How people are treated when they are victims of such crimes has improved dramatically over the years. The understanding of the psychological impacts has developed considerably and the methods for dealing with the individuals have become much more victim-centred. In Derby, and Derbyshire, one of the organisations that has a significant presence in this field is SV2 – Supporting Victims of Sexual Violence.
In the County, SV2 is responsible for the Sexual Assault Referral Centre (SARC) – for over 16s. This is the place of safety that rape victims go to, following an incident.
The SARC, which is in Codnor, is a discreet building. Inside, the main rooms are furnished comfortably, with the intention of creating a relaxing and calming environment. This is subtly blended with recording equipment to allow filming of interviews. The team and facilities are fully approved for forensic examinations either in conjunction with the Police, or independently. The Police are not always involved with rape victims; it might be something that the person wishes to consider over time, but still wants evidence to be collected. Traces of semen, and DNA, can be collected for a period up to 7 days for vaginal rape, but only 2 days for oral, and anal; on clothes semen is very durable at a DNA level for some time after, but the advice is not to delay.
When a person, and around 90% are women, is taken to the SARC following a rape, they are met by a Crisis Worker regardless of the time of day. Helen, one of the Crisis workers told me:
“I’m looking for it to feel homely, I’m looking for them to feel that we’re there to care for them, and we’re going to feed them, and do everything that they need, and make sure they know what’s happening. One point is that they’re free to go at any time”
The Crisis Worker is there for the client.
Following the rape, the client has catastrophically lost control; they may be consumed by a myriad of confusing emotions, and are totally disorientated – somehow they will need to cope. One way is by dissociation – that is, to escape from themselves psychologically; to remove themselves from the moment. It is the job of the Crisis Worker to support them during these difficult times, and guide them through the formality of the procedure. The Crisis Worker’s aim is, as best as possible, to make the client feel that they have control of the situation.
The Crisis workers have good relationships with the Police, and Doctors with whom they work closely. The Police Sexual Offence Liaison Officers (SOLO) are trained to interview rape victims, and they are sensitive to the psychological consequences of the trauma. The sequence of events may be muddled, the client may well be confused– they may be embarrassed, ashamed, feel foolish, shocked about what’s happened; they will be trying to cope with what’s happened to them.
“If you say it as it is – it makes the world a really scary place…so they try to protect themselves”
was Helen’s experience.
Success is a strange concept in this environment. If all of the necessary police evidence has been gathered, and the client has felt safe, comfortable, and in control during that period, then that would be success.
Independent Sexual Violence Advisor (ISVA)
The Crisis Worker’s involvement is short-lived. The next person who the client may wish to engage with is the ISVA. The ISVA is about providing practical and emotional support. Sallie, one if the ISVA’s explained:
“Realising the extent of their vulnerability will have an automatic knock-on effect to their level of confidence, which will creep into all areas of their lives. The confidence will have taken a complete nose-dive so the simplest of tasks will become onerous – suddenly they don’t have that sense of trust in themselves or in the world anymore – so having someone there can help normalise it”
The client may have problems with their job, money, housing, looking after themselves, the simplest of tasks, as well as the likely trauma of a potential court appearance, and the ISVA is there to work with them through this. The client may choose not to meet an ISVA for months after the incident; it will depend very much on how they, individually, respond to the trauma, and the timescales of the court process.
Accessing the ISVA is not compulsory, and the client can chose to end the relationship at any time which maintains the principle of ensuring that the client is in control. There is no standard case- there are too many variables, and that is the skill of the ISVA. Identifying the issues, and adapting to the needs of the client, quickly, and responsively.
The ISVA’s role continues for as long as the client needs it. The post-trial period is important as it can be very traumatic, and that emotional support is critical to ensure that the client can still remain as grounded as possible.
For under 18s there are specialised Children’s ISVAs; the youngest client that SV2 has is of pre-school age. Although the role, in principle, is the same as the adult ISVA, it tends to be more around emotional support, rather than practical. This is a particularly delicate relationship, as in many cases the perpetrator is a family member, or even a parent. The skill is in adapting the approach to the age, and the actual level of maturity of the child. It is about gaining a level of trust, and understanding in a situation when the child might not really know what has happened to them.
Many children’s reaction to sexual abuse is to self-harm. This can be deep cuts in the arm, which are both a distraction from their internal pain, and a release of suppressed pressure, through the discharge of blood. Other symptoms can be nightmares, flashbacks, bed-wetting as well as erratic behaviour, sensitivity to triggers, anxiety and panic attacks. In some cases they will attempt suicide.
For those adult clients who have much more complex and deep-rooted psychological conditions they can be seen by one of SV2’s qualified Therapists.
The Therapist is an analyst , an explorer, a navigator – piecing together the jigsaw puzzle, identifying the routes in, and routes out, building trust, creating awareness, being the client’s mirror on themselves, a reconnector of neural pathways, ultimately de-coding historical dissociative coping mechanisms, and helping the client find a manageable future. Debra, who is one of the Therapists, summarises:
“The therapeutic relationship – that’s the healing. It’s an understanding of the deep complexities of how, especially childhood sexual abuse, can have a massive impact on someone. If someone experiences abuse, from as young as a baby, their mind will split.”
For those complex cases when the “mind splits” at traumatic periods in their past the client can exhibit distinct multiple personalities. The “split” , freezes in time the clients persona, as the unprocessed trauma, leaves the experience “unfiled”, re-appearing and re-surfacing, periodically. The client may, at one time, be a 6 year old, then a 13 year old, then their adult self. Unpicking this, and creating an awareness that allows the client to cope with life is the skill of the Therapist.
Listening is critical -this might be the first time that someone has actually spent extended amounts of time trying to understand them. This is, in itself, an important part of the healing process – it’s about validation, and trust, and this takes time…and money. Therapy is not a short term process. Funding is a problem, and the basic minimum time is 6 months, although this can be extended to a year, but for many this is still not long enough.
SV2 sees many people through a number of referral routes. In the 9 months to the 31 December 2015, SV2 saw 600 new service users, this was in addition to the 784 people who were existing clients at the beginning of April. 708 cases were closed in that period. This is achieved with a modest number of staff. There are 9 Crisis Workers, 7 ISVAs including 2 Children’s ISVAs, 2 employed Therapists (with access to 14 external Therapists and 3 students) plus 2 Managers and a Chief Executive Officer.
The volume of people accessing their services has increased, particularly from those who have suffered historic abuse; in one month, 62 people came forward. The recent publicity over Savile etc has encouraged people to come forward and seek help. Whilst the SARC is jointly funded by NHS England, the Police and the Local Authority, this does not include the Therapy side which is always struggling for financial support and this is most crucial to support those who are living with historic abuse.
Metaphorically, SV2 are “healing wounds”, but unlike physical ones, they are not visible, not static, not standardised, not well understood, not always routinely symptomatic, and seem to be infinitely complex such is the profoundness of the human mind.
The physical effects of rape and sexual abuse will usually heal very quickly, and successfully. The psychological impacts may be life-long, may be life-changing, may never heal fully – but through support and therapy there is always hope. The longer it is left untreated, the more entrenched, fossilised and insidious it becomes. SV2’s work tries to avoid this, and where it is historical, to recover that person’s life to some sense of manageable normality
One can try to rationalise the breadth and nature of what SV2 covers but one will always be met with permutations, and depths which are almost unimaginable. Whether it is the depravity of one person’s actions against another, or the almost surreal consequences of the brain’s coping methods.
One of the ISVAs summed it, simply and poignantly:
“Unless you’re working in it, you don’t get a full understanding of the complexity of it, and how massive it is.”
SV2’s work is uniquely valuable in that through their support, their clients can progress from a position of just coping, and surviving to a future which has real hope and renewed opportunity.
Categories: Sex/Domestic Violence