"Were you wearing underwear?" Stigma and fears around sexual violence: A narrative of stranger rape and considerations for mental health nurses when working with survivors

J Psychiatr Ment Health Nurs. 2023 Apr;30(2):141-147. doi: 10.1111/jpm.12864. Epub 2022 Aug 25.

Abstract

WHAT IS KNOWN ABOUT THE SUBJECT?: Although sexual violence is prevalent, incidents of stranger rape remain statistically uncommon. Societal stigma and myths surrounding sexual violence are widespread. An individual's experience in the immediate aftermath and beyond can be shaped by the perception/s of sexual violence which are held and expressed by those they come into contact with. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This paper adds to the limited literature base and the population and practical-knowledge gap around a specific form of sexual violence. This paper also demonstrates the need for reflection and discussion in minimizing blame that can unconsciously be shifted onto survivors in the form of myths and stereotypical views of sexual violence. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Perceptions may be held around sexual violence, and by extension about the survivor, which may impede engagement and the building of trust within a therapeutic relationship. Myths that are synonymous with rape and all forms of sexual violence can be held by professionals, and lead to blame, negative judgement and lack of empathy towards survivors. Given the prevalence of sexual violence, this paper is applicable across all health and social care settings, and in particular mental health nursing professionals who may be more likely to meet people who have experienced sexual trauma. ABSTRACT: Introduction This narrative illustrates the lived experience of a specific form of sexual violence (stranger rape) and its resulting implications as experienced by the second author, which is discussed under the following headings: your body as a crime scene, how lived experience compares to the myth of the 'real rape' and the wellbeing and health consequences arising from the experience. [Correction added on 5 September 2022, after first online publication: The preceding paragraph has been corrected in this version.] Aim In their capacity as mental health nurses, the authors invite readers to consider the spoken, or more likely unheard stories of sexual violence, which are unfortunately commonplace among those who access mental health services. Implications for Practice For professionals holding the privileged position of hearing these stories, there is a need to be reflective as to how fear, and personal or professionally held myths and stigmatizing views of sexual violence, and by extension views towards the survivor, are carried into therapeutic spaces, and the implications these can have. Practical suggestions as to how to discuss and manage disclosure of sexual violence in the context of trauma informed care are also provided.

Keywords: adult survivors of abuse; crime and mental health; narratives; stigma; trauma.

MeSH terms

  • Fear
  • Humans
  • Mental Health
  • Nurses*
  • Psychiatric Nursing*
  • Rape* / psychology
  • Sex Offenses* / psychology
  • Survivors / psychology