Understanding and Treating Military Sexual Trauma

By Kristen Zaleski

This authoritative update presents current findings on—and clinically and ethically sound responses to—the epidemic of sexual assault in the military. It examines in powerful detail how military culture enables a pervasive subculture of sexual violence, from consistently devaluing women to blaming victims and denying them justice. The author’s dual attachment/trauma theory lens attends to a wide range of outcomes such as unit members closing ranks against survivors and the continuing impact of assault trauma on veterans’ lives. And the book’s second half critiques standard forms of treating military sexual trauma in favor of individualized therapy addressing the physical, psychological, and neurological aspects of trauma and recovery.

 

This important volume covers:

 

·         Theory and history of sexual violence as a weapon of war.

·         Legal and health considerations in the aftermath of military sexual assault.

·         Critical distinctions between military and civilian legal response to sexual assault.

·         Variations in symptomology among survivors.

·         Specific barriers to services for male and LGBT survivors.

·         New and emerging treatment options for military sexual trauma/PTSD.

 

This Second Edition of Understanding and Treating Military Sexual Trauma follows its predecessor as an essential reference on its subject for mental health clinicians treating sexual trauma in the military as well as trauma researchers, sociologists, women’s health practitioners, and university students whose focus is women’s studies, public policy, public health, social work, psychology, sociology, or political science.                                                                    

• Language: English
• Publisher: Springer
• Release date: May 2, 2018
• ISBN: 9783319737249

Book preview

© Springer International Publishing AG, part of Springer Nature 2018

Kristen ZaleskiUnderstanding and Treating Military Sexual TraumaFocus on Sexuality Researchhttps://doi.org/10.1007/978-3-319-73724-9_1

1. The History of Sexual Violence in War

Kate Majewski¹ 

(1)

Veterans Affairs Medical Center in Long Beach, Long Beach, CA, USA

War provides men with the perfect psychologic backdrop to give vent to their contempt for women.

—Susan Brownmiller

The element of truth behind all this, which people are so ready to disavow, is that men are not gentle creatures who want to be loved, and who at the most can defend themselves if they are attacked; they are, on the contrary, creatures among whose instinctual endowments is to be reckoned a powerful share of aggressiveness.

—Sigmund Freud

Keywords

Wartime rapeSexualized violenceAggressionWeapon of war

In recent years, there has been an explosion of publicity in the United States into the issue of military sexual trauma. In researching this topic, a student might be tempted to focus on recent events as a means of understanding and conceptualizing it. Unfortunately, human history in many ways is one that has been recorded in blood, as it is replete with horrifying examples of violence. For instance, one of the first stories in the Bible is Cain slaying his brother Abel in a jealous rage (Genesis 4:8 New International Version). Archeologists studying excavation sites in what is now Germany found evidence that about 5000 years ago, Mesolithic hunter-gatherers slaughtered a village of men, women, and children, carefully placing their skulls as trophies in a cave as a sort of homage to their crime (Kiernan, 2007). Thus, any study of man’s cruel and brutal treatment of each other must extend further back.

Perhaps the only historical theme as old as violence is the relationship between sex and violence. As Hicks (1994) notes, this seeming marriage of Mars, the Roman god of war, and Venus, the goddess of love and sex, is a theme consistent throughout history. Similarly, in the twentieth century, Sigmund Freud linked the twin human instincts of Eros and Thanatos, or the innate life and death instincts residing in every person (Bourke, 2007). Historical examples include the founding myth of the Roman Empire, which included the forced capture and rape of Sabine women. The Greek epic poem Iliad details the Trojan War, which started after Helen, the beautiful wife of the king of Sparta, was kidnapped as a result of the sexual desire of Paris, the prince of Troy (Homer, Fagles, & Knowx, 1998).

More recent examples include the mass rape and brutalization of Belgian women by invading German soldiers in World War I (Brownmiller, 1975). Approximately 30 years later, German women experienced a similar nightmare, as an estimated 100,000–1 million German women were raped over the course of a few weeks in 1945 by Soviet forces entering Berlin (Grossmann, 1995). In 1968, US servicemen massacred hundreds of unarmed Vietnamese inhabitants of the small village of My Lai, raping and sexually brutalizing dozens of women and children in the process (Neill, 2000). Conflict-related sexual violence has occurred in approximately 51 countries in the past 20 years, a global scourge that has occurred in both developed and developing nations (Bastick, Grimm, & Kunz, 2007, p. 7). Although sexual violence is most commonly perpetrated by men against women, women have also participated in the violence, as demonstrated by the Abu Ghraib scandal. At this prison in Iraq, American soldiers, including women, sexually humiliated Iraqi detainees, some even taking photographs as trophies (Leatherman, 2011).

Other examples include when extremist group Boko Haram kidnapped 250 Nigerian girls from their school in April 2014. The group, whose name means Western education is sin, claimed it would sell the girls as slaves, in accordance with the group’s interpretation of Islamic teachings (Duthiers, Sesay, & Carter, 2014). In June 2016, a UN report found that the Islamic State was committing acts of genocide against the Yazidis, an ethnic and religious minority group, including the abduction and sale of Yazidi women and girls into sexual slavery (Human Rights Council, 2016). Subsequent reports claim that the rape and enslavement of these women and girls have become a formal part of the Islamic State’s organization and doctrine, with the promise of obtaining a sex slave being used as a recruitment tool to attract new members (Callimachi, 2016).

These examples demonstrate the long and horrifying relationship between military conflict and sexual violence. Although sexual violence has clearly been evident in military conflicts and institutions for a long time, the historical record rarely includes the voices of victims . Scholars argue this lack of study is attributable to several factors; the first is that it is often the victors who do both the raping and the recording of history, and thus there is little incentive to admit any transgressions (Brownmiller, 1975). A second reason is misogyny, as historians and policy makers often pay little attention to that which is not valued, namely, the health and safety of women (Hynes, 2004; Kristof & WuDunn, 2009). A third factor for this silence is cultural and social discomfort with sex and sexual violence. For instance, many victims refuse to come forward after conflicts out of a desire to avoid the shame and stigma associated with sexual victimization (Diken & Bagge Lausten, 2005; Leatherman, 2011). Additionally, for non-victims, comprehending the cruelty that humans are capable of inflicting on each other in the form of sexual violence is uncomfortable. This inability to comprehend such terror leads to silence and a resistance in the study of sexual violence and war. Unfortunately, refusing to understand an issue does not solve it, but rather prevents accountability for perpetrators and increases the shame and isolation of victims (Leatherman, 2011).

This chapter will explore some of theories scholars suggest in answering why sexual violence happens so often within military conflict. This chapter will also explore conflicts where sexual violence did not occur, perhaps illustrating that this issue is not a fixed one, but rather one that might be preventable for future generations.

What Is Sexual Violence?

Traditionally, rape has been legally defined as the unwanted penetration of a woman’s vagina by a penis or other item (Bourke, 2007). Unfortunately, rape is not the only form of sexual violence that occurs. For instance, forced marriage, sterilization, sexual humiliation, branding, sexual slavery, genital mutilation, and trafficking are all forms of violence commonly used in conflicts (Leatherman, 2011). Men, women, and children can all be victims of sexual violence. Additionally, lesbian, gay, bisexual, and transgender communities may face increased risk for violence as they are often subjected to legal, cultural, and religious discrimination (Bastick et al., 2007; Leatherman, 2011). Thus, sexual violence can take many forms and be perpetrated against a variety of groups. In 2005, the Inter-Agency Standing Committee Task Force on Gender and Humanitarian Assistance proposed a general definition for sexual violence that included

… any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances, or acts to traffic a person’s sexuality, using coercion, threats of harm or physical force, by any person regardless of relationship to the victim, in any setting, including but not limited to home and work. (Bastick et al., 2007, p. 19)

When examining sexual violence within the context of armed conflict, the question becomes when does sexual violence become a weapon of war? Or, how does sexual violence in war differ from acts during peacetime with civilian actors and when is that difference clear (Kelly, 2010)? Generally, scholars assert that this transition occurs when sexual violence is used as a part of strategic campaign that also has military aims or objectives. This determination is made by examining the individual acts of violence, such as rape by soldiers, but also the broader macro political and cultural framework in which such act (or acts) occurs (Hagen & Yohani, 2010; Skjelsbaek, 2001).

Sexual violence therefore becomes a weapon of war when the individual attacks on men, women, and children are also part of a strategy employed to obtain specific political or military objectives. Farwell (2004) argues that sexual violence during war is often used as an instrument of terror (p. 393) intended to control, coerce, or destroy certain populations.

Brutality and slavery are also characteristics of sexual violence in war . For instance, approximately 90% of rapes during violent conflicts are gang rapes (Hagen & Yohani, 2010). This behavior, labeled by Mukwege and Nangini (2009) as rape with extreme violence (p. 1), often features genital dismemberment, such as the cutting of breasts or penises or the insertion of objects such as glass or heated plastic (Leatherman, 2011; Thomas & Tiessen, 2010). In addition, military conflicts often provide soldiers the opportunity to enslave women and children for sexual purposes. For instance, a 2004 Amnesty International report found that women in Sudan often had their legs broken so that they could be raped repeatedly by soldiers and not be able to escape (Hagen & Yohani, 2010). These characteristics allow soldiers to demonstrate their limitless power over the subject population, as well as their devotion to their units or leaders (Hagen & Yohani, 2010, p. 17; Neill, 2000).

Finally, sexual violence becomes a weapon of war when it has characteristics of ethnic cleansing or when a group is targeted based on their shared race, ethnicity, religion, or culture (Engle, 2005; Hagen & Yohani, 2010; Milillo, 2006). Examples of this included forced pregnancy and the mass rape of women of a certain tribe or religious group (Skjelsbaek, 2001). In these cases, sexual violence is not just a crime against an individual victim but a part of broader political or military objective to subjugate or eradicate an inferior group (Farwell, 2004; Neill, 2000).

Theories on Sexual Violence

The biological theory of sexual violence sees men as inherently sexually aggressive, with war providing the opportunity for this trait to be expressed (Gottschall, 2004; Snyder, Gabbard, May, & Zulcic, 2006). Those relying on this theory cite the structure of male anatomy (e.g., forced sexual intercourse is possible with a penis) and the long history of males fighting over access to female reproductive assets (Brownmiller, 1975; Neill, 2000). Thus, according to this theory, humans fight and rape because it is in their nature to do so. Similar to Freud’s understanding of drives, this approach sees rape as an inevitable, genetically predetermined reflex (Gottschall, 2004, p. 133).

While the biological approach looks primarily at innate influences, most other theories consider the sociocultural contexts of sexual violence. One of the first theories to do this was feminism, which has within it several different schools of thought (Gottschall, 2004; Skjelsbaek, 2001). The first is essentialism , which derives from radical feminism (Leatherman, 2011). This approach views sexual violence during wartime as a natural expression of the patriarchal hierarchy that has historically existed between men and women. As masculinity has traditionally been viewed as powerful and femininity associated with passivity, behavior during war is simply a natural extension of this relationship. Thus, sexual violence is just men acting out their natural role of male aggressor, seeking to dominate and exploit what they view as their possession, namely, the bodies of women (Brownmiller, 1975; Skjelsbaek, 2001). Thus, for essentialist theorists, when men rape during times of conflict, it is simply boys being boys, or as Leatherman (2011) states: It is what men do to women when they can… (p. 14).

Structural theory also relies on feminist theory but seeks to also incorporate ethnic, religious, political, and racial contexts as well (Leatherman, 2011). This approach criticizes the essentialist approach for being reductionist and deterministic, meaning it views all women, regardless of class, age, race, or religion, as victims and all men as perpetrators (Leatherman, 2011; Skjelsbaek, 2001). Scholars using this approach argue that not all women have the same risks in war. In many conflicts, certain groups are targeted more than others. For instance, in El Salvador, women who were supporters of guerilla groups fighting government forces were often targeted for sexual attacks, meaning their political and sexual identities increased their risk for sexual violence (Bastick et al., 2007; Skjelsbaek, 2001; Wood, 2006). Under this theory, women are targeted in war when they represent female embodiments of other socio-cultural identities, or when their gender intersects with their political, religious, ethnic, and racial identities (Skjelsbaek, 2001, p. 223). Thus, this theory explains sexual violence in conflict as not solely attributable to patriarchy and misogyny. Rather, it examines when men belong to groups with power (e.g., political, ethnic, religious) and how this affects women and girls of the same, or other, groups (Leatherman, 2011). One benefit of this theory is that it views female identity, and not male aggression, as the primary aspect worth studying, thereby raising awareness of the trauma suffered by women and girls in armed conflict (Leatherman, 2011; Skjelsbaek, 2001).

A related theory is social constructionism , which rejects the notion that gender is fixed or should be solely understood through patriarchy. Rather, it views gender, and gender roles, as constructed or artificially created within a society or culture. Generally skeptical about broad categories or narrow dichotomies (e.g., male versus female, victim vs. aggressor), this approach instead examines how acts are shaped and constrained by the system of power relations, and how behavior either reproduces or reinforces that system (Leatherman, 2011, p. 17; Skjelsbaek, 2001). Thus, under this theory, gender is something a person does, as opposed to something that person is (Gerecke, 2010). As a result, sexual violence during wartime would be viewed through the lens of the norms, rules, and beliefs about social behavior that prevail in such transaction (Leatherman, 2011). For instance, social constructivist theorists would point to situations where males are victims of sexual violence or where females act as perpetrators. Neither of these could be easily explained by the theories listed above (Leatherman, 2011; Skjelsbaek, 2001). This theory would argue that to act masculine is often associated with exerting power over someone weaker, who is often seen as feminized. Thus, in the case of a sexual assault against a female of another group, the perpetrator seeks to masculinize (or gain power) his identity as a male and member of his group and feminize (or make weak) the identities of the female victim. This approach would also explain situations where males are victims and women are aggressors, as the actors in such situations would be similarly feminized (or victimized) or seeking to express power (masculinized) through their actions (Skjelsbaek, 2001). This theory rejects the notion that gender is static or fixed. Rather, it argues, a much broader context of systems, beliefs, and norms must be examined to explain how gender is expressed within a situation (Gerecke, 2010; Leatherman, 2011; Skjelsbaek, 2001).

Related to the social constructivist theory are cultural theories of understanding sexual violence. These attribute acts of violence that occur within conflicts or military institutions to aspects of military culture. As an institution, the military is hierarchal, dominated by males, and often socializes its members to be masculine (aggressive) and devalues what is feminine, or weak. In addition, it is also a system that views violence as a legitimate means of resolving conflict (Farwell, 2004; Meger, 2010; Trenholm, Olsson, & Ahlberg, 2011). Thus, under culture theory, sexual violence in war and within military institutions is a natural product of the hyper-masculine climate of abuse and antipathy towards women (Meger, 2010, p. 122). Similarly, other scholars argue that war, with its ability to destroy social order and norms, makes sexual violence seem less taboo and therefore rational and permissible (Baaz & Stern, 2009; Chang, 1997). For instance, when soldiers are trained to kill, or accept being killed in action, would the ethics of sexually assaulting a woman remain clearly wrong for that soldier? As one Japanese soldier explained, If my life was not important, an enemy’s life became inevitably less important… (Chang, 1997, p. 58).

Another theory that attempts to explain sexual violence in wartime is the strategic rape theory . It relies on the pragmatic view that rape can be, and often is, used as an extremely effective weapon of war. Like a bomb, sexual violence against civilians or other soldiers can serve a military or political objective (Gottschall, 2004). For instance, it can terrorize civilian populations as a way to decrease resistance. It can also be used to emasculate enemy fighters, thereby demoralizing them (Farwell, 2004). In addition, military leaders often use the promise of access to women as an enticement to soldiers, hoping to motivate them, build group cohesion, and control libidinal energy (Diken & Bagge Lausten, 2005; Hynes, 2004; Morris, 1996; Rosen et al., 2003).

Finally, rape can be used as way to destabilize the social and family structure of the enemy. As Diken and Bagge Lausten (2005) argue, if one aims to destroy an ethnic group, women are good targets in the family structure….Raped women should therefore stand as a metaphor for a defeated community (pp. 115–116). Raped women are often seen as spoiled and are rejected by their communities (Diken & Bagge Lausten, 2005; Leatherman, 2011). Thus, the raped women is not only assaulted, but her community, family, and culture are also attacked and weakened (Farwell, 2004; Gottschall, 2004). Thus, this theory argues that sexual violence not only physically harms individual enemies but also has the insidious ability to fray the fabric of their communities. This is why it so often planned, encouraged, and employed in conflicts around the globe (Gottschall, 2004; Leatherman, 2011; Meger, 2010). An example of this strategic targeting was seen in the conflict in Rwanda, where allegations surfaced that Hutu militia leaders specifically ordered HIV-positive members to rape Tutsi women as a way to infect them and spread disease in the community (Thomas & Tiessen, 2010). This theory is therefore primarily concerned with examining the ultimate goals of the actions in a macro context and examining how military and political groups commonly utilize sexual violence against specific groups for certain purposes.

Borrowing from a wide variety of disciplines, the theories above provide a foundation for explaining why sexual violence occurs in wartime. Each theory has its strengths and weaknesses and should be employed with caution so as not to exclude, marginalize, or minimize any individual’s or entity’s role. Below are descriptions of recent examples of sexual violence that has occurred during military conflicts. Which theory do you think best explains these events?

Modern Examples of Sexual Violence in War

(a)

TheRape of Nankingand theComfort Women

In 1931, Japan invaded Manchuria, then part of the Republic of China. As part of the invasion, the city of Nanking was occupied (Chang, 1997). The city fell on December 13, 1937, beginning weeks of terror for the Chinese civilians trapped in the city. Called The Rape of Nanking , this period saw unspeakable cruelty and violence unleashed on the population by Japan’s military, with approximately 260,000 civilians killed and 20,000–80,000 Chinese women and girls were raped (Aydelott, 1993; Chang, 1997; Hicks, 1994). European missionaries within the city attempted to warn the world of the atrocities taking place within Nanking, sending out messages describing the decapitation contests held by soldiers, disembowelment of raped women, and use of torture such as castration, live burial, and hanging (Chang, 1997).

Some historians attribute the brutality exhibited during this period to Japanese military training, which was notoriously strict, hierarchical, and violent. According to Chang (1997):

The Japanese solider was not just hardened for battle in China; he was hardened for the task of killing Chinese combatants and noncombatants alike. Indeed, various games and exercises were set up by the Japanese military to numb its men to the human instinct against killing people who are not attacking. (p. 55)

Recruits were often beaten with spiked boots or belts and made to fight other recruits, a strategy meant to secure instant obedience and acceptance of authority (Hicks, 1994). Other experts argue that Japanese cultural norms encouraged the behavior, in particular rape. These include the belief that raping a virgin made a soldier more powerful in battle (Chang, 1997).

As the rest of the world heard of the atrocities occurring at Nanking, the Japanese government was criticized for the harm caused to civilians. This criticism led Japanese military and political leaders to create a new strategy, or the organization of military brothels as a method of containing and controlling sexual violence (Chang, 1997; Hicks, 1994; Wolfe, 2014). This strategy called for the creation of complex web of brothels that would be staffed by comfort women . Unfortunately, this plan called for the kidnap, purchase, and forced prostitution of between 80,000 and 200,000 women in Southeast Asia (Chang; 1997; Hicks, 1994). By forcing these young women to sexually service Japanese soldiers, the Japanese government hoped to reduce the embarrassing rape of local women (which might decrease the local population’s willingness to support the Japanese), limit the spread of sexually transmitted disease, and provide soldiers with the reward of access to sex (Chang, 1997; Copelon, 2000).

These comfort women were often kidnapped or enticed with false promises of receiving jobs such as housework (Hicks, 1994; Wolfe, 2014). Often forced to live in camps close to the battlefield, many women were forced to sexually service as many as 20–30 men per day (Barstow, 2000). These women were primarily Korean; however, many originated from the Philippines, Malaysia, and Burma, ethnicities traditionally viewed by Japanese as culturally inferior (Copelon, 2000; Wolfe, 2014). Women lived with the threat of beatings, contracting sexually transmitted disease, pregnancy, and death from military engagement (Hicks, 1994; Lee, 2003). After the war ended, many comfort women were killed in military action or abandoned and left to make their way home. Unfortunately, many of these women found themselves as permanent exiles in their communities, labeled dirty and publicly humiliated for the sexual crimes committed against them. Facing incredible social and cultural stigma, many women elected to never speak about their experience (Barstow, 2000; Hicks, 1994; Wolfe, 2014).

Until recently, very little was known about the comfort women. After World War II ended, Japanese military leadership was never charged for their crimes against these women (Wolfe, 2014). It was not until the 1980s, when South Korean women’s groups began to demand accountability from the Japanese government, was any substantial coverage provided to this issue (Lee, 2003; Wolfe, 2014). The attention largely began after the discovery by Japanese historians of official documents showing the full support by the Japanese government during World War II of the creation and maintenance of the comfort women brothel system (Copelon, 2000; Wolfe, 2014). This discovery prompted lawsuits from several surviving comfort women, demanding reparations for their suffering and an official acknowledgment of what occurred (Lee, 2003; Wolfe, 2014). To date, such efforts have been unsuccessful, and the Japanese government has been strongly criticized by human rights and women’s rights groups for their continued refusal to accept legal responsibility for the crimes committed against the comfort women. In particular, groups cite the lengths the Japanese government has gone to suppress information about official government involvement with the comfort women, such as excluding all mention of them from memorials, museums, and school textbooks (Chang, 1997; Lee, 2003; Wolfe, 2014).

Unfortunately, the few comfort women who survived now face the double insult of lengthy legal battles and a historical record that denies their suffering and excludes their stories. Some women’s group blame this silence on the historic tendency to downplay and excuse sexual crimes against women, especially women of color (Wolfe, 2014). Korean feminist Chung Hyun-Kyung (2000) asserts that:

Neither the Korean nor the Japanese government wanted to talk about what happened to Korean women during World War II . For Korean men it was too shameful for their egos to accept what happened to Korean women, and there were more important things they needed to talk about in relation to Japan. And for Japanese men it was too guilt