Rape Trauma Syndrome

Rape Trauma Syndrome (RTS) is a kind of post-traumatic stress, but specific to those who have experienced rape and sexual assault. It can involve physical, emotional, cognitive and interpersonal behaviour disruptions.

Major symptoms include:

  • Re-experiencing the trauma - this may be through recurring nightmares, flashbacks or the inability to stop remembering or thinking about the rape or sexual assault.
  • Social withdrawal - this can involve not experiencing any feelings.
  • Avoidance behaviours and actions - survivors may want to avoid any thoughts or feelings that might recall events about the rape or sexual assault.
  • Increased psychological arousal characteristics - survivors may have exaggerated startled responses, hypervigilance, sleep disorders or difficulty concentrating.


Each person's experiences of RTS is and will be different, but it can generally be broken down into stages: the Acute stage, the Outward Adjustment stage, the Underground stage, the Reorganisation stage and the Renormalisation stage (sometimes, these stages may have different names). It's also important to remember that the length of each stage can vary from person to person, and sometimes people will move back and forth between the stage.

  • The Acute Stage

    This may beging days or weeks after a rape or sexual assault, and generally last for a few days to a few weeks. The symptoms of the Acute stage tend to be experienced after the initial shock of the rape or sexual assault has worn off. These symptoms may include:

    • diminished alertness or hyper-alertness
    • numbness
    • dulled sensory, affective and memory functions
    • disorganised thoughts
    • nausea and vomiting
    • paralysing anxiety 
    • an obsession with washing and cleaning oneself 
    • confusion about everyday life
    • acute sensitivity to reactions of other people
    • thoughts and increased risk of suicide
  • The Outward Adjustment Stage

    This usually begings when the Acute stage ends, and tends to last longer if it is not interrupted - from a few months to several years. 


    In this stage, the survivor may appear to have 'moved on', but in reality they are experiencing serious inner turmoul. At this stage, survivors may increase their dependence on coping mechanisms - some of these may be helpful (like support from friends and family, mindfulness, increased self-care), but some maye be counterproductive (like self-harm, drug and/or alcohol buse, high risk sexual behaviours or disordered eating). Other coping mechanisms in this tage may include:

    • minimisation - pretending everything is fine, or the assault wasn't a big deal
    • dramatisation - they can't stop talking about the assault
    • suppression - they refuse to discuss the assault
    • explanation - an intense analysis of what happened
    • flight - moving to a new home or city, changing jobs, altering their appearance etc. 

    Symptoms may include:

    • poor general health
    • continued anxiety
    • a sense of helplessness
    • hypervigilance 
    • an inability to maintain close, personal relationships
    • gneeral startled responses or nervousness
    • persistent fear
    • mood swings - from relatively happy to depression, extreme anger, hostility etc
    • sleep disturbances such as insomnia, vivid dreams and recurring nightmares
    • flashbacks and intrustive thoughts about the assault 
    • dissociation - feeling unattached to their own body 
    • panic attacks

    Survivors may also feel that their lifestyle is changing in a variety of ways, including:

    • sense of personal security is damaged, possibly leading to changing behaviours and abandonment of activities which were previously enjoyed
    • hesitation around entering new relationships
    • questioning their sexual identity or orientation
    • disrupted sexual relationships and sexuality, including difficulty re-establishing 'normal' sexual relationships, inhibited sexual responses, flashbacks to the rape or sexual assault during sexual activity or hyper-sexuality
  • The Underground Stage

    During this stage, survivors may work on returning to their 'normal' life. This stage can last for years - while there may be limited disruptions to daily life, emotional issues continue unresolved. Survivors may:

    • attempt to return to their lives as if nothing ever happened
    • block thoughts of the assault from their mind, not wanting to talk about the incident or any related issues
    • find concentration difficult and have symptoms of depression
    • experience dissociation and/or hypervigilance 
  • The Reorganisation Stage

    This stage can start with an external trigger, a life transition, or another reason which may not be clear to the survivor. This length of this stage varies - it can end with a return to Outward Adjustment or Underground, or it can end when the survivor is able to resolve the trauma and move onto the next stage. 


    The Reorganisation stage is centred on a return to internal and external turmoil. Those surrounding the survivor, such as friends and family, may be confused by these feelings and behaviours, as they likely thought that the survivor had resolved them. Survivors may also be surprised, confused and even fearful during this stage, where strong feelings about the assault return. 


    Survivors may experience fear and phobias specifically related to the rape or sexual assault or they may be more general, inclduing:

    • a fear of being in crowds
    • a fear of being left alone
    • a fear of men or women
    • a fear of going out
    • a fear of being touched
    • specific fears relating to the perpetrator of the rape or sexual assault, e.g. straight hair, type of clothing, the scent of smoking or a certain perfume/aftershave
    • general suspicious or paranoid feelings about strangers
    • eating disturbances such as nausea, vomiting or developing eating disorders
    • sleeping disturbances light nightmares
    • violent fantasies of revenge
    • increased thoughts and risk of suicide
  • The Renormalisation Stage

    In this stage, survivors are able to reprocess their experience and integrate it into their lives. The rape or sexual assault is no longer the central focus of their life, and feelings like guilt and shame can be resolved. Survivors are also able to recognise and address secondary consequences of maladaptive coping mechanisms.


    While survivors may still feel sad about the rape or sexual assault they experienced, their feelings generated in other stages are no longer as overwhelming or strong as they once were.