Read all the news from The Healing Place – Spring 2012 Newsletter

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GHB, Rohypnol and Ketamine

Taken from www.psacorp.com

Three drugs are being used to “knock out” unsuspecting potential rape victims that cause them to

blackout, unable to fight off their attacker. The names of these drugs are Flunitrazepam
(Rohypnol), GHB, and Ketamine.

Who Uses These Drugs?
They are popular on high school and college campuses, raves, and nightclubs. And not everyone
who abuses them is a sexual predator. In some circles they are used to counter depression and
other withdrawal symptoms after a high on cocaine or heroin. Many users incorrectly believe
these drugs can’t be detected in urine drug tests.

What is Rohypnol?
Rohypnol, the trade name for Flunitrazepam, is a depressant used to treat insomnia and is used as
a pre-anesthetic. Rohypnol is a prescription drug manufactured around the globe, but in the
United States, it is illegal to manufacture, sell or use. When manufactured in pill form, it is an
oblong olive green tablet imprinted with the number 542.

Street Names for Rohypnol
Slang names include: Roofies or Ruffies, Mexican Valium, Rib, Roach-2 or R-2 or Roaches,
Rope or Ropies or Roopies, Circles. People under the influence are considered to be “roached
out”.

How Rohypnol Affects the Body
Some people have said that Rohypnol is similar to Valium, another depressant, but is
significantly stronger than Valium. Rohypnol is usually taken in pill form, but it can be crushed
and snorted. Its effects begin to appear in about 30 minutes, peak in 2 hours and can last at least
8 hours, depending on the dose. Rohypnol stays in a person’s system for up to 72 hours.

How Rohypnol is Used
Rohypnol can be dissolved into the drink of an unsuspecting person. In a short time, the victim
feels excessively intoxicated and often wants to sleep. The attacker offers to take the victim
home and after the attack, the victim wakes and is confused about what has happened. Rohypnol
is also used to subdue the victim for physical attack and robbery.

What is GHB?
Gamma-hydroxbutyrate acid is a chemical that produces sedative effects: slowed breathing,
intense sleepiness, disorientation and poor muscle coordination. It was developed as an
anesthetic for surgery and other medical procedures. Because of its unpredictable effects, GHB
was discarded by the legitimate medical community in the early 1990s.

GHB Street Names
Slang names include: “G”, Liquid Ecstasy, Georgia Home Boy, Gamma G, Growth Hormone
Booster, Liquid K, Scoop, Easy Lay, Grevious Bodily Harm, Goop

How is GHB Used?
As a clear and colorless liquid, GHB is sipped from the bottle cap or mixed in drinks. Similar to
Rohypnol, GHB easily can be poured into an unsuspecting person’s beverage at public places
such as clubs and parties.

How GHB Affects the Body
The consequences of GHB use include: drowsiness, dizziness, unconsciousness, seizures,
hallucinations, and euphoria. An overdose can result in severe shortness of breath,
unconsciousness, seizures, coma, and death. Overdose usually results in a trip to the emergency
room and the intensive care unit.

What is Ketamine?
Ketamine hydrochlorine is a general anesthetic for medical procedures in people and animals.
Veterinary clinics often report burglaries in which Ketamine is stolen.

Other Names for Ketamine
Other names include: Ketalar (human anesthetic), Ketajet, Ketaset, Vetalar (veterinary products)
Slang names include: Special K, “K”, Vitamin K, Kat, Jet, Super Acid, Green, Cat Valium, Cat
K

How is Ketamine Used?
Pharmaceutical Ketamine comes in two forms: a liquid and a white powder. In liquid form, it is
injected, consumed in drinks, or added to smokeable materials. The powder is snorted or can be
dissolved and injected. When abused, the odorless and tasteless Ketamine can be poured into a
beverage and usually goes undetected.

How Ketamine Affects the Body
Use of Ketamine can cause impaired attention, learning and memory functions, dizziness,
disorientation, a delusional dream-like state, inability to move, amnesia, hallucinations,
flashbacks, and depression. Higher doses can produce an effect referred to as “K-Hole”, and out
of body experience or near death experience.

For more information
Partnership for a Drug-Free America www.drugfree.org/Parent
Drug Abuse Resistance Education (D.A.R.E.) www.dare.com
National Institute on Drug Abuse (NIDA) www.nida.nih.gov
American Council for Drug Education www.acde.org

Click here to view or print the new Annual Report 2010-2011.

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1. What is child sexual abuse?
   Child sexual abuse refers to sexual activity forced upon someone under 18 years of age.  Usually an older individual uses tricks, bribes, threats, or physical force to make a child submit.  Children are usually taught that older people have power and authority over them, so children do not feel like they have a choice in such situations.  Sexual abuse is much more common than rape, which is forced intercourse.  It refers to a wide range of sexual encounters including, but not limited to, exhibitionism or exposure, kissing, fondling, oral sex, rape, and pornography.
   Child sexual abuse should not be confused with physical contacts between an adult and a child that are fond or playful expressions of love.  Responsible adults automatically limit their physical exchanges with a child, thereby respecting the child and at the same time maintaining a warm, healthy, affectionate relationship.
2. What is incest?
   Incest refers to everything included in child sexual abuse, but indicates that the sexual contact is between family members, such as a child and parent, grandparent, brother, sister, aunt, uncle, or step-parent.
3. How many children are actually sexually abused?
   Reliable statistics reflecting the incidence of sexual abuse committed against children are difficult to determine.  There are many reasons for this vague statistical picture, the most  important of which may be that the secrecy and taboo aspect of the offense prevents the majority of incidents from being reported.  However, recent research has established the following statistics:Nationally, approximately
   1 in 3 girls will be assaulted before adulthood.
   1 in 6-8 boys will be assaulted before adulthood.
   1 in 25 girls will be assaulted by her father.Are most sexual offenses against children committed by strangers?
   No.  In fact, in 85% of all cases, the perpetrator is someone the victim knows.  The people most likely to sexually abuse children are their own family members, friends of the family, neighbors, and acquaintances.
4. Does sexual abuse occur more frequently inside or outside the family?
   It occurs more frequently inside the family.  Some studies indicate that 70-80% of all abusers are related to their victims.
5. Is it true that incest occurs mostly among rural, isolated, and uneducated poor families?
   No.  Incest occurs among all groups of the population — it crosses all socioeconomic and educational levels.  It occurs in all races and religions, and in all areas, whether urban or rural.
6. What are some characteristics of offenders?
   Offenders frequently exhibit feelings of inadequacy and of isolation or alienation from others.  They are usually concerned only with meeting their own needs, and have low self-esteem.Two other general characteristics common to those who sexually abuse children are:
   1.    lack of impulse control;
   2.    a confusion of roles, where the child becomes an object for the needs of the adult without the adult recognizing the inappropriateness or inability of the child to meet those needs.These two dynamics–lack of impulse control and confusion of roles — are also common to child abuse cases in general.  Additionally, the practice of incest is frequently passed on from one generation to another.
7. What are some characteristics of the incestuous family?
   Fathers who are abusers are described as being either passive or authoritarian.  The passive abuser may have a weak self-image and be introverted and socially isolated.  During periods of stress, this person may turn to the child for comfort and reassurance.  The authoritative offender is more violent and domineering in his relationship with the entire family.  This abuser may be over-controlling, overly restrictive, and employ excessive discipline.Mothers in families where incest occurs are often described as being passive individuals whose dependency on her husband forces her to ignore signs of the incest.  Less frequently, the mothers are strong, independent women who may acknowledge the abuse and try to stop it.Other common characteristics are:
   •    Prolonged or habitual absence of either the mother or the father from home.
   •    Assignment of a “mother” role to a daughter;  for example, caring for other children, cooking, looking after father.
   •    Loss of wife by divorce, separation, or death.
   •    History of child abuse in the background of one or both parents.
   •    Condition of overcrowding, alcoholism/drug addiction, intellectual limitation of parents or child.
   •    Inability to establish normal social and emotional contacts outside the family because of eccentric belief systems, extreme poverty, or remoteness of the area in which the family lives.
8. What should you do if  you suspect that a child is being sexually abused?
   Report it.  In North Carolina anyone who suspects that a child is being abused in any way is required by law to report his or her suspicions to the Department of Social Services at (828) 694-5500.
9. Does a person who reports have any legal protection?
   Yes. People who report “in good faith” are granted immunity from civil and criminal court action, even if the report proves to be a mistake.
10. How sure should someone be before reporting?
    There is no rule.  If there is serious doubt, resolve that doubt in favor of the child and report.  Also, remember that North Carolina law mandates that every adult must report any suspected child abuse, no matter how much or how little she or he knows.
11. What happens if someone reports?
    The Department of Social Services makes an investigation within 24 hours of the report and on the basis of its findings decides whether or not sexual abuse has taken place.  In some of the more difficult cases, the DSS may file a petition in court.  In these cases the court makes a final resolution.  A court may order certain actions;  for example, removing the child or offender from the home, mandatory participation of the family in a treatment program, or bringing criminal charges against the offender in criminal court.
12. Are girls sexually abused more frequently than boys?
    Statistics indicate that girls more frequently report sexual abuse, but the number of cases reported with boys as victims appears to be on the increase.  Some studies indicate that prepubescent boys may be abused as often as girls.  Boys appear more reluctant than girls to seek help.  When abused by a male, boys may feel shamed or have fears about homosexuality.  When the offender is a women, boys may not report since sexual adventures are sometimes culturally confused with proving one’s manhood and related to a belief that no “real man” refuses sex when it is offered.
13. Is a child who is the victim of incest likely to report it to the authorities?
    No.  Loyalty to the family, fear, and the nearly total dependence of the child tend to ensure secrecy.  Often, the child has been bribed or threatened to keep silent, or is made to feel that she or he is to blame for the abuse, and will be punished if anyone finds out.
14. A mother surely must know if her husband or boyfriend is sexually abusing her child?  Isn’t she the one most likely to report?
    Yes, a mother may know something is wrong, but she may not suspect sexual abuse.  Other mothers may be vaguely aware of the incest, but are as threatened by it as their child.  If reporting it could further threaten her relationship with her husband or jeopardize her financial position, she may remain silent or deny the incest, thereby becoming an accomplice to it.  Many of these mothers were victims of sexual, physical, or emotional abuse as children.  Upon disclosure some mothers actively protect their children.  Other mothers may not have the internal or external resources to protect or support their children.
15. How can I tell whether a child is being sexually abused?
    Symptoms of sexual abuse may include physical and behavioral signs as well as indirect comments made by the child.  There are several clues to look for when considering the possibility of child sexual abuse.  One sign alone may not be a positive indication.  If a number are present, it is wise to consider the possibility of abuse.Physical Indicators
    •    Swollen, irritated or bleeding genital area
    •    Sexually transmitted diseases
    •    PregnancyHowever, it is common for no physical indicators of abuse to be present.  The following list of behavioral indicators should also be taken into consideration.Behavioral Indicators
    •    Sleep disturbances; e.g., nightmares, bedwetting, trouble falling asleep, suddenly needing a night light.
    •    Loss of control of bladder or bowels.
    •    Loss of or sudden increase in appetite.
    •    Lots of new fears, needing reassurance, clinging, not wanting to be left alone.
    •    Returning to younger, more babyish behavior.
    •    Unusual behavior shift; e.g., from outgoing to withdrawn.
    •    Giving up or throwing away a favorite toy, piece of clothing, or other possession.
    •    Sudden turning against one parent, relative, etc.
    •    Lots of school difficulties or sudden immersion in school.
    •    Explicit sexual acting out, obsession with sexual parts or words, inappropriate French kissing, sexual knowledge beyond their age.
    •    Vague references to an incident; e.g., “I don’t like Mr. Smith anymore.”
    •    Reluctance to go to a particular place or be with a particular person.
    •    Irritability, crankiness.
    •    Use of drugs, alcohol.
    •    Running away.
    •    Prostitution.
    •    Suicide attempts or self-mutilation.While these symptoms may indicate a problem, they are not confirmation of child sexual abuse.  Child sexual abuse should, however, be kept in mind as one of the possible causes of these symptoms.
16. When incest happens, whose fault is it?
    The offender bears the entire responsibility;  it is not the child’s fault!  The offender is usually the key to the disturbed dynamics and is responsible for choosing a sexual relationship with the child.  Whatever else is said in sympathy for his/her motivations, and regardless of the rest of the family’s contributions, the offender’s responsibility must be emphasized.
17. How much harm does a child suffer from sexual abuse?
    In all instances of child sexual abuse, one must consider both physical and emotional harm to the child.  The degree of harm depends upon the nature of the act(s), the age of the child, the duration of the abuse, the relationship between the child and the abuser, and the child’s general environment.  Physical harm may include acute genital pain, transmission of sexually acquired disease, and pregnancy.  Emotional harm may elicit feelings of pain, panic, devastation, betrayal, shame, fear, guilt, vulnerability, inability to have children or normal sexual relationships, and erroneous feelings of disfigurement; these may persist throughout the victim’s life.While child sexual abuse may not always lead to permanent injury, it is in the best interests of the child to assume that all sexual experiences are potentially harmful.  Research is greatly needed in this area.  The implications of harm are now based only on complaints of people already identified as being harmed.Please keep in mind that not all abusers are fathers and not all families are nuclear. There has not been as much research about female abusers or sibling abuse. We don’t have as much information about this type of abuse but that should not leave us to believe that it does not happen.Reactions of Sexually Abused Children
    Please note that children from different cultural, racial or socioecconomic groups may have different reactions than the ones listed here. This is not meant to be an exhaustive list but a starting point.Females3-6 years
    • have generally fewer problems than older age groups.
    • parents often have more anxiety, upset, trouble dealing with anger than does the child.
    • problems include nightmares, stomach-aches, nervousness, crying, specific fear of offender and/or general fear of others or of being touched; regressive behaviors such as clinging, thumb-sucking, or bowel problems; sexual acting-out (i.e. taught to them) behaviors such as masturbation, sex play with peers, sexually explicit language, there tend to be more problems which usually cluster around anxiety, fear, crying, clinging, sleep disturbance, and somatic complaints.

    6-9 years

    • more likely to refuse to talk about incidents and/or have trouble expressing feelings about it (beginning to understand sexual aspects creates guilt, shame).
    • all the above problems plus school avoidance and/or disruptive behavior, aggression, eating problems, depression and withdrawal, acting confused.
    • cognitive development of empathy for offender creates greater confusion and ambivalence about who’s to blame.

    9-12 years

    • increase in the number and types of problems:  frequent nightmares and other sleep disturbances; somatic problems; aloof, withdrawn, depressed.
    • more aware of impact on whole life – no longer seen as an isolated incident
    • tend to feel more responsible for own role, more guilt; may become very preoccupied with incident and see self as “bad.”
    • more anxiety about physical exam and court proceedings.
    • more concerned about reactions and responses of others; may have more relationship problems (aggression, fearfulness, avoidance).

    12-16 years

    • this group has more problems than any other age group of girls or boys.
    • most frequent problems include nightmares and sleep disturbances; fears of the offender of more generally of being outside, being alone, or being touched; more frequent and severe somatic complaints; eating problems; poor self-esteem, feelings of body damage, depression, and occasional suicidal thoughts; school problems such as grade deterioration or school avoidance; interpersonal problems such as verbal or physical aggression and difficulties relating to peers and/or members of opposite sex.
    • while younger girls often experience more problems if offender is a stranger, this age group experiences more problems with known offender–probably related to a sense of self-blame and doubt about own role in the situation.
    • assault really interferes with adolescent issues of interpersonal relationships, bodily changes, autonomy–this group is particularly vulnerable to long-term problems.

    Males

    3-6 years

    • typical problems similar to 3-6 year old girls.
    • tend to engage in more aggressive and negative behaviors than girls (may reflect socialization).
    • most offenders are male, so must consider the issue of same-sex relationships–boy victims always have concerns about their sexuality, i.e. homosexual implications.

    6-9 years

    • problems similar to 6-9 year old girls, including refusal to talk about incident.
    • in forced situations, tend to view assault as physical hurt rather than sexual
    • must consider same-sex offender issue.
    • these boys sometimes worry about whether they will grow up and assault other children.
    • Males 3-9 years tend to be victimized by offenders known to them–stranger assault is rare.

    9-12 years

    • problems similar to 9-12 year old girls, but more acting-out.
    • more worry about aftermath of assault and its implications; poor self-esteem.
    • forced situations lead to more assault-related fears; non-forced situations generally involve victims who are more passive, less able to protect themselves, and vulnerable to future assaults and more likely to need long-term therapy.

    12-16 years

    • problems seem to reflect possible personality problems rather than crisis-related fears.
    • tend to be withdrawn and depressed, have low self-esteem; pronounced concern with gender identity concerns; concern with societal expectation that males should be able to protect themselves.

     

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Effects of Childhood Sexual Abuse
Child sexual abuse (CSA) has lifelong effects.  Adults who are survivors of CSA often report a feeling of being “stuck”.  Their efforts to build and manage their lives often seem fruitless, hollow, or even hopeless.  There can be a persistent perception that they are somehow different from others.  They commonly report feeling that they are on the outside looking in or believe that they just don’t belong.

Often, these symptoms are a mystery to the sufferers.  They may not understand the connection between their childhood situation and their adult experience.  Generally, the abuse has either been accepted by the survivor as “normal” or is viewed as something that is better left in the past.  In some cases, the abuse may not be remembered.  Consequently, the significance of symptoms and problems arising from the abuse is often not recognized.

The adult symptoms of childhood abuse can take many forms.  Many adult survivors may:

• Find it difficult to develop or maintain close personal relationships.
• Have a strong desire to live in isolation or to “hide out” from life.
• Endure physical ailments like neck, back, stomach and gynecological problems that persist despite efforts at good self-care.
• Experience feelings of sadness, fear and anger that often seem unmanageable or overwhelming.
• Undergo panics, rages, depressions, sleep disorders, or self-mutilation or have suicidal thoughts.
• Find themselves depending on alcohol, other drugs, or may develop eating disorders to cover feelings of humiliation, shame and low self-esteem.
• Experience problems like low self-esteem, avoidance of sex, promiscuity, or inability to experience orgasms or erections.
• Exhibit signs of trauma like panic attacks, numbing of body areas, and feeling of being disconnected from their bodies.

Most of these symptoms are due to the disruption of a healthy psychological development.  An abusive childhood situation interferes with the child’s natural movement toward growth and expansion of his or her experiences.

All children have a right to have their basic needs met. Children need to feel secure in order to learn to trust their environment.  They need support for the development of dreams and wishes.  They need encouragement to be separate unique individuals.  They need a consistent sense of belonging, and of worth from their families and home situations.  Abuse denies these very basic needs.  As a result, adult survivors are often left with a deficit of emotional and practical skills for dealing with their present “grown-up” world.  As a result of having limited opportunities to naturally develop these skills, survivors will frequently develop extraordinarily complex coping mechanisms in their attempts to appear “normal.”  As a child, the survivor may have learned the importance of “pretending that nothing is wrong.”  This coping mechanism allows them to function in society in ways that never allow anyone to guess that they struggle with such pain on the inside.

Some survivors compensate for their feelings of shame or inadequacy by becoming “over-achievers.”  They frequently mask their pain or feelings of fragility so successfully that it becomes all the more important to the survivors that others around them do not discover that they are not really who they pretend to be.  Having not been given appropriate levels of love, care, or attention when they were their true selves as children, they might feel that they will not be given love, care, and attention if they allow their true selves to be seen as adults.

Furthermore, the effects of childhood abuse also tend to recur at important junctions throughout survivors’ lives.  Symptoms undisturbed for years may flare as they enter  serious romances, consider marriage, or become the parent of a child.  Adult survivors may fear the intimacy and responsibility of committed relationships.  Caring for children may arouse memories of the survivors’ unmet childhood needs and lead to sadness and/or depression.  They may fear that they may abuse children the way they were abused.

The death of a parent can also evoke disruptive responses for adult survivors.  Buried feelings toward the parent about the abusive childhood situation can surface at the time of the parent’s death and overwhelm the survivor if she/he is unprepared to handle them.  Other friends and relatives may not know how to be sensitive to the survivor’s feelings and experiences.  They may disbelieve, be unsupportive, or be unresponsive if the survivor discloses.  These reactions can compound the difficulties the survivor is already experiencing.

Impact of Childhood Sexual Abuse
Because our culture regards sexual contact between children and adults as taboo, sexual abuse usually takes place in secret and is kept secret.  Denial of sexual abuse is much stronger than denial of physical or emotional abuse.  Because of the silence surrounding most sexual abuse, children are forced to endure the abuse and it’s effects alone.  As adults, survivors often continue to feel alone and isolated.  They fear exposing the shame, rage, and hurt connected to their childhood experiences.  They tend to blame themselves for the abuse, especially if there was pleasure, comfort, or a sense of caring attached to the incident.  They frequently feel ashamed by the fact that they could not stop they abuse.  In many instances, adult survivors do not have the words to talk about the sexual abuse.  They often do not remember the details but have only a vague feeling of discontent with another family member or friend of the family.  Adult survivors frequently report childhood blackouts in which large chunks of time are forgotten.  The denial of sexual abuse may cause total blocking of the experience, leaving only an intuitive sense that something wrong has happened.

Sexual abuse survivors commonly live with a deep sense of shame.  They may blame themselves for the abuse and fear being blamed by others if they ask for help.  This self-blame is often exacerbated because it is not experienced as a guilty sense of having done  wrong, but as a shameful sense of being  wrong.  Incest survivors are particularly harsh with themselves about causing trouble within the family and believing they deserve to be hurt.

Survivors deal with the sexual abuse in a variety of ways.  They may become over-responsible, believing that they are accountable for everything and must take care of others, often meeting the needs of others before their own.  On the other hand, they may act out against others in manipulative or abusive ways, especially if that is the only way they have learned to get their needs met.  Moreover, the survivor may have developed self-destructive behaviors (substance abuse, eating disorders, acting out sexually, self-mutilation, etc.) as ways to escape from or as attempts to gain control over the pain that stems from the abuse.  Survivors who did not have the resources or opportunities to work through the trauma they experienced are frequently prone to self-hate, self-destructiveness, and feelings of hopelessness.  It is important to remember that many adult survivors of CSA who have come to some sort of resolution with the trauma lead happy, healthy, fulfilled lives.

Barriers to Healing
It is often difficult for adult survivors to seek help.  The following are some of the most common barriers to getting help that they face:

• Denial that childhood abuse is a problem. Many adult survivors have difficulty connecting their current life situation with earlier childhood abuse. This denial can take many forms: rationalizing, minimizing, intellectualizing, focusing of the problems and shortcomings of others, hoping the problems will take care of itself, feelings that they can take care of their problems on their own.
• The belief that things can never get better, there is no hope.
• Fear that they will be consumed by the intensity of their feelings if they begin to deal with the abuse. They often fear the feelings will engulf them or that they will explode if they lose control.
• Fear and shame about sharing family secrets. Survivors often fear that to get help is to betray and hurt their families, or that they will be punished for exposing family secrets.
• Fear that they will not be believed because they may not be able to remember the details of their abuse.
• Inability to blame their parents or other adults for the abuse. We are taught to love and honor our parents and to be respectful of other adults.
• Fear of taking responsibility for looking at oneself and one’s behvior. It can be much easier for the survivor to continue to blame others for the maladaptive ways that she/he is dealing with the abuse.
• Fear that there will be nothing left in the advanced stages of healing. This fear is sometimes overwhelming. As survivors strip away all the old negative beliefs that have been the burdensome but familiar foundation for their lives, they begin to feel that everything they’ve ever known is shifting and nothing is certain or sure.

While these barriers are strong ones, they can be overcome.  Consistent, patient, and caring effort is needed by both the survivor and those who are aiding in this healing process.  While it is difficult and often painful to work towards recovery from childhood abuse, healing is possible when survivors have access to a support network that can provide them with nurturance, assistance, and appropriate levels of care.

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Definition:  Sexual contact that occurs without the explicit consent of the recipient of the behavior.

Such contact can take the form of:
•    Harassment
•    Exposing/flashing
•    Forcing a person to pose for sexual pictures
•    Fondling
•    Unwanted sexual touching or penetration with any object

In most extreme cases, sexual assault may involve force which may include, but is not limited to:
•    Use or display of a weapon
•    Physical battering
•    Immobilization of the victim

More often, sexual assault involves psychological coercion and taking advantage of an individual who is under duress or incapacitated and, therefore incapable of making a decision on his/her own (including being under the influence of alcohol, drugs, and/or prescription medications).

Physical & Emotional Reactions
•    Shock
•    Numbness
•    Loss of control
•    Disorientation
•    Helplessness
•    Sense of vulnerability
•    Fear
•    Self-blame/guile for “allowing” the crime to happen
•    Feeling that these reactions are a sign of weakness

This section was adapted from materials provided by the Texas Association Against Sexual Assault.

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Definition:  Forced sexual intercourse, including vaginal, anal or oral penetration.  Penetration may be by a body part or an object.  Rape may be forced through threats, physical force, or psychological coercion.

In the most extreme cases, rape may involve force which may include, but is not limited to:

• Use or display of a weapon
• Physical battering
• Immobilization of the victim

More often, rape involves psychological coercion and taking advantage of an individual who is under duress or incapacitated, and therefore, incapable of making a decision on his/her own (including being under the influence of alcohol, drugs, and/or prescription medications).

Physical & Emotional Reactions

• Shock
• Numbness
• Loss of control
• Disorientation
• Helplessness
• Sense of vulnerability
• Fear
• Self-blame/guile for “allowing” the crime to happen
• Feeling that these reactions are a sign of weakness

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Definition:  Sexual contact of any king between a helping professional (doctor, therapist, etc.) and a client/patient.  Such behavior is regarded as unethical and, in every licensed profession, can be grounds for malpractice and possible loss of licensure.

The helping professional starts from a position of great power over the client/patient and has a duty of care to protect the interests of the client/patient and not to serve his/her own needs.  Therapeutic clients are the most susceptible because the client is already vulnerable and trust the therapist to help her/him feel better.  Also the relationship is particularly intimate with clients sharing their innermost thoughts, feelings, and experiences.

Issues of Transference
Transference is the way in which a client transfers negative/positive feeling about others to the therapist.  Transference s necessary in all therapeutic relationships.  Counter-transference is when a therapist projects his/her own feelings back onto the client.  A problem exists when the therapist is unable to recognize transference and counter-transference reactions and, instead, responds in a sexual manner.  It often takes several years for the client to recognize the harm done by this type of relationship.

Physical & Emotional Reactions

• Sexual dysfunction
• Anxiety disorders
• Depression
• Increased risk of suicide
• Feelings of guilt, shame, anger, confusion, worthlessness
• Loss of trust

It is estimated that only 4-8% of survivors report the exploitation.

Three ways survivors can take action:

• The survivor may make a complaint to the professional’s licensing board.
• The survivor may hire an attorney and sue the therapist direction in a civil lawsuit.  The best possible outcome is a monetary award.  The burden of proof is on the client.
• The survivor could make the allegations known to law enforcement and the District Attorney’s office could prosecution in criminal proceedings.  The best possible outcome is a criminal sanction (probation, incarceration).

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Sexual harassment has, in the past ten years, become more noticeable and talked about.  The general public is still confused about what constitutes sexual harassment which leads to more jokes and discussion.  Those individuals within the anti violence movement understand the ramifications of being subjected to such abuse and realizes its escalating potential.

Sexual harassment if a form of sexual discrimination that violates Title VII of the Civil Rights Act of 1964.

Unwelcome sexual advances, request for sexual favors, and other verbal or physical conduct of a sexual nature constitutes sexual harassment, when submission to or rejection of this conduct explicitly or implicitly affects an individual’s employment, unreasonable interferes with an individual’s work performance or creates an intimidating, hostile or offensive work environment.

Case law interpreting both Title VII and some state laws distinguishes between two broad categories of sexual harassment:  “quid pro quo” and “environment sexual harassment”. A quid pro quo claim involves allegations that submission to unwelcome sexual advances or request for sexual favors was made in a condition to getting, keeping or advancing in a job.  A hostile environment claim is based on allegations that the company either created or condoned an intimidating, hostile or offensive work environment.

Quid Pro Quo Harassment
Quid pro quo harassment is generally viewed as a more blatant form of sex discrimination than environmental sexual harassment because it results in a tangible economic loss.  An example of quid pro quo harassment might involve a supervisor threatening an employee with demotion if s/he failed to acquiesce to his/her sexual advances.  Significantly, the alleged harasser need not explicitly state promotion or continued employment on submission to his request.  Rather, it is enough that it be implied from the words or conduct used by the alleged harasser.  Because of the vagueness of quid pro quo sexual harassment definition, we provide the following examples of conduct that was deemed by different courts to have met the standard:

1. An employee rejected her male supervisor’s sexual advances and was later fired by higher-level administrator purportedly for calling in sick.  A male employee who called in sick the same day was not discharged.
2. A female resident was discharged from a residency program.  She contended that a senior resident had requested a sexual relationship and told her that low-level female residents usually engage in such relationship to ease their way through the residency program.
3. A female receptionist refused to have sexual relations with a customer and resisted the owner’s sexual advances.  It was found that through his remarks, demands and conduct, the owner made it a condition of the employee’s job that she provide sexual favors to him and to his customers.
4. The U.S. Postal Service was held liable for a supervisor’s sexual harassment of a deaf-mute mail sorter.  Although the supervisor never explicitly conditioned job benefits on the granting of sexual favors, the court held that discussions of employment topics, such as attendance, leaves of absence and performance appraisals shortly before asking the employee to engage in oral sex was implicit quid pro quo sexual harassment.

Sexual Favoritism as Quid Pro Quo Harassment
Similar, but potentially more troublesome, is sexual favoritism as quid pro quo harassment.  These claims involve allegations by an employee denied a promotion or other job benefit that the employee who received that benefit did so because s/he performed sexual favors for a supervisor.  The apparent reason the courts allow such claims is that by the employer allowing sexual favoritism, the employer implies to others that if an employee does not submit to such sexual advances, the employee will not receive an employment benefit.  The practical effect for employers is that they can potentially be sued by two or more employees for a single act of course of conduct by a supervisor.  Thus, there is extra incentive for an employer to prevent this type of quid pro quo sexual harassment.

Hostile Environment Harassment
Hostile environment claims involve allegations that a company (or its employees) either created or condoned an intimidating, hostile, or offensive work environment.  Such an environment can be created, for example, by making unwelcome sexual advances, requesting sexual favors, or engaging in other verbal or physical conduct of a sexual nature.  A hostile environment exists when an employee’s work environment becomes polluted with unwelcome sexual words or conduct.

When evaluating an employee’s complaint that s/he had been subject to hostile environment sexual harassment, employers will want to keep in mind the elements the employee will have to prove if s/he decide to sue under either Title VII or some state laws.

Hostile Environment claims require the employee to show all the following elements:

1. That s/he was subjected to a work environment in which there were sexual advances, requests for sexual favors or other verbal or physical conduct of a sexual nature.  Remember that same-sex harassment is now recognized under federal law;
2. That the conduct was unwelcome; and
3. That the conduct was sufficiently severe or pervasive to alter the conditions of the victim’s employment and create an abusive working environment.

The following are examples of the type of conduct that is prohibited by the statutes governing sexual harassment.  You should understand that there is no exhaustive list to which an employer can turn in determining what type of conduct is prohibited.

• Verbal harassment, including epithets (descriptive name or title, derogatory comments or slurs that are based on sex.
• Physical harassment, including assault, impeding or blocking movement or any physical interference with normal work or movement when directed at an individual based on sex, or
• Visual harassment, includes derogatory posters, cartoons, or drawings based on sex.

It should also be noted that non-sexual conduct can support a sexual harassment claim when that conduct is based on sex or gender.  In an often cited case, a female police officer sued her employer, alleging that she had been subjected to a campaign of threats, rejections, mockery, and intimidation because of her gender.  She did not allege that she was subjected to any overly sexual acts.  Even so, the court held that the conduct was actionable because it constituted harassment based on the officer’s gender.

To report a sexual harassment claim
Do not make legal assumptions or give legal advice.  Should a caller seek information on how to file a claim, refer them to the North Carolina Department of Labor at 1-800-NC-LABOR (625-2267).

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3 Major Categories

1. Blitz sexual assault – the perpetrator rapidly and brutally assaults the victim with no prior contact.  Blitz assaults usually occur at night in a public place.
2. Contact sexual assault – the perpetrator contacts the victim and tries to gain his/her trust and confidence before assaulting him/her.  Contact perpetrators pick their victims in bars, lure them into their cars, or otherwise try to coerce the victim into a situation of sexual assault.
3. Home invasion sexual assault – the perpetrator breaks into the victim’s home to commit the assault.

Physical & Emotional Reactions
•    Shock
•    Numbness
•    Loss of Control
•    Disorientation
•    Helplessness
•    Sense of vulnerability
•    Fear
•    Self-blame for “allowing” the crime to happen
•    Feeling that these reactions are a sign of weakness