Blitz rape and confidence rape: implications for clinical intervention.

Corroborating a typology of rape proposed 10 years earlier, a recent demographic study of 1,000 incidents of rape concluded that the two predominant types of assault were blitz and confidence rape. Blitz rape is characterized by sudden surprise attack by an unknown assailant using force or the threat of violence to gain control over the victim. In confidence rape, the assailant is known to some degree, however slight, and gains control over his victim by winning her trust. The characteristic details that differentiate one type of rape from the other suggest that the psychological impact on the victim will differ according to the type of rape. Specific clinical approaches for the mental health care of each victim group need to be provided. The immediate concerns of blitz rape victims center around their sense of safety, their fear that the rapist may return, and their dismay at having failed to ward off their attacker. They may respond like typical trauma victims with nightmares, flashbacks, sleep and appetite disturbances, heightened startle responses, anxiety, and depression. Treatment--usually sought soon after the rape--may include psychotherapy, medication, and behavioral desensitization. The confidence rape victims' chief concerns are guilt and self-blame. The rape may be revealed only years later. There is often significant delay between the rape and the victims' request for help. The victims need to be assured that they are deserving of help and need the meaning and definition of rape clarified. Providing services may require active and sustained involvement on the part of clinicians. Confidence rape victims will have strong doubts about their ability to discern who is truly trustworthy.(ABSTRACT TRUNCATED AT 250 WORDS)