Military sexual trauma (MST) is a global crisis (Fatima, 2018; Galloway, 2017; Morse, 2017). MST is psychological trauma that results “from physical assault of a sexual nature, battery of a sexual nature, or sexual harassment which occurred while the veteran was serving on active duty, active duty for training, or inactive duty training.” Sexual harassment is “repeated, unsolicited verbal or physical contact of a sexual nature which is threatening in character” (U.S. Government Publishing Office, 2006, 38 U.S.C. 1720D).
The prevalence of MST has been challenging to establish. The United States (U.S.) is the predominant military region to study the reporting and surveillance of MST. The U.S. Department of Defense (2018) indicated that 65-84% of sexual assaults and rape are not reported in the U.S. military. Metareviews have found accounts of sexual harassment has ranged from 55%-70, and reports of sexual assault have ranged 11% - 48% in women veterans (XXXX et al., 2018).
This presentation focuses on a concept that was unearthed using hermeneutic phenomenology in a study of women veterans suffering from MST. Phenomenology is the study of experiences. With a greater understanding of emotionally painful experiences, interventions can be developed and tailored to fit the experience. Hermeneutic “interpretation…is the work of thought which exists in finding the hidden meaning in the apparent meaning, in unfolding the levels of meaning implied in the literal meaning” (Ricoeur, 1974, p.13). Uncovering the hidden meanings in a text is a form of art and can take significant time to manifest or come to fruition. Such was the case for us. The concept of embodied shame is a concept that emerged post-publication.
Methods:
In our study, administrators at a transitional house for the homeless requested assistance in helping with body image issues of women veterans (XXXX et al., 2018). Our previous body image research had focused on the mirror viewing experience for those with visible disfigurement due to trauma and surgery (XXXX et al., 2015, XXXX, 2017). As such, our recruitment efforts focused on women veterans who had any physical condition perceived to be due to military service.
Data was obtained in audio-taped focus group meetings using a semi-structured interview guide. Three researchers analyzed the transcripts using Ricoeur’s (1974, 1981) hermeneutic phenomenology. A meeting with the researchers and four veterans was held to validate and further explore the findings.
Results:
Twelve women veterans between 25 and 63 years (mean age 44) participated in audio-taped focus groups. The participants were invited to share their stories about viewing self in the mirror and being in society. All participants indicated they had suffered a physical injury due to military service. The study took a significant turn when the veterans began to tell their stories about MST.
Six veterans told stories of being raped and shared their emotions of sheer terror. Eleven veterans described sexual harassment incidents that consisted of humiliating words, degrading tones of voice, and sexual gestures. Comrades would expose their genitals or mimic the sexual act in public. Actions were considered more difficult to tolerate than words and often penetrated deeply into the human psyche. Four veterans witnessed the after-effects of MST. One veteran told the story of losing her friend. “We were very close…because someone raped her, she shot herself in the head”.
The veterans tried to find words that spoke of the inner torment they felt years after the MST took place. The invisible scars of MST were worse than visible scars. A phenomenological interpretation of the invisible scars uncovered three bodily experiences: 1) viewing oneself in a mirror was to see a stranger in the mirror, 2) the veterans wore a fake face or mask with others including their families and, 3) the statement I am broken was used to illustrate that intimacy was non-existent or sexual encounters were strained.
The veterans struggled to formulate a word or phrase that represented the shame that permeated these experiences. In the validation meeting, the term shameful anguish emerged. In that meeting, the veterans talked about how rape, assault, and harassment were things that were done to their bodies and/or their minds. The shame that accompanied those experiences was not merely cognitive; it was a shame that was lived in and through one’s body. After reading the literature and philosophy on embodiment, we have come to realize the transcripts were revealing embodied shame.
Conclusion:
Nursing scholars (Draper, 2014; Marchetti, Peredda, & Grazia De Marinis, 2016; Mason, 2014) stress that the focus of nursing should be embodiment. The embodied self is the experience of being one’s entire being – body, mind, and spirit. Draper suggested there is a difference “between ‘having’ and ‘being’ a body” (p. 2237). Merleau-Ponty (1962) developed a phenomenology of being: “I am my body” (p. 150). One is born into circumstances beyond one’s control. Similarly, one may travel through a “foreign civilization” (p. 363) which intertwines with one’s being and leaves its impression as one continues life’s journey.
Our study brings to the nursing profession a glimpse of the experience of the embodied shame that lingered years after suffering MST. Our findings support the research on the difficult interpersonal relationships that occur after MST. This research project is the first known study to note a correlation between shame and MST. It is also the first known study to indicate that there is difficulty in viewing self in the mirror for those who have suffered MST. Additional research is needed to validate these findings.
Sensitive interventions focused on embodiment for this population need to be developed. We learned from our participants that there were finding and giving words to their bodily experiences of shame for the first time. As the veterans listened to each other, they began to see similar patterns in their experiences. We observed a shared identity and a movement toward greater self-understanding. Phenomenology, in this study, acted as an intervention.