As a therapist would later confirm, Lucy's seemingly random voice loss was actually a mark of post-traumatic stress disorder (
PTSD). Although we tend to associate the condition with battle-scarred soldiers, studies show
rape survivors have more severe PTSD, and a harder time overcoming it, than combat veterans. While between 10 to 20 percent of war vets develop the disorder, about 70 percent of sexual assault victims experience moderate to severe distress, a larger percentage than for any other violent crime.
PTSD typically takes the form of nightmares, flashbacks, and feelings of guilt and shame that can surface right away or years after a trauma. But it can also manifest in physical ways, like chronic pain, intestinal problems, muscle cramps, or, as in Lucy's case, a paralyzed vocal cord.
For 94 percent of survivors, symptoms last at least two weeks; for a full half of them, they persist for years, even decades—sometimes long after the victim thinks she has laid the ghosts to rest. Consider the women, some now in their sixties, still grappling with the effects of decades-old alleged assaults by comedian
Bill Cosby. German researchers found a third of women raped during World War II had PTSD symptoms nearly 70 years later.
Any trauma can lead to PTSD, but
sexual assault is a particularly potent cause. Although rape is, at its core, about power, sex is analogous with pleasure and connection. Violating that intimacy can shatter a victim's trust in all relationships, fracturing the bonds with family and friends that are critical for healing. And since 75 percent of victims are attacked by someone they know, every person they meet and every situation they're in can feel dangerous, making sexual assault difficult to cope with, says Ananda Amstadter, Ph.D., an associate professor of psychiatry and psychology at Virginia Commonwealth University.