When a person is about to be attacked, the ability to react depends on the amount of time between the threat of attack and the actual attack. Initially, the victim may use verbal or physical tactics or may be overwhelmed with fear and not resist at all.

• 23% use physical means to fight backsuch as hitting, biting, kicking or pushing
• 24% scream for help
• Over 50% are too frightened or intimidated to use physical resistance

Once the assault occurs, internal defense mechanisms kick in to cope psychologically with the fear and horror of the violation. Survival becomes the goal despite the demands being made which can include oral, vaginal and/or anal penetration.

These defense mechanisms serve to provide some "mental distance" from the reality of what is happening. It is important for staff, who are not trained in such matters, to understand how these defense mechanisms work so as not to misunderstand the extent of the trauma when they hear the victim talk about how she felt during the attack.

Typical internal defense mechanisms used:

• Denial - "This isn't happening to me. It doesn't feel real. Surely this can't be true."
• Dissociation - "I felt like I was outside my body watching it happen."
• Suppression - "This will be over in a few minutes; it's not the end of the world."
• Rationalization - "This poor man, he looks desperate; is this the only way he knows how to get sex?"

There are physiological responses to rape that can include some involuntary choking, gagging, nausea, vomiting, pain, urinating, hyperventilating (rapid shallow breathing) and losing consciousness.

After the attack is finished, the stressful situation is not over. The victim must alert others to her distress, escape, get help, and endure peoples' reactions to her story. During the acute stage immediately after the assault, the victim may have varying reactions.

She may:

• Seem agitated or hysterical or she may appear totally calm and be in shock
• Have crying spells and anxiety attacks
• Have difficulty concentrating, making decisions, and performing simple, everyday tasks
• Show little emotion, act as though numb or stunned
• Have poor recall of the rape or other memories

An apparently calm demeanor should not be mistaken for evidence that the rape did not occur or that she is unaffected by it.

The most important role that staff can play after a student has been raped is to get to her as soon as possible and begin creating an environment where she can feel safe.

Allow her to be in as much control of herself and of her situation as is possible, even in small ways. Don't decide everything for her. For example - "Do you want to talk to the police now or in a few hours?"; "Do you want to drink a soda or have some water?"; "Where or with whom would you feel safe spending the night tonight?"

There are three basic messages she needs to hear verbally and behaviorally from everyone who is in a supportive role with her:

• You are not alone. We are with you.
• I am so sorry this happened to you.
• It was not your fault.

At this stage, it isNOThelpful to point out ways that the victim used poor judgement or placed herself at risk. Avoid all statements or attitudes that would imply blame, criticism or judgement. Remember that no matter what the victim did or did not do, she did not ask to be attacked. She was vulnerable perhaps through her actions, but not to blame for being raped. The rapist is to blame for the rape.

The person needs to be accompanied by a responsible staff member to the police station or to any legal proceeding. Never leave her alone there. Be her advocate and protect her from further abuse. If possible, allow the student to have input into who will be accompanying her.

Except for those who "need to know", respect her need for privacy. Do not tell others that she has been raped unless you have her permission.

It is strongly recommended that all rape victims have access to counseling. If the person is returned to the U.S., she can receive counseling right away and be followed very closely. Counseling will continue for support and to assist her in resolving the trauma. Sometimes students are reluctant to leave country and their friends to go to the States. Yet they do not feelsafe in country. It can be helpful to validate that concern and point out to the student that others have felt the same way at first. Tell her that those who have gone to the U.S. have been very glad they allowed themselves to benefit from the care they received there. It also gives the victim an opportunity to talk to and perhaps see friends and family for additional support and sense of safety. One of the most important factors in creating a healthy recovery from assault is to establish a consistent environment of safety and support, something that is almost impossible to do in country where there are so many reminders of the trauma.

According to Burgess and Holstrom (1979) there are three stages of emotional reaction following a rape trauma.

This stage occurs immediately after the assault. It may last a few days to several weeks. During this stage the person may:

• seem agitated or hysterical or she may appear totally calm and be in shock
• have crying spells and anxiety attacks
• have difficulty concentrating, making decisions, and performing simple, everyday tasks
• show little emotion, act as though numb or stunned
• have poor recall of the rape or other memories

Any apparently calm demeanor should not be mistaken for evidence that the rape did not occur or that she is unaffected by it.

During this stage, the person resumes what appears to be from the outside, her/his "normal" life. She tries to put the rape in the past and may not want to talk about it. This closure is premature. Inside, there is considerable turmoil which can manifest itself by any of the following behaviors:

• continuing anxiety
• sense of helplessness
• persistent fear and/or depression
• severe mood swings ( e.g. happy to angry, etc.)
• vivid dreams, recurrent nightmares, insomnia
• physical ailments
• appetite disturbances (e.g. nausea, vomiting, compulsive eating, lack of appetite)
• efforts to deny the assault ever took place and/or to minimize its impact
• withdrawal from friends and/or relatives
• preoccupation with personal safety
• reluctance to leave the house and/or to go places which remind the person of the rape
• hesitation about forming new relationships with men and/or distrust of existing relationship
• sexual difficulties
• disruption of normal everyday routines (e.g. high absenteeism at work suddenly or, conversely, working longer than usual hours; traveling different routes; going out only at certain times

This stage can begin within a month or years after the attack. During this stage the rape is no longer the central focus in the person's life. The person begins to recognize that while s/he will never forget the assault, the pain and memories associated with it are lessening. S/he has accepted the rape as a partof her/his life experience and is choosing to move on from there. Some of the behaviors of the second stage may flare up at times but they do so less frequently and with less intensity. In this fashion, the person who has survived has moved from being a "victim" to a "survivor."