Talking helped me to get rid of these feelings, because after that I managed to tell Mrs XXX (a lecturer) of the rape. Ja, I consulted her as an adult mentor.

So before you told your niece, before you told her were you worried about all those things, like about how she was going to react?

No, I know her, because we are very 15. My niece and are very close so I close, so… was not worried about how she would react. So your trusted her?

Ja, I trusted her. 16. I trusted her.

Ok and how did she react?

She was like, “Oh my God” (laughs). 17. She was surprised and shocked “But did it really happen to you?” and I 18. She was not expecting this was “yes it did”. She was surprised and shocked at the same time, she never expected her stepfather to this kind of thing especially to her aunt. So it was unexpected.

Ok and how did you feel seeing her surprise and her shock? How did that make you feel?

I sometimes… I found myself blaming 19. I blamed myself for telling her as myself, for telling her this kind of thing. I she is very young think she is too young for this, but she is 20. I wanted to tell her to be careful never too young to know about these that it may happen to her and she issues that are happening every day. I must talk about it. wanted to tell her she must be careful that this might happen to her and as a result she will have to talk about it.

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So you were doing two things, you were telling her for your own healing but you were also trying to warn her?

Ja, this are social issues which we are 21. Being raped is a social issue finding every day.

Were you worried that because it was her step dad that he might do it to her too?

Yes, I was worried because they are not 22. I was worried it would happen to having this kind of a close relationship, her as she is not close to the because after all he is an outsider, a perpetrator Nigerian.

Ok, I’m thinking now about the fact that you knew him and that he was a family member. How did that impact on how you reacted? Maybe you could tell me immediately after it happened what were some of your thoughts?

Hmm, many things came into my mind. I 23. I never expected him to do this never expected him to do this kind of a kind of thing. thing especially to me, because we were 24. He and I were really close really close, we were really close. I was 25. I was shocked and surprised. shocked at the same time, still surprised. 26. I trusted him How can he do this to me, I trusted him. 27. I don’t have bad feelings towards But still I don’t have those bad feelings him towards him, I don’t have bad feelings.

How do you make sense of that? That you don’t have bad feelings?

Umm, because at most times when my 28. I still speak to him when my sister sister is calling me he calls me and we calls talk. We don’t go to what has happened 29. I don’t speak to him about what before and as a result I don’t really bring happened up the matter, “remember you did that to 30. I have forgotten about it me?” I have forgotten about it, it is out of 31. It is out of my system my system. Still I want to talk to help 32. I want to talk to help other people other people. As well as I will be healing. 33. It is healing to talk about it It will be a healing process to me.

But in terms of talking to him, have you every spoken to him about what happened.

Um, after a week when it happened I 34. I did speak to him a week after it asked him “do you remember what you happened. still did to me?” he said, “yes I did, I was 35. His response that he was drunk drunk”. I didn’t see that as an excuse for 36. Being drunk is not an excuse for his unruly behaviour so, no ways. He his behaviour told me he was sorry but the thing which 37. He apologised but still came into surprises me the most is the next day the bathroom the next day after raping me he came into the 38. I have mixed feelings bathroom while I was still bathing, I still 39. He is sorry but being drunk does

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have these mixed feelings that, this not excuse what he did person is not sorry. But now I can see 40. He has a child so nothing gives that he is sorry but being drunk does not him the right to rape give him the right to go into people lives and raped them the way he has. Because he has a child as older as I am, he can still do this to her so that doesn’t give him the right to do that.

So it sounds like even though you understand him as a person and you still have a relationship with him, no matter the circumstance and the he was drunk, he didn’t have a right to do this to you.

Yes he didn’t have a right, ja 41. He had no right to do that

It sounds to me as if you have…that you are willing to have a relationship with him. Can you describe your outlook to me?

I don’t understand

I don’t want to say positive but that you have spoken about your own healing and speaking to your niece that there seems to be maybe a positive feeling, positive view towards what has happened in the way that you have moved forward from this.

Ja, there can be a positive because I’ve 42. I have tried to forget what tried to forget about has happened but happened as a result I won’t forget it, but I am 43. I continue to maintain a trying my level best to maintain that relationship with him, I will respect standard, that he is still my brother in law that he is my brother in law. and I still respect him the way I did the 44. We have to both move on last time. We have to move on both of 45. I have to move on us, especially myself I have to move on. 46. The relationship is the same as it I still maintain the same standards that was before we used to have in the relationship we 47. If I reported him, it would have used to have before. I understand that caused conflict in my family, people can make mistakes and when I especially since my mother and wanted to report him, it will have resulted sister do not have a good in a conflict within my family structure. relationship Because I know that my sister and my 48. My mother would disown my sister mother do not have a good relationship with my sister, she dropped out of university after falling pregnant with my niece, so as a result my mom still has the mentality that “she has disappointed me” after all my sister is not the child of my father, my father is her step-dad. As a result my mom will feel disappointed in her; she will disown her like she did many times before,

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It seems like you are taking a bit of responsibility for keeping the family together, that your mom would disown your sister because of what her husband did to you.

Ja and I am also feeling sorry for the guy 49. I feel sorry for him, as he is a because he is from Nigeria, an outsider foreigner. but it doesn’t give him the right to do 50. Being a foreigner does not give what he did. So I am feeling sorry for him the right to do what he did him. Because an outsider will get harsh 51. I feel sorry for him treatment especially from my family. So I 52. He will get harsh treatment from want to keep that family still functioning my family. together like we used to do. 53. I want to ensure that the family still functions as it used to. But it sounds to me like I am hearing two different points of view.

The one view says that something happen it was a mistake let’s keep the family together and think of the bigger picture and another voice says that it wasn't right what he did

Those are very conflicting feelings, how do you experience that? How do you deal with it?

I deal with it in a way that I don’t think 54. I don’t think about what happened about what happened to me, I am to me. I don’t relate to the matter always not relating to the matter that I that I was raped. was raped. I was raped. I was raped. I 55. I was raped bring myself not to think about it most 56. I try not to think about it times.

So you put it out of your mind…

And focus on your family…

I am thinking mostly on my family, 57. I am thinking mostly about on my because one can’t choose a family, I can family. choose friends but I can’t choose family, 58. I still love my family no matter no matter how imperfect they can be. I what happened still love them no matter what may happen, so in that way I can choose friends one can’t chose family, so the genes that they are having I also have them.

I’m just thinking about when it was happening, were you very scared?

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Ooom, I froze, I froze and I was for that 59. I froze. moment, I was never thinking about 60. I did not think about anything anything. I just froze.

And how do you make send of that?

Because I didn’t even move, I didn’t 61. I didn’t move even fight, I guess, I just remained 62. I didn’t fight constant as the way I was.

You say now that you didn’t fight. Did you think that you should have fought?

Yes I am thinking about that. I should 63. I should have fought have fought for my rights.

How do you think he would have reacted if you had fought?

He was so aggressive in his manner that 64. If I had fought he would have he would have killed me killed me.

Did you get that sense that he would have killed you if you had fought?

Ja, because a man is stronger. He was 65. He is stronger real strong,

So he had overpowered you?

Yes

Now in the moment that it was happening and you were “freezing”, even though you knew him as a person in that moment you felt as though he would have killed you if you had tried to fight back?

Ok. And when you think about that now, what do you feel?

Ahh, I know… I relate it as a joke. I often 66. I think about it as a joke now laugh about that… Ag people can be 67. People can be cruel cruel.

While we are here and there are no defences, when you think about the moment that you felt threatened, what feelings come up for you?

For now or back then?

Well back then and when you think about it now?

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Because sometimes when I was 68. I thought of killing him washing dishes, when I came across a 69. I thought of fighting back knife, I thought of killing him because he did this to me. So I’d fight back

So the emotion would be?

(Laughs), I don’t even know how to put 70. I don’t know how to put what the it. emotion would be

Almost like anger and revenge?

Ja, anger and revenge at the same time, 71. I was angry and I wanted revenge I was angry and I wanted revenge. But at the same time during that stage now it is a thing of the past, now I am not 72. Now I don’t think about it thinking about it. It was for that stage and that time.

The next day, what were the things that you were worried about?

I was worried about my sister. That how 73. I was worried about my sister can she be married to this kind of an 74. I was also worried about my niece animal? What will happen to my niece, and if this will happen to her. because you see she is always visiting 75. I was worried that if I am not my sister, so I was thinking if I am not around this would happen to her around then this will happen to her? 76. My sister is a party animal who will Because she is the kind of girl who leave my niece with that drunken which she is always going upside down, 77. He will violate her rights and rape she is a party animal she like partying so her much so she will leave her child with that drunken and he will violate her rights by raping her, that’s the thing I don’t like and the most thing that is disturbing me, 78. He pretends I am a child is that when I am around he will pretend 79. Demanding I behave in a certain I am a child. He’ll say like, “You don’t way talk to boys, you must wear like and not like this” And that day I was wearing very 80. I was dressed appropriately that appropriately, I was wearing like this… day, in jeans and a shirt.

Jeans and shirt? 81. I was not wearing a mini skirt that Ja, not a mini skirt that will make him will make him rape me. rape me. So you may never know

So maybe what you are telling me is that you didn’t do anything that might have encouraged him?

…To do what he did…

Which is why you are so worried about your niece because he it’s not like he is someone who needed to be enticed, you did nothing to ask for it yet he still did it me, so you were worried about

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your sister and niece. Sounds like it was easier to worry about others people than about yourself?

Ja, I always put most people first before 82. I always put most people before myself. Most people. (Mumbles quietly) myself.

So what happens to all those feeling?

(Laughs)

Where do they go?

Oh ok. Um, when I was talking to my 83. My friends are surprised when I friends telling them about what tell them what happened happened to me, most of them were 84. I am always laughing surprised because I am always laughing, 85. I am an outgoing person I am an outgoing person. I don’t find 86. I don’t find these issues affecting those issues affecting me in a manner me in a way that I won’t that I won’t concentrate. So talking to my concentrate friends and boyfriend helped me, 87. Talking to friends and boyfriend because he understood me, better than helped. anyone else. Also consulting Miss XXX 88. My boyfriend understood me helped me a lot. 89. I consult with my adult mentor a lot But now you’re saying it looked like it didn’t affect you?

It didn’t 90. It didn’t effect me

Didn’t it?

That time it did, but now I am looking at 91. At the time it did it as a positive manner. 92. I look at it in a positive manner

I want to talk about when it did. You said that earlier that sometimes you felt angry and sometimes sad. Tell me a about the sadness?

I was sad because I was thinking, “how 93. I was sad can I be raped?” An intelligent child like 94. I thought about how can I be me. I must put it in that matter. How can raped, especially by someone I I be raped and especially by a person I know can know. What can happen to my niece 95. What could happen to my sister in and my sister in law? I was feeling lonely law and niece in fact, lonely at the time. Because I was 96. I felt lonely also having this other abusive boyfriend I 97. I also had an abusive boyfriend was feeling lonely, that no one really 98. I was feeling lonely cares about me, that I am all alone in 99. No-one really cares from me this world. 100. I am all alone in this world

That’s quite sad.

It was quite sad but now it’s ok, 101. It was sad but now its ok

But it felt like something had happened to you

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and it was hard for you to understand why?

Why? I was always asking myself that 102. I was always asking myself why question: why? Why? Why? Without any 103. Without any answers answers.

What were the answers that you considered even for a moment, what were some of the things you thought might be the answer?

Um, that we are born to suffer, that 104. We are born to suffer, woman are woman are born to suffer. That I had to born to suffer endure the pain that I was going 105. I have to endure pain through.

That sounds a little bit like a philosophy.

I must put it that way. I had to think that I 106. I must put it that way was going through. Ja, that’s the thing.

Ok, it sounds to me like the answer to the why was more about a bigger picture than you specifically?

Ja, hmm.

So the thing that comes to my mind now, is did you feel any guilt for what happened?

No, I never felt any guilt. Because I know 107. I never felt guilty what…I am not ashamed of what had 108. I am not ashamed of what happened to me, I never wanted it to happened to me happen, I never applied for that kind of 109. I never wanted it to happen behaviour, the behaviour for him to 110. I did nothing to invite that kind of invade my rights. behaviour.

So there was not sense that you had done something…

Ja, I was not guilty of it 111. I was not guilty

So your answer to the “why?” was more around “this is the suffering that people go through in life and…”

I am not the only one. A lot of people are 112. I was not alone going through it. Through that thing 113. Many people go through what I which happened to me. I must learn and happened to me it is involvement with the person I am. 114. I must learn from this Ja, because I am seeing things in a 115. I now see things in a broader light. much broader, way big pictures. Just as I am thinking of starting a support group 116. I want to start a support group for but not only for the rape victims for also rape victims, other people and for other people as well as orphans. orphans

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So for you there was some kind of meaning that came out of what happened. It gave you a sense of something bigger?

Which is also part of your personality?

(Laughs)

You chose to study social work whish shows a sense…

Ja because I came home saying I 117. I knew before the rape that I wanted to do social work in December, wanted to do social work and it happened in April this year, so I 118. I had the mentality that I can cope came with the mentality that I am with this capable of doing this, I know I can do 119. I wanted to make a difference in this because I want to make a difference people’s lives before the rape in people’s life. Ja, I came with the mentality not after the rape…

Before that?

I came with the mentality before that. My 120. I wanted to open an orphanage in parents are thinking of making an my hometown orphanage for me, home based care. 121. My parents are constructing an We have a big site at home; they are orphanage for me busy constructing it, after completing my 122. I come from a very disadvantaged degree I will take over where they have place finished. The place that I am coming from is very disadvantaged; there are a lot of kids who are orphaned, when I am 123. I feel sorry for the kids who are with those kids I feel sorry for them. orphaned Because at home even though we don’t 124. I want to make a difference have much, I can’t sleep without eating. I am feeling sorry for them. I want to make a difference. Ja

So it sounds like being raped didn’t change your life but it gave you a little more perspective on what you were already thinking?

No it didn’t. I do strongly agree with that. 125. I agree that being raped gave me perspective on what I was already I want to go back to what you said right in the thinking beginning about your behaviour that you found you were bunking classes. What other things did you find you were doing that were not typical of you?

Ok, I would not concentrate during a 126. I could not concentrate lecture class and a lecturer would be 127. I would distract myself teaching and I would be doing other 128. I was in denial things to distract myself. I would distract

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myself as far as possible. I was in denial for that time. I was in denial.

Did you find that you were perhaps going out more often and drinking?

Ok, for that I will say that yes, because I 129. I had friends that went out to was having these friends, hey wena, parties, drank a lot and bunked (laughs) who will go to parties, drink a class lot, bunk classes, but those friends who 130. I did not tell these friends about were not the one who I had told my rape my rape dilemma to, I never trusted them, now 131. I am not friends with them we are no longer friends. The one who anymore we have been friends since 2004 is the 132. My long-term friend is the one I one I told about my rape dilemma. We told about my rape dilemma are friends.

But there was a period while you were in denial that you were filling your time with parties and drinking. Do you think it helped?

No, it didn’t because everyone can drink 133. Everyone can drink but your and drink and the problem can still be problem is still there there and I felt as if I wasted my time 134. Drinking wasted my time and and energy for that because here is energy there, the problem is still very much 135. The problem is still there around, as a way I was trying to get rid 136. Drinking and partying did not get of it by drinking and partying. I am proud rid of the problem to say that I am no longer doing it. 137. I am proud to longer be drinking and partying But that its part of the journey part of the healing. I see that you went for an HIV test. Were you worried about that?

I was very worried. Many things would 138. I was very worried about HIV come into my mind. What if I am HIV 139. If I was HIV positive I was thinking positive? By that time I was thinking of of committing suicide committing suicide, if I find that if I am 140. If I am HIV positive I am done with HIV positive I am done with this living. I living can forget about this home based care 141. The results came back negative and living. I am done with that. But when 142. I was so happy the results came back negative I was so happy.

So the thought that this might have left you being positive was so overwhelming that you thought about ending your life.

Did you find that you focused more on that than on the fact that you had been raped?

I was focused more on committing 143. I was so focused on committing suicide, than this was on my mind. “If suicide if I was HIV positive

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you find that you are HIV positive commit suicide, commit suicide, commit suicide”. Like that I was no longer focusing on myself

Ok, in your view of people go through something like this because it is a part of suffering and being part of being human. How would you have made sense of being HIV positive? Where would have that fitted in your view of the world if a consequence of the rape was that you were positive?

Um, I don’t know what I could say. It happened.

Is that why suicide was the option because there was no fit?

It was only the option because I can say 144. Suicide was the only option that at this time I was feeling guilty, 145. At this time I was feeling guilty maybe I was the cause of the HIV 146. Maybe I caused the HIV positive positive result, because I never fought result as I did not fight back back while he was raping I should have 147. I should have prevented it prevented that at the time. So I blame 148. I blame myself myself for that.

So it sounds like you could handle being raped emotionally, you could make sense out of that but you wouldn’t have been able to make sense of being HIV positive. Then you would have said that it was my fault.

Ja, to prevent it as a preventative 149. I should have prevented it measure

But you were negative?

Ja, negative and I am still thinking about 150. I am negative it. I went during May and in September 151. I still think about it and now I am also thinking of going a 152. I have been tested twice and will third time to be sure. test a third time to be sure

You spoke about your friends and boyfriend and that they have been very supportive. How have you found that has impacted on you dealing with it?

Umm, ok. What can I say? Um. I could 153. My boyfriend offered the support I say… (Laughs). Ok. Oh, my boyfriend needed offered me support that I needed; he told 154. He told me the right words me the right words that lead to here.

What were those words?

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He told me that “you are not the cause of 155. He told me I was not the cause of your rape. You are not the cause of your the rape rape. No one will ever wish of that kind 156. He told me no-one would wish that of thing, even your worst enemy you kind of thing won’t wish for him or her to be raped. So 157. You wouldn’t even wish your worst don’t blame yourself for being raped be enemy to be raped strong and look at life in a positive light”. 158. He told me to not blame myself for being raped And you needed to hear that? 159. He told me to be strong 160. He told me to look at life in a Ja, that was the thing I was looking for positive light because at times I will tell people but 161. I needed to hear these things, but they were not in that good stage of others were not able to tell me telling me what I wanted to hear in that what I need to hear time. Some people would say “ag 162. Some would say “ag shame” shame” and that was not the thing I 163. I didn’t want people to feel sorry wanted to hear from them because I did for me not want them to feel sorry for me. Ja, that’s it.

Um, you said earlier that you never felt like you were to blame for it. So when he said those words did it just confirm it for you or did you need to hear from him first

I needed to hear it from him first as 164. I needed to hear it from someone someone who is close to me. who is close to me

Was there some doubt that you were to blame for it or that maybe people would think that you were to blame for it?

Sometimes, because in our culture there 165. In our culture many people will say are many people who will say that she that she wanted it wanted it. That’s why we should not feel 166. We should not feel sorry for her sorry for her she deserves it. That’s why 167. She deserves it sometimes I was feeling guilty as a 168. I was feeling guilty as a result of result of my culture. my culture

And when you say your culture do you mean the big South African culture? How would you define your culture that has that impression?

Through my culture, as I can say form 169. In my towns culture the sister who the city the town which I’m coming sleeps with her brother in law from… because Tsongas’s have this wants her sisters marriage belief that if one sleeps with her brother in law it is believed that a sister and a younger sister must be married to the same, so they should put it in the manner that she is doing this as she wants the sisters marriage.

And is there any in the same cultural belief that he has the right to sleep with you and your sister?

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Does it come from that side?

No 170. It is not the belief that he can sleep with his sister in law So it would be that you were doing it, not that he was doing it. So your boyfriend’s words helped you to feel that you, to confirm that it wasn’t what was going on.

Yes.

When you said that in the days afterwards that you were very worried about your sister and family. Were you worried that they would also think that about it?

Yes, I was also thinking about that but 171. I was worried that the extended expect for my mother that she would not family would think that I wanted to think about things like that. My father sleep with him too. But there are a whole lot of family, 172. My mother and father would not the extended family were thinking about think that that.

Who knows about it in your family? 173. My brother knows about the rape My brother knows about it.

Ok. Um, I think you have really tried to cover a lot and you have told me a lot about your journey and that there were times that you were in denial and the anger and sadness and worrying about the HIV was a difficult period but that you stuck to your belief system that you had even before the rape that was a around people who are growing and being strong even through suffering, And that by talking to people you found a lot of healing in that process. Anything else you want to add?

Not anything I can think of.

Ok, I just wanted to just or confirm that with regards to the actual rape that your didn’t feel guilty or ashamed but that when you were worried about the HIV that you were feeling guilty?

I was feeling guilty 174. I was feeling guilty when I worried about being HIV positive That you might have done something to stop the possible HIV infection. But when you told me about what had happed that you froze because you were very very worried that he was going to hurt you. Thank you, I think that we covered everything. Particularly around your feelings.

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APPENDIX G – FIRST ORDER PROFILE AND CONSTITUENT PROFILE OF PARTICIPANT TWO (Explicated as described on pg. 75.)

First Order Profile Constituent Profile Description I bunked class, I could not concentrate, I As a distraction, I bunked class, went to would distract myself, I had friends that parties and drank a lot. went out to parties and drank a lot and bunked class

I didn't want to come into contact with I withdrew from people out of concern as to people, I withdrew from people out of how they would react concern as to how they would react People in African culture react a certain In African culture people can react with pity way to rape, they can react with pity and or by saying I wanted it, it was worried cruel people will say I wanted it. I was about how those close to me would react worried how those close to me would react

Culturally, people can say I wanted to There is a cultural belief that I would want sleep with my brother in law to have my my sisters marriage and would want to sister’s marriage. I was worried that the sleep with my brother in law extended family would think I wanted to sleep with him

I didn't want to be judged I didn't want to be judged I would blame other people for the things When things went wrong due to my that were going wrong due to my behaviour I would blame other people behaviour/negative events I was angry and wanted revenge I was angry and wanted revenge I was sad I was sad I would be aggressive and break things I would be aggressive and break things

Talking about the rape helped me to get Talking about the rape was healing in that it rid of these feelings. It is healing to talk helped to get rid of certain feelings, I spoke about it. I talked to my niece, a lecturer, with my niece, my boyfriend, a lecturer and my boyfriend and friends selected friends

I worried about my niece who is at risk of I worried about my niece who is at risk of being raped by the perpetrator too being raped by the perpetrator too Being raped is a social issue, I want to talk As rape is a social issue I want to talk to to help other people help others I never expected him to do this kind of I trusted him and did not expect the rape to thing; he and I were really close. I trusted happen him. I don't have bad feelings towards him, I I continue to maintain a relationship with continue to maintain a relationship with him and do not have bad feelings him

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I was shocked and surprised that I was I was shocked and surprised that I was raped by someone I know raped by someone I know I have forgotten about it, it is out of my I have forgotten about it and moved on system. I have to move on and try to not think about it. I did speak to him about it after it happened and his response was that he was drunk Being drunk is not an excuse for his He says he was drunk, which is no excuse behaviour. Nothing gives him the right to for his behaviour rape. I have mixed feelings I have mixed feelings If I reported him, it would have caused I wanted to ensure that my family still conflict in my family, especially since my functions as it used to and so I did not mother and sister do not have a good report him as it would have caused conflict relationship. My mother would disown my sister. I want to ensure that the family still functions as it used to. I was worried about my sister

I was raped I was raped I froze, I did not think about anything, I I froze, I did not think, move or fight, he didn't move, I didn't fight. If I had fought he would have killed me if I had would have killed me. I should have fought, I thought of killing I thought of fighting back him, I thought of fighting back People can be cruel People can be cruel

I did nothing to invite that kind of I did nothing to invite that behaviour, I was behaviour; I was not wearing a mini skirt dressed appropriately that will make him rape me. I was dressed appropriately that day

I don’t find these issues affecting me in a I don’t find these issues affecting me in a way that I won’t concentrate, It didn't effect way that I won’t concentrate me My boyfriend understood me, My My boyfriend understood me and did not boyfriend offered the support I needed, he blame me for the rape said the right words, that I was not to blame for the rape

I look at what happened in a positive light, I look at what happened in a positive light, broader light broader light I felt lonely, as if no-one really cares for I felt lonely, as if no-one really cares for me me I was always asking myself why, without I was always asking myself why, without any answers any answers

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Women are born to suffer, I have to Women are born to suffer, I have to endure endure pain and many people have gone pain and many people have gone through through what I went through what I went through I never felt guilty, I was not guilty I did not feel guilty I am not ashamed of what happened to I am not ashamed of what happened me, I never wanted it to happen I was not alone I was not alone I must learn from this I must learn from this I want to start a support group for rape I want to help others through a support victims, other people and orphans group Even before the rape I wanted to be a I wanted to help people even before the social worker and make a difference in rape peoples lives. I want to open an orphanage.

I had the mentality that I can cope with I had the mentality that I could cope with this; I was already thinking I could cope this even before I was raped with things before I was raped. I was in denial I was in denial I would drink to get rid of my problem, it I would drink to try to get rid of the problem, wasted my time and energy and did not it was a waste of time and energy get rid of my problem I was very worried that I was HIV positive I was very worried that I was HIV positive

If I was HIV positive I was done with living. Suicide became an option if I was HIV Suicide was the only option positive I was HIV negative, I was so happy. I have I am HIV negative been tested numerous times to be sure

While I was worrying about HIV, I felt I felt guilty that I may have caused the HIV guilty, guilty that I had caused HIV as I did infection by not fighting back not fight back or try to prevent it. I blamed myself

Others were not able to tell me what I Others were not able to tell me what I needed to hear needed to hear I didn’t want people to feel sorry for me I didn’t want people to feel sorry for me

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APPENDIX H – SECOND ORDER PROFILE OF PARTICIPANT TWO (Explicated as described on pg. 75.)

1. I was raped 2. It was so unexpected 3. I froze 4. I was worried about others judging me 5. I withdrew from people 6. I did not want pity 7. I felt lonely 8. I did nothing to invite the rape 9. I did not feel guilty 10. I am not ashamed 11. I have mixed feelings 12. I was in denial 13. I was angry 14. I would be aggressive and break things 15. I was sad 16. Did not affect my concentration 17. I behaved badly as a distraction 18. I was worried others would also be raped 19. I have forgotten about it and moved on 20. I did not report him in order to keep peace with family 21. Continue relationship with perpetrator 22. Question why it happened 23. Positive perspective on what happened 24. I must learn from this 25. Pain and suffering is part of life for many people 26. I was not alone 27. It helped to talk about it 28. Felt understood and not blamed by boyfriend 29. I want to help others to deal with rape 30. Being HIV positive was a huge concern 31. I considered suicide if I was HIV positive 32. I am HIV negative 33. When thinking I could have been infected with HIV, I feel guilty that I did not fight back

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APPENDIX I – CATEGORIES (Explicated as described on pg. 76.)

• Obtained from Participant One Ø Obtained from Participant Two

1. Being raped by someone you know is so unexpected • It was so unexpected Ø It was so unexpected 2. Froze while it happened Ø I froze 3. Feeling vulnerable and helpless towards the perpetrator • Feeling vulnerable and helpless towards the perpetrator 4. Life loses meaning • Normality ceases and becomes meaningless 5. Suicidal idealation • I did not want to keep on living Ø I considered suicide if I was HIV positive 6. Withdrawing from people and hence feeling lonely • Feeling angry keeps others away Ø I withdrew from people Ø I felt lonely 7. Changes in behaviour Ø I behaved badly as a distraction 8. Lack of energy 9. Reactions of others Ø I was worried about others judging me Ø I did not want pity • Feel judged by others • Feel misunderstood 10. Self blame and lack of self blame • It was my fault as my actions let it happen • It wasn't my fault Ø I did nothing to invite the rape 11. Shame • Shame Ø I am not ashamed 12. Guilt Ø I did not feel guilty Ø When thinking I could have been infected with HIV, I feel guilty that I did not fight back 13. Anger • Angry at myself for letting it happen • Feeling angry keeps others away • Feeling angry gives a sense of strength • Anger not healthy Ø I was angry Ø I would be aggressive and break things 14. Sadness Ø I was sad 15. Mixed feelings/denial/moving on Ø I have mixed feelings Ø I was in denial

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Ø Did not affect my concentration Ø I have forgotten about it and moved on 16. Feeling misunderstood • I felt misunderstood 17. Dealing with HIV possibility Ø Being HIV positive was a huge concern 18. Lack of trust • Guys are not always trustworthy 19. Relationship with the perpetrator Ø I did not report him in order to keep peace with family Ø Continue relationship with perpetrator 20. Talking helped /Support of others • Talking helps Ø It helped to talk about it Ø I was not alone Ø Felt understood and not blamed by boyfriend 21. Helping others Ø I want to help others to deal with rape 22. Concern for others Ø I was worried others would also be raped Ø When thinking I could have been infected with HIV, I feel guilty that I did not fight back Ø I considered suicide if I was HIV positive Ø I am HIV negative 23. Perspective on pain and suffering /Damaged by the rape • Felt used • Felt ruined Ø Question why it happened Ø Positive perspective on what happened Ø I must learn from this Ø Pain and suffering is part of life for many people

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Appendix J – The Extended Description (Explicated as described on pg. 76.)

Being raped by someone you know is so unexpected and while the rape is happening the reactions of freezing and feeling vulnerable and helpless exists. In the time after the rape life loses meaning and can lead to various reactions such as lack of energy, suicide idealation, social withdraw and changes in every day behaviour.

As the victim considers culpability regarding the rape, the reactions of others is a predominate factor, others are thought of to be judging the victim and hence resulting in the victim feeling misunderstood or pitied. When the victim considers her own culpability, blame is associated with behaviours that may have contributed to the rape happening or a lack of action to prevent it.

The emotional reactions are described as being mixed. These include feeling shame, guilt, anger and sadness.

Dealing with the possibility of HIV infection can intensify the emotional reaction of guilt and lead to suicide idealation should infection have occurred.

Knowing the rapist can lead to either an extreme response of losing trust in males at large or to having to isolate the incident and continue the relationship with the perpetrator.

Perspectives on what the rape means can have both a damaging or uplifting result.

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