The minutes and hours following a sexual assault are an eternity we hope no one close to us will ever have to endure. But for one in four women and one in six men, it’s a reality that will bring as many conflicted feelings as it will questions. Helping to guide survivors through the process are advocates, who provide non-judgmental support, information about legal and medical rights, and assistance in navigating the criminal and civil justice systems.
“Part of the importance of an advocate is that they’re there to validate and support a survivor’s feelings and decisions,” explains Sarah Layden, who has been an advocate for three years. “By providing survivors with information about their options so they can make informed decisions about the medical process, the criminal justice process, et cetera, advocates also help survivors regain a sense of control. In a crisis where the loss of control and choice underlies the victimization that has taken place, the ability to decide what’s next and be supported through those choices is crucial.” Sarah underwent a 40-hour training and certification by the Illinois Coalition Against Sexual Assault in Sexual Assault Crisis Intervention to become an advocate; additionally, “Advocates must be under the direct supervision of a rape crisis center in order for their conversations with survivors to be considered confidential under Illinois law,” she says.
Sarah also serves as director of Advocacy Services for Rape Victim Advocates, a not-for-profit organization that focuses on both social services and social change. We asked Sarah, as well as RVA Executive Director Sharmili Majmudar, to explain the role of an advocate, the uphill battles they face in assisting survivors, the differences in how the law and society define consent, and how people can best support those in their lives whom have been affected by sexual assault.
Explain the logistics of being an advocate: Who manages you? Are you compensated for your time?
SARAH Some advocates are compensated for their time. Rape Victim Advocates has four staff advocates, an advocacy volunteer coordinator and the director of advocacy services (myself), who are all full-time, paid staff. RVA also has about 130 volunteer advocates. These advocates are supervised by the advocacy volunteer coordinator and help RVA provide 24-hour in-person crisis response to 11 Chicago-area hospitals. Staff and volunteer advocates respond to these 11 hospital’s emergency departments any timea patient discloses they have been assaulted or abused. Volunteers are not paid to provide these services. Most do it to fulfill school or professional experience requirements; others have an interest in the fight against sexual violence; some are survivors themselves or have loved ones who are survivors.
Tell us about who you see when you respond to hospital calls.
SHARMILI In terms of our emergency room services, we respond to 30-70 calls a month. Our advocates spend anywhere from one to 12 hours in the emergency room with survivors. We stay there with them as long as they need and want us.
We provide legal advocacy, medical advocacy and counseling services to an average of 140 victims a month. Ninety percent identify as women, 10 percent as men. In terms of age, 46 percent are between the ages of 18 and 29; 26 percent are under 18 and 28 percent are 30-65+.
When you first meet with the survivor, what are your immediate steps?
SARAH Rather than asking a survivor what happened, our advocates will ask what they need. When we first meet the survivor in the ER, we introduce ourselves, who we are and what we do, and we ask them if they’d like to talk to us. It’s important to let the survivor know we’re separate from the hospital and the police, and are solely there for them. We also let the survivor knowthat anything they tell us is confidential, and that confidentiality is protected by law. Advocates will then ask where they’re at in the process. Did they just arrive in the ER? Have they seen the nurse ordoctor? Have the police been called or have they spoken to police already? This allows us to provide information about what will happen during theirER visitas well what options they have.
What is the range of emotional states experienced by victims immediately following an assault?
SHARMILI Unlike what most people believe, there is no ‘true victim’ response. She may be quiet and calm, angry, crying, withdrawn, laughing – all of these are normal responses and do not in any way indicate whether or not an assault has happened. Just as we all grieve differently, we also respond to trauma differently. Many survivors experience Rape Trauma Syndrome (RTS), a version of Post Traumatic Stress Disorder. In general, the survivor’s initial response to the assault will be shock and disbelief. Many survivors may appear numb. This response provides an emotional ‘time-out,’ during which the survivor can acknowledge and begin to process the myriad components of the experience. A survivor who was assaulted by an acquaintance may have a particularly difficult time overcoming shock and disbelief, [and may] question the trustworthiness of others in their life. If the assault was particularly terrifying or brutal, the survivor may experience an extreme shock response and completely block out the assault. Following the shock and disbelief most survivors initially experience, they may experience a variety of emotions or mood swings. Survivors may feel angry, afraid, lucky to be alive, humiliated, dirty, sad, confused, vengeful, degraded. All of these responses, as well as the many that are not listed, are normal. In short, whatever a survivor is feeling is valid, because they are feeling it.
Do most survivors opt to have a rape kit done in the hospital?
SARAH It’s hard to say. Generally, in my experience in the ER, I would say most do. The kit itself isa long and somewhat invasive examination and this process can take a toll on many survivors.The victim is asked to undresson a sheet andis examined from head to toe for any signs ofinjury or trauma. Oral, anal and vaginal swabs are taken of the survivor’s mouth, anus and vagina. In addition to the swabs, fingernail scrapings are taken from under the fingernails, as well as pubic and head hair combings. Many survivors do not want to be exposed or touched after an assault and this examination can be very difficult. It’s up to the survivor to consent or decline any parts of the kit. The advocate can also be in the room while the kit is being done to help to support and encourage the survivor throughout the exam. I’ve found most women have wanted me in the room with them while the examination is taking place. I think I’ve helped put them more at ease during the process by just being there to support them and explain the steps of the kit.
Does your relationship with the survivor end when he/she leaves the hospital?
SARAH For volunteer advocates, sadly, the relationship does end after the ER visit, which can be difficult for the volunteer. Volunteers are required to make one follow-up call after the visit and then, if the survivor has requested services, they are referred to an RVA staff advocate or counselor (depending on the services they have requested). The sameprocess is followed by staff advocates; however, if the survivor has requested services, the staff advocate would be the one providing them, so the relationship continues.
RVA works with 11 hospitals in Chicago. Do all rape victims in the U.S. have an advocate present with them when they come to the hospital?
SHARMILI The short answer is no. The response to rape victims in hospital emergency rooms varies widely across the country. In some places, like Los Angeles, there is one centralized place that all rape victims can go to seek medical treatment, report the assault and get an evidence collection kit done. In Cook County, only about a third of hospitals have agreements with rape crisis centers to provide on-call crisis response by advocates.
How do advocates help victims communicate with doctors, nurses, police, friends and family?
SARAH Advocates are there as a liaison on the behalf of the survivor when working withthese parties. In communicating with doctors, nurses and police, advocates have training and an in-depth understanding of the rights of survivors, both medically and legally. [They] also understand the role of the doctor, nurse or police officer; we’re there to help [them] understand what the survivor is going through and bridge the gap between the survivor’s needs and the system they work for. Hospitals and the criminal justice system are not set up for sexual assault survivors and sometimes these systems operate outside of what the survivor wants or needs.
An advocate is also helpful in providing support and information to significant others of the survivor. Sometimes family members mean well but don’t always have the best reaction to survivors once they disclose. Significant others may also act on what they believe is the right thing to do or the right thing for the survivor, but it may not be what that person wants. All of RVA’s services are offered to both survivors and their significant others, because we recognize sexual assault and abuse do not only affect the person whom is the direct victim.
Why do you think the “false rape victim” allegation continues to be so prevalent in discourse surrounding rape?
SHARMILI There is a prevailing belief that most victims lie, but solid, reliable research indicates that the rates of false reporting are 2-8 percent, despite media reports often sensationalizing ‘false accusations.’ There’s also a stereotype of what ‘real rape’ is, and this stereotype leads us to not believe people whose experiences don’t fit. Ironically, the stereotype – an attractive young woman, assaulted by a stranger, sustains physical injuries, immediately reports to the police and remembers all of the details in chronological order – does not reflect the vast majority of sexual assault. But as long as people believe the stereotype is the truth, they will believe the vast majority of victims are lying.
How have you seen survivors be re-victimized while pursuing their cases? In what ways does the way we process rape cases need to change?
SARAH Many people have views of what rape is and what rape is not, and medical and criminal justice professionals are not immune. Anyone outside of a ‘perfect victim’ stereotype is subject to victim-blaming statements and scrutiny, not only by people in their social circles, but many times by the very systems that are in place to help them.
Sometimes this means police interrogate victims as though they had committed a crime, or discourage them from pursuing a case. It may be that they are told their case will not go forward because they were drinking and can’t remember exactly what happened. Someone in the emergency room may ask the victim, ‘Are you sure it was rape and not just a miscommunication?’ In addition, many people believe that if a woman goes on a date with someone, has a drink or invites someone into her home, consent to sex is implied. Or they believe that if you consent to sex once, you have consented to sex at anytime, and if you have consented to one sexual act, you have consented to all sexual acts. The law implicitly defines consent as informed consent, yet as a society many believe in implied consent to sex. We must break away from this thought process and define these situations as what they really are: rape.
There are some institutional moves in the right direction. We are working with the Chicago Police Department to get an idea of trends in police response. The Cook County State’s Attorney’s Victim Witness Assistance Unit and the advocacy community are working together very closely, and the Cook County State’s Attorney’s Office Sexual Assault Advisory Group is working on getting more prosecutors trained. Obviously, there are many compassionate, committed professionals who understand rape. But more extensive and intensive training, as well as openly available data on the current institutional response to rape, are needed, so professionals can be better prepared to respond to this crime and the public can assess the institutional response. Ultimately, we must continue working on changing societal attitudes and beliefs toward rape, and combating myths with facts.
Many people wonder what the “right thing to say” is when a friend tells them they’ve been sexually assaulted.
SARAH There are many ways to offer support to survivors after someone has shared with you that they have been raped. The most important things to say are: 1) You believe them, 2) It is not their fault, and 3) There are resources that can help them; they have options. Stay away from probing why questions (‘Why did you go with him?’ ‘Why did you leave by yourself?’). Questions that start off this way, while one may mean well, come off as blaming. It’s also important to mirror someone’s language around what happened to them. Don’t ever define an experience as ‘rape’ unless the survivor is comfortable with that language and has used it themselves; it often takes time for victims to come to grips with the fact they’ve been assaulted. Lastly, follow their agenda. One of the most difficult things for a rape victim is the loss of control and violation of boundaries. Anything that can help them gain back control is beneficial to their healing. This includes respecting their decision to go or not go to the hospital, or to report or not report the assault to the police. RVA also offers support for the loved ones of survivors – so you may want to call yourself to be able to talk about your feelings and how you can be helpful.
Some answers have been shortened for clarity. This interview is the last in a series for Sexual Assault Awareness Month. Check back on Friday, April 29 for a wrap-up on topics discussed this month and how you can get involved to make an impact.
Pictured above: Sarah Layden, left, and Sharmili Majmudar of Rape Victim Advocates.