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Reasonable responses to unreasonable behaviour?:  medical and sociological perspectives on the aftermaths of sexual violence Liz Kelly CWASU June 2011
Overview ,[object Object],[object Object],[object Object],[object Object]
Starting points 1 ,[object Object],[object Object],[object Object],[object Object],[object Object]
Starting points 2: Language  in discourse ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Wider context ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Evidence on sexual violence and  mental health  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The trauma framing
Rape Trauma Syndrome (RTS) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Post Traumatic Stress Disorder (PTSD) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Judith Herman – Trauma and Recovery   (1992)   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Critiques of trauma model  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Feminist engagements  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
Sociological framings
Stigma, spoiled identities  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Feminist version: Victimism ,[object Object],[object Object]
The relational self ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The ‘v’ words ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Child and Woman Abuse Studies Unit
(Dis)embodiment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Resistance, Harm and Social Suffering ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
RECENT RESEARCH ON RESPONSES
Specialist services  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Specialist services 2 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What women think ,[object Object],[object Object],[object Object],[object Object]
Food for thought ,[object Object],[object Object],[object Object],[object Object],[object Object]
RCCs: The whole place self ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Basis for progress and dialogue? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Susan Brison ,[object Object]

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Reasonable responses to unreasonable behaviour?: medical and sociological perspectives on the aftermaths of sexual violence - Liz Kelly, CWASU, London Metropolitan University

Notas do Editor

  1. Effect - implies individual psychology Impacts and consequences include wider circumstances including the responses of others (Kelly, 1988) Trauma concept – medical model Greek word means injury. Modern usage began with Freud – symptoms as traumatic effect, traced back to irritation of the genitals – 1896 - Where trauma originally denoted a physical wound, within the fields of psychoanalysis and psychology, any inspection or treatment of the traumatic wound shifts the main emphasis from somatic to psychic topologies. TAKEN ON CULTURAL DIMENSIONS Empowerment - rebuilding self recognition of strengths and abilities MEANINGS – social analysis or individual level Harm – HR discourse Social suffering – from Bordieu and developed by Veena Das in anthropology, that life is, social and individual, and much suffering is created, experienced and coped with socially
  2. 2007 study in east London up to 75% of women reported shame following sexual assault (Vidal and Petrak, 2007) Jan Jordan -women opted out of previously enjoyed social and recreational activities. 16 studies demonstrate equal psychological distress regardless of relationship with perpetrator (Frazier and Seales 1997) – however additional factors of betrayal etc not measurable? Sudan – rape survivors’ biggest fear is stigma and social isolation (Amnesty, 2004) Equation of childhood and innocence – sexualised children are knowing and therefore stigmatised (Kitzinger 1997) ‘ In the experience’ or ‘in the social context’?
  3. Ann Burgess professor or MH nursing, Lynda Holmstrom a sociologist – started a RC at a hospital. Documented responses of women they saw. Model still widely cited today. Used to introduce to CJ system the impacts of SV – help jurors understand immediate and subsequent responses can vary. HOWEVER has also been used by defence – if she did not show symptoms of RTS – one case 1982 victim ordered to undergo MH examination – 1989 another case defendant entered evidence to argue that she did not show evidence of RTS so no rape occurred. Have to locate syndromes and disorders in context of US private health insurance regime - if can show impacts can argue for counselling, but at same time becomes a normative framing
  4. Square the need for a diagnosis in a US context with a more social model
  5. Popular and expert discourses (Hengehold, 2000) may conflict – what happens when disclosures become co-opted into discourses? Louise Armstrong talked about CSA survivors on US TV framed in infantilised terms, teddy bears, girlish voices. Paula Reavey’s work shows what happens when women survivors of CSA in adulthood draw on discourses of abuse ‘effects’ and make links between problems experiencing now and past abuse unproblematically. Invisible perps. Weakness and deficit model not about strengths and abilities – resistance/coping Ethnocentrism - these meanings may not be psychological or medical but may be spiritual, cultural, or political. By imposing this Western trauma framework on other populations, psychological practitioners have largely ignored the role that culture plays in issues of distress and mental health, instead focusing on interpreting the suffering of people by means of pre-determined psychiatric categories and PTSD symptom checklists.   Salvadoran women and calor (Jenkins, 1999, cited in Wasco, 2003) Ataques de nervios – attack of nerves, shouting, crying, trembling and aggression – Latina women (Bryant- Davis et al, 2009) Chest pains (China), burning on soles of feet (Sri Lanka), ants in head (Nigeria) – Ussher (2010)
  6. Bonnie Burstow suggests rid ourselves of medical language such as recovery, symptoms, diagnosis but whether or not keep concept of trauma more complex. Symptoms often survival skills Part of everyday language and theorises not as disorder but reaction to a wound - despite ethnocentrism idea of connection with wounds speaks to people across cultures – people feel distress because they have been wounded
  7. The meaning of ‘victim’ product of social relations, culture and language Victimhood discourse part of the fashionable conservative critique in the 1990s of PC – but adopted by many who regard themselves as critical Post-structuralists – language constructs reality/meaning Little recognition of critical engagement of feminists with language Interesting which words and concepts deemed ’worthy’ of filling with new meanings
  8. Dissociation – separate thinking, feeling self from the physical body switching off, pretending it’s not happening, watching from the ceiling Med/psych perspective focuses on dissociation as a mental health disorder sexual abuse signifies to women that bodies can be appropriated by others for their sexual gratification, reinforcing both a sense of personal powerlessness, and (dis)embodiment,
  9. Social suffering been mainly applied to political violence – that experienced by communities, but some of this is SV – but could extend to SV and see women as a group affected by adversity
  10. Fry (2007) merging of DV and SV, SV is less served O’Sullivan and Carlton (2001) compared 8 independent SV services, with 8 integrated SV/DV: independent SV had more inclusive definitions, worked with young people, paid more attention to diversity, and undertook outreach and community education Conclusion re integrations – if it is an SV service expanding is more positive, marriages of convenience with DV less so If are going to combine SV service should have autonomy – control of budgets and staff so that can focus on the needs of their service users