For her first assignment in the Army, Diana Brown was stationed in Germany. As the newbie, it was tradition that her fellow service members take her out for drinks. While the 19-year-old wasn’t much of a drinker, she wanted the opportunity to bond with her comrades, and she enlisted two female colleagues to stay by her side and make sure she made it back to her barracks. Unfortunately, that wasn’t enough to keep her safe.
“There was a [non-commissioned officer] at our base who watched for new females on their first nights out,” Brown recalled. “He came into my room in the middle of the night and started having sex with my unconscious body.”
Brown woke up during the assault and had the presence of mind to ask her attacker for his name. “He stared at me for a minute, laughed, and said, ‘You won’t remember it anyway,’ and answered me.”
For 37 years, Brown, now a 56-year-old IT director, has been living with post-traumatic stress disorder (PTSD) as a result of that assault.
Military sexual trauma takes a toll
According to the U.S. Department of Veterans Affairs (VA), about 1 in 3 women tell their medical provider they’ve experienced military sexual trauma (MST). The term is used to describe a range of abuses that happen during military service, from sexual harassment to rape.
Read: What to Do If You’ve Been Sexually Assaulted in the Military >>
In the short term, MST can lead to a host of problems, like insomnia, eating too much or too little, trouble concentrating, and difficulty connecting socially with others. If these symptoms continue for a month or more, that may be a sign of PTSD.
“When [people] can’t go back to work, when they start having panic attacks by just engaging in their normal lives, when they’re having severe nightmares, flashbacks and are just unable to feel safe anywhere, then we have a lot of concern about chronic stress or PTSD,” said Kristen Zaleski, Ph.D., chief clinical officer of the Mental Health Collective in Newport Beach, California, and an expert on sexual trauma within both civilian and military culture.
Eight out of 10 people with PTSD have at least one additional mental health disorder, such as depression, disordered eating or a substance use disorder. And trauma may also trigger any mental health issues you’ve had in the past. For example, if you have a history of restrictive eating or self-medicating with drugs and alcohol, trauma may trigger these conditions if you don’t have access to [healthy] coping skills, according to Zaleski.
Experiencing trauma without treatment or healthy coping skills can lead to physical issues as well because trauma impacts the nervous, endocrine and immune systems.
Trauma survivors’ brains go into overdrive scanning for threats, putting them in a state of chronic stress that, over time, can wreak havoc on their bodies.
A 2017 retrospective study looking at the health data of more than 500,000 female veterans found that women with a history of MST were more likely to experience chronic pain conditions including irritable bowel syndrome (IBS), chronic pelvic pain, back pain, chronic joint pain, fibromyalgia, painful intercourse, chronic abdominal pain and headache attacks. They also had higher rates of anxiety and depression. Additionally, 40% of women who experienced MST also had PTSD diagnoses, compared to 9% of women with no history of MST.
Read: The Problem with Pelvic Pain in the Military >>
In turn, numerous studies show that people who have PTSD have higher rates of chronic pain and report greater pain severity.
“There are other long-term physical health implications — such as cardiovascular risk factors, hypertension, diabetes — that are likely consequences of the significant distress that the trauma survivor is carrying,” said Tara Galovski, who is director of the Women’s Health Sciences Division at the National Center for PTSD and works with MST survivors through the VA.
For service members, sexual trauma is complicated
PTSD is common when anyone — civilian or military — experiences sexual assault, but there may be an added element to the trauma when it happens between service members.
“Military sexual assault feels a lot more like sexual violence in a family, like incest,” Zaleski explained. “When you’re in a military culture, everyone has taken an oath of safety and protection. There’s language in the military of ‘battle buddy.’ There’s a family structure, there’s a hierarchy and everyone above [you] in the hierarchy is supposed to protect you just like a parent in a family system.”
The betrayal of that trust can be devastating, according to Galovski. Survivors often have no choice but to live near the perpetrator and they may have mutual friends. There may even be implications for the survivor’s career if they speak out.
Read: What Is the Military Doing About Sexual Trauma? >>
For Brown, it wasn’t so much the assault that traumatized her, but the way she was vilified by leadership after she reluctantly reported the assault and was shunned by colleagues who were worried about the optics of socializing with her. She never felt safe during the rest of her two-and-a-half year stint in the Army.
“I knew what happened to me wasn’t my fault, so I never blamed myself,” she said. “What destroyed me was having everything I believed in — my Army — turn their back on me, from command who should be taking care of me to peers who should have my back, and trying to work on the day-to-day with other soldiers that I knew I couldn’t rely on.”
Being in the military is stressful in and of itself and leaves little time for recovery. Overcoming the added trauma of sexual assault can be especially difficult in that environment and lead to an increased risk of PTSD and related consequences.
“Your body, from a neurobiological lens, has higher rates of chronic stress in military sexual assault cases than civilian sexual assault cases just because when you have traumatic stress, you need to be able to rest and overcome it,” Zaleski said. “But in military culture, you’ve got to suck it up and drive on. This horrible thing happens. You feel betrayed. You may or may not feel supported, and then you have to continue your job.”
Coping with the aftermath
Brown didn’t realize that PTSD from MST was the reason behind her hot temper, workaholism and inability to build relationships. She finally sought counseling in 2013 after watching “The Invisible War,” a documentary about sexual assault in the military, and connecting the dots.
Even if, like Brown, you experienced MST decades ago, you can still get treatment.
“Across four different clinical trials, the average time since [participants’] trauma and when they sought treatment was 17 years,” Galovski said, adding that one of her favorite patients was a 75-year-old who finally decided she was tired of living with PTSD. “Living any days with PTSD is too much. So I think there’s no time like the present.”
It’s important to get support if you’ve experienced MST, and counseling is one option.
“There is no single path that fits everybody, but there are lots of good resources that can help survivors to choose their path, so the first step is getting that information,” Galovski said, recommending the Beyond MST app created by the VA. You can also seek community support online through Facebook groups dedicated to MST survivors.
If you’re open to counseling, Galovski recommended getting an initial assessment to determine whether you have PTSD or other mental health conditions. The VA provides free mental health counseling to people who have experienced MST.
“Once you get an assessment, we have excellent evidence-based treatments that we can offer to really start down the road of recovery,” Galovski said.
Because MST can manifest in many mental and physical conditions, it can be helpful to disclose your experience and any related diagnoses to your medical provider. But bringing up the memory can be painful. Gynecological exams can be particularly daunting, and often, Zaleski said, women who’ve experienced MST won’t schedule annual GYN visits to avoid being retraumatized. This can lead to other health problems and missed diagnoses.
Zaleski suggested that survivors look for medical providers trained in trauma-informed gynecology, who will take extra steps to prevent triggers.
It may also be a good idea to tell a person you trust that you might need support during or after your medical visit and schedule the appointment when you have time to process or recover afterward.
“Develop a cope-ahead plan so if you do have trauma triggers, such as memories of the assault while the exam takes place, you have a safe person in the room that you can turn to,” Zalenski said. She also added that it can be helpful to listen to music or have soothing items in the room like hot or cold blankets.
The most important piece of advice Brown shared for coping with MST and the aftermath is to remember that you aren’t just on your own. “It matters to know that there are other people experiencing that same thing, probably somewhere on some other base right now. You are not alone in the universe.”
Resources
- DoD Sexual Assault Prevention and Response
- DoD Safe Helpline
- Victim/Witness Assistance Program
- Victim’s Legal Counsel
- Veterans Affairs Military Sexual Trauma
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