Maria was only 15 when she was attacked by a group of men on the way home from school. They took turns screaming abuse at her and then they each raped her. Finally, they tried to stab her to death and would almost certainly have succeeded had the police not arrived on the scene. For months after this horrifying event, Maria was not herself. She was unable to keep the memories of the attack out of her mind. At night she would have terrible dreams of rape, and would wake up screaming. She had difficulty walking back from school because the route took her past the site of the attack, so she would have to go the long way home. She felt as though her emotions were numbed, and as though she had no real future. At home she was anxious, tense, and easily startled. She felt "dirty" and somehow shamed by the event, and she resolved not to tell close friends about the event, in case they too rejected her.
Joe saw a good deal of active combat during his time in the military. Some incidents in particular had never left his mind – like the horrifying sight of Gary, a close comrade and friend, being blown-up by a land-mine. Even when he returned to civilian life, these images haunted him. Scenes from battle would run repeatedly through his mind and disrupt his focus on work. Filing up at the gas station, for example, the smell of diesel immediately rekindled certain horrific memories. At other times, he had difficulty remembering the past — as if some events were too painful to allow back in his mind. He found himself avoiding socializing with old military buddies, as this would inevitably trigger a new round of memories. His girlfriend complained that he was always pent-up and irritable – as if he were on guard, and Joe noticed that at night he had difficulty relaxing and falling asleep. When he heard loud noises, such as a truck back-firing he literally jumped, as if he were readying himself for combat. He began to drink heavily.
Both Joe and Maria suffered from PTSD and, with time, both were able to control their symptoms. The first step in this process was for each of them to find someone they could trust – for Maria it was her art teacher, and for Joe it was his girlfriend. It was important for them to share how they were feeling, but it was also helpful for them to have someone who would listen. To Maria's surprize her art teacher reacted very supportively, seeing her not as "soiled", but as very hurt, and in need of help and comfort. Joe's girlfriend also expressed her willingness to help him cope with his intrusive memories, but she insisted that he find a way other than alcohol.
Maria and Joe both decided to participate in therapy. Maria worked with a therapist and then began group therapy where she was able to discuss the rape and her reaction to it with other people who had been sexually assaulted. She found that the support of others who had been in similar situations made her feel less alone. She learned that feeling "dirty" and somehow guilty after being raped is a very common experience, and after that she was better able to express her anger towards the man who had raped her. Working with this group also allowed her to begin to re-connect with and trust others.
Joe was not comfortable working with a group of people and chose to work with a therapist one-on-one. His first step was making the decision to stop drowning out his memories by using alcohol. He and his therapist then began to discuss his combat experiences, identifying the activities, people, sounds, and smells that could trigger these symptoms, and working on ways to manage his symptoms. Although he was initially reluctant to deliberately expose himself to such cues, he eventually agreed to an exercise of seeing old war movies. Over time, he learned to watch such movies and continue to remain reasonably calm.
In addition to therapy, medications helped Maria and Joe relieve some of their symptoms. The anti-depressant that Maria took helped to decrease the intrusive memories and her levels of anxiety. For Joe, the medication made him less irritable, less jumpy, and also helped with the problems he had falling asleep. Joe developed sexual side effects on his first medication, and although he wanted to discontinue all medications, his therapist succeeded in encouraging him to switch to a different agent.
Maria's symptoms ended within three months, while Joe's lasted longer. Both were eventually able to control their symptoms through a combination of therapy, medication, and the support of family and friends.
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