The many facets of shame in intimate partner sexual violence

ACSSA Research Summary No. 1 – January 2012

Implications of victim shame for health professionals

The lack of disclosure of sexual violence has important implications in understanding the trauma of intimate partner sexual violence. It also implies a need for health professionals to consider possible sexual violence in all intimate relationships where other forms of violence are acknowledged or suspected. By asking or talking more directly about this type of violence, women may feel safer or more comfortable about seeking help for the sexual aspects of the violence.

Due to the low rates of reporting and disclosure, the potential for intimate partner sexual violence to go undetected is high and this puts victims at increased risk of ongoing sexual assaults and other violence perpetrated by their partners. Researchers have linked the presence of sexual violence to more severe physical violence in a relationship (Bennice & Resick, 2003; Bennice et al., 2003; Bergen, 2006) and also as a risk factor for lethality in domestic violence (Bennice & Resick, 2003; Campbell & Soeken, 1999; Heenan, 2004).

The findings of a study of counselling services for women abused by their partners by Howard et al. (2003) suggested that women who were raped as well as physically assaulted by their partners had different support needs than women who were physically assaulted only. The study found that these women also respond differently to counselling than those only physically assaulted. The results indicated that the addition of the sexual aspect of the assaults could have additional negative effects on women's coping skills and feelings of shame. Mahoney (1999) examined the variation in experiences and responses to sexual assault by victim-offender relationship. The results supported the need to reach out to these women, due to a lower likelihood that they would seek out assistance on their own. They may also find it more difficult to discuss the sexual violence compared to other violence (Mahoney, 1999). This means it could be more difficult to identify and provide appropriate support. By talking about sexual violence, and bringing it out into the open, the victim/survivor is offered a starting place to discuss the experiences and potentially access appropriate help should they choose to.

Weiss (2010) commented that although our culture features sexualised images everywhere in the public space, there is still a concept of personal sexuality being a private matter that is too taboo talk about. This could also be an issue in precluding professionals from asking about sexual violence in an intimate relationship - it may be too embarrassing for the professional as well as for the victim to ask directly about their sexual experiences within the intimate relationship.

Weiss argued that demystifying these sexual crimes and encouraging a public discourse about sexual violations, would reduce the shame for victims. This resonates in the context of intimate partner sexual violence, where the statistics indicate that many women are enduring sexual violence at the hands of their partners but may undergo the trauma in isolation due to the cultural norms that inhibit public acknowledgement of the problem. The need for health professionals to be more willing to ask about and discuss the possibility of intimate partner sexual violence is a key theme running through the research reviewed.

Research with clients in community health centres and the experiences of workers in community services reveals that clients are more likely to report trauma when specifically asked about it (Duncan & Western, 2011; Probst, Turchik, Zimak, & Huckins, 2011).3

Parkinson (2008) relayed survivors' experiences of the positive effects of supportive health professionals. These were the professionals who helped by "listening, believing and understanding that these women were victims of criminal acts" (p. 56). This emphasises the importance of health professionals asking about sexual violence separately and as a distinct form of abuse from physical violence.

It is also important to identify that various kinds of sexually coercive behaviours may cause women to experience vulnerability and shame in their sexual experiences with partners even if physical force is not the coercion used. This indicates that when asking about sexual violence, it is important that a range of sexually coercive behaviours are considered, not just experiences that are more clearly identifiable as sexual assault (Basile, 2008).

Shame can present in physical and verbal ways. This could include a lack of direct eye contact or a particular posture, or it can be evident in the use of certain language (Feiring & Taska, 2005; Rahm et al., 2006). In the research by Rahm et al. (2006) "code words" that indicated the presence of shame in sexually abused female subjects were used. These words and phrases, used by the women involved, may describe feelings like alienation, powerlessness and a lack of worth that are part of the shamed persona.

In addition to talking about intimate partner sexual violence more directly, it is important that health professionals and other supporters of victim/survivors know how to react and support patients/clients when sexual violence is revealed. This includes being familiar with local sexual assault and family violence services for the purposes of referral. These services exist in all states and territories. It will be important that victim/survivors are believed and are offered compassionate and respectful responses. Referral to specialist services that deal with the sexual aspects of the violence as well as the physical violence will assist the victim/survivor to access the necessary support, however it is important that the victim/survivor is able to maintain autonomy over the decisions regarding their own wellbeing.

Footnote

3 The manner in which a disclosure is brought about may or may not have forensic relevance for evidentiary purposes in a criminal proceeding relating to the sexual abuse of an adult. However, this should not prevent health professionals from taking a therapeutic approach to asking about sexual violence in their professional capacity.