The business of childbirth.
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Biomedical subjects
Publications and source records attributed to L L Holmstrom.
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The present study reports on the forced sexual, excretory, and sadistic acts that occur during rape. The main sample consisted of 115 adult, adolescent, and child rape victims that were admitted during a 1-year period to the emergency wards of a large municipal hospital. Forced vaginal intercourse was the most frequent act reported, but many other acts also occurred, ranging from fellatio and cunnilingus to urinating on the victim. It is argued that various social-psychological meanings are attached to forced sexual acts, most notably power, anger, and male camaraderie. Pair/group rape differs from single-assailant rape in the emphasis placed on watching and taking turns. Analyzing the social meanings attached to forced sex makes a contribution to our knowledge about the use of sex to express nonsexual issues.
The authors conducted a follow-up study of 81 rape victims to analyze the effect of adaptive or maladaptive response to rape on recovery over a 4-6 year period. They found that victims recovering fastest used more adaptive strategies, including positive self-assessment; defense mechanisms of explanation, minimization, suppression, and dramatization; and increased action. Victims who had not yet recovered had more maladaptive mechanisms, such as negative self-assessments, inaction, substance abuse, and action on suicidal thoughts.
Accounts from both offenders and victims of what occurs during a rape suggest that issues of power, anger, and sexuality are important in understanding the rapist's behavior. All three issues seem to operate in every rape, but the proportion varies and one issue seems to dominate in each instance. The authors ranked accounts from 133 offenders and 92 victims for the dominant issue and found that the offenses could be categorized as power rape (sexuality used primarily to express power) or anger rape (use of sexuality to express anger). There were no rapes in which sex was the dominant issue; sexuality was always in the service of other, nonsexual needs.
The coping behavior of rape victims can be analyzed in three distinct phases--the threat of attack, the attack itself, and the period immediately thereafter. The authors analyzed the reported coping behavior of 92 women diagnosed as having rape trauma. Most of the women used verbal, physical, or cognitive strategies when threatened, although 34 were physically or psychologically paralyzed. The actual rape prompted coping behaviors in all but 1 victim. Escaping the situation or the assailant is the primary task immediately after the attack. In counseling the rape victim, it is important to understand her individual style of coping, to be supportive of it, and to suggest alternatives for future stressful situations.
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Accountability by the professional is especially important in a crisis situation. Rape is experienced by victims as a life threatening situation and it thus triggers an acute stress reaction which requires them to go through a long-term reorganization process. As a crisis situation, it makes them hypersensitive to the attitudes of those people to whom they turn for help and assistance. Clients--in this case rape victims--benefit when professionals are careful to be accountable to them. The victim counselors defined and redefined their role to the victims through their work with the victim as well as explaninig the services they could provide. In reviewing the reactions of 146 victims to treatment by police, hospital, and counselors, one theme emerged again and again: clients want explanation from professionals about role expectations and about procedures that are to be done.
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