I sit in a chair where I have to be non-judgmental
Docfort medical journalism student Spurthi Venkatesh interviewed Dr Rizwana Begum, clinical & counselling psychologist in Bangalore. Her article was originally published by NewsTracker at https://bit.ly/2O9lYBR.
Why do people rape? Over the past few months, several people interviewed by NewsTracker said it is important to seek answers to this question, and that journalists should get into the minds of sexual offenders for impactful reporting. We took the question to Bangalore-based psychologist Dr Rizwana Begum. Withmore than 13 years of experience in counselling and psychotherapy, she has encountered a range of clients, including those who have survived sexual assault. In this interview, Dr Begum speaks about the motivations behind rape, the psychological aftermath of sexual crimes, and how to talk to survivors. Some excerpts:
Doctors and mental health experts are best positioned to recognise if a person has undergone sexual abuse. Recently, a 17-year-old girl went to a hospital complaining of a migraine, but ended up confiding that her father had been sexually abusing her at night for several years and would beat her when she tried to resist. Have you ever encountered such revelations in your practice? How does a medical professional deal with it?
I have not lost the ability to be shocked when clients talk about being sexually abused by their own family members, such as brothers or uncles. It’s difficult and awkward for the victim to acknowledge the abuse and talk about it when the offender is related to her or him.
Once the client reveals sexual abuse to a medical professional, we need to build trust and rapport and assure them that everything they say is confidential. We have to make them comfortable enough to talk more about it. It is a painful situation — and one that can cause feelings of helplessness — if the victim has faced any sort of sexual violence during childhood from a known perpetrator, especially a relative.
IN THE CASE OF YOUNG ADULTS, IT AFFECTS THEIR PERSONALITY… SELF-HARM, IMPULSIVENESS AND EMOTIONAL IMBALANCE MAY BECOME THEIR COPING MECHANISM.
Not all survivors speak openly about abuse. Are there any red flags that indicate someone may be in such a situation?
We don’t generally look for abuse, but there are some signs that indicate there could be deeper issues. If a person seems lost or preoccupied, is absent-minded, has poor concentration, it can indicate the need for more investigation. Their expressions and breathing patterns may change when recalling certain events. They may seem unhappy or even have a panic attack. Sometimes there is a silence in the conversation — or they fall short of words recollecting an event during a session. All these leave me with a lot of questions. To a trained professional, these signs can communicate the possibility of violence and sexual abuse.
How do you deal with it if a client opens up about sexual assault or abuse to you, before they’ve discussed it with anyone else?
I have come across many cases where the client has reported to me when the offender is a relative. I think being in the moment is very helpful to them.
My suggestion is to go with the client’s flow. Don’t make it a big issue or minimise it, but help them in the process of recalling the event.
Do you convince your clients to report the offence to the police?
Not at all. But when required, it has to be considered: if the client is under the age of 18, I have to discuss it with the informant. In the case of mature adults, it is their decision to report or not.
What is the emotional aftermath of rape for a survivor?
It definitely remains at the back of their mind. The management of [psychological issues in the] aftermath, such as depression and anxiety, depends on each survivor’s cognitive process. In the case of young adults, it affects their personality… self-harm, impulsiveness and emotional imbalance may become their coping mechanism. Long-term impact includes trust issues, addictions, substance abuse and multiple relationships as a way of managing their emotions. The general challenges of life add to their feelings of loneliness, and the intensity of the challenge is high where their self-worth is questioned.
When help is provided, victims can overcome the above issues. We can help make these conditions/issues manageable.
MALE VICTIMS FACE PSYCHOLOGICAL PROBLEMS ON A GREATER SCALE THAN FEMALE VICTIMS. LIVING IN A PATRIARCHAL SOCIETY, IT IS VERY DIFFICULT FOR THEM TO ADDRESS SUCH A SITUATION.
What do you think drives some people to perpetrate sexual violence?
The answer to this has a lot to do with gaining power over an ‘inferior’ subject.
Also we need to take into account the perpetrator’s life history, such as their parenting, belief system, environmental factors and schooling, especially in the midst of our patriarchal society. They hold a lot of irrational beliefs about their victim, like the clothes s/he wears. The perpetrator believes that it is not a crime as she is inviting him to commit the act.
A perpetrator doesn’t simply jump into a heinous crime: there would be a history of misdemeanours or crimes which have been neglected or not addressed. Anti-social personality disorder may also contribute to the perpetrator’s psychological makeup.
How do you go about counselling sexual offenders?
It is a big challenge for me to see the other side of the story. However, I sit in a chair where I have to be non-judgmental and have to give everyone a chance to get better. We help them acknowledge their issues and give them insights into themselves.
In 2007, a study found out that 53.22% of children in India faced one or more forms of sexual abuse. Among them, 52.94% were boys. What do male survivors of sexual assault face psychologically?
Male victims face psychological problems on a greater scale than female victims. We live in a patriarchal society which believes men don’t cry or express emotions. Living in such an environment, it is very difficult for them to address such a situation. It can lead to self-blaming and doubting their capabilities. There is less reporting of sexual assault by male survivors.