PTSD and Sexual Assault Are Pervasive and Unrelenting
She froze. Beads of perspiration broke out on her scalp…her eyes flashed wide. Terror gripped her and she prepared to fight off her attacker…
She waited. Held her breath. Seconds passed. Then a minute….so she quietly sucked in some air… and slowly — almost imperceptibly— looked into the bathroom mirror.
No one was behind her. She was alone… again. A string of curses flew out of her mouth. And then, again, she collapsed in sobs.
Those moments were so real. But they weren’t. Was she losing her mind..??! She just knew he was there ready to grab her…or worse.
Destined for Success
Joanne had worked hard to climb her way to leadership in her marketing firm. She was smart. And well-educated. And had that special savvy that generates millions for clients. She was director of her division, and proud of her accomplishments.
Bright-eyed, warm, and ambitious. Everyone around her wanted to be part of her inner circle…until it happened.
Rape: The Night She Couldn’t Forget
That weekend night was such a bad, bad night.
She remembers his voice. The sounds. Her fear. His smell. A backhanded slap across her face…a sickening thud when her head hit the floor…
She’d been raped. She’d heard that voice before. Thought she’d seen that face. On the elevator…? Where was it…?
He was gone…but her awareness of his presence filled her apartment for weeks… and then months. And the more time that passed, the worse her terror grew. The gripping fear he’d come back was there 24/7, especially at night.
She felt horrifically vulnerable.
A sitting duck.
Why PTSD Is So Hard
She found she was utterly unable to leave the apartment, take the elevator, or to step out into the sunlight and walk to her car. So she created and occupied a little fortress in her small apartment. What a joke.
What if he came back..? Just got in the elevator..??
Her friends tried to hover around her, and to never leave her alone.
Still, she couldn’t feel safe. But eventually she needed her place back to herself.
When she realized he worked in her building(!!) … it all came back. So she called the police and gave them a statement. But still…he could come back at any time…
And her torment persisted…
She felt alone in her prison of chilling terror. Her friends’ warm, caring efforts at comfort seemed unable to penetrate the icy cold cage that held her in its grip. The assault had shackled her; the PTSD she developed afterwards made sure she never forgot it.
Joanne’s illustrious career began to stall, as her ambitious and talented co-workers surged forward in her absence. Like sharks to blood, she thought.
She had the building supervisor install safety clamps on the windows and an extra lock on the door. But she couldn’t concentrate. Her mind wouldn’t work. She kept checking the locks…
The slightest sound…the ice maker initiating a cycle, a car backfiring in the street below…a man’s voice… launched her into all those same feelings from the night of the rape… magnifying the moment from a passing sound to an explosion of terror within her.
There Has to be Something That Can Be Done
Joanne reached out. She had reported it, had all the tests, was given the name of a counselor. She told her doctor she couldn’t sleep. Told her counselor she couldn’t think. Saw someone who prescribed Zoloft, then Paxil. Someone else who added prazosin, and then Abilify. The nightmares worsened, her anxiety skyrocketed. And she crumbled.
How Does PTSD Happen ?
PTSD can come from any sort of severe trauma. A car wreck, a mugging, a sexual assault, domestic violence, combat, a life-threatening illness…
But the terror, the loss of productivity, the sense of profound vulnerability, the grip of powerlessness, the unrelenting vigilance, the rage…
…and the nightmares…waking up in terror and not knowing if the paralyzing fear is reality or a dream.
The symptoms of PTSD can emerge no matter what event flipped the switch to a roaring ON.
Triggers, we call them. Anything that lights the fuse of flashback symptoms and the fight/flight urges along with symptoms like Joanne experienced: irritability, hyper-vigilance, withdrawal, night terrors, mood swings, lack of focus, guilt… and shame that she couldn’t protect herself.
No matter how much empathy you have, unless you’ve been in combat, you can’t really know what a combat veteran has seen.
Unless you’ve been repeatedly battered, you can’t know what a survivor of domestic abuse feels.
And unless you’ve been sexually assaulted, you can’t know what a survivor lives with in the days, weeks, months… and even YEARS that follow.
The changes can render you unrecognizable — even to yourself. Joanne’s confident and warm demeanor disappeared …and in its place was now irritability, short-tempered emotional outbursts, and criticism of everyone around her.
It became “normal” for her to shake… as if she had a constant case of the jitters… and she found it impossible to let down, relax, and enjoy anything.
Her relationships with her friends deteriorated over time.
As hard as they tried to understand, listen, support, and comfort her, Joanne’s harsh and unforgiving onslaughts against them wore down their confidence in her friendship, and her isolation slowly drove them away. They got tired of it. And tired of always helping her.
Knowing the damage she was causing, she’d sometimes cry herself to sleep. But most of the time, her preoccupation with impending danger filled her thoughts. She had no idea how to do any better than she was doing.
Her reactions seemed justified to her, and she lashed out if anyone questioned her.
But deep in her heart, Joanne knew that what had happened to her was slowly destroying her.
She’s didn’t want it to define her.
She picked up the phone.
Hope Quietly Bubbles Up
At the appointment, the psychiatrist took a full history to better understand Joanne’s condition.
She explained to Joanne that she was, in fact, suffering from PTSD, and for such a long time, that it had worn her down. Depression and chronic anxiety permeated her. And nothing had helped.
They discussed at length a variety of approaches for treatment, including the off-label use of IV ketamine infusions to rapidly treat PTSD, lift her depression, and restore Joanne’s ability to function in her daily life.
In spite of Joanne’s rage at her assailant, she wanted to get her life back. To be able to enjoy going out with friends again, attending dinner parties, and relaxing at home with her cat. To feel whole again.
She had her first ketamine infusion the following day.
Relief Builds in Cadence with the Treatment
After the first infusion, Joanne didn’t feel exactly great. But the doctor had prepared her to keep her expectations in check until the medicine had time to work.
She felt nauseous during the infusion, so the doctor added medicine to the IV to help her feel better, and she felt a bit dizzy afterwards. So the doctor treated her again for that. She did notice that the panic that always rose inside her when there was a trigger seemed less intense maybe…? Sort of blunted…?
Still, she wanted to get home as quickly as she could. The couple of hours she’d been away intensified her sense of vulnerability and she ached to get home and lock all those barricading latches on her door.
Then came the second infusion a couple days later, and she felt the slightest **ping** of relief for a fleeting moment. Nothing dramatic, but unmistakable. The air seemed a little clearer…and the sunshine on her shoulders gave her a mild, though transient, warmth.
Really? Or was this just a placebo effect? Was she trying too hard to talk herself into believing that this was working?
Then… after the third infusion… she noticed on the way home she was liking the drive. Watching people walk by on their way to lunch. The aromas wafting from the restaurants along the way… The verdant greens of the neighborhood parks.
Incapacity Yields to Triumph
With the fourth, fifth, and sixth infusions, she rapidly felt better …and better …and better. She called a friend to meet her for lunch after each of those infusions, and they took in some shopping afterwards.
Noticing the sparkle tickled by the sun on the colorful cars as they drove by. It occurred to her she hadn’t noticed colors in a long time. She remembered the world around her as being more like shades of grey. How neat.
Once home, she felt calm. She locked the door and the second deadbolt…but ignored the rest of the locks on the door.
“That’s plenty,” she told herself.
Next, she launched into laundry, vacuumed, dusted, and washed the dishes. As the apartment began to gleam, she took a look at her laptop…and set out to catch up on months of emails.
Day by day, she worked more and more from her laptop on a new campaign with her team. She hadn’t been this creative in such a long time. Then, two weeks after the last infusion, she called her boss about returning to the office.
Next, she invited her friends over for wine and cheese. They were wary when they arrived, but they came. She was worried that they’d gotten so tired of her that they’d just say no. She explained what had been going on with her through all the horror of the last months…and what had changed.
It meant the world to them that she was finally talking to them again… and opening the curtain to her previously closely-guarded thoughts.
Her animated descriptions of the last several months prepared the path to healing between them. And she had the capacity, once again, to really listen to what they experienced throughout the whole ordeal.
Rape is a Crime…Not a Mistake or Lapse of Judgment
Rape is a terrible crime, and an indelibly traumatic experience for the victim.
While it’s common to hear the diatribe about standing up for yourself (great advice) and rising above the trauma (easier said than done on the power of sheer will), if sexual assault has caused PTSD, healing often involves not only venting your rage, but reaching out for a treatment that actually works.
Your rage, indignation, and need for justice are justified.
You were robbed of something sacred and intensely personal.
But in the big picture, it’s important to get better and have the power to live again.
To create. Produce. Feel motivated and inspired. To love your family and friends. To be generous. And recover.
At Innovative Psychiatry, we often see victims of rape and sexual assault who’ve developed PTSD. This traumatic and crippling condition can cause your life to crumble before your eyes. In addition, it can hold you hostage and keep you enslaved to your fear.
But, just as often, we have the privilege of watching a broken-hearted person with PTSD recover through the rapid and robust effects of IV ketamine treatment.
The same effective medicine that was used to float the young Thai boys through hours of their rescues from the caves earlier this year—
Ketamine has been used around the world in trauma and disasters. It has a 50-year track record of safety and effectiveness in people of all ages.
But it’s the off-label use of ketamine in psychiatry that’s been discovered to be so extraordinary for treatment of depression, PTSD, social anxiety, OCD, bipolar disorder, addiction, and suicidal thinking.
If you’ve been sexually assaulted, and you feel plagued by some of the symptoms in Joanne’s story, call us.
Your pain is real. And justified.
But you can recover from the pain and fear of that terrible assault.
And you can heal…and start to really live again.
To the healing of your best self,