some cases victims are shunned by partners or their families when it is discovered that they have suffered rape or sexual exploitation. disclosure is not forthcoming or it is disclosed only as “attempted rape” because stigma or “honour” precludes full revelation.61 – Tolerating unequal or dangerous personal relationships because of lack of confidence and an inability to assert their own needs, or to stand up for themselves. This is often compounded by poor socio-economic circumstances which can make them dependent upon partners. 5.7 Obstacles to Memory, Recall and Providing a Chronological Account – Some men and women may perceive their own sexual organs or another part of their body which has been abused as despoiled, foul, in pain or needing to be continuously cleansed. In some cases this results in self-harm through rigorous scrubbing or actual cutting/ harming. A man trafficked for sexual exploitation describing his trauma from rape by multiple assailants “I thought people could notice – could see what had happened to me.” A West African man trafficked for sexual exploitation Sean described being raped by his trafficker and other men. His gaze was downcast, he started twisting his hands around and picking at his fingernails “I tried to fight them off but they were too strong. I tried to pretend nothing had happened.” He says that his memory of being raped is “just like a dream” and that he has very brief moments in which he visualises it “like a blink in your eye. It’s there and then it goes.” This represents the “flashback” experiences which often occur in the aftermath of extreme trauma. Sean also describes episodes of intense panic during which his heart pounds, he sweats and has a headache. An East Asian woman trafficked for sexual exploitation “I know I’m not right. Sometimes when I have sexual contact with my boyfriend, I feel like he’s a client from before. I scream suddenly. Then I say ‘sorry’. I think I have brought him a lot of trouble. I have changed him from a happy man into an unhappy man. I’m not his problem, I’m my problem.” Experiences of rape, sexual abuse and sexual exploitation are often not disclosed at initial contact. However, they may arise in discussion much later when a relationship of trust between client and clinician has been established. In some cases clinicians suspect that rape has occurred but 80 Many victims of trafficking suffer from difficulties with memory and the ability to accurately recall traumatic events 62 or organize them into chronological sequence.63 Despite this, they may be expected to answer questions that would test any non-traumatized person in terms of requiring them to provide exact dates, times and places for events that happened months or years ago. A man trafficked as a child for sexual exploitation speaking at his asylum interview “The problem is I don’t remember, I can say something to you right now and two minutes later I forgot.” In addition to difficulties of recall, victims of trafficking may suffer memory loss which is caused by psychological problems and in some cases, brain injury from beatings to the head. Post-Traumatic Stress Disorder (PTSD) is suffered by many victims of trafficking and this is characterized by reduced attention, concentration and short and long-term memory. PTSD is associated with irritability, hyper-arousal, re-experiencing of traumatic memories, intrusive memories and distracting thoughts, as well as general memory problems.64 The Criminalisation of Migrant Women - The British Journal of Psychiatry, “Cases where victims’ credibility has been dismissed by decision makers because of late disclosure of rape and sexual abuse are not uncommon”. International journal of forensic psychology, “If the reliability of memory is on shaky ground to begin with, it is not surprising that trauma can influence both the completeness and the accuracy of the memories with which it is associated. Extreme arousal has been reported to affect aspects of memory, especially attentional and perceptual processes”. Journal of Aggression, Maltreatment & Trauma, “Koss et al. (1996) found that the severity of the rape experience per se, as well as the victim’s appraisal of the event, independently contributed to the lack of clarity of detail and disorganization of the narrative memory”. Psychological review, “Perhaps the hallmark characteristic of PTSD is the alternation between re-experiencing and avoiding trauma-related memories. The memories that are associated with PTSD appear rapidly and spontaneously, often intruding into consciousness with high frequency”.