Rape Support Group

In response to enthusiastic encouragement here, I've written a little essay on how to tell if your rape trauma therapist is competent. Hope it helps.


Many therapists claim or advertise that they treat rape and abuse issues, but surprisingly few are actually well-trained. The dirty secret of psychotherapy is that attending a course on a topic to achieve Continuing Education Units toward annual license renewal is perceived by many therapists as qualification. Example: "I went to a training on rape trauma, so I've got Rape Trauma training."

Here are a few guidelines on recognizing a skilled therapist.

First, most rape crisis centers offer free counseling. That alone suggests that the counseling you would receive is by a person specifically experienced in rape trauma therapy.

I am not particularly impressed with "alternative" approaches to rape trauma therapy. For example, Emotional Freedom Technique (EFT), which involves tapping points on your body alleged to represent neural pathways has not been very effective. I once had a coworker who used it incessantly, and her clients would leave sessions and plead with us to reassign them; the "tapping" was driving them nuts but they had to pretend it worked so she would stop. Consequently, she was convinced she had helped every client she saw. Likewise, things like acupuncture/pressure, or new-age approaches have not proven themselves in research studies. EMDR has more substantial promise in reducing feelings of trauma, but does little to re-educate life and relationship skills.

My personal preference for treating RTS (Rape Trauma Syndrome) is Cognitive Behavioral Therapy (CBT) in a group setting.

Gender: Conventional wisdom suggests that the RTS therapist ought to be female, but actual life clients have disagreed with this. Males and females can both be excellent RTS therapists. Many female clients PREFER a male therapist, in fact. Some refuse a male therapist. The risk with untrained male therapists is that they will tend to emphasize the sexual dimension of rape, rather than the power and control dimension. If your therapist--male or female--seems to approach rape as a sexuality issue, it's time to move on. Rape *affects* sexuality, but it is not a sexual behavior.

It is VERY fair to question a prospective therapist before contracting for services. You are a customer, not a beggar, and a good therapist will not balk or appear threatened by inquiries.

Some questions that should be asked first:

1. What is the extent and type of training you have received in Rape Trauma Therapy? What books do you consider most helpful as a therapist, or for me as a client?
2. What is your approach to “victim-blaming” issues that often arise in processing rape?
3. How frequently do you treat cases of rape trauma syndrome?
4. Do you regard rape as a societal and cultural problem, or a problem of individual pathology in rapists?
5. Other than providing treatment services, what forms of social advocacy or activism do you do about the issue of rape?
6. Do you have songs, books, workbooks, or other media available for your clients to use in recovering from rape?
7. Do you see rape as a sexual issue? What is your understanding of the underlying causes of rape?
8. How do you explain that 99% of rape is perpetrated by males? What makes this a men’s issue, and why are men the primary perpetrators?
9. How will you define successful recovery?
10. If I have trust issues that cause occasional resistance, how will you handle that?

Those are my basic questions.

Now, just to be interesting, here are what MY answers would be if I were asked these questions as a therapist:

1. Some of the better books that a therapist ought to be acquainted with would include: “Cognitive processing therapy for rape victims” by Patricia Resick and Monica Schnicke; “Quest for Respect” by Linda Braswell; “Rape Recovery Handbook” by Aphrodite Matsakis; “After Silence” by Nancy Venable Raine; “Treating the trauma of rape” by Edna B. Foa and Barbara Olasov Rothbaum. Give extra credit if the therapist is familiar with Jackson Katz (“The Macho Paradox”) or the book “Transforming a rape culture.”
2. A good therapist will not even send subtle hints of victim-blaming. Too many therapists think it’s therapeutic to ask leading questions like these: “Can you change other people’s behavior? Whose behaviors can you change? What could you change in this situation?” or “Let’s talk about how to not put yourself in that situation again.” Women don’t put themselves in the position to be raped; RAPISTS put women in the position to be raped. If it had not been for a rapist in the environment, the same behaviors the woman was doing when she was raped would not have resulted in a rape. A good therapist understands that remnants of self-blame are the driving factor in flashbacks and nightmares.
3. This should not be the therapist’s first (or one of a few) instances of treating RTS. Too many therapists think that merely having an opinion on the matter of rape qualifies them to treat it.
4. Rape is a SOCIAL problem, not individual pathology. If a therapist portrays a rapist as a sicko, psycho deviant, they miss the point. Rape is increasingly NORMALIZED by cultural values, and rapists are so-called NORMAL boys and men who respond to the social attitudes about power, sex, and control in relationships. Anyone who fails to get this point should be forced to read Jackson Katz’s stunning book, “The Macho Paradox.” A key component to successful rape recovery is social activism precisely BECAUSE our society tolerates misogyny. Likewise, if your therapist sees rape as a “women’s issue,” they are failing to understand. Rape is a men’s issue, and framing it as a women’s issue gives men permission not to address it.
5. Does the therapist support or participate in activism such as Take Back the Night? Can your therapist even tell you when Sexual Assault Awareness Month is? (answer: it’s every April). Do they have literature from your local crisis center? Do they happen to have any bookmarks for websites about rape?
6. A good RTS therapist will understand the role of art in recovery. They should be aware of songs that positively address sexual assault (extra credit if they know Tori Amos, Beth Hart, Plumb, or Ani Difranco). I have collages created by previous clients that I can show to new clients so they can see tangible examples of victory (or progress) by women who have gone before.
7. Rape is not a sexual act. Men don’t rape in an effort to get sex; they use sex in an effort to get power and control. Sex is the method, not the goal, of rape.
8. See #4. Males receive socialization that endorses the use of power, control, and privilege in relationships with women. If your therapist fails to accept this premise, or make absurdly-untrue statements that “women rape too, but it’s just not reported”, they cannot accurately address the role of social norming in the creation of rapists. Likewise, your therapist should not excuse rapists as “people who were abused as children (or sexually abused) to make them that way.” Hell, YOU’VE been sexually abused, and so have 1 in 4 women, but women aren’t turning out in droves to become perpetrators. So this crap about “rapists are that way because of abuse” is a phony excuse.
9. YOU should define recovery. But here are some things to look for: you can begin to think and talk about your rape without feeling shame or fear, and you should be well-informed enough to confront and challenge ignorant comments by others. Nightmares and flashbacks should subside. You should be able to experience moments of conflict or sadness without using self-destructive coping measures. You should be able to accept your innocence in this crime, and not just intellectually—you should FEEL innocent again. You should be inspired to assist other women who are struggling with this issue.
10. A good therapist will accept these issues. I was once confronted by a client on her first day when she said to me, “I have issues with men” (and remember, I am a man). All her previous therapists had immediately begun challenging her beliefs, reminding her that “not all men are bad” and assuring her “you can trust me.” So her first response every time was to have her feelings invalidated. She agreed to see me for therapy only because I gave the answer she needed: “Of COURSE you have issues with men! Why wouldn’t you? Frankly, men DESERVE your distrust.” By not being defensive, and honoring the validity of her emotion, she saw potential to collaborate with me. I also asked her another question that opened up a door for her: “What mistakes have other therapists made with you that you hope I won’t do?” finally, I did something no other therapist had done before: “If you want to talk about this with me, how should I prepare myself as your therapist? For example, are there any topics you want me to do homework on so I’ll know how to understand better? Any songs I should listen to that mean a lot to you so I will understand you more? Anything I should pray about? Do you want to give me journal homework so I’ll be ready to help you?” I’m not boasting and saying I’m a superior therapist; but the fact is, those questions were refreshing to her and she needed to feel valid in her distrust and “men issues.” My final statement on this: Your recovery has NOTHING to do with whether men (or “malekind”) is redeemed in your eyes. Recovery is not about getting you to accept malekind. Frankly, it’s YOU who have been doing the work here, not malekind, so the ultimate goal is your acceptance of yourself. If, along the way, you begin to notice that good men exist, then great—but that it an eventual outcome, not the goal. If you leave therapy with me and still feel conflicted toward men, that’s perfectly fine. I’d rather you give trust too slowly than too quickly. You are not at fault simply because you recognize that not all men deserve to be your partner in your recovery.

Comments?
Posted on 01/09/08, 10:01 am