oliver@unc.UUCP (Bill Oliver) (07/21/85)
A fair number of people have been posting questions and speculations about the natures and motivations of rapists. I recently re-read an intriguing couple of articles, and thought the net might share my interest. While I had a passing interest in the psychiatric aspects of sexuality as a medical student, I am not a psychiatrist and now approach the rape workup from a more concrete viewpoint(1,2). Thus, do not take the views I personally express as those of a specialist in the field of forensic psychiatry or, for that matter, of general psychiatry. With that caveat, then, I direct your attention to the single article most people are referring to (whether they know it or not) when they speak about rape being a crime of power rather than sexuality. In 1977, Groth, Burgess and Holmstrom wrote a classic (both in its ideas and in the sense of being stylistically extremely well written) review of 133 perpetrators and 92 victims(3). They found that the motivation for rape can be divided into two general types - power and anger. To quote the article : "Rape then, is a pseudo-sexual act, a pattern of sexual behavior that is concerned much more with status, aggression, control, and dominance than with sensual pleasure or sexual satisfaction. It is sexual behavior in the service of nonsexual needs and, in this sense, is clearly a sexual deviation." They go on to describe what they call power rape as assault in which the perpetrator uses aggressive acts, whther verbal or physical, to exercise control and power over the victim. Sexual intercourse is thus an expression and culmination of this dominance. The rape is preceded by an obsessional fantasy in which the victim initially resists but eventually becomes a willing and energetic partner. The reality is, of course, disappointing, and the perpetrator must seek further victims in the search for the right one. The rape may be associated with sexual dysfunction, and may involve increasing acts of violence. Power rape can be further divided into two types - power assertive in which rape is an expression of virility (`You want it as much as I do `) and power reassurance in which the perpetrator is attempting to resolve internal doubts of sexual adequacy. Anger rape, the second major category, is a rape in which the perpetrator uses the crime to vent his rage. The intent is to hurt and degrade the victim. The sexual offenses are sporadic and frequently represent anger displaced from an important women in his life. Thus the attacks may be triggered by conflicts in these relationships. Like the power rape classification, the anger rapes can be considered in two types. The anger-retaliation rapists commits rape as an act of revenge. The anger-excitation rapist finds pleasure and exitation in the infliction of suffering. In this study, about 65% of rapes were power rapes and 35 were anger rapes. The anger-retaliation type made up 40% of the offenders, but 15% of the victims. Special Agent Robert R. Hazelwood of the Behavioral Science Unit, FBI Academy, Quantico, Va. has written another excellent review(4). The thrust of his article, which is written as a practical article to those who encounter rape victims, is that behavioral profiles of the perpetrator are of utmost importance in the search for the criminal. He identifies three categories of approach of the rapist towrd the victim : the `con`, `blitz` and `surprise`. In the con approach, the rapist attempts to gain the confidence of the victim by friendly actions ( asking directions, giving aid, etc). He then suddenly changes attitude. The `blitz` offender immediately uses overpowering physical force. The `surprise` method involves lying in wait (in the car, behind a wall, etc), and then uses a weapon or threat to subdue. Once the encounter has been initiated, it is important to learn the method by which control over the victim is maintained (threat, force, display or use of weapon), and the degree of actual force used (mild slapping to intimidate versus sadistic torture and intentional gratutious infliction of pain). Resistance to the attack may be passive (in which the victim does not physically resist but also does not comply with demands), verbal (pleading, screaming, negotiating, etc), or physical (hitting, biting, kicking, gouging, etc). Rape is stressful to the attacker as well as the victim. Thus, the response of the rapist to resistance is frequently characteristic. He may cease the demand altogether, negotiate demands (initailly demand anal sex and negotiate to vaginal sex), flee, increase threats, or increase the use of force. The rapist may experience sexual dysfunction. A study by Groth and Burgess found that 34% of the offender population experienced some sort of dysfunction(5). Dysfunction can include erectile insufficiency, premature ejaculation, retarded ejaculation, and conditioned ejaculation (the rapist can ejaculate only when specific conditions,such as particular sexual acts, are met). The language used and the specific sexual acts (both type and sequence) are important in developing a profile. Language may be anything from complimentary and reassuring to profane, cruel and threatening. The attacker may quickly shift affect during the crime. He may steal items of no intrinsic value, but which may give motivational clues. Rapists often select their victims well before the crime, and the victim may receive unidentified calls or letters, be a victim of a residiential or car break-in, there may have been peeping toms or prowlers in the neighborhood, or the victim may have had a `feeling` that she was being watched. In 1978, the North Carolina Council on the Status of Women published the results of 300 interviews with rape victims(6). The sample was obtained by setting up two toll-free phone in lines and publicizing a statewide request for anonymous victims. Their sample is by no means statistically determined, and any conclusions from it must be considered at best suggestive. Still, I think they did a good job of getting data from cases otherwise unreported. They found that 74% of the sexual assaults reported to the survey had not been reported to law enforcement. There were a number of reasons, including fear of retaliation (51% of the victims were known by the attacker, and in 30% of the cases the attacker threatened to return), fear of insensitive treatment by the courts (it is now forbidden in North Carolina to inquire into the sexual behavior of the victim on the stand unless the sex had been with the defendant, and then only in certain conditions), a desire to avoid recapitulating the assault and `re-living` the experience, and fear of public ridicule. The oldest victim was 72, and 33 victims were between 10 and 14 (97 victims were between the ages of 15-19, and 82 were between 20 - 29 years). 36% were assaulted in their own homes. 73% were between members of the same race. No physical injury occurred in 51% of the cases. 65% of the victims feared death, though a weapon was used in 38% of the cases. 97% of the victims who called were female, 87% were white, 46% were single, 56% had some college or above. 84% were attacked by one perpetrator; the assaults had occured anywhere between 1929 (1 case) and 1977 (21 cases). A knife was used in 60% of the cases in which a weapon was employed, and a gun was used in 20%. The most frequent age of the attacker was about 20. Only 32% of the victims sought medical assistance. Of the cases going to police, 51% of the 35 cases ended in arrest. The demographic data differ from those cases reported and evaluated by law enforcement agencies in North Carolina primarily by the race of the victim (and by extension, the attacker), and by the clearance rate. In the 1982 Uniform Crime Report (one of my colleagues has the later issue hidden in his office), the 1300 victims were about 50/50 black/white, 50.3% of the victims knew the perpetrator, 24% were injured. A gun was used in 7%, knife 12.4%, other weapon 68.8%. 32% of the attacks occured in the victim`s home, 20% in a road/street/ditch, 18% in a building (office/store/school/barn/etc). No information is presented concerning education. The number of perpetrators per rape is roughly the same. 67% of the cases known to the police were resolved by arrest or equivalent (67% clearance rate). A 63% clearance rate was reported in 1978.(7) Now for my own little say. Within the past 8 years, much has been done to increase support for the rape victim. Some of it has been in the form of rape crisis centers, support groups, etc., but more important in my own perception, there has been a pervasive greater understanding and compassion in the medical and law enforcements communities. While it is necessary for the physician and the law enforcement person to ask probing and uncomfortable questions on occasions, we are by no means being callous. It really is necessary to learn these things. It is sometimes difficult to keep pushing at questions without appearing uncaring, but in fact, investigators really are on the victim`s side. You can`t give a vaccination without using a needle, and you can`t get answers without asking questions. No one is trying to trick the victim into giving a `wrong` answer; the technique of asking the same question in many different ways is to get more detail, not to catch the victim in a lie or suggest the investigator thinks the victim did anything wrong. In the article by Special Agent Hazelwood, asking the detailed questions such as outlined in his article allowed, in an example case, a profile of the attacker to be made with opinion to the offenders race, marital status, occupational level, arrest history, socioeconomic background, proximity of residence to victim, military history, age and style of automobile, and various personality characteristics. When the offender was captured, only the marital status was incorrect. Similarly, while a victim may feel `dirty` or otherwise unpresentable, it is imperative that she be examined by a competent physician as early as possible, well before she cleans herself. There are numerous tests and identification methods, which I won`t detail here, by which the attacker can be linked to the crime and convicted. It is by no means the victim`s word against the rapist`s word in cases where we are able to get the trace physical evidence in time, and where the law enforcement officials are able to get to the attacker quickly. When a rape victim ends in my office, it is the culmination of any number of tragedies, not the least of which is that victims, by not reporting the crime, become unwitting accomplices because of unnecessary and frequently unfounded fear and embarrassment. Rape is a crime in which, unless he contemplates being a victim of homosexual assault, it is difficult for a male to experience true empathy. Still, this does not mean that a male officer (though female officers are increasingly available) or male physician (though female physicians are increasingly available, a male must be able to handle this competently as well) cannot be sympathetic - there is a certain uniformity to profound pain and suffering regardless of the etiology. That is something all physicians learn as they mature. 1) Daniel, DG, Abernethy, V, and Oliver, WR. The relationship between beleifs about men`s and women`s roles in society and views on male sexual dysfunction in 135 women. Soc. Psych. 19:127-133,1984. purely descriptive statistics - boring. 2) Daniel, DG, Abernethy, V, and Oliver, WR. A distant intimacy: Correlations between female sex roles and attitudes towards male sexual dysfunction in 30 women. (bisexual study) To be frank, I don`t have my cv here, so I don`t know the page numbers. J Sex and Marital Therapy. 10:??-??, fall 1984. this is the better of the two. 3)Groth, N, Burgess, AW, Holmstrom, LL. Rape: Power, Anger, and Sexuality. Am. J. Psychiatry 134:1239-1243,1977. 4)Hazelwood, RR. The Behavior-oriented interview of rape victims: The key to profiling. FBI Law Enforcement Bull. 59(Sept):8-15,1983. 5) Groth, AN and Burgess, AW. Sexual dysfunction during rape. New England Journal of Medicine. 297(4):764-766,1977. 6) Hummer, KE. Aftermath : A report on sexual assault in North Carolina. Department of Administration, North Carolina council on the Status of Women. 1978. 37pp. 7) Edmisten, RL, Corley, WC. Crime in North Carolina : 1982 Uniform Crime Report. North Carolia Department of Justice, Police Information Network, pubs. pp 41-48, 1983. Bill Oliver Assistant Chief Medical Examiner State of North Carolina The opinions expressed above are my own and do not necessarily represent those of the Office of the Chief Medical Examiner or any other Office, Agency, or employee of the State of North Carolina.