In the past few years there has been a lot of attention paid to the problem of sexual assault in the U.S. military. Congressional hearings, military panels, and nonprofit organizations have looked at how to lower the incidence of assault, help women feel safe reporting it, and allow them to recover from the post-traumatic stress disorder (PTSD) that often follows it.
A new report from Australia recommends prolonged exposure therapy for preventing PTSD. The treatment involves reliving the traumatic experience with a therapist in order to face your fears and learn coping skills. Last year a study published in the Journal of the American Medical Association (JAMA) recommended the therapy specifically to treat women vets with PTSD—a condition they are more likely to report suffering from than men.
These studies have not looked at whether prolonged exposure therapy helps PTSD stemming from sexual assault, however, as opposed to the trauma of watching a fellow soldier or an entire town blown to bits. And it’s an omission that frustrates the Miles Foundation, a private group that tracks violence inside the military and has helped 25,000 active duty members victimized by sexual assault, harassment, and other crimes.
The foundation also believes investigators would be more effective with therapy if they probed women’s pre-soldier histories. According to the foundation, a disproportionate number of women have already experienced “sexual victimization” when they sign up. (It’s a scenario that makes sense; people have always used the military as an escape route.) So whatever form of psychotherapy is employed (prolonged exposure therapy was compared with cognitive restructuring in the Australian study), the Miles Foundation believes women should be queried more pointedly about pre-military rape, incest, and other assaults. “It can leave you more vulnerable,” the foundation’s Anita Sanchez told me. “But they never addressed that,” she says of the study in JAMA.
Access to support services is another complicating aspect of an already difficult and thorny problem. In a New York Times op-ed last week, Helen Benedict, a journalism professor at Columbia University, criticized the Department of Veterans Affairs for providing inadequate counseling services to women suffering from PTSD.
Providing services to these women appears to be a steep climb, but getting a more complete understanding of their experiences and discovering what treatments work are a few obvious first steps.
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