Hadi Wijaya
The experience of sexual violence, particularly when it occurs during the formative years of childhood or adolescence, represents one of the most profound disruptions to human psychological development. Beyond the immediate physical harm, the internal trauma inflicted on a victim can ripple through their psyche for a lifetime if left unaddressed. Medical professionals and mental health experts emphasize that without timely intervention, psychological support, and specialized counseling, these victims face a high risk of developing severe, chronic mental health disorders. Dr. Lahargo Kembaren, SpKJ, a prominent psychiatrist and the Head of the Psychosocial Rehabilitation Installation at the National Mental Health Center (RSJ dr. H. Marzoeki Mahdi) in Bogor, underscores that the spectrum of psychological damage is vast, ranging from acute emotional distress to long-term psychiatric conditions that can fundamentally alter a person’s personality and ability to function in society.
According to Dr. Lahargo, the trauma of sexual violence is not a singular event in the mind of a victim but a catalyst for a series of complex psychological reactions. Among the most common conditions triggered by such trauma are generalized anxiety disorder, clinical depression, bipolar disorder, and in more severe cases, psychotic disorders and various personality disorders. The manifestation of these conditions often begins with subtle shifts in behavior or physical health, which, if not recognized by caregivers or professionals, can solidify into permanent psychological scars.
The Somatic and Emotional Manifestations of Trauma
One of the primary challenges in identifying trauma in victims of sexual violence is that the symptoms are not always purely emotional; they often manifest as physical or "somatic" complaints. Dr. Lahargo explains that victims frequently experience a range of physical symptoms that have no clear organic cause but are deeply rooted in psychological distress. These include chronic headaches, heart palpitations, shortness of breath, gastrointestinal pain, and persistent muscle tension. These physical reactions are the body’s way of signaling a state of constant "hyper-arousal" or "fight-or-flight" mode, which remains active long after the threat has passed.
Emotionally, the toll is equally devastating. Victims often find themselves trapped in a cycle of intense anxiety, sudden outbursts of anger, profound sadness, and a sense of pervasive frustration. A defining characteristic of this emotional state is the feeling of profound isolation. Victims often report feeling "lonely" even when surrounded by people, as the weight of their experience creates a perceived barrier between them and the rest of the world. This sense of being "different" or "tainted" often leads to social withdrawal and a feeling of being ostracized, even if the community is unaware of the trauma.
Cognitive and Behavioral Disruptions
The impact of sexual violence extends into the victim’s cognitive functions and daily behaviors. Dr. Lahargo notes that cognitive symptoms often include a significant difficulty in maintaining focus, poor concentration, and a tendency to be forgetful. Victims may struggle to make even simple decisions, paralyzed by a mind that is constantly preoccupied with intrusive thoughts or "rumination"—the repetitive looping of traumatic memories.
Behaviorally, the disruption is often visible in the basic pillars of daily life: sleep and nutrition. Victims frequently suffer from insomnia, nightmares, or, conversely, excessive sleeping as a form of escape. Eating patterns may become erratic, leading to significant weight fluctuations. Furthermore, victims may exhibit signs of "psychomotor retardation" (a general slowing down of physical movements and speech) or its opposite, heightened aggression. In professional or academic settings, this often manifests as chronic procrastination or a complete loss of motivation, as the victim’s energy is entirely consumed by the internal struggle to process their trauma.
The Two-Phase Psychological Trajectory: Acute and Long-Term
Dr. Lahargo categorizes the psychological journey of a sexual violence victim into two distinct stages: the acute phase and the long-term reorganization phase. Understanding these phases is crucial for family members and first responders to provide the appropriate level of care at the right time.
The acute phase typically occurs immediately following the incident and lasts for approximately two to three weeks. During this period, the victim’s mind is in a state of "acute stress reaction." This phase is characterized by a profound chaos of thoughts and behaviors. Emotional volatility is common; a victim might swing from uncontrollable sobbing to inappropriate laughter or smiling without an obvious cause. This "incongruent affect" is a sign of the brain’s inability to process the magnitude of the trauma.
Interestingly, some victims may appear eerily calm and controlled during the acute phase, acting as if nothing has happened. Dr. Lahargo warns that this "composed" exterior is often a mask for deep shock, intense fear, and internalized anger. This reaction is frequently driven by an immediate fear for their physical safety or a fear of death. Once the victim begins to feel a modicum of external safety, the "floodgates" of emotion typically open, leading to mood swings, feelings of humiliation, low self-esteem, and a crushing sense of helplessness. Many victims also fall into the trap of self-blame, a psychological defense mechanism where the mind tries to find a sense of control by assuming responsibility for the event.
The second phase is the long-term reorganization phase. This is the period where the victim attempts to integrate the trauma into their life story and return to a semblance of normalcy. According to Dr. Lahargo, this phase can go in one of two directions. In the first scenario, with adequate support, the victim successfully adapts, regains their functional abilities, and becomes productive again. In the second, less favorable scenario, the victim fails to adjust. The symptoms from the acute phase become "chronic," and the victim develops persistent psychological disorders that interfere with every aspect of their daily life.
Factors Influencing Recovery and the Risk of Chronic Disorders
The ability of a victim to navigate the long-term phase successfully depends on several intersecting factors. Age is a primary determinant; generally, the younger the victim, the more difficult the recovery process, as children lack the cognitive and emotional tools to process such complex violations. The presence of a robust "support system"—comprising family, friends, and community—is perhaps the single most important predictor of recovery. Other factors include the victim’s pre-existing personality traits and the current stability of their living situation.
If the trauma is not addressed effectively, the victim is at high risk for Post-Traumatic Stress Disorder (PTSD). PTSD is characterized by "re-experiencing" the trauma through flashbacks, avoidance of anything associated with the event, and persistent hyper-vigilance. Beyond PTSD, victims may suffer from psychotic disorders, where their ability to perceive reality becomes impaired, leading to hallucinations or delusions. Additionally, sexual dysfunction or a fundamental shift in one’s relationship with their own sexuality is a common long-term consequence.
The Critical Risk of Suicide and the Necessity of Professional Intervention
One of the most alarming implications of untreated psychological trauma in sexual violence cases is the increased risk of suicidal ideation and attempts. Dr. Lahargo emphasizes that when the mental burden becomes unbearable and professional help is absent, victims may see suicide as the only way to end their internal pain. This makes the prioritization of mental health in sexual violence cases not just a matter of "wellness," but a matter of life and death.
To combat these risks, a multi-faceted therapeutic approach is required. Dr. Lahargo outlines several levels of treatment:
- Psychotherapy: This includes "supportive therapy" to stabilize the victim, "re-educative therapy" to help them understand and manage their symptoms, and "reconstructive therapy" to address the deep-seated changes in their personality and worldview.
- Pharmacotherapy: In many cases, medication is necessary to balance the neurochemical disruptions caused by trauma. This may include antidepressants, anti-anxiety medications, antipsychotics, and mood stabilizers.
- Psychosocial Rehabilitation: This involves helping the victim reintegrate into society, regain their confidence, and rebuild their social and professional lives.
Global and National Context: A Call for Prioritization
The insights provided by Dr. Lahargo Kembaren align with global data regarding the impact of sexual violence. According to the World Health Organization (WHO), approximately one in three women worldwide have been subjected to physical or sexual violence, and the psychological impact is cited as a leading cause of the global burden of disease related to mental health. In Indonesia, the passage of the Law on Sexual Violence Crimes (UU TPKS) in 2022 marked a significant step forward in providing a legal framework for victim protection. However, as Dr. Lahargo’s analysis suggests, legal recourse is only one part of the equation.
The "hope for recovery," as Dr. Lahargo puts it, is significantly higher when professional intervention is sought immediately. This intervention must come from a multidisciplinary team including psychiatrists, mental health nurses, psychologists, counselors, and social workers. Furthermore, the role of the family and the surrounding community cannot be overstated. A supportive, non-judgmental environment is the foundation upon which all clinical therapies are built.
In conclusion, the psychological impact of sexual violence is a complex, multi-stage trauma that requires a sophisticated and compassionate response. By prioritizing mental health, ensuring early intervention, and fostering a supportive societal environment, the transition from victim to survivor becomes a tangible possibility. The goal of treatment is not merely the absence of symptoms, but the restoration of a victim’s dignity, agency, and hope for the future.
