Academic journal article American Journal of Psychotherapy

Treating the Trauma of Rape: Cognitive Behavioral Therapy for PTSD

Academic journal article American Journal of Psychotherapy

Treating the Trauma of Rape: Cognitive Behavioral Therapy for PTSD

Article excerpt

EDNA B. FOA AND BARBARA OLASOV ROTHBAUM: Treating the Trauma of Rape: Cognitive Behavioral Therapy for PTSD. Guilford Press, New York, 1997, 320 pp., $30.00, ISBN 1-57230-178-3.

"When does fear become pathological?" ask the authors of this new text on treating rape victims. Normal fear occurs with the perception of real threat and disappears when the threat is removed. Fear becomes pathological when it is disruptively intense and unrealistic. PTSD develops in rape victims, according to the authors, with the development of pathological fear or "pathological trauma memory structures."

This new text by Foa and Rothbaum is a very thorough treatment of the field of behavioral therapy of rape victims and represents the culmination of many years of research by the senior author, Edna Foa, of the Allegheny University of the Health Sciences, and her former student, Barbara Olasov Rothbaum, now at Emory University School of Medicine. The book opens with a brief case study to draw the reader into the material, which is fortunate in that the next 90 pages present very dense reading. The review of the literature in the field of PTSD and the efficacy of various treatments is quite thorough but presents weighty reading for nonresearchers.

Next, Foa and Rothbaum present their theory, which links cognitive elements to pathological fear. Referring to "emotional processing theory," they propose that victims who develop PTSD as a result of a rape do so because of pretrauma schemas (the way in which they viewed themselves and the world prior to the assault), the way they remember the trauma itself, and the memory records of posttrauma experiences (the way in which they view themselves and the world after the assault). This elegant theory ties together what so many workers in rape crisis centers have observed-that it is how the individual integrates the rape into her existing personality dynamics, which determines who will fare poorly after an assault.

The authors go on to outline several programs of treatment, many of which are not cognitive. …

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