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For sexual assault survivors, triggers are never far away

Palm Beach Post - 9/25/2018

Sept. 25--Regardless of how the Brett Kavanaugh Supreme Court nomination hearing turns out, one thing is certain: Victims of past sexual trauma are at increased risk for being triggered.

Last October, when the Harvey Weinstein rape accusations jump-started the #MeToo movement, the Rape, Abuse and Incest National Network (RAINN) -- the nation's biggest anti-sexual-violence organization -- said that its national crisis hotline received more calls than usual.

Similarly, after the Robin Williams suicide in 2014 and the Kate Spade and Anthony Bourdain suicides in June, suicide hotlines nationwide reported an uptick in calls.

For the past two weeks -- and presumably for as long as the Kavanaugh story remains front and center -- the topic of sexual violence will be unavoidable for anyone who follows the news even casually.

And for sexual assault victims (of which RAINN estimates there are more than 320,000 annually) this barrage means survivors -- even those whose incidents happened decades ago -- may be at increased risk for conditions that include:

* Post-traumatic stress disorder (PTSD)

* Anxiety/fear

* Depression

* Social withdrawal

* Sleep disturbance

* Difficulty concentrating

* Eating disorders

* Drug/alcohol abuse

As New York University psychologist Katherine Porterfield told Health, "If you have survived something like a sexual assault, it's common -- and in some ways quite easy -- to be brought back to memories of that experience. Triggers can definitely include someone else telling a story or describing an assault they went through."

Likewise, Laura Palumbo, a counselor with the National Sexual Violence Resource Center (NSVRC) explained to Self that "a level of detail or specific terms" can be "deeply triggering."

According to NSVRC, 1 out of every 5 women will be raped in her lifetime and 1 in 3 have "experienced some form of contact sexual violence."

So, how can survivors (and their loved ones) of these types of traumas cope with what they've been through -- especially in today's charged environment?

"Sexual assault is something that can be 're-experienced' by the victim if it's not effectively dealt with," explained Boca Raton psychiatrist Dr. Samantha Saltz. "And symptoms related to PTSD can crop up any time and for any reason -- not just because of what's happening in the news."

In trauma-focused treatment, Saltz said that cognitive behavioral therapy (CBT) is the most commonly utilized protocol.

"What we're trying to do is reframe the patient's cognitions, behaviors and maladaptive thought patterns."

In CBT, therapists like Saltz guide their patients toward retraining their brain. The goal is usually to have the patient "unlearn" the negative emotions and/or physical reactions related to the trauma.

Typically, PTSD is comprised of symptoms from four categories:

* Re-experiencing (flashbacks, nightmares, intrusive memories)

* Avoidance (repressing emotions; avoiding people, places and things that remind one of the trauma)

* Arousal/reactivity (sudden mood shifts; inability to relax; self-destructive behavior)

* Cognition (shame; self-blame; detachment; depression)

Through a combination of techniques -- which can include journaling, mindfulness training, meditation and thought and breathing exercises -- the patient is taught coping skills to combat the negative emotions associated with the trauma.

And when necessary, Saltz is also a proponent of "medication management. Often, a tailored approach of a selective serotonin reuptake inhibitor such as Zoloft or Paxil can be effective for a PTSD sufferer."

Other, less conventional modalities for treating PTSD include equine therapy and art therapy.

Local philanthropist and former U.S. Ambassador Earle Mack is an advocate of the former, helping fund research to create an evidence-based equine therapy protocol.

And Saltz herself is a benefactor of the latter as a sponsor of this Friday's HEArt Show -- an annual charity fundraiser created by Boca Raton therapist Clara Bossie whose "expressive art therapy" enables "clients to express through art the things for which they don't have the words."

Every year, Bossie's Healing Through Expressive Arts puts on an artistic exhibit and art sale that brings together professional, amateur and child artists to display their talents and creations.

All proceeds from this year's HEArt Show will benefit Professionals United for Parkland.

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(c)2018 The Palm Beach Post (West Palm Beach, Fla.)

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