Measuring the trauma

2008-11-28 00:00

THE trauma associated with rape is obviously enormous, but measuring that trauma and its effects is not easy. Pietermaritzburg clinical psychologist Prishika Pillay has been researching the area, and is the first person to do so. Her findings have excited considerable interest.

She presented a paper earlier this year at a conference on psychoneuroimmunology in the United States. “Mine is the only research into rape survivors in the immediate aftermath of the rape, although some has been done on the long-term survivors of abuse,” she says. Pillay has been looking specifically at the effects of rape on the survivor’s health, and on the immune system. After all, it is well known that there is a strong link between what happens in your mind and what happens in your body. Stress — the stress of writing exams, marital stress or the stress of rape — has an effect on physical health.

To do her research, Pillay worked with a group of rape survivors, having blood samples drawn for tests, including the CD4 count, five days after the rape, 10 days later and finally 35 days after the event. These, done at the same time each day to rule out any variabilities, indicated distress levels.

The findings show that the survivors were most affected on the second visit, 15 days after being raped. “Probably at the first test, they are focused on the practical problems they face and by the final one, they have managed to gain some perspective on what has happened,” says Pillay.

The findings have important implications for counselling and support, and the development of health-care strategies. Health workers and psychologists could develop intervention strategies such as setting in place routine counselling to take place two weeks after a rape — when Pillay’s research suggests it is most needed.

“Of course, you have to treat each case individually,” says Pillay. “You have to see what a person’s pre-existing life was like, who the perpetrator of the rape was and the degree of trauma. And people have different ways of coping.” Some focus on the problems they face while others take a more emotional stance, and research shows that the way in which you cope will have different effects on the immune system.

Pillay’s interest in the field comes from her days at Rape Crisis, where she was chairperson. At the time — 1995 — there were just two people running the organisation, counselling rape survivors. Over time, the way rape survivors are treated has improved; Pillay can recall sitting for six hours in the police station at Loop Street waiting for the district surgeon, while drunken drivers were being given priority over the people she was trying to help.

“Police are more sensitive now,” she says. “But the legal system comes down to one person’s word against another in rape cases.” Pillay knows all about that. In 2005 she went to the High Court to prevent a magistrate in a rape case forcing her to disclose confidential information she had received from a client. “The magistrate said that rape survivors abolish their right to privacy if they lay a charge. That’s ridiculous.” The High Court ruled that she did not have to divulge the information — but three years later the rape case is still going on. Survivors still face horrific obstacles in getting justice.

Another thing that interested Pillay was the science involved, the testing of the blood to find out stress levels. In her first degree on the local university campus, she majored in microbiology and psychology, a combination that pointed her in the direction of an interest in the immune system.

Inevitably, research in this field is very difficult. Each rape survivor had to give her informed consent — and be prepared to go through with the three carefully timed sessions in a period of acute stress. And the psychologist has to be to able to disengage from the patient — to be a pillar of strength at a difficult time, but be able to leave her work behind when she goes home at night.

However, her continuing fight to help survivors of rape, combined with her research, which she plans to carry on to PhD level, should ultimately make life — and recovery — a little easier for those who have been abused.

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