Ours is a nation where according to an estimate by the Human Rights Commission of Pakistan, a woman is raped every two hours, and gang raped every eighthours. While it is well established how the judicial systems fails these people, there is also little awareness or support for the survivors of this barbaric ordeal.

Erum Ghazi, a therapist with vast experience in the field feels that rape survivors aren’t treated with the compassion they deserve, “The law enforcement agencies need to be trained by psychologists to handle such cases with sensitivity and the respect that someone seeking justice deserves. Which means specially trained officers should be interviewing the victim. Moreover, the media needs to know how to handle such cases in terms of what to say to a victim and what not to say. One rule of thumb to remember is to put yourself in their place: How would you like to be treated? What would you wish the other person would say? Basic humanity is what is needed here. The interviewers should have knowledge on how to deal with a situation like this, should feel kindness, compassion, empathy and understanding towards the victim, and must leave judgment and preconceived notions at the door. Open your heart and mind to another human beings pain and distress, as the person being interviewed has been through a harrowing ordeal, and does not need additional trauma.”

For a rape survivor, the road to healing is often a lifelong and complex journey where support is paramount

Frustratingly, the attackers often go unpunished while some of the responsibility of the attack is unfairly placed on the already overburdened shoulders of survivors. Erum states that this lack of justice adds to the trauma, and is compounded by survivor’s families who are more concerned with their standing in society than the well-being of the victim.

“The family stands by quietly while the rapist or abuser goes scot free. Tell your family it is their duty to stand by you. It is not the rape victim that needs to be stigmatised, it is the abuser.”

If anything, the therapist feels it is the justice system which needs to be stigmatised for failing those who seek redress.

Erum explains that victims of such sexual abuse can suffer from depression as well as borderline personality disorders that sometimes extend to psychosis, “This means that the person may be suffering from suicidal inclinations and may have made multiple suicide attempts, as well as inflicting self-harm. They may also suffer from dysfunctional personal relationships, eating disorders, obsessions, compulsions, anxiety, panic attacks, hyper-sexuality or even hypo-sexuality.”

As with any person who has suffered from a trauma, rape survivors can have days where negative emotions are triggered by seemingly innocuous happenings, “Post-traumatic stress disorder is rampant in these cases with the victim experiencing trauma again and again at the smallest triggering event. In the movie Ground Hog Day, the actor relives the day again and again. Now just imagine the trauma being relived day in and day out.”

Though many rape survivors in Pakistan are provided with therapy, their families are impatient when the signs of progress are slow, “Therapy is not a pill that you pop in your mouth and all will be well. It is not a magic wand nor is it an overnight change. It is a journey, a long process because what has happened is no small thing.”

Though many rape survivors in Pakistan are provided with therapy, their families are impatient when the signs of progress are slow, “Therapy is not a pill that you pop in your mouth and all will be well. It is not a magic wand nor is it an overnight change. It is a journey, a long process because what has happened is no small thing.”

For a survivor who has experienced little empathy, often the simple act of being heard can prove to be therapeutic, “What we do is listen first — the initial task is to do get all the information that you can and deal with the emotions to acknowledge and validate the clients distress. I work from a person-centred perspective and then bring in other elements, thus making my work eclectic. I find cognitive behaviour therapy helps with immediate issues and tasks; however more intense work is required which requires a more psychodynamic perspective. Moreover, I work from a holistic perspective; the mind, body, heart and soul are interconnected.”

Naturally, survivors try to make sense of their ordeal, “A lot of times the client will have spiritual crises, which needs to be dealt with. Questions like, where was god when I needed him? Why did he not help me? Am I being punished for some wrong that I did?”

Managing a survivor’s torment can be trying for even the most experienced therapist, “Listening to a victim talk about their innermost turmoil can be heartbreaking and the sense of helplessness and futility of a great wrong having been done and having no power to get justice for it is horrific.”

Aside from self-harm, certain rape survivors punish their bodies on a subconscious level by taking unhealthy lifestyle choices, “The body carries memories, so I start with the basic fundamentals, of recreating and replacing the old memories that the body has. The client learns to look after the body, by eating well, getting adequate and sound sleep, exercise, etc. [This is] incorporated into the treatment plan. Victims will stop eating or eat till they drop to numb the pain or as part of their depressive state. Physical areas are easier and very basic to begin with; we learn to walk first and then run. With therapy also I believe it begins with the basic and then goes deeper.”

While mending the body, Erum also focuses on the thought pattern of the survivor so that they can respond to their triggers better, “The person may start fearing everything and everyone. The slightest trigger may bring on a panic attack or severe anxiety or mood fluctuation.”

But the emotional battle can be quite complex, “Sadness, anger, lack of trust in oneself and others, these are some of the things that a person may go through. There may be repression and denial also. They may act as if nothing has happened, which is another form of defence mechanism used to deny the reality. If I think it did not happen or that it has had no impact on me then I will be fine.”

Sometimes the most powerful healing aid is spiritual, where survivors seek the deepest answers, “My job is not to convert them but to help them find the answers, and also to help them understand that not all questions will reveal their answers now, that they have to understand that there is a time and place for an answer. The universe or god or whatever we believe in has to run its course. We are mere cogs in the wheel in a bigger scheme. It starts with rebuilding faith in one self and a higher power, and ultimately learning to live and dream again.”

Published in Dawn, Sunday Magazine, October 26th, 2014