By Izzy Smith
CN: PTSD, rape, harassment,
graphic violence, suicide
sexism, stigma, victim-blaming
Post-traumatic stress disorder seems to be one of the few mental health problems that people actually believe can be severe and debilitating, and not simply a sign of weakness or attention seeking. This is probably because, unusually for a mental health problem, it always has a clear external cause, and because it is commonly associated with men, and ‘masculine’ experiences like combat. This association is so strong in the public consciousness that PTSD caused by forms of trauma more commonly experienced by women is often dismissed or disbelieved. It seems that respect for the seriousness of PTSD comes at the price of constant vigilante gatekeeping regarding which trauma is really severe enough to cause it.
PTSD is ‘an anxiety disorder caused by very stressful, frightening or distressing events.’ It is characterised by re-experiencing the traumatic event, for example through flashbacks; avoidance and emotional numbing, as well as hyperarousal (being anxious, highly aware of threats and easily startled). While men and women are comparably likely to experience a traumatic event, women are more than twice as likely to develop PTSD as a result (20.4% vs 8.1%). This is primarily because sexual assault, the leading type of trauma among women, is more likely to cause PTSD than most other traumatic events, including accidents, the most common type of trauma experienced by men. Rape, which is experienced by one third of women, is a form of interpersonal trauma, the type most strongly associated with PTSD, and also imposes powerlessness, considered central to the development of the disorder. Half of rape victims develop PTSD, compared to one fifth of firefighters. Other trauma more commonly experienced by women, notably, child abuse and domestic violence, are also examples of interpersonal trauma.
‘You will soon forget about it in the joy of motherhood’
The US National Center for PTSD also cites the fact that women are ‘more likely to blame themselves for traumatic experiences’ as a reason for their heightened risk of PTSD – a mentality that is encouraged by a culture of victim-blaming and slut-shaming. It also finds that women are more likely to develop PTSD if they suffer further stressful events after trauma, certainly a common occurrence when we consider this victim blaming that rape survivors are so often subjected to, even within the courts, and the low prosecution rates for rape (2%). Only prisoners of war experience similar risk of PTSD.
However, despite the fact that more women develop PTSD, and that trauma most commonly affecting women proves more likely to result in PTSD, it is widely considered exclusively a veterans’ disorder. Civilian female PTSD sufferers are often dismissed or even attacked. The mental health charity, ‘Mind’, notes regarding PTSD following birth complications that ‘The impact of these experiences is often underestimated, as people may feel that the baby is adequate compensation for the trauma and that…you will soon forget about it in the joy of motherhood.’
‘She’s confusing PTSD with menopause’
Melody Hensley, an executive at the CFI, who was diagnosed with PTSD after ‘a vicious flood of online and social media attacks that included threats of rape, murder and photographs of dismembered women,’ has been widely disbelieved, ridiculed and further harassed. The Pew Research Centre for Internet and Technology found that ‘young women experience particularly severe forms of online harassment,’ with 26% having been stalked online, and 25% having been targets of online sexual harassment, compared to 6% and 7% of the general population respectively. Even though her employers confirmed her diagnosis, and psychologists such as Caleb W Lack agreed that PTSD can be caused by extreme bullying, including online, the Daily Mail published an article entitled: ‘”Twitter gave me PTSD”: Woman claims mean comments and “cyberstalking” gave her an illness usually suffered by WAR VETERANS.’ Twitter users declared ‘You’re a disgusting and horrible human,’ ‘Kill yourself please. You are a dumb bitch,’ and, ‘She’s confusing PTSD with menopause,’ their expressions of outrage taking distinctly misogynistic directions. Users seemed to take her diagnosis as an insult to veterans, and as belittling the horrors of war, telling her, ‘Go get blown up and see your friends die, then you’ll understand true PTSD,’ and ‘Go talk to a war veteran about PTSD, kid.’
Lady Gaga faced similar responses to disclosing that she suffers from PTSD, having been raped at 19. One commenter on the Guardian site asked, ‘How many more times will she bring up this story?’ continuing a clear trend of colouring women’s suffering as attention seeking. Piers Morgan evidently agreed, accusing her of ‘promo[ting her]self,’ and responding, ‘No, soldiers returning from battlefields do [have PTSD]. Enough of this vainglorious nonsense.’ Any suggestion of comparability between trauma from combat and from rape is seen to minimise the seriousness of combat-related trauma. This says a lot about how dismissive our society is about rape. Seemingly people only see PTSD as legitimate if they perceive the cause to be suitably traumatic, and rape is widely regarded as insufficiently serious.
‘Go get blown up and see your friends die, then you’ll understand true PTSD’
PTSD only being seen as valid for these ‘masculine’ traumas is not only counterfactual, but destructive. It functions to deny the severity of problems that disproportionately affect women, like sexual assault and domestic violence. On a large scale, this enables the underfunding of Rape Crisis organisations, and continued lack of consent education in our schools. On an individual level, it silences rape survivors from discussing how their experiences have affected them, branding those who do speak up as disrespectful to ‘real’ sufferers, i.e. veterans, whose trauma is supposedly more legitimate.
This also makes rape survivors, and other PTSD sufferers whose trauma is not considered valid, less likely to seek help, with 40% of adults who screened positive for PTSD not having spoken to their GP about a mental or emotional problem in the past year. Gendered perceptions of rape and PTSD most likely particularly affect male rape survivors, with men already significantly less likely to seek help for mental illnesses.
Interpersonal causes of PTSD, and PTSD in women, are also under researched. The illness was first recognised in First World War soldiers, and early studies were conducted on Vietnam veterans. It was only realised that rape could have a similar effect much later. Still, the majority of studies into stress responses involve male lab animals, and most trauma research on humans involves combat veterans and motorbike crash survivors. This is a particular problem, since recent neuroimaging studies show differences in brain activation patterns between PTSD dominated by hyperarousal and by dissociation. The latter kind is more common among women after interpersonal trauma, and carries an increased risk of developing into chronic PTSD, and resisting drug and psychotherapy treatment.
This scorn for PTSD caused by rape specifically is also symbiotic with a culture of disbelief and rape victim-blaming. If the arguments, ‘it probably didn’t happen’ (as Piers Morgan also said of Lady Gaga) and ‘it was probably her fault’ fail, then denying the traumatic nature of sexual assault is a third way to silence victims and protect abusers. When women are victimised, the public is quick to rewrite this narrative: she herself is ‘playing the victim,’ or she made herself too attractive a victim by being alone, or drunk, or pretty, or already vilified for promiscuity. Or, she isn’t a victim at all, and the real victim is the man who will spend six months in prison for raping her and no longer enjoys his favourite food, or who will lose his college scholarship – or veterans, who have to suffer her stating that she has the same condition as them.
‘It probably didn’t happen, it was probably her fault. She is playing the victim’
This is an example of how the underassessment and dismissal of problems commonly affecting women can cause real damage. We need to understand and admit that the shocking rates of rape and domestic violence, especially against women, are a serious issue. They require an organised and concerted response both preventatively, through consent education, and after the fact, through properly funding Rape Crisis and mental health services. We also need to understand the complexity of trauma and PTSD before trying to participate in conversations about these issues. I believe it would be useful to teach school children basic information about some common mental health problems, perhaps in PSHE (replacing a few of the hundreds of ‘don’t do drugs, kids!’ sessions). This would help combat stigma based on misinformation and a lack of understanding.
Our understanding of a common illness being clouded by gendered misconceptions feeds misogyny, mental illness stigma and low rates of sufferers seeking treatment.