Exposure therapy has shown positive results in the treatment of Post-Traumatic Stress Disorder (PTSD) suffered by victims of rape. Edna Foa, Director of the Center for the Treatment and Study of Anxiety at the US University of the Health Scienes in Allegheny, developed a novel method of using exposure therapy in treating rape victims. Her method is generally regarded as the standard method for treating rape victims.
Women appear to be soft targets for PTSD, as research suggests women being twice as likely as men to suffer from the disorder. A further confounding variable making PTSD a more frightening reality for women is the increase in rape and other crimes against women. Although PTSD is recognized as a true illness by the medical profession, public awareness of the disease is low and many sufferers discount the extent of their symptoms and suffering. The fear of being incompetent, crazy or senile becomes very real to sufferers upon realisation that they have not overcome the initial attack which may have triggered off PTSD.
Edna Foa’s research reveals that in the USA, 95% of rape victims experience their first PTSD symptoms during the two weeks following the attack. After six months however, the figure drops to 35% and continues to decline. It is estimated that between 13 and 20 per cent of rape victims will in fact develop chronic PTSD. She believes that the vast majority of victims can be helped through exposure therapy, which in terms of her practice, consists of nine 90-minute therapy session with relevant homework and assignments for completion between sessions. A very basic idea provides the framework for therapy : the patient must confront the traumatic memories they are so desperately trying to forget as avoidance perpetuates the disability and suffering.
Patients are asked to recount the trauma in such a way as to make it feel real and happening in the current context of space and time. The therapeutic significance of this painful re-enactment is that by allowing themselves to recount the trauma and think about it, what happened will be understood in more realistic terms and it will be easier to make sense of the experience. “Because traumatic memories are encoded in the brain under extreme anxiety, they are not encoded in the same way as other memories. Time and space become confused – recounting the story enables patients to organise the narrative in such a way as to be able to deal with it”, emphasises Foa.
As the patient starts to recount the experience, the therapist encourages her to fill in the details and gradually lengthen the narrative. With time, the narrative will become shorter as the patient opts to focus more on making sense of the event rather than placing significance on specific details.
In terms of success rates for the treatment, as many as 75% of victims will recover from PTSD, while 90% will show remarkable improvement. In more difficult cases where the response to exposure therapy is not adequate, anti-depressant medication may be prescribed to assist recovery.