Sexual Assault In Herbal First Aid

November 17, 2017

 I have been doing first aid now for over 5 years and have gone twice to the rainbow gathering to work for “CALM” that provides first aid, and health care for lots of under-served people who attend the gathering. In a week time you can serve up to hundreds of people. The charm of a dirt floor clinic and working alongside seasoned herbalists, nurses, doctors and other practitioners has taught me a lot. You see everything from staph infections, mental illness, drug addiction, to broken bones, and also rape. Unfortunately, there is never a year where we don’t encounter someone who has been raped at the rainbow gathering and that is what has brought me to write this article. We have lots of herbal protocols or medical protocols for all of the above but it seems there is lack of information about what to do in a sexual assault situation. So here I have compiled a simple how to list in these situations, (though these situations are far from simple) by personal correspondence with rape crisis workers, personal experience, and extensive research with medical databases like up to date that is the most current information on all medical protocols.

 

A lot of times there is hesitancy from the victim to go to the hospital due to many factors including; the predator might have been a friend, they feel like they were at fault for what happened, shock, humiliation, fear, anxiety of unknown procedures at the hospital that are invasive (which can make victims feel re-traumatized), they could’ve been intoxicated, or meeting someone for illicit drugs, it could have happened with a spouse and more. And honestly some hospitals are not up to date on how to handle these situations and can sometimes make matters pretty uncomfortable for the victim. 1 out of 6 American women will experience sexual assault in their lifetime (RAINN), and 1 in 2 transgender individuals will experience sexual assault (http://endsexualviolencect.org/lgbtq/), and for men its 1 in 33 (RAINN).  For every 100 sexual assaults, there are only 32 that lead to police reports. Of those reports, there are only two felony convictions with as few as two rapists spending just a single day in prison (JEM).

 

EVIDENCE PRESERVATION

 

Trying to preserve as much evidence as possible is important. Although wanting to wash yourself, dispose of your clothes, brush your teeth, and gargling, are a completely natural response to being assaulted, it’s helpful if the victim doesn’t.  Even removing of tampons or inserting them, douching, and wiping the genitals should be discouraged. However, the victim has complete rights to do so if they wish. If the person has already washed up that’s fine, just make sure they don’t do anymore. If clothing has been removed, try to access them and place each article of clothing or evidence in separate plastic bags so there isn’t any cross contamination and bring them with you to the hospital. Plastic bags are more helpful if you are using “wet” evidence since they won’t degrade like paper bags will. Collect items in plastic bags and label properly. Collecting evidence of course has to have consent of the victim. If proceeding to the hospital have the victim get out of the clothes that they were assaulted in, and get them some new clothes to wear, or bring a new change of clothing with you to the hospital.

 

 

 

WHAT TO SAY

 

So what are things to say to someone who has been raped? Making sure that you make the victim feel like they have control over their body by giving the victim options about services and making them feel empowered through education is crucial since this person has just been left with feeling completely powerless. To start, be there as a supportive advocate giving them choice, options, and a safe space. Even asking things like “can I get you another blanket?” seems small but gives them the power of choice. A rape victim will have to repeat their story many times to different authority figures, so make sure you only ask questions about their emergency medical care, this makes it less overwhelming. However, if they want to share their story to you then listen carefully. If they do share their story with you it might be a good idea to write some things down that might help later when speaking with cops or emergency room staff. Of course with their consent first.

Saying things like:

  • I believe you

  • it’s not your fault (no matter what!)

  • I’m sorry this happened

  • You can trust me

  • Its healthy and OK to feel what your feeling

  • Healing takes time but it’s completely possible to have healthy relationships again, and rebuild trust.

  • Reassurance that their privacy will be protected

  • Do you have family or friends back home that can support you in your healing process?

are ways to let the victim know that you acknowledge their experience and that they are not to blame.

 

WHAT NOT TO SAY

 

Though it seems like common sense to not say these things, it’s still good to have a reminder. Things not to say are:

  • Telling someone how they could have avoided the situation

  • Everything happens for a reason or its Gods will

  • Disbelieve or question the situation

  • It happened on a date, that’s common

  • Telling someone to get over it

  • Other people have it a lot worse

  • Question the victim’s actions leading up to rape

  • This is common I know a bunch of people who have been raped

  • Did you say no?

  • Did you change your mind?

  • Where you drunk or under the influence of drugs

  • Did you like it (I just cringed)?

  • They are your partner/spouse maybe it’s a misunderstanding

  • Why didn’t you scream for help?

  • Why didn’t you tell anyone immediately?

 

CAREGIVERS BEING TRIGGERED

 

Because rape and sexual assault is so common, it is possible that you yourself might feel triggered when dealing with the emotional trauma of rape in first aid. PTSD ranges from person to person and how we handle it does too. Being triggered can sometimes feel obvious while other times it may be subtle. Sometimes PTSD will show its ugly horns days after the event. Even when you feel really confident that you can handle something to this extreme you may find out that you can’t, and that’s OK. Knowing how you act when you are triggered can be surprising; for some it is being zoned out and not listening while for others its crying, not sleeping, and anger, or it could be none of those things. If your feeling like this might be a possibility and there are other people in first aid that can help, reach out and express to them that it might be too much for you. Don’t try to take on a situation like this alone. In every first aid situation you should always be working with another first aid crew member. This ensures support for each other, breaks, and more support for the person. Taking care of yourself during first aid is like first aid 101, as first aid staff we are susceptible to getting sick, emotional strain, long shifts, and little time to eat and sleep. So it’s very important to make sure you take care of yourself, and reach out for help when you feel you need it.  Some helpful tips are:

  • Remind yourself where you are

  • Remind yourself you are safe

  • Remind yourself how this is different from your personal experience

  • Get a cup of hot tea/ herb blend of calming herbs /supplement like GABA, or Calm magnesium.

  • Name something for each sense, something you see, hear, smell, touch and taste.

  • Grab a tactile object like; rocks, soft blanket, tree bark

  • Breathe deeply

  • Ground yourself, sense your feet on the ground

  • Talk to someone

  • Disassociate yourself from being the victim and realize your place

 

 

GOING TO THE HOSPITAL/MEDICAL EVALUATION

 

So what happens during a medical evaluation? can be a question the victim asks. Hopefully the hospital will make sure to give the victim a private room right away. This is important for multiple reasons, but most importantly because you don’t know if the perpetrator followed the victim there. Most people aren’t aware with how fast medical evidence degrades. Usually after 120 hours a vaginal exam isn’t recommended and for oral or anal assault you have 20 hours. Getting an exam does not mean you have to report it to the police, the victim can get an exam and it will be handed to the police department but the victims consent must be given for an investigation and a report. According to up to date, a medical database, healthcare workers will go through the history of events with the victim. Usually a sexual assault nurse examiner (SANE) will interview the victim privately, however a family member, or friend is allowed to come with the victim. Victims can also request SANE nurses and in some counties the exam will be paid for. In some hospitals there are sexual assault response teams that have protocols in place for victims. They tend to offer great compassionate care and offer emotional support 24 hours a day and seven days a week. After verbalizing the assault, a physical exam will be conducted with the victim’s consent. This includes documenting any cuts or bruises on the body including genital or rectal areas. Areas of injury may be swabbed for culture. A STI test is done along with HIV if the victim consents and in some states STI testing is mandatory. Examiners may also want fingernail scrapings, pubic hair and head samples along with blood and saliva. A blood and urine test to test for drugs might be offered to the victim if they have problems remembering the event, however do know that if the victim has taken any drugs and they want to press charges this evidence may be used against the victim in court. A mistake seen in the ER is staff coming off as judgmental, they might question intoxication and the history of the story, do your best to be an advocate in these situations as long as the victim is comfortable with you doing so.  If the staff is seeming unsupportive try to let the victim know that they are still in control, and at any time during the exam they can say no. This evaluation can take a long time to finish, sometimes up to 6 hours. Also the emergency department can be hectic and other patients can come in where the medical staff deems them top priority instead of a sexual assault case making it take even longer for the victim. If in a facility with a sexual assault team they tend to try to make victims not wait as long so the process is a little easier for them. Usually preventive measures against pregnancy are discussed and options are given along with the proper resources for mental health help and follow up. This is really important, making sure the victim gets good resources for follow up is crucial. It’s good to know that the collecting of evidence, reporting the incident, and the prosecution procedures very by state. In some states a rape kit will not be collected unless police are notified. RAINN which stands for Rape, Abuse & Incest National Network has an amazing website that lets you look up the laws by state. https://apps.rainn.org/policy/ I will also be making a separate list that can be printed out for ease of travel.

 

 

 

 

HERBS AND THEIR ROLE

 

So how do herbs fit into this all? Though it’s not recommended for anyone who has been recently assaulted to drink or eat anything, we are talking about first aid situations which is sometimes in a rural setting, far away from hospitals, and the person is asking for help and wants to calm down - then herbs can work really well in aiding in that. When working at CALM if someone came with a huge gaping wound from a hatchet or a broken hand from a fight, offering herbs that help bring that person from a 10 to a 1 from pain or just plain agitation seems to work. One of the herbs that I work with a lot in intense situations is Anemone spp. It is an absolutely fantastic herb to help people who feel “out of their body” per Se, make them come back into their body and give them a feeling of being grounded. It’s actually incredible to see how fast it works. It helps people who have just experienced a really traumatic event (ex; car accident, rape, serious injury), or someone who has taken hallucinogenic drugs, and are having a “bad trip” and might be panicking. It can also help people who are having a psychotic episode, and is really just excellent for panic attacks, feeling out of this world with circular thoughts kind of moments. It pulls people out of the spiraling “rabbit hole”. It is a low dose botanical so between 1-5 drops is recommended. If there is physical pain from the assault and the victim wants something to remedy then herbs can also be of help there. However, I would advise if giving any herb that can cause someone to feel drowsy or even fuzzy headed, to communicate this to the person and say "I would like to give you some Valerian to help you sleep and calm down, sometimes this herb can make people feel drowsy, is that okay with you?" You don't want to make the person feel startled and out of control. And of course always ask if taking alcohol is okay.

 

Other calming herbs that can be mixed in a formula, or added with Anemone spp, to help someone who may have just experienced sexual assault are:

 

  • Chamomile (Matricaria recutita)- comforting, mildly relaxing and helps with upset stomach due too emotional stresses.

  • Mimosa (Albizia julibrissin)- mood elevator, grounding, anxiolytic. David Winston says to use it for people who are “emotionally brittle”

  • Rose (Rosa spp)- seems to make everyone feel safe and calm down, it is nice to put in with any anxiety or depression formulas when there is heart ache and trauma.

  • Kava kava (Piper methysticum)-an excellent anxiolytic, helpful if anxiety is accompanied with muscular tension.

  • Hops (Humulus lupulus)- slightly sedating, irritability, calming, helps with insomnia, can be helpful if there is pain.

  • Valerian (Valeriana officinale)- triggers GABA receptors in our brain, calming to the central nervous system. pain relieving, slightly sedating (drop test first as a small percentage of people display the opposite of relaxation and become excited) works well for overly anxious people who are having a hard time with falling asleep, can develop dependency, also good for people who are in a lot of pain and cant sleep because of it.

  • Skullcap (Scutellaria lateriflora) - great for over stimulated situations, nervousness, anxiety, tension.

  • Lavender- helps with anxiety, David Winston says that it helps “the patient who may be fixated on a traumatic event”

  • Lemon balm (Melissa officinalis)- nice herb for people who feel like they can’t calm down, uplifting.

  • Passionflower (Passiflora incarnata)- helps to reduce obsessive circular thoughts, helps with anxiety due to worrying, and can help with sleep.

  • Motherwort (Leonurus cardiaca)- useful for anxiety and nervousness, accompanied with heart palpitations.

  • Blue vervain (Verbena hastata)- Calming, bitter, grounding. Useful herb in first aid for panic attacks.

At calm,and now at other first aid stations I work at we always dispense herbs in a 1 oz plastic bottle for convenience. We fill the 1 oz bottle with 20 ml of herbs and 10 mls of water, tell the person to take a cap full as needed or 2-3x a day. 

 

Formula example Anxiety:

Scutellaria: 5 ml

Lavendula: 5ml

Hummulus: 5ml

Verbena hastata: 5ml

Anemone 5 drops

 

Formula example uplifting and calming:

lavendula: 5ml

Albizia: 5ml

Passiflora: 5ml

Rosa: 5ml

Anemone 5 drops

 

If there is injury and pain then we can use anti-inflammatory herbs internally or externally, linaments, salves, soaks, and even tea bags. Herbs that work for pain are sometimes also helpful for anxiety, and nervousness. some herbs useful for first aid injury are:

 

  • Willow (Salix spp)- great general anti-inflammatory. You can use the fresh bark and decote it in a pot, or make a strong tea. Better as a tincture as it seems like the more willow the better it works. Whats nice about willow is it wont cause any sedative effect, so if someone doesn't want to feel drowsy this is a nice alternative for pain and prevention of bruising