Sexual violence, including rape, harassment, and other forms of sexual assault, occurs in our society in high numbers. It is one of the most undisclosed and under-reported crimes, partially due to the shame and stigma faced by many of the victims and as a result, the crime is shrouded in silence and secrecy. A reluctance to disclose has been found to be a barrier to treatment, when treatment can often be of significant help in resolving the feelings of guilt, shame, fear, anger, anxiety, and depression that might follow a sexual attack.
Nevertheless, though sexual violence is a traumatic and life-altering experience, recovery is possible. A compassionate therapist who understands trauma, especially sexual trauma, and its effects is often able to help people who have experienced rape and other forms of sexual abuse. Research has consistently shown that the relationship between the therapist and the person in treatment is the most significant predictor of recovery. Hence, it is important for mental health professionals to intensify their efforts to support victims and survivors.
I had a quick chat with Mr. Victor Ugo about mental health challenges resulting from sexual assault and the mental health services that are available for survivors. Mr. Victor Ugo is a medical doctor, and the founder of Mentally Aware Nigeria Initiative, a non-governmental, nonprofit organization working to improve the dire state of mental health advocacy and care in Nigeria and Africa.
Where are the best resources for trauma-informed care in Nigeria?
Do you mean physical trauma or emotional trauma from the past?
I mean emotional trauma from sexual violence, I’m focusing on sexual trauma… sometimes when an individual has mental health challenges like depression, there are underlying causes, so trauma-informed care requires that mental health service providers dig deeper instead of only focusing on symptoms.
Oh ok! Yes, for most people that have a predisposition to mental health challenges, there’s emotional trauma in their past. What trauma-informed care does is to explore what happened in the past. Some of them might be repressed memory. I’ve seen cases where it took someone having a psychotic break to remember what she went through in the past. Things that were done to her by her father who she’s in good terms with, but the memory was repressed, the whole thing is just very confusing for her. So, yea, some mental illnesses are because of past trauma. However, talking about best resources for trauma-informed care…we don’t currently have such in the country. It is evidence-based, there are models to it that you’ll have to adapt but we don’t practice that here. We have practices like CBT, behavioral therapy, interpersonal therapy, etc. but extensively, trauma-informed care is a new model like you pointed out, I’m not sure it’s currently being practiced. Sure, therapists explore things that happened in the past while working with people, maybe during evaluations when they ask questions to go deeper into the individual’s history. But for best resources, other places to look for that is maybe in the UK, Canada, Australia. They have very good mental health systems and they have adopted this new informed method.
Where are the best resources for suicide intervention?
We have access to that ourselves at Mentally Aware Nigeria…
Do you have a hotline?
Yes, we do. People who are having suicidal thoughts or any form of emotional/psychological distress can call us at 08091196264. We’ve had the hotline for at least a year. It’s not toll-free, we call the person back. We recognize the importance of calling back because it gives the individual the opportunity to speak freely for however long they want to talk. We tried to get the Telcos to sponsor toll-free lines, but it didn’t work out, so we decided to go another route which is to call back every caller so that they won’t rush the call and they can really get talk about their issues. We’ve had more than 3000 call entries in one year. We have resources for media. We have resources for our trainers – they’re counselors but we train them, we have refresher courses for them as well.
Do you think trauma from sexual assault is chronic?
I think it affects the person extensively no matter how little. It chops up a bit from the person’s personality or sense of personhood and influences their future behavior. What they consider sex as, for example; for some of them, they don’t enjoy it but they just do it because it’s something they’re used to, or it is “required” of them or they’ve been conditioned to do it. While for some others, they enjoy it too much to the point of becoming addicts. Most of the sex workers we have, apart from financial circumstances, are doing that because of the way they were introduced to sex, most especially child sexual abuse. They develop low self-esteem and they don’t place so much value or seriousness on sex, it is what had been done to them when they were a lot vulnerable and defenseless, so they just carry on like it means nothing. I wouldn’t say chronic, but the repercussions stay with the person for life no matter how little it is. It does affect the victims in the way they think and how paranoid they are.
What can a survivor do if support from a mental health institution doesn’t help?
That’s a very key question. Most times some people seek mental health services from institutions but don’t receive the intervention they need. I think it’s to keep trying, keep looking for the service that suits you until you get the one that works for your specific need. If you need to change your therapist then it is within your right to do so, keep changing your drugs until you get the right cocktail and the same goes for therapists.
Is it possible to prevent mental health issues from resulting from sexual violence?
Well, it depends on how early it is caught on. If you start early to counsel the victim, then it can stop any future mental health challenges.
What should people do if they’re worried about a friend?
For one, you can speak to them but most importantly listen to them. When you listen to someone you get to understand a lot about their condition, about that thing you’re worried about, ask questions – not questions that will push them away but questions that can allow them to talk. Sometimes, just be there and don’t say anything. Be with them wherever they are, text, message:
“how are you doing?”
“Are your sure you’re doing alright?”
If you feel it’s bad then tell them you know somewhere you can refer them to, where they can talk to someone. That’s usually what happens, people tell us about a friend or loved one who is having a difficult time and we ask for the person’s number to call them…
Do they inform their friends before you call?
Yes, it is important that they inform their friends first before giving us a number to call or the individual who is in distress would shut us off and no progress would be made as a result. So, get permission first.