Carolyn Zerbe Enns

Feminist therapy is an approach to recovery that emphasizes an egalitarian counseling relationship, goals that are consistent with achieving equality in the full range of human relationships, and a perspective that explores the sociocultural, ecological context in which life issues are experienced. Feminist counseling highlights the "personal as political," which means that personal issues are seen as connected to the social structure in which we live and have implications for social as well as personal change. This set of assumptions has significant implications for how healing after sexual violence is viewed by feminist counselors.

Feminist therapists think of symptoms of individual distress, including the consequences of sexual violence, as survival mechanisms. They see clients who have experienced violence as coping with their life challenges to the best of their ability, and the psychological challenges associated with the aftermath of sexual violence represent "normal" reactions to abnormal circumstances. In other words, feminist therapists believe that "not all symptoms are neurotic. Pain in response to a bad situation is adaptive, not pathological" (p. 90).1 This perspective means that the therapist treats the client as her (or his) own best expert, and together, a counselor and client work as partners to uncover issues and promote healing. The client's efforts to contend with the consequences of violence often appear as disorienting symptoms. The job of the client and counselor is to sort out how to transfer or redirect the personal energy that results in these symptoms toward methods of achieving health and resolution.

The words feminist or feminism are sometimes assumed to be relevant only to women, and even more specifically, white women. As black feminist bell hooks's2 book title notes, however, Feminism is for everybody.

Inclusive feminisms involve a commitment to ending all forms of oppression and are attentive to the intersections of racism, classism, colonialism, heterosexism, ethnocentrism, ageism, ableism, sexism, and other forms of inequality. Although sexual violence is disproportionately perpetrated by men against women,3 both men and women can be survivors of sexual violence and both men and women can be perpetrators of sexual violence. These understandings are central to the content of this chapter.

CASE STUDY: WHY FEMINIST THERAPY?

The following personal experience conveys why I believe a feminist approach is a necessary option for healing. Shortly after I identified myself as a feminist counselor, I worked with a woman who had been raped and then revictimized in an unequal psychotherapy experience. Some weeks into our work together, my client (who I will refer to as Anne) disclosed details about a previous experience with therapy that Anne had initiated after she had been raped by someone who had broken into her home. Her traditional psychoanalytically trained therapist suggested that at some deep and nonconscious level, she had experienced a type of masochistic pleasure during the rape. Although this psychotherapy had occurred about ten years prior to our work together, it was still very much on her mind. Anne was confused and angered about the feedback she had received, and mystified about how an event that was so devastating could have been construed by her therapist as an act that gave her masochistic satisfaction. Rather than helping her cope effectively with the aftermath of sexual violence, her psychotherapist had contributed to self-blame and self-questioning attitudes that had kept her in a state of psychological paralysis. I was shocked and appalled by Anne's story and conveyed my distress that a therapist would propose such an outrageous hypothesis. During the ensuing weeks, we spent much time challenging the rape myths that had been reinforced by this experience. Her trust slowly increased as we challenged myths, worked to understand her experience within the context of a culture that supports blaming victims, and developed new and productive tools for reaching her goals.

The therapist my client had seen worked from a classical psychoanalytic model that viewed women as passive, narcissistic, and masochistic. This triad of "feminine" traits had its origins in Sigmund Freud's4 views about the differences between the sexes and was further developed by some of his followers, including women psychoanalysts such as Helene Deutsch.5 With regard to masochism, this approach proposed that women may unconsciously seek out pain and suffering, and may become attuned to these experiences of pain through childbirth and other life experiences. Freud's original ideas about women were not the only ones to support negative views. In the area of intimate violence, an influential article from the 1960s was titled "The Wifebeater's Wife"6 and proposed that a husband's aggression fulfilled the wife's masochistic needs to maintain equilibrium through a relationship that cycled between passivity and aggression. It is important to note that since the 1960s, feminists have worked to correct these biases and have proposed psychoanalytically informed feminisms that are compatible with feminist counseling practices.

The views described in the previous paragraph reveal the biases embedded in early psychological theories. In her groundbreaking book titled Women and Madness, Phyllis Chesler7 compared the traditional therapy relationship to that of a patriarch and patient. She described the traditional psychotherapy encounter as "just one more instance of an unequal relationship, just one more opportunity to be rewarded for expressing distress and to be 'helped' by being (expertly) dominated" (p. 140). The client's belief in her helplessness and dependency on an all-knowing figure is reinforced in such a relationship. This scenario is consistent with the negative therapy experience I summarized in the case study, in which a therapist imposed a narrow view of sexual violence on his client by suggesting that she had at some level seen her rape as fulfilling a masochistic need. To counteract these views, feminist mental health workers who were influenced by the women's movement of the 1960s and 1970s proposed new forms of therapy and recovery. These feminist therapies emphasized the importance of consciousness-raising about how inequality influences problems. They also proposed healing approaches that valued women's perspectives and empowered them to take control of their own lives as well as change social systems that serve victims of violence.

In response to the efforts of feminists, rape crisis centers and domestic violence shelters also emerged as places where victims of violence could experience validation and recovery in safe environments. Feminist mental health workers identified acts of sexual violence as events that traumatize and challenge one's sense of meaning and safety in the world, and labeled predictable patterns of symptoms as rape trauma syndrome8 and battered woman syndrome.9 These descriptions connected the personal and political by showing how violence, which is learned by the perpetrator from the culture, can shatter an individual's sense of safety and trigger disorienting personal symptoms. More specifically, the survivor's personal pain is not the result of some type of inner weakness or pathology, but the consequence of a society that tolerates violence. The personal repercussions of violence tell us about the need for political and social change. Early activists also clarified how violence can lead to changes in a person's internal self-structure and result in learned helplessness, avoidance behaviors, emotional numbness or other distortions of emotions, jarring nightmares or flashbacks, or disrupted cognitive experiences such as self-blame and confusion. Many of these reactions are now reflected in the diagnostic category of posttraumatic stress disorder (PTSD),10 which identifies patterns of emotions, cognitions, and behaviors that often follow traumatic events of many types.

Feminist approaches have grown in influence and diversity over the past forty years. The following sections focus on the social context of violence, phases of trauma and recovery, the feminist counseling relationship, assessment in feminist counseling, and feminist interventions.

THE SOCIAL CONTEXT OF SEXUAL VIOLENCE

Sexual violence is a global issue, and survivors of sexual violence live in societies in which sexual violence myths are rampant and permeate popular culture. Survivors are at risk for internalizing these messages, often at an unconscious level. Challenging these social beliefs is a major aspect of working toward wholeness. These myths include the belief that victims secretly desire to experience sexual violence, that women "ask" for assault by acting or dressing in seductive ways, that sexual assault is primarily a consequence of men's stronger desire for sex, or that the perpetrator didn't really mean to assault the victim. Other myths include notions that victims exaggerate the impact of sexual assault, that victims should be able to "get over it" quickly, or that only strangers can be perpetrators of sexual violence. Furthermore, those who do not fight back physically but seek to survive assault through other methods are not seen as "real" victims, and victims who bring charges against perpetrators are often defined as trying to get back at men for various imagined wrongs from the past.11,12,13,14

The first myth on the list, the belief that women secretly desire to be violated, is consistent with the rape myth held by the therapist I described in the case study, pointing to the degree to which myths are widespread and can revictimize those who experience assault and other forms of sexual violence. The presence of these myths also underlines the reason a socio-cultural, ecological perspective is central to recovery from sexual violence. During feminist therapy, therapists typically explore the ways in which the victim/survivor has internalized negative beliefs about sexual violence, and help the client challenge these beliefs. Therapists may also counter these myths by providing information based on research about the realities of rape. Unfortunately, the legal system and even well-intentioned persons in one's support system often convey victim-blaming attitudes that make it difficult for survivors to transcend the power of sexual violence myths.15,16,17 Patricia Rozée18 identified "normative" or condoned rape in 97% of the thirty-five societies she examined. Normative sexual violence takes on a variety of different forms such as marital rape, exchange rape (rape as a bargaining tool), punitive rape (rape designed to punish a family or group), ceremonial rape (e.g., rape as an introduction to womanhood), rape as a weapon of war, and acquaintance or date rape.19,20 Sexual violence may also reinforce male status over women or the power of one ethnic group over another. Although the right to experience freedom from violence is recognized as a fundamental human right, evidence indicates that sexual violence is a global health burden21 with major implications for both physical and psychological health. In other words, the personal act of violence has political implications. Thus, feminist therapy, which recognizes the link between the personal and political, is an important foundation for working toward healing. From a feminist perspective, change needs to occur at individual, interpersonal, family, community, national, and global levels.22,23,24

PHASES OF RECOVERY FROM A FEMINIST PERSPECTIVE

Recovering from sexual violence often involves a long-term process. Survivors often (but not always) experience a series of predictable stages during their journey toward wholeness, and knowledge of these common experiences may decrease self-blame and increase patience toward oneself.25 As noted in the previous section, sexual violence occurs in a social context in which myths about sexual violence are widespread. Thus, the first phase represents presexual violence events and sociocultural beliefs. These realities may contribute to women's fears about freedom of movement even before acts of sexual violence occur. Given the power of this cultural climate and the fact that those who experience sexual violence are also likely to be revictimized by inadequate legal, medical, and social support services, this social context represents the first phase of a phase approach to understanding sexual violence and its impact on individuals.

The second phase consists of acts of sexual violence, including the specific sequence of events that occurred before, during, and after sexual violence.26 At this point, immediate survival and escape are the central concerns of the victim/survivor. In the case of a specific incident of rape, these events tend to occur over a relatively circumscribed time span. In contrast, when the individual is a victim of long-term sexual harassment or intimate violence, physical escape may not be possible, and mental coping skills for dealing with ongoing violence may become priorities. The different interpersonal contexts of long-term and shorter-term interpersonal violence have an impact on the nature of a survivor's immediate coping needs and symptoms.

Crisis and feelings of disorganization typically follow sexual violence. Although reactions to violence vary, one early study found that 94% of all rape victims experienced significant traumatic stress symptoms in the immediate aftermath of sexual violence.27 Acute reactions of distress are com mon, and a recent study found that three months after surviving rape, 45% of victims met PTSD criteria.28 Another study found that among women survivors who experienced PTSD, 52% also experienced depression.29

Following an acute phase, individuals tend to cope by getting back to "normal" life as quickly as possible. This period may be marked by efforts to avoid thinking about violence by practicing forms of denial or minimizing the impact of the violence.30 However, the types of coping mechanisms used by victims/survivors vary substantially, with some individuals more likely to use adaptive, problem-focused coping than avoidance or denial.31 When individuals experience long-term sexual violence, they are more likely to experience dramatic, complex changes in self-image or emotional experience or idealize perpetrators in order to cope with violence from which they were/are unable to escape physically.32

Although denial and pretending that nothing has happened are frequent coping mechanisms, they are difficult to maintain for long periods, in large part because of the psychological and stress-related costs of these alternatives. As a result, victims often find themselves reliving scenes related to violence or finding that it becomes more difficult to control or "contain" their reactions.33 It is not unusual for individuals to avoid seeking counseling until they experience the disorienting symptoms associated with this phase. During this phase, the counselor and client work on remembering and processing the fragments and details of sexual violence for the purpose of creating a new story in which the survivor gains increasing control and perspective.34 A final phase can be referred to as resolution and integration. The survivor finds ways to place sexual violence within a larger perspective, often making a transition from feeling victimized to experiencing a sense of greater empowerment. Survivors may also find meaning and purpose by engaging in prevention, social change, and activism that contribute to a safer world for others.35

The past events, current circumstances, and learned patterns of behavior of a woman contribute to significant diversity with regard to how women react, cope, and experience distress and recovery. The "phases" described in this section provide only one example of how crisis and healing may unfold. Some phases may not be present, and the ordering of typical reactions may vary, reflecting the many individual and cultural differences among victims and survivors. The following sections provide greater detail about the type of counseling relationship, assessments, and interventions that help individuals move effectively through these phases of recovery.

THE FEMINIST THERAPY COUNSELING RELATIONSHIP

During the twenty-first century, a wide range of counseling approaches have emphasized the importance of a collaborative partnership as a foundation for successful psychotherapy and recovery. Feminist therapists were some of the first mental health workers to identify an egalitarian relationship as central to successful recovery. In order to counteract the negative impact of sexual violence, a counseling relationship marked by safety is essential.

To convey respect for their clients, feminist therapists believe that it is important to be aware of their personal values and to be well informed about the potential life experiences of diverse groups of women, such as women in poverty, lesbians, adolescent girls, women of color, and older women. Feminist therapists typically communicate their feminist values to their clients while also conveying their respect for a client's worldview, personal experiences, and values. More specifically, feminist counselors convey their belief that persons working toward recovery from violence are competent and capable persons who, despite current coping difficulties, have many insights that will contribute to their healing. Although clients have often learned to question their competence or defined their own behaviors as "crazy," the therapist helps clients to gradually redirect their energies from battling symptoms toward enhancing positive coping. The role of the therapist is to act as a knowledgeable guide and resource person to clients as they eradicate "patient identities," redirect perceived weaknesses into strengths, and generate plans for building new skills.

The feminist counselor seeks to model communication skills such as genuineness, confrontation, self-disclosure, empathy, and congruence as methods for establishing egalitarian relationships. When clients enter counseling, they often feel isolated and inadequate and may believe that the counselor is an all-powerful expert. In such instances, the counselor may use brief self-disclosure statements to communicate that she (or he) is a human being who must also work to resolve problems and difficulties or who may have worked through the effects of violence or broken trust. When a client has the opportunity to see the counselor as a coping role model, psychotherapy is demystified, and an egalitarian climate is rein-forced.36,37 In addition to being a coping role model, the therapist provides a climate of safety and one in which the client can express the full range of her or his emotions without needing to fear that his or her reactions and feelings may overwhelm the counselor. Given the fact that disconnection and disempowerment are major markers of sexual violence, a therapeutic relationship that supports open expression, relational support, validation, and safety is central to the healing process.

In general, feminist therapists work toward implementing a reciprocal model of influence in which counselors share power, avoid making decisions for the client, and communicate confidence in the client's decision-making skills.38,39,40 The counselor participates as a colleague in order to ensure that the client develops problem-solving skills that will help her (or him) become her (or his) own therapist in the future. Although the feminist counselor works toward eliminating artificial boundaries and models egalitarian behaviors that support a client's negotiation of effective relationships both within and outside of counseling, the feminist counselor remains mindful that she or he brings skills and expertise to the relationship and shares these skills generously and respectfully.41,42,43

As part of the egalitarian relationship, the feminist counselor works together with the client to clarify goals, ensure that the client and counselor maintain a clear focus in their work, and minimize the risk of misunderstandings. When goals are clearly specified, clients are able to take greater responsibility for their change and evaluate progress regularly. Clients have more information about what they can expect from the counselor and what the therapist expects of the client.44 This predictability can also help the survivor recover from the disorientation and violation associated with sexual violence. As the counseling relationship evolves, the client is likely to assume a more active and collaborative role in decision making and is able to take higher levels of responsibility within counseling and within their daily lives.

Many feminist counselors also provide their clients with written rights and responsibilities statements, which include descriptions of their approach to counseling, areas of strength or expertise, views about how feminism influences their counseling practice, as well as expectations about the client's role in counseling. Depending on a client's specific needs, expectations for the client may involve participating in homework assignments, trying out specific types of coping skills, disclosing intense or suicidal feelings if they emerge, or raising questions on occasions when the client disagrees with the counselor. An important aspect of informed consent involves creating an environment in which the client can feel comfortable about asking questions about the direction and focus of counseling. To counteract the disempowerment they experienced as victims of violence, clients need to know that "they have rights and privileges that do not disappear no matter how frightened or vulnerable they feel" (p. 166).45 In addition, "the therapist is committed to the protection of those rights and sees the empowerment of the client as integral rather than incidental to the therapy process itself" (p. 166).

ASSESSMENT IN FEMINIST COUNSELING

Comprehensive assessment allows the counselor and client to gain a complete sense of the client's background and history, symptoms, and coping skills and strengths. It is crucial for the counselor to understand the symptoms that disrupt survivors' experiences as well as the resources and strengths they have used to cope with life difficulties. Knowledge of coping resources provides a foundation for building confidence for the future and supports a growth-oriented approach.

Feminist counselors are likely to ask questions about the various ways in which the client has experienced empowerment and disempowerment. Gaining information about the impact of race, culture, social class, ethnicity, disability, sexual orientation, and gender on a person's life is important for understanding the impact of trauma as well as supporting successful coping. Abuses of power and experiences of oppression in a person's past may contribute to personal vulnerability as well as provide clues about how sexual violence myths may have an impact on survivors.

Revealing sexual violence to a stranger is difficult, and survivors may choose to disclose "safer" problems when they first enter counseling. Given the high frequency with which violence is related to psychological coping difficulties, feminist counselors are likely to ask all new clients whether they have experienced sexual violence. When appropriate, therapists may also use various trauma assessment questionnaires to gain a more complete sense of the types of symptoms that are disrupting the clients' equilib-rium.46 The feminist counselor will typically ask about any history of sexual violence within the context of a comprehensive social identity analysis.

Social identity analysis, the cornerstone of feminist assessment, can be defined as a variety of activities designed to explore a person's multiple identities related to gender, culture, race, religion, class, sexual orientation, and other personally relevant domains. The purpose of this assessment is to understand a client's life challenges and sources of empowerment or support, as well as their implications for change at personal, interpersonal, and institutional levels. One of the goals of these activities is to explore and raise consciousness about how a person's membership in these categories affects her or his life experiences and worldview. For example, the counselor explores the costs and benefits associated with these identities, as well as their implications for personal, interpersonal, and institutional change.47,48 Knowledge of the person's cultural socialization and multiple identities reveals information about her or his experiences of disempower-ment (e.g., being a member of a sexual or ethnic/racial minority group) or privilege (e.g., white or male status) and can be central to understanding the impact of sexual violence.49

Social identity assessment includes efforts to clarify the "rules" and expectations connected to various identities and how they affect the client's approach to the world and the challenges she or he faces. For example, women receive a wide variety of messages about what it means to be a woman, as well as what roles and behaviors are "appropriate." Families, friends, teachers, and other significant others convey a wide variety of "shoulds" about being a woman or man. Exploring these "shoulds," which are often subtle and unspoken, can provide insights about how women and men have been taught to cope with gender role expectations. As another example, women are often taught to be "nice" rather than assertive, to blame themselves for not fulfilling traditional gender roles adequately, or to question their realities when challenged by persons with greater power. These "rules" for behavior can interact with sexual violence myths and complicate healing from sexual violence experiences. Sexual violence can also illuminate or sensitize the survivor about how the culture supports sexual aggression or promotes dichotomized views of women as "virgins" or "whores."50 Following sexual violence, survivors may be acutely aware of how gender socialization and other social identities are related to feelings of disempowerment associated with sexual violence as well as to other experiences of gender or racial discrimination. As they become sensitized to how sexual violence has reinforced other aspects of discrimination and social control, they may gain heightened access to strong feelings of anger. During feminist counseling, finding ways to channel this anger into productive healing and social change activities is a priority.

The gender role training of men can also contribute to coping difficulties and distortions. For example, men are encouraged to be powerful, controlling, and aggressive. These socialization messages and popular culture may lead some men to believe that paying for a date entitles them to sex. They may have learned to believe that a "no" from a woman means "maybe" or "yes." Although the focus of counseling is on healing for the survivor, there is value in exploring how a male gender-role conflicts and beliefs about power and dominance may have contributed to a victim's (either male or female) vulnerability. Gaining insight about these attitudes may also help reduce a person's self-blame and provide a foundation for feminist prevention training with men.

Stereotypes associated with diverse groups of women can be especially harmful and complicate healing. For example, Asian women are often placed into the polarized categories associated with the "China doll," which signifies subservience, compliance, and passivity, and the "dragon lady," which conveys a sexually opportunistic and cunning image.51 For African American women, the Jezebel stereotype, which dates back to slavery eras, portrays Black women as hypersexual, promiscuous, and seductive. This image in combination with general rape myths contributes to invalidation and a lack of sensitivity to African American women's experiences.52,53 Exploring and challenging the impact of these types of stereotypes may be crucial to social identity analysis and healing. The cultural, ethnic, and familial backgrounds of victims can also represent powerful sources of support and resilience. Assessing these strengths provides a foundation for building positive coping skills.

To summarize, social identity assessment is used to place sexual violence within a larger social context. It helps individuals (a) identify socialization, expectations, privileges, and oppressions related to multiple identities; (b) clarify the ways in which these messages and associated behaviors are reinforced or punished; (c) consider the costs and benefits of expectations attached to various social identities and gender roles; and (d) understand areas of resilience and strength associated with multiple social identities. This reflection phase is followed by decision making about challenging restrictions, and constructing new expectations and behaviors that are supportive and empowering. The final phase of gender and social identity analysis focuses on developing strategies for enacting changes.54

INTERVENTIONS IN FEMINIST COUNSELING

Prior to the emergence of feminist counseling approaches, most models of psychotherapy focused primarily on the importance of removing pain and helping clients adjust to existing realities, even if they were embedded in unjust circumstances. Although removing pain is a crucial step to healing, feminist counselors emphasize the value of transformative change for the individual as well as the culture. As noted by Mary Ballou and Carolyn West,55 "The goals of feminist therapy are not about achieving a better, a quieter, a more compliant fit within a system that oppresses" (p. 275). Feminist therapists work with their clients to build personal resources to challenge the social attitudes and expectations that have contributed to their pain. Many of the specific interventions that feminist counselors use resemble those used by other therapists who do not refer to themselves as feminists. The tools used by the counselor depend, to a large degree, on the phase of recovery that is most relevant to the client. Distinctive to a feminist approach are its dual emphases on personal as well as social change and its philosophical assumption that equality is an important goal for all types of counseling issues. In other words, feminist counseling is concerned with all forms of social justice and seeks to eradicate multiple forms of oppression at personal and social levels.

Many clients seek counseling when they are feeling paralyzed by a variety of traumatic memories and reactions. In this case, one of the first goals of feminist therapists is to help their clients work through the disorienting symptoms that may limit their ability to function effectively. A variety of studies show that exposure to painful memories and symptoms is crucial for decreasing the intensity of traumatic memories, gaining new perspectives, decreasing anxiety, increasing mastery, and developing skills for reorganizing one's life and moving forward.56,57 Interventions that help clients work through traumatic symptoms and memories focus on a variety of tasks including writing about trauma or visualizing trauma, challenging distorted thinking patterns about trauma, developing breathing and other skills for coping while processing painful memories, and reorganizing one's thinking about traumatic events. The feminist counselor is attentive to the timing and pacing of exposure to traumatic experiences and also helps the client develop self-nurturance and coping skills for dealing with occasions when disruptive memories or traumatic symptoms emerge outside of the safety of the counseling relationship. The goal of these techniques is to reestablish a client's sense of safety, trust, power, esteem, capacity for intimacy, and a sense of personal efficacy and competence, control, and meaning.

Self-care and self-nurturing skills are also important tools for this phase of work. Self-nurturance involves affirming one's value as a person, gaining awareness of personal goals and desires, considering new options, and transcending old roles. Self-nurturing activities often help the person experience a sense of pleasure and/or mastery and may include fantasy and goal-setting exercises, physical exercise, personal care, stress-management techniques, or classes that focus on building new skills. For sexual violence survivors, self-defense or martial arts training may also help increase a sense of bodily confidence and competence.58,59

As survivors explore the impact of sexual violence, social power differences, and socialization relevant to their social identities, they are likely to gain awareness of denied, buried, or distorted emotions. Survivors who have learned to use numbing, suppression, or denial to cope with pain may find that feelings of anger become more accessible and prominent. As a part of feminist counseling, clients learn to communicate their anger effectively so that it is not internalized or expressed haphazardly or indiscriminately. Instead, it is channeled in direct, constructive, assertive ways that decrease self-blame, redirect responsibility for violence on perpetrators, and facilitate personal efficacy and power.60

Sexual violence often contributes to one's sense of isolation and alone-ness. Support groups and feminist group counseling are useful for decreasing feelings of isolation as well as counteracting negative and self-blaming thoughts. Participants realize that others have also survived sexual violence, and this commonality helps them place sexual violence within a more complete context. As members of a safe community, group members can facilitate trust, challenge each other, support each other's coping skills, and practice new skills. Group members may find that by supporting each other, they are also able to gain new perspectives on their own pain, thus helping them transcend personal circumstances. Support groups that make connections between sexual violence and the larger social context that condones victim blaming are likely to be especially helpful to recovery.61

Within feminist therapy, empowerment includes analyzing power structures in society, building awareness of how individuals are socialized to feel powerless, and discovering how clients can achieve power in personal, interpersonal, and institutional domains.62 In light of these goals, feminist therapists are aware of the importance of linking personal empowerment and social change.

Many feminist therapists become involved in prevention, education, and social change activities related to sexual violence. As survivors develop greater confidence and feelings of personal power, feminist counselors may also encourage them to consider becoming involved in advocacy or social change roles. These activities may include participating in grassroots antiviolence community organizations, educational and prevention programs, local sexual assault coalitions, or online forums that combat violence.63 One example of an influential social action program is INCITE!,64 a multiracial, grassroots, feminist organization that has also published writings of activists. Too frequently, survivors are encouraged to see recovery as an individual experience alone. A feminist activist approach helps survivors envision and work toward a hopeful future for themselves and others.

CONCLUSION

Although this volume emphasizes recovery from sexual violence, it seems productive to conclude by highlighting the value of prevention and education activities. Although rape-supportive beliefs are deeply embedded within the culture, there is also evidence that well-structured, sustained, personally relevant, and well-timed interventions can lead to productive conversations about sexual violence and changed attitudes.65 Educational interventions from the elementary school through college levels and in work settings can help potential victims become aware of circumstances associated with higher risk of sexual violence. More specifically, programs directed at college students can increase awareness of myths and facts about sexual assault as well as gender-role socialization relevant to sexual assault and can help individuals deal more effectively with risks related to sexual violence.66 Feminist counselors and activists as well as survivors of sexual violence can play central roles in developing and supporting social change activities that educate potential victims, perpetrators, and those who provide services to victims/survivors.

Suggestions for Those Who Have Experienced Sexual Violence

1. Feeling safe and free of danger, both physically and psychologically, are crucial to achieving health. Surround yourself with people, activities, and environments that increase your sense of safety. This foundation is important for helping you explore and resolve the painful aspects of sexual violence. If you are in a relationship in which vio lence occurs, create a specific plan to ensure that you can get to safety when in crisis.

2. Coping with disorienting symptoms and impulses is a major challenge for survivors of sexual violence; these symptoms can surface at unexpected times. It is tempting to deny symptoms or to mask them through the use of alcohol or self-destructive behaviors. Instead, make a list of healthy coping options and develop a plan for implementing these healthy coping skills. The acronym CARESS can be used to organize adaptive options.67 CA stands for communicate alternatively, and is especially useful when you feel like expressing or dulling pain in a self-harming or self-blaming manner. Methods for communicating alternatively may include writing a poem, creating a collage, or jour-naling. RE stands for releasing endorphins, and may include activities such as running, hiking, yoga, or even hugging a stuffed animal. SS stands for self-soothing, which can include a variety of self-nurturing and pleasurable activities such listening to soothing music, taking a warm shower, cooking a healthy and nutritious meal, or reading poetry.

3. Expressive writing is useful for regaining perspective after traumatic events, and many psychotherapists integrate writing activities with other activities. Typically, the first step involves writing about the factual aspects of the violence in as much detail as possible; during later stages of recovery, write down your thoughts, feelings, and as many sensory details as possible (e.g., sounds, smells, imagery). If, while writing, the intensity of emotions becomes difficult to manage, set aside the task and come back to it later. Before writing, make plans for implementing methods for coping with the intense feelings and thoughts that might emerge. Writing helps overcome avoidance forms of coping and can help defuse feelings of danger. Placing events, feelings, and thoughts on paper and "in the open" can help decrease rumination, brooding, and repetitive thinking patterns that reinforce depression and trauma symptoms. Writing allows you to break up overwhelming events into manageable parts and to reorganize your thoughts, feelings, and experience so that you can engage in greater closure and problem solving. It is often optimal to participate in writing and expression tasks under the guidance of a trusted counselor.

4. List some of the messages and myths about violence that you have seen in media or encountered from others. After listing the specific incident or myth, identify your feelings and personal reactions to the myth or stereotype. Now write an assertive challenge to the myth, validating your experience and clarifying how the myth is hurtful.

5. Create a list of your strengths and sources of resilience. When feeling paralyzed and unable to move forward, act "as if" you are feeling healthy and whole, and choose to act on a strength. It is not essential to feel good in order to cope effectively. Behaving in a way that allows you to achieve a goal, even a small one, is likely to provide momentum and energy. Even small successes can help you get "unstuck" and serve as reminders of your potential. Feminist therapists emphasize resilience and growth as well as removing symptoms, and post-traumatic growth can be one outcome of surviving trauma.

6. Purchase a self-help guide that will assist your self-help recovery. One example is The Rape Recovery Handbook by Aphrodite Matsakis.68

7. Overcome feelings of isolation by staying engaged with people and trusted support systems. Joining a sexual assault survivors group within a local community or mental health service organization can facilitate insight about how the "personal is political." Support groups and sexual violence survivor groups can increase understanding that you are not alone. Within groups, members can listen and learn from others about coping while also giving back support and guidance to peers. Participating in a self-defense class or a program that focuses on physical strength and skills can also increase personal safety awareness and confidence in physical strength and resistance skills.

8. When ready, consider participating in some form of social change. Survivors of sexual violence have been major contributors to social activism projects that have increased social awareness of the culture of violence, supported prevention and education in schools and communities, and led to sexual violence advocacy services. Social activism can help survivors redirect anger in positive directions and contribute to more complete personal healing. Participation in social change activities may not be advisable during early phases of healing when feelings are raw, but can emerge and expand over time. A first step may involve becoming informed about sexual violence at local community or national levels and learning about existing organizations involved in combating sexual violence. Social change may encompass many types of activities such as providing material support or child care to victims/survivors, participating in victim advocate programs, cofacilitating a sexual assault education group, or providing leadership for community-wide programs. Self-monitoring of personal readiness and volunteering for smaller and then larger tasks helps to ensure that one's involvement will support personal growth and limit the likelihood of becoming overwhelmed.

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