Psychiatry Advisor: How do such comments act as a trigger, and what effects could this have on women with PTSD?
Dr Tyler: These types of comments, whether publicly stated or caught on a hot mic, serve as reminders for many women that have experienced sexual assault. In some cases, the comments can serve as an actual trigger for remembering specific trauma events. In other cases, it’s the symbolism of hearing aggressive and disrespectful language come from people in powerful positions. Regardless, when someone experiences a trauma, these trauma memories are encoded differently than other memories.
And as we discuss in the article, there seems to be something particularly disturbing about experiencing a sexual trauma, as it is the strongest predictor of developing PTSD among women and men. Sexual trauma leaves a psychological wound, and PTSD occurs when the wound has not fully healed. In fact, PTSD is like having an infected wound that’s been covered with a bandage. You may not see it but it’s there, and it’s painful if when somebody touches it. For a woman with PTSD, hearing a politician make the types of comments we are talking about is like someone hitting directly, or close to, that wound site — it’s painful.
Psychiatry Advisor: What are the treatment implications of this issue for our mental health clinician audience?
Dr Tyler: It is likely that in this particularly tense political climate, clinicians will work with patients who are experiencing increased distress, anxiety, and trauma-related symptoms after hearing unsavory rhetoric by some politicians. I think it’s best to embrace these topics with your patients and provide a space for them to explore and process their emotional reactions. If you have patients who have experienced sexual assault, let them talk about how they’re impacted by what they’re hearing in the media.
I recognize that talking about political topics might be uncomfortable for some clinicians, but I encourage you to embrace it and tolerate your own discomfort if it can be beneficial for your patient. You don’t have to express your political views to connect with your patient on this topic, but you can connect with and validate their emotional experience. The goal is to help your patients explore what meaning these experiences hold for them. If your patient has PTSD, remember that it is a highly treatable disorder. Prolonged exposure therapy for PTSD is a highly efficacious therapy that can help survivors of sexual assault recover from their trauma.4
Psychiatry Advisor: Along with specific comments by some politicians, there is clearly a more hostile environment toward women in general being promoted by many supporters of the current presidential administration. Are you noticing effects of this as well?
Dr Tyler: Yes. Unfortunately, I’ve noticed that this tense political time has fostered a tendency for just about any issue to become politicized. As a society, we ought to be able to come together and agree that an issue such as sexual assault and violence against women doesn’t have to be political. Sexual assault is happening all too often in our country, and I truly believe it is a cultural epidemic. It saddens me to still hear of so many cases, both civilian and military, in which sexual assault is being swept under the rug. It shocks me that we still have women being blamed for someone raping them. And it angers me to hear the now-president of the United States allege that his sexual assault accusers are simply seeking fame.
When politicians speak disparagingly about women and victims of sexual assault, it’s truly a disservice to our society and to human decency. In the majority of my patients, I think the uniting experience tends to be disappointment with the realization that politicians who embody this disservice still have such strong supporters to this day. Unfortunately, I think too many people have confused the difference between political correctness with respectfulness. We should be encouraging politicians to be respectful, which includes denouncing the use of derogatory language towards women.
- American Psychological Association. Stress in America: coping with change survey part one. Stress in America™ Survey. 2017. http://www.apa.org/news/press/releases/stress/2016/coping-with-change.PDF. Accessed May 25, 2017.
- Department of Justice, Office of Justice Programs, Bureau of Justice Statistics. National Crime Victimization Survey, 2010-2014. https://www.justice.gov/ovw/sexual-assault. Accessed May 25, 2017.
- Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB.. Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995;52(12): 1048-1060.
- Foa EB, Hembree EA, Rothbaum BO. Prolonged exposure therapy for PTSD: emotional processing of traumatic experiences therapist guide (Treatments that work). Oxford University Press; USA: 2007.