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“It is impossible to get an accurate number of exactly how many men and women have experienced MST;
nonetheless, there are sufficient data to indicate that the numbers are disturbingly high. Several factors mask the true
prevalence, such as low incident reports, lack of objective adjudication, and contextual factors that silence victims,”
(Katz, 2015). Looking this statement, the fear of reporting, fear of retaliation and insufficient handling by higher
command of the report causes many MST events to go unreported. “MST is not itself a diagnosis, but rather a
stressor that is associated with the subsequent development of a wide range of psychological and physical sequelae,
including a greater number of negative mental and physical health consequences, poorer quality of life, and work-
related problems,” (Millegan et al., 2015; Rosellini et al., 2017; Williamson et al., 2017) (Moore & Penk, 2011).
“Sexual assault is traumatizing whether in the civilian sector or the military,” (Moore & Penk, 2019).
“While sexual assault in the civilian world can lead to PTSD, a soldier is over 2.5 times as likely for this to occur;
this may be due to their exposure to other military related components which may also contribute to the
development of PTSD,” (Moore & Penk, 2019). The difference in Military and Civilian MST victim treatment is the
nature of the job most likely, a victim of sexual trauma or MST in the Military can be looked upon as weak and the
self-blaming of an attack can affect them both physically and mentally. Unfortunately, “the reality is, while on active
duty, victims of MST need to continue to rely on their unit, command, possibly the perpetrator himself or herself,
friends of the perpetrator, and/or command of the perpetrator for survival in battle, health care or other services,
promotions, duty assignments, and other experiences of daily functioning. Victims realize that their own career and
well-being are at risk,” (Katz, 2015)
In a Military MST victim this is the issue. “The stigma and shame associated with MST is a barrier for
engaging in care (Suffoletta-Maierle, Grubaugh, Magruder, Monnier, & Frueh, 2003) and following up with services
(Campbell & Raja, 2005). Accordingly, patients may be demoralized before starting, believing that treatment is not
going to work and become reticent to trust a new therapist,” (Katz, 2015).
“High stress levels during deployment, image of masculinity, strict adherence to those in positions of
authority and unit cohesion are of the utmost importance in the military culture,” (Freeman, Moore & Freeman,
2009). We have seen in this module that those who serve in the Military are more likely to be sexually assaulted than
their civilian counterparts. “With regard to physical health, MST has been associated with impaired health status, as
well as with increased chronicity of health problems,” (Moore & Penk, 2011).
Various potential aspects of Military Sexual Trauma may be different from instances of sexual trauma in the
civilian world. Freeman et al. (2009) states, “service members who experience sexual assault while deployed are
likely to have to remain in close proximity to the offender; this would be a significant challenge and may prove to be
an important consideration when treating MST as opposed to other sexual assaults.”
CPT and PE are the recommended therapies for MST treatment. That being said a concern for some
therapists is that these therapies are not flexible enough to assist the MST victims. “In CPT, the clinician helps the
patient understand how the assault impacted their beliefs about trust and intimacy. In PE, as the patient recounts the
memory, he or she learns from the therapist’s reactions that he or she can trust others. In in vivo exposure, patients
are encouraged to increase social interactions and deepen existing relationships (e.g., share emotions with trusted
friends), (Katz, 2015). When treating a Military MST victim, it is stated in regard to treatment, Regarding treatment
for PTSD from MST, the VA’s Uniform Mental Health Services Handbook directs that “all veterans with PTSD must
have access to Cognitive Processing Therapy (CPT) or Prolonged Exposure Therapy (PE) as designed and shown to
be effective” (Office of Mental Health, 2008, p. 31). “Eye movement desensitization and reprocessing, (EMDR)
therapy is particularly adept in treating survivors of MST,” (Katz, 2015).
EMDR therapy is an eight-phase approach that includes (a) history taking; (b) preparation; (c) assessment;
(d) desensitization; (e) installation; (f) body scan; (g) closing; and (h) reevaluation. Each of the eight phases has
specific therapeutic objectives that the therapist needs to consider.
“MST is a stressor that can derail a military career if not addressed appropriately, which would include
getting adequate and timely medical and psychiatric care. In the past, veterans have reported to us that they have had
to choose between pursuing justice and pursuing their careers when dealing with reporting perpetrators of assault,”
(Moore & Penk, 2019).
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References:
Freeman, S., Moore, B., & Freeman, A. (2009). Living and Surviving in Harm's Way: A psychological treatment
handbook for pre-and post- deployment of military personnel.
Katz, L. S. P. (Ed.). (2015). Treating military sexual trauma. Springer Publishing Company.
Moore, B. A., Penk, W., & Friedman, M. J. (2019). Treating PTSD in military personnel: A clinical handbook
(Second). The Guilford Press. Retrieved January 18, 2022, from
https://mbsdirect.vitalsource.com/books/9781462538454.
